Fakes Illness

Children often complain of stomach aches and vague symptoms like “not feeling well.” When there isn’t a fever, a rash, an x-ray or other “evidence” of illness, parents often feel confused. Is the child really sick of just “faking it?” Should the parent allow the child to stay home from school or send him off whining and crying?

What would cause a child to “fake illness?” While some parents may feel that laziness, lack of motivation or some other attitude problem may be the culprit, in fact there are often more serious reasons lurking beneath the surface.

If your child frequently complains of illness that the doctor cannot substantiate, consider the following tips:

Social Problems
Some children feel unsafe or uncomfortable at school. The discomfort can be triggered by the teacher, classmates or children in the schoolyard. How does a parent find out if the child is feeling frightened? Try not to ask directly. For instance, try not to ask, “Is someone frightening you?” Instead, use bibliotherapy – the reading of stories (or telling stories) about kids who are having trouble with friends, bullies or teachers. As you are reading, share some of your own memories of difficult times in your own childhood school days. In that context, you can ask the child “did something like this ever happen to you?”  This approach eases the child, allowing the youngster to learn first that social difficulties are normal and common. This helps him to relax, talk and listen better, giving you more opportunity to be helpful.

If the child does end up sharing a social problem, try to stay very calm and quiet no matter what you are hearing. This helps the child feel safe enough to tell you the whole story and to continue to share with you. If the child needs your help or intervention, do all problem-solving calmly and slowly. Take time to seek advice from your spouse, the teacher or a professional – whoever is appropriate. Work out a plan with the child and/or with a professional. Sometimes a formal plan isn’t necessary – just giving the child the opportunity to talk about his problem can be helpful. Often the child can work out his own solutions when a parent just listens compassionately, without jumping in with advice.

Academic Issues
If you have an exceptionally bright child, then he or she may not be interested with the current lessons and is painfully bored at school. On the other hand, school can sometimes be too challenging for a child, leaving the youngster feeling stressed or overwhelmed. Sometimes a child just needs a day off – a mental health day – after a period of hard work, academic stress or general life pressure. In such a case, just give your child an occasional day off and tell him directly that he doesn’t need to be sick. Just arrange a break once every couple of months or so. If you’re not sure whether schoolwork is the issue, a psycho-educational assessment can pinpoint the problem and offer solutions. Sometimes, it’s as simple as ordering glasses for a child who can’t see the board or read the instructions.

Family Problems
Sometimes a child is emotionally distressed by stress in the home. The child wants to stay home either because he is too distressed and distracted by what’s happening in the family (conflict, violence, separation, divorce, illness, dying, etc.), or because he wants to keep the home safe himself by “holding down the fort.” Sometimes the child is trying to divert attention from a family crisis by being “sick” and needy; if everyone has to take care of him, then they won’t be able to die/fight/dissolve or otherwise engage in some destructive process.

If you suspect that the child is reacting to family problems, make sure you are addressing the family problems. Enlist the help of a professional family therapist – your child’s behavior is a real cry for help. Make sure that the adults get the help they need and that the child has someone to talk to.

Hidden Health Problems
Just because the family doctor can’t find a problem, doesn’t mean there isn’t a problem. Consider consulting a naturopath or alternative health practitioner to explore the aches and pains more fully. There are many different paradigms and healing options out there – you might discover one that really helps. Especially when stomach problems are reported, keep in mind that stress is NOT always the problem. Hidden food intolerances can cause lots of physical, emotional and even behavioral issues.

When Your Child is Sad

Dealing with sadness effectively is a skill that will serve a child all throughout his or her life. After all, loss is an inevitable experience in this world – whether it is the loss of a favorite sweater, a cherished pet or beloved family member. Sadness is the appropriate response to loss. It is an emotional signal that says, “something is missing.” We feel sad until we have somehow reorganized our inner world to sew up the gaping hole left by the loss.

Parents can help children move through sadness. Moving through this feeling is important because failing to do so – staying stuck in sadness – can lead to feelings of depression, anxiety and panic, among other reactions. Unresolved sadness can also manifest as bodily pain and/or illness. For instance, unexplained tummy aches and headaches can be fueled by unresolved feelings of sadness. Parental support and guidance can help move sadness through and out of the child’s heart.

