I love working with children and teens because of the impact therapy can
have in a short time. In adults it is not unusual to see dysfunctional
patterns that began in early life and then had devastating effects
later. When working with children, psychologists can have an impact
before the dysfunctional pattern becomes entrenched.
Adults can live most of their lives with a troubling belief that they
later find to be inaccurate, which leads to confusion and
misunderstanding. When working with children, such beliefs can be
challenged before they interfere with one's life and cause psychological
problems.
I work with children of all ages and believe it is very important to
know their developmental stages. Luckily for psychologists, there is
much valuable research which helps us understand children. For example,
Piaget has been very helpful in describing how—cognitively—a child's
view of the world is not the same as an adult's. Children unfold in
stages and the process takes 22 years according to Erickson, a well
known social psychologist.
Children often do not have words to express themselves and their world.
For example, this is a drawing by a seven-year-old girl, who is unsure
of what is being said in her surroundings, and may spend time
eavesdropping (Big Ears). (picture on right) In this particular case,
the girls' parents are getting a divorce.
Children exhibit various capabilities at various times, according to
their age or developmental maturation. For example, if a 5-year-old is
told to wash her hands, get dressed, brush her teeth, and bring in the
newspaper, she most likely would be overwhelmed. Sometimes adults see a
child's ability to follow through as the child's being obstinate when in
actuality the child is confused, and in that moment, incapable of
accomplishing certain tasks.
Additionally, children under five have difficulty answering "why"
questions, so that a parent may think the child is being unresponsive or
stubborn, when in reality the child is simply confused. Over time,
well-meaning parents unaware of these developmental limitations may
create an environment where children feel anxious resulting in their
lower self-esteem.
Teenagers have their own complex issues especially in the area of peer
relationships, which are crucial for teen development. Teens need to
explore their roles within their peer group; puberty greatly affects
this exploration. Often teenagers find themselves in roles for which
they are unprepared, leaving them ill-equipped to manage further
challenges. Older teens are often expected to make life decisions about
college and beyond. Feelings of confusion and inadequacy may result, and
may isolate teens from their parents.
In addition to teenagers and small children, my practice addresses the
needs of infants as young as one year old with issues of separation
anxiety, the ability to bond, and attentional abilities. Issues
unaddressed in these areas may manifest as dependency, aggression, and
poor performance. (Poor performance in what? Dependency on what?)
Effective modes of treatment in children's therapy include:
Art Therapy, which helps establish rapport, diagnosis, and treatment.
(Picture of child's drawing.)
(Picture of two children role playing.) Role Play, which consists of
rehearsing desired behavior and learning empathy for others.
Play Therapy, which is especially useful for small children, helping
them explain the view of the world through their eyes. (Picture. ??)
CHILD AND ADOLESCENT DEPRESSION: DIFFERENT FROM ADULT
If your child has seemed persistently sad, is uninterested in
previously enjoyed activities, and seems at the same time to be
doing worse in school, it may be more than "just a phase." About 14%
of adolescents and 6% of prepubescent children suffer from
significant depression.
Depression in children and adolescents manifests itself differently
than in adults. In addition to the symptoms above, children may
complain of headaches, stomach aches, or persistent boredom. If you
have noticed that your child's school performance is deteriorating,
this may be another sign of depression.
Rather than wait and hope that your child is merely passing through
a phase, it is probably best to see a mental health professional.
Untreated depression can cause unnecessary suffering or in some
cases even suicide.
Correct Diagnosis:
The first step is to obtain a diagnosis. the same symptoms can be
caused by other medical and psychological problems. A mental health
professional first must rule out such conditions as sleep disorders,
substance abuse, attention deficit disorder, and so forth. If the
symptoms do indicate depression, there are varying degrees of
severity and duration. Your child may suffer from an adjustment
disorder with a depressed mood from dysthymia or from major
depression. A bipolar disorder (manic-depressive illness) is rare
but also possible in children and adolescents. Both major depression
and bipolar disorders have significant genetic components. If there
is a family history of depression or bipolar disorders, they are
like to surface in childhood or adolescence.
Treatments:
Pharmacologic treatment of adult depression has improved
dramatically in the past two decades, and antidepressant drugs have
been successful for adults. Unfortunately, antidepressant medication
seems to be less successful for depressed children and adolescents.
This may be because neural pathways are still immature, or because
chemical balances are different during adolescence. Currently,
physicians prescribe antidepressant medications on a case-by-case
basis, and some youth do seem to benefit from them.
Active and focused talk therapy seems to be most successful with
depressed children and adolescents. A therapist can address your
child's distorted thinking and self-impressions, such as feelings of
hopelessness, helplessness, worthlessness, or a combination of
perfectionism and low self-esteem.
