Dr. Lawrence E. Shapiro - An Ounce of Prevention: How Parents Can Stop Childhood Behavioral and Emotional Problems Before They Start

All parents understand the importance of prevention when it comes to the physical health and safety of their children. Before the baby even arrives home from the hospital, parents begin plugging up electrical outlets and installing baby gates on the top and bottom of their stairs. They teach their toddlers to brush their teeth several times a day and to stay away from sharp objects. Parents conscientiously buckle their young children into approved car seats and make sure that bicycle helmets are securely fastened. They remind their children over and over not to speak to strangers. These are classic preventive measures, and parents everywhere adhere to them in order to keep their children physically safe.

But unfortunately, too many parents stop there. They think ahead when it comes to bodily harm, yet when it comes to emotional problems, most parents tend to start paying attention only when signs of maladjustment appear on the horizon. Depression, eating disorders, behavioral problems, school underachievement, shyness, and more come into focus only when the child displays disruptive symptoms.

Certainly these problems can be treated and/or managed once they appear, but it is always far more complex to undo a problem than it is to keep one from occurring at all. It would, in other words, be infinitely better if preventive measures for emotional problems were undertaken as early and automatically as are those for physical safety. There are no guarantees, of course, that doing so would completely eradicate emotional difficulties, but certainly preventive measures could keep such problems more manageable and less likely to interfere with a childs normal development.

The fact is that children are as vulnerable to emotional dangers as they are to physical ones. The statistics are staggering.

• Childhood and adolescent depression is rising at an alarming rate, nearly doubling over the last twenty years.

• Eating disorders affect almost 15 percent of teenage girls.

• Three thousand children a day start smoking, at an average age of 11.

• According to a recent Harvard study, nearly 45 percent of all college students are binge drinkers.

• Over 45 percent of children are affected by divorce, and studies show that 20 to 30 percent of these children will suffer long-term effects from the breakup of the family.

• American children use 90 percent of the worlds Ritalin, more than five times the rest of the world combined.

• Every school day 17,152 students are suspended for misbehavior, and another 2,789 high school students drop out entirely. Over 5,000 children are arrested, 237 for violent crimes.

Its not that parents are unaware of potential emotional problems. All parents hope that their children will feel good about themselves, form close friendships, and enjoy a satisfying and challenging life as they grow up. Most parents experience concern at the slightest sign that their children are troubled. But it seems a far simpler matter to grip a childs hand firmly when crossing the street than it is, for instance, to figure out how to help him control his impulsiveness, make friends easily, or cope with divorce. Then, too, it is not only that parents dont know how to ensure their childs emotional health; many are unconvinced that their efforts would indeed have any effect at all.

In 1998, Judith Harris touched on this chord of self-doubt in her book The Nurture Assumption: Do Parents Really Make a Difference?, which questioned whether parents really have any significant role in shaping the lives of their children when compared to the influence of their childrens peers.

To be fair to Ms. Harrris, her stated intention in writing this book is not to degrade the role of parenthood but rather to put it into a realistic perspective. In questioning the omnipotence of parenthood, she seeks to relieve parents from shouldering 100 percent of the blame when, in spite of their devotion and sacrifices, their children fail to grow up to be happy, successful, and caring adults. As the description on her book jacket notes, Parenting does not match its widely publicized job description. It is a job in which sincerity and hard work do not guarantee success.

To some degree I would have to agree with that. Children are not born as blank slates. They bring into the world their own unique temperaments, some of which are more open to modification than others. And yes, as they grow they will find themselves under the influence of many people, including peers, teachers, and other relativesnot to mention the media. But to conclude therefore that parents have a minimal impact on their children is an oversimplification of fifty years of developmental research and an affront to the tens of thousands of mental-health professionals and educators who dedicate their lives to helping parents raise happier, healthier, and more successful children. The paramount relationship in a childs lifethe one in which there exists the most constancy and trustis that with a parent. Only a parent is always there to reframe a life experience, guide a child through the dangerous rapids of lifes challenges, and help to mold her into an emotionally healthy person.

Our knowledge about a childs inborn temperament is frequently traced back to the work of two physicians, Alexander Thomas and Stella Chess, who conducted a study investigating the role of temperament in 140 children from birth to adolescence. It was concluded in this and subsequent follow-up studies that temperament is a highly stable part of development. A baby who hardly cries will become a toddler who does not complain when his clothes are pulled over his head, and still later he will likely be a ten-year-old who corrects his mistakes quietly. A baby who reacts irritably when being diapered will likely be a picky eater and have a hard time adjusting to change.

However, studies have also shown that even though temperament is a genetically loaded trait, it can sometimes be altered through intervention. Studies that compared parents who gently pushed their timid babies into being more adaptable with those parents who protected their shy babies from change revealed that the infants who were prodded to venture out grew out of their shy habits by age five.

In this book I intend to give you the skills you need to help your child grow into an emotionally healthy and satisfied person. I will help you understand the parameters of the key emotional trouble zones, assess the risk factors that affect your child for a particular problem, and offer practical and effective ways either to avoid a difficulty altogether or help to dissipate its disruptive effects.

Many of the suggestions I make will seem like common sense to you. Teach your child good eating habits to prevent obesity. Refrain from giving your child constant treats and rewards to help prevent her being spoiled and developing behavioral problems. If youre getting a divorce, spare your child from any vitriolic and mean-spirited arguments.

Other recommendations might seem counterintuitive to the way that you are now raising your children. Fearful babies should not be coddled if they are to outgrow their hypersensitivity. Toddlers should not be overly praised if you want them to become respectful and cooperative. School-age children should be involved in community service rather than spend hours in front of the TV or playing video games. Parents should become more involved in their teenagers education even when their teens are pulling away.