If your child is feeling sad, consider the following tips:

Let Your Child Know That’s It’s Okay to Feel Sad
Many parents are so distressed at seeing their kids upset that they want to cheer them up, reassure them and if possible, replace their loss, immediately. However, this approach only teaches children that sadness is an intolerable emotion. Unfortunately, such a message not only fails to teach a child how to handle feelings of sadness, but also increases the likelihood that kids will eventually run to escape measures like addictions when sadness threatens. Therefore, the first and most important step for parents to take is to calmly and compassionately welcome feelings of sadness. A simple acknowledgement of sadness can suffice, as in “you must feel so sad about that.” A period and a pause is necessary in order to convey acceptance, before continuing to speak. Avoid the word “but” since that word rushes too quickly to “fix” the sad feeling without processing it (see below for more about this). Allowing a child to feel sad also means letting him or her become temporarily withdrawn, unhappy and moody when suffering a loss. Refrain from trying to distract a sad child and from telling him or her to “cheer up.”

Provide Emotional Coaching
Dr. John Gottman, author of Raising an Emotionally Intelligent Child explains that naming and accepting a child’s feelings helps the child to both manage and release painful emotion. Just saying something like, “that must make you feel sad,” or “it really hurts” or “that’s very painful” or “I know it’s very upsetting” can give a child a channel for acknowledging difficult feelings inside of himself.  When the child can acknowledge the feeling, half of it disappears immediately. The other half will slowly melt out of the child’s heart with the continued support of the parent. All that is required is to let the feeling be, without  minimizing it or trying to change it in any way. For instance, suppose a child is very sad because his best friend is changing schools. The parent is tempted to say things like, “don’t worry – you can still visit him and have a friendship over the computer and the telephone.” However, the parent who offers Emotional Coaching says things like, “Wow, that’s hard. It’s sad to lose a best friend. I bet you’re pretty upset.” The parent accepts whatever the child says, naming the feelings that seem to be present. Emotional Coaching often allows a child to go even deeper into the bad feeling before resurfacing with a positive emotional resolution. Perhaps the child in our example might say something like  “Yes I am upset! I’ll never have another friend like him! I hate everyone else at school. There’s no one I’ll be able to be friends with!” If this happens, the parent just affirms how awful all that must feel (“It’s such a disappointment that he’s leaving, especially when there’s no one else to take his place and you’re going to be all alone.”) Once the child hears his feelings being spoken out-loud, he usually self-corrects and starts to cheer himself up (“well, maybe I’ll spend more time with Josh Lankin”). If the child doesn’t pull himself out of the sad feeling, the parent who has provided emotional acknowledgement is now in a good position to help the youngster think things through: advice that is offered AFTER Emotional Coaching is often much more likely to be accepted. You can learn more about Emotional Coaching in the book Raise Your Kids without Raising Your Voice by Sarah Chana Radcliffe.

Provide Perspective
Parents can provide education and guidance AFTER providing Emotional Coaching. Trying to do it beforehand often backfires, as the youngster feels that the parent just doesn’t understand the pain he or she is experiencing. Without understanding, the parent has “no right” to start offering advice. After Emotional Coaching, on the other hand, the child knows that the parent really understands and accepts the feelings of sadness. Now the parent “has the right” to try to provide information or perspective on the matter. In a study of children with depression, it’s been found that optimism is one of the factors that help protect children from the effect of overwhelming sadness. Kids who experience intense feelings of sadness (e.g. the sadness that comes after parents’ divorce or separation), but remain resilient are those who believe that the sadness is temporary — and that tomorrow will bring better days. If you can teach your children to look at the next day as having the potential to bring a new beginning, then you can help your child manage sadness better. Some parents will be able to draw on a strong religious faith to bring this notion forward and some will draw it out from their own bright view of life. If you have neither, however, try looking at the writings of Norman Vincent Peale – the father of “positive thinking.” Peale wrote dozens of books on the subject of maintaining an optimistic outlook, but even a quick perusal of his famous “The Power of Positive Thinking” will fill you with a rich reservoir of ideas to share with your children.

Encourage Your Child to Seek Social Support
Friends are handy in all moments of grief! As kids grow older, they can look to friends as people they can trust with their innermost thoughts and feelings. Studies among children and adults confirm the value of social support when handling difficult situations in life. Encourage your child to always maintain a couple of close friendships and a couple of casual friends. Close friends can provide valuable emotional support through sad and troubled times and casual friends can provide welcome distractions. Model this practice in your own life.