Because children and adolescents are so dependent on adults for
caretaking, the therapist may wish to assess your child's home
environment. This could mean that the therapist may look for abuse,
neglect, family conflict, and school difficulties. As a result, the
therapist will more than likely want to discuss your child or
adolescent with each parent.
Severe depression in childhood or adolescence is frequently a
chronic and recurrent disorder. As many as 70% of school-aged
children treated for major depression will have a recurrence of
depressive symptoms within five years.
However, most depressed children and adolescents respond to various
combinations of psychotherapy, family therapy, pharmacological
treatment, and environmental improvement. As with most psychiatric
disorders, earlier diagnosis and treatment is associated with faster
and more complete recovery.
The trustworthiness of children's memory has recently
become a matter of public debate because of the increasing
frequency with which children are called upon to testify as
witnesses in criminal cases and because the standard defense
strategy of course is to challenge the reliability of
children's memories.
We need to understand the basic,
general principles of memory development before we can say
how accurate children's memories are likely to be in
specific contexts. Our understanding depends heavily on
fundamental research in memory development.
Fortunately, a good deal of such research has been
published in the last quarter century, providing a solid
body of experimentation in memory development during
preschool and elementary school years. The public and
professional community can glean much good advice from the
experimentation and its documentation. Courts can supply
juries a scientific basis for deliberations drawing upon
expert testimony from child-memory researchers.
The recent research has shown among other findings:
Younger children's memories tend to be less reliable
than older children's, and older children's memories
tend to be less reliable than adults'.
The first finding does not necessarily signify that
children's memories are too unreliable for accurate
testimony in legal proceedings. On the contrary, by
taking account of well-established principles of
memory-development research it is possible greatly
enhance the accuracy of even young children's testimony
and to advise courts on the reliability of their
testimony.
Example principles include:
Sensitivity of the question used to tap children's
memories: Open-ended recall tends to be less sensitive
than questions that involve choices between clear
alternatives.
Opportunities for reminiscence: Forgotten memories
tend to resurface if questions are repeated.
Avoidance of suggestive or misleading statements:
Children's memories are susceptible to misinformation.
Expert testimony on reliability of children's memories
demands a thorough grasp of the results of research on
memory development; otherwise it is not expert testimony.
Courts must seek such testimony from child memory
researchers or professionals.
Studies have revealed some distressing facts:
Individuals classified as experts in child
psychology are almost never called as witnesses in the
initial trial of a case.
When experts in child psychology do testify, they
tend to only practitioners and to be unaware of the
research in memory development.
Although it is feasible lately to provide juries a
scientific base for their deliberations, it is rarely done.
Many terms are used to describe
emotional, behavioral or mental disorders. Currently,
students with such disorders are categorized as having a
serious emotional disturbance, which is defined under
the Individuals with Disabilities Education Act (IDEA),
Public Law 101-476, as follows:
(4) Emotional disturbance is defined as
follows:
(i) The term means a condition
exhibiting one or more of the following
characteristics over a long period of time and to a
marked degree that adversely affects a child's
educational performance: (A) An inability to learn
that cannot be explained by intellectual, sensory,
or health factors. (B) An inability to build or
maintain satisfactory interpersonal relationships
with peers and teachers. (C) Inappropriate types of
behavior or feelings under normal circumstances. (D)
A general pervasive mood of unhappiness or
depression. (E) A tendency to develop physical
symptoms or fears associated with personal or school
problems.
(ii) The term includes schizophrenia. The term does
not apply to children who are socially maladjusted,
unless it is determined that they have an emotional
disturbance.
[Code of Federal Regulations, Title 34, Section
300.7(c)(4)]
TREATMENT
Children who qualify for special education may
receive psychological services and counseling as part of
their Individual Education Plan. Parents should
consider this entitlement when planning for the needs of
their children.
INCIDENCE
For the school year 1994-95, 428,168 children and
youth with a serious emotional disturbance were provided
services in the public schools (Eighteenth Annual Report
to Congress U.S. Department of Education, 1996).
CHARACTERISTICS
The causes of emotional disturbance have not been
adequately determined. Although various factors such as
heredity, brain disorder, diet, stress, and family
functioning have been suggested as possible causes,
research has not shown any of these factors to be the
direct cause of behavior problems. Some of the
characteristics and behaviors seen in children who have
emotional disturbances include:
Children with the most serious emotional disturbances
may exhibit distorted thinking, excessive anxiety,
bizarre motor acts, and abnormal mood swings and are
sometimes identified as children who have a severe
psychosis or schizophrenia.