Consider Bach Flower Therapy
Bach Flower Remedies provide emotional relief in the form of a harmless water-based tincture. A few drops of remedy in liquid (water, tea, milk, juice, coffee, soda, etc.) several times a day can help feelings resolve more rapidly. Star of Bethlehem is one of the 38 Bach Flower Remedies – it helps heal feelings of shock and grief. It can help kids deal with death, divorce, loss of a good friend and other serious losses. Walnut can help kids move more gracefully through changing circumstances. Gorse can help lift depressed feelings. Mustard can help with sadness that comes for biological reasons like shifting hormones, grey skies and genetic predisposition to low moods. Larch can help with sadness that is caused by insecurity and Oak can be used when excessive strain and effort leads to unhappiness. There are other Bach Remedies that can help as well, depending on how the child is experiencing sadness. Consult a Bach Flower Practitioner or read up on the remedies. You can purchase them at most health food stores and online.

Consider Professional Help
If your child is “stuck” in sadness and can’t get out of it despite your interventions, do consult a pediatric psychologist or psychiatrist. A mental health professional is highly trained to help kids move through sadness and get on with a happy, productive life!

Suicidal Feelings

A certain number of people kill themselves each year, most of whom were suffering from severe depression. Fortunately, 90% of people with depression are able to live full lives while managing their episodes of depressed mood. Only about 10% will end their lives (this number depends on where a person lives – countries vary in their availability of effective treatments and support for depression, so there is a wide international variability in suicide rates).  The pervasive sad mood that comes with depression, as well as the increased tendency among the depressed to obsess on negative thoughts, makes them susceptible to the hopelessness and irrationality characteristic of the suicidal person. People do not “choose” suicide; they fall victim to it as part of their illness.

What are the Implications for Parents?
The link between suicidality and depression should serve as alarm bells when helping our children deal with mental health issues. If we have a loved one who is suffering from depression, it is always prudent to watch out for signs of suicidality. A depressed child is at risk for succumbing to suicidal thoughts; it is up to parents to help prevent this. Vigilant parents can be familiar with the warning signs of suicidality and take action. Moreover, they can do everything possible to get their child the right kind of help. In addition, they can work hard to reduce the other stressors in the child’s life – like school work (negotiate accommodations with the school) and conflict in the home. In fact, when the parents work on their own marriage and parenting skills to increase peace in the home, this can help tremendously.

What are the Warning Signs?
According to the American Academy of Child and Adolescent Psychiatry these signs are:

  • Change in eating and sleeping habits
  • Withdrawal from friends, family, and regular activities
  • Violent behavior or running away
  • Substance abuse
  • Neglect of personal grooming
  • Personality change
  • Difficulty concentrating, persistent boredom
  • Drop in academic performance
  • Marked personality change
  • Frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc.
  • Loss of interest in previously enjoyable activities
  • Speaking positively about death or romanticizing dying (“If I died, people will appreciate me more.”)
  • Writing about death, dying, or suicide
  • Engaging in reckless or dangerous behavior; being injured frequently in accidents
  • Giving away or discard favorite possessions
  • Saying permanent sounding goodbyes to friends and family
  • Seeking out weapons, pills, or other lethal tools

A child or teen  who is planning to commit suicide may also:

  • Complain of being a bad person or feeling rotten inside
  • Give verbal hints with statements such as: “I won’t be a problem for you much longer.”, “Nothing matters.”, “It’s no use.”, and “I won’t see you again.”
  • Become suddenly cheerful after a period of depression
  • Have signs of psychosis (hallucinations or bizarre thoughts)

The risk of suicide is high among those who have attempted suicide before, know someone who has killed themselves, and are pessimistic about the chances of getting relief from chronic depression. Also, teens who have a family history of mental illness and suicide are more likely to attempt suicide as are teens who have clinical depression or who suffer from active addiction. Teens who’ve already made a suicide attempt have a higher chance of committing suicide successfully. Vulnerable teenagers who suffer a serious loss (like the breakup of a romantic relationship) may try to stop the pain with suicide. A history of physical or sexual abuse, incarceration, alienation from parents and refusal to access mental health services all increase suicidal risk. Males have a higher “success” rate for suicide than females, but females make many more suicide attempts than do males. Also take note if your depressed child suddenly seems unusally happy. Sometimes this switch in attitude happens because a child has decided to end his suffering and he is actually experiencing a state of relief. Remember that depressed mood is a serious and potentially life-threatening condition and should always be professionally treated.

The American Academy of Child and Adolescent Psychiatry recommends taking a child’s suicidal statements seriously. If a child or adolescent says, “I want to kill myself,” or “I’m going to commit suicide,” ask him what he means. Don’t be afraid of saying the word “suicide.” You won’t be giving the teen an idea that he hadn’t thought about. Instead, you’ll help him or her think things through. Ask about depression, anxiety and unhappiness. Don’t just tell the child no to talk that way.  Show interest and concern and get your child to a qualified mental health professional (such as a psychiatrist or clinical psychologist).

Suicidal Behavior in Teens
Teenagers are a vulnerable group. They experience tremendous pressure from all sides: from inside their changing bodies, from their parents, from their schools and from their peers. No one can be perfect in every area and so everyone is doing poorly in something. But teenagers can feel isolated with their failures and setbacks, lacking the perspective that older people have that “we’re all in this together.” Teenagers are intent on fitting in, looking good, being acceptable. If the only group they can fit into is a violent, drug-ridden street gang, then that’ll be the group they might very well join, especially if they have little support elsewhere or few sources of success and strength.

Because the pressure is so intense, many teens do not cope well. Their survival strategies depend to a large extent on their genetic make-up and the strategies they learn at home. Some teenagers have “hardy” genes that help them survive and thrive under stressful conditions. They can laugh their way through almost anything or simply tough it out. Others are genetically vulnerable to bouts of depression. However, the depressed teen is more at risk than depressed adults. Teens are very focused in the present. They have trouble imagining that in a few years life can improve tremendously. Their impulsivity can lead them to put an end to it all right now because they just can’t see any way out.

What You Can Do
Parents can also help buffer teens from stress by keeping the doors of communication open. Make it easy for your kids to talk to you. Keep criticism to a minimum; instead, give praise and positive feedback generously. Have fun with your teenager and try to make your home pleasant, comfortable and safe. Keep conflict down with your spouse. Avoid drama. Take care of yourself and create a healthy model of stress management strategies for your kids to learn from. Create a positive atmosphere. Have a dinner table several times a week and use it to have discussions on politics, human nature, interesting things in the news or whatever—keep talking with your kids. Make your values clear. Bring tradition and ritual into your home.  Accept all feelings without correction or disapproval. Ask for behavioral change gently and respectfully. Never yell at your teenager. Never insult, name call, use sarcasm or any other form of verbal abuse. Instead, be sensitive to your teen’s feelings at all times. Discipline when necessary but only after you’ve warned a child that discipline will occur and only with mild discipline—never affecting the teen’s social life (see Raise Your Kids without Raising Your Voice for safe and effective ways of guiding teenagers).

If your teen demonstrates any of the symptoms of depression or suicidality, talk to him or her about what you are observing and arrange an appointment with a mental health professional. You can call suicide helplines in your area to get information about how to help your child. You can take your child for a mental health assessment. If your child is uncooperative, seek mental health guidance yourself. Since a suicidal person feels isolated and hopeless, any steps that family members take to address the situation can be powerfully preventative. Remember, too, that many parents have walked this road before you. Access on-line and community support if your child has been threatening suicide.

Types of Depression

“Depression” is a common mental health condition. However, the word refers to many types of mood issues, rather than just one straightforward condition. In fact, there are many types of depression, depending on symptoms, severity, cause and duration of the illness.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the following are some of the types of depression:

Major Depressive Disorder
When people use the term depression, they usually mean a Major Depressive Disorder. Unlike short-term feelings of sadness, which can be due to any situation that can cause one to feel rightly sad and upset, major depressive disorder is an intense and debilitating condition affecting many aspects of one’s mood, energy and physical functioning.

A person with Major Depressive Disorder can suffer from feelings of hopelessness and despair, self-incriminating thoughts, crying spells, fatigue, weight loss, sleep disturbances, lost of interest in activities and relationships, inability to work, and thoughts of suicide. Major Depressive Disorder, also called clinical depression, is diagnosed if the debilitating symptoms are manifested by the patient for at least two consecutive weeks and causes significant distress and/or impairment in functioning.