Many children who do not have emotional disturbances
may display some of these same behaviors at various
times during their development. However, when children
have serious emotional disturbances, these behaviors
continue over long periods of time. Their behavior thus
signals that they are not coping with their environment
or peers.
EDUCATIONAL IMPLICATIONS
The educational programs for students with a serious
emotional disturbance need to include attention to
mastering academics, developing social skills, and
increasing self-awareness, self-esteem, and
self-control. Career education (both academic and
vocational programs) is also a major part of secondary
education and should be a part of every adolescent's
transition plan in his or her Individualized Education
Program (IEP).
Behavior modification is one of the most widely used
approaches to helping children with a serious emotional
disturbance. However, there are many other techniques
that are also successful and may be used in combination
with behavior modification. Life Space Intervention and
Conflict Resolution are two such techniques.
Students eligible for special education services
under the category of serious emotional disturbance may
have IEPs that include psychological or counseling
services as a related service. This is an important
related service which is available under the law and is
to be provided by a qualified social worker,
psychologist, guidance counselor, or other qualified
personnel.
There is growing recognition that families, as well
as their children, need support, respite care, intensive
case management services, and multi-agency treatment
plan. Many communities are working toward providing
these wrap-around services, and there are a growing
number of agencies and organizations actively involved
in establishing support services in the community.
Parent support groups are also important, and
organizations such as the Federation of Families for
Children's Mental Health and the National Alliance for
the Mentally Ill have parent representatives and groups
in every state. Both of these organizations are listed
under the resource section of this fact sheet.
OTHER CONSIDERATIONS
Families of children with emotional disturbances may
need help in understanding their children's condition
and in learning how to work effectively with them. Help
is available from psychiatrists, psychologists or other
mental health professionals in public or private mental
health settings. Children should be provided services
based on their individual needs, and all persons who are
involved with these children should be aware of the care
they are receiving. It is important to coordinate all
services between home, school, and therapeutic community
with open communication.
RESOURCES
Adamec, C. (1996). How to live with a mentally ill
person: A handbook of day-to-day strategies. New York:
John Wiley & Sons. (Telephone: 1-800-323-9872, extension
2497.)
Children's Hospital of Philadelphia. (1994). A
parent's guide to childhood and adolescent depression.
New York: Dell. (Telephone: 1-800-323-9872.)
Hatfield, A.B. (1991). Coping with mental illness in
the family: A family guide. Arlington, VA: National
Alliance for the Mentally Ill. (Product #082. See
telephone number below.)
Hatfield, A.B., & Lefley, H.P. (1993). Surviving
mental illness: Stress, copying, and adaptation. New
York: Guilford Press. (Telephone: 1-800-365-7006.)
Jordan, D. (1991). A guidebook for parents of
children with emotional or behavior disorders.
Minneapolis, MN: PACER Center. (Telephone: (612)
827-2966.)
Jordan, D. (1995). Honorable intentions: A parent's
guide to educational planning for children with
emotional or behavioral disorders. Minneapolis, MN:
PACER Center. (Telephone: (612) 827-2966.)
National Alliance for the Mentally Ill. (1996).
Resource catalog: A listing of resources from the
National Alliance for the Mentally Ill (Rev. ed.).
Arlington, VA: Author. ([Telephone: (703) 524-7600;
1-800-950-NAMI.]
National Clearinghouse on Family Support and
Children's Mental Health. (1993, April). National
directory of organizations serving parents of children
and youth with emotional and behavioral disorders (3rd
ed.). Portland, OR: Author. (Telephone: (503) 725-4040.)
Wood, M.M., & Long, N.J. (1991). Life space
interventions: Talking with children and youth in
crisis. Austin, TX: Pro-Ed. (Telephone: (512) 451-3246.)
National Clearinghouse on Family Support and Children's
Mental Health
Portland State University
P.O. Box 751
Portland, OR 97207-0751
(800) 628-1696
(503) 725-4040
For your state CASSP (Children and Adolescent Service
System Program) office and State Mental Health
Representative for Children call NICHCY (1-800-695-0285)
and ask for a State Resource Sheet for your state.
This fact sheet is made possible through Cooperative
Agreement #H030A30003 between the Academy for
Educational Development and the Office of Special
Education Programs. The contents of this publication do
not necessarily reflect the views or policies of the
Department of Education, nor does mention of trade
names, commercial products or organizations imply
endorsement by the U. S. Government.
This information is in the public domain unless
otherwise indicated. Readers are encouraged to copy and
share it, but please credit the National Information
Center for Children and Youth with Disabilities
(NICHCY).
As a psychologist working with children, adolescents, and
their families, every week I hear a parent ask me for
assistance in motivating their child. Questions often
resemble this one from a single parent, who asked, "He's got
an IQ of 140 and he's getting bad grades in all of his
classes. What should I do?" This is a question about
motivation—the whys of human behavior. What people do, how,
when, and where they do it are comparatively easy to
observe. Why we do, is the subject matter of motivation; it
lets us find in what-is-done, context and direction.
Further, motivation gives intensity to behavior. People work
harder toward one goal than another. The aspect that seems
most important to parents is how this affects their
children's and adolescents' learning, school performance,
and behavior.
Encouraging Healthy Motivation
Most parents and teachers are concerned about their
children's motivation. There is a feeling that early
so-called proper motivation and self-motivation
carry over into children's adult lives. Observations,
experiences, and research seem to bear out this feeling. The
child who does well in school usually does better at work
later. This, then, reinforces parents who spend time,
energy, and worry on ways to motivate their child or
adolescent. Theories have shown motivation flows from
numerous sources and can be directed in multiple channels.
However, most parents use the term motivation in the
sense of assisting their children to learn, grow, and
achieve objectives that conform to the family's—and not the
child's—ideas of success. It is important to remember there
is no universal schedule for children to achieve success.
Every child's inner timetable motivates her to learn in
various subjects at various moments and rates.
It is recommended that as parents you strive to set your
standards and limits, and assist your children in striving
for excellence—their excellence. Your child needs to know
that worthwhile effort is reinforced in their learning to
discriminate between good and poor tries.
Most importantly, your children benefit from feeling that
others in their life approve of effective tries that do not
necessarily lead to success. Children experiment with their
abilities and interests; this causes motivation that should
be reinforced.
Guidelines for Motivation
Real concern for your child, watchful interest in them,
and open communication are primary keys to motivation.
Children and adolescents are flexible and resilient and grow
in spite of imperfect human and material environments.
However, parents can assist them in developing emotionally,
intellectually, and psychologically. As you do, remember the
following guidelines:
Children vitally need warm, accepting parents who
expect the best while considering their children's
unique needs.
Set reasonable, consistent limits to let your
children and adolescents know there are boundaries to
acceptable behavior and there are unacceptable
behaviors.
Confident expectations of success based on your
child's potential (not yours) often bring success. It is
often not necessarily what happens but what your child
expects to happen that causes anxiety. Expectations of
success such as "You've worked hard." or "I'm sure
you'll do well on your math test." usually hit a
responsive chord with a child.
Let your children know that occasional chastisement
and failure will not be permanent or constant. Let them
know the slate is wiped clean and that criticism is
temporary because children too often generalize emotions
between situations.
Let your children know you see their effort or lack
of it, and that you care. Blanket, indiscriminate
approval just as general disapproval may send your child
the message you are not paying attention.
About one of every six American children is a slow learner.
The slowly learning child is difficult to recognize,
identify, and understand. So many children give the
impression of being slow that teachers and parents are
confused as to what the cause of their slowness really is.
Any number
of causes- whether physical or psychological or social is
usually normal in appearance and is able to function
satisfactorily in many situations. This is precisely
why they are difficult to understand and identify. While
slow learners usually possess common sense and adequate
memory, are physically adept and have normal memory, this
does not mean that they have normal ability for schoolwork.
It is not unusual to hear the parents of slow learners say
they are puzzled over their children's school difficulties
because they "seem to do so well at home."
The measured
intelligence of a true slow learner is about 75% to 90% of
the average child's. Their maximum mental age ranges from 11
years to 13 1/2 years. They learn at a rate which is 4/5 to
9/10 of normal, and they learn to read approximately one
year later than the majority of children. Most authorities
agree slow learners may be slow in reading and arithmetic,
but not necessarily to the same extent in shop, mechanics,
and social activities. They may also be adept at peer play
activities, work, and sports. Most elementary school classes
in an average community can be expected to include three to
five slow learners.
The slow learner in the regular classroom usually
exhibits the following behaviors:
Labored abstract or deep thinking: the child needs to
think in relation to her experiences in concrete ways.
A short attention span: the child may find difficulty in
concentrating as long as other children.
Awkward in self-expression: the child is not adept at
words or their meanings; their speech may not be as fluent
as other children.
Has a harder time than other figuring things out for
himself: the child requires more direction and supervision
but should not be overprotected.
Reacts and learns slower than other children: the child
is not as quick to grasp what the teacher or teacher says.
Things must be explained more simply, repeated in different
ways, and reviewed from time to time.
World view is narrower than their friends: the teacher
can counteract this by tying the child's daily life to the
classroom teaching.
Reading seems to be more difficult: subject matter is
often mastered more easily when extensive reading is not
required.
Regardless of these limitations, the slow learner does
learn. The child can make progress in the classroom if the
teaching and the materials used are at her level.