Dysthymic Disorder
A less severe form of depression is called Dysthymic Disorder or Dysthymia. The feelings of sadness and helplessness in Dysthymia are less debilitating, and are often merely aggravated by other physical or mental illnesses. Symptoms of Dysthymia come and go, and vary in intensity per episode. However, it can be a chronic disease that runs in families. Diagnosis requires at least two years of chronic low mood. People with dysthymia tend to underfunction at home and at work, due to low energy, low mood, chronic irritability and negativity, low motivation, sleep issues, low self-esteem and other symptoms. If left unmanaged, Dysthymia can progress to a Major Depressive Disorder.

Bipolar Depression 
Bipolar Depression, also called manic-depressive disorder or bipolar disorder, is a mood disorder that is characterized by cycles of extreme elevated moods (called mania) and depressive episodes. During the manic stage of the disorder, patients can exhibit symptoms like extreme alertness, difficulty sleeping, increased energy and erratic euphoria. But this “high” is often followed by an extreme low typical of a Major Depressive Disorder. Bipolar Depression comes in two types – Bipolar I and Bipolar II. The first is a very disturbed state in which manic episodes can lead to high risk behaviors, highly inappropriate behaviors and troubles with the law (picture a teenager standing naked on a neighbor’s rooftop singing at the top of his lungs). Bipolar II is characterized by more eccentric-looking behavior that is out of character for the person (picture someone enthusiastically filling her entire house with antiques that she’s thinking of selling in order to make an enormous fortune – even though she’s never done anything like this before).

Loved ones of people with Bipolar Depression often miss the illness in the patient, because the manic stage is mistaken for a sign of recovery. But note that the mania stage has a particular irrational urgency to it, and is not to be mistaken for actual happiness. In fact, a depressed person with Bipolar Depression is anxious, irritable and prone to self-defeating behaviors during their emotional high.

Seasonal Affective Disorder (SAD)

Seasonal Affective Disorder (SAD) refers to depression that only comes during particular times of the year. For instance, there are patients who exhibit symptoms of depression only during the cold winter months, but they are otherwise fine during the summer. In other cases the opposite is true; it’s the summer that brings in the blues. In tropical countries, the rainy season can be the most troublesome part of the year.

Psychotic Major Depression (PMD)
There are occasions when the depression is so intense; it causes a loss of contact with reality. A person with Psychotic Major Depression may experience hallucinations (sensing things that don’t really exist) or delusions (irrationally interpreting events and observations). Psychotic symptoms in PMD are often temporary, and will go away once the cause of the depression is addressed. The condition is not to be confused with schizophrenia, which can also cause depression.

Atypical Depression
A kind of depression that is difficult to diagnose and treat is called atypical depression. As the term implies, atypical depression is depression whose symptoms don’t always follow what is traditionally associated with clinical depression. The symptoms also appear to come and go, and can be lifted by positive life events. It is believed that atypical depression is primarily biological in origin, a product of chemical imbalance in the brain.

Symptoms of atypical depression may include loss of energy, unexplained and uncontrollable crying, insomnia or hypersomnia, irritability, unexplained aches and pains, difficulty concentrating and loss of interest in daily tasks.

Depression in Teenagers

The teenage years are known to be emotionally challenging. Kids are going through so many transitions and are experiencing so many pressures at this time. Aside from the physical changes of puberty and their effect on body image and personal confidence,  there’s also adjustments to high school and dating and new challenges in the realms of alcohol, drugs, sexuality and the virtual social universe. For the most part, adolescents negotiate all of this without too much trouble. However, a percentage of teenagers will struggle with addictions and mental health challenges. Adolescence is the time when many people first experience panic attacks, eating disorders and mood episodes.

Teenage depression is one mood disorder that is fairly common, affecting around 20% of teenagers. Some forms of depression are comparatively mild while others can be so intense that they are life-threatening. In all cases, adolescent depression must be taken seriously. Parents need to know about depression and what they can do to help their kids.

What is Depression?
Depression is a mood disorder characterized by low mood (which, in teenagers, is most often expressed as irritability or “moodiness,” but can also be expressed as sadness), hopelessness, trouble making decisions, feelings of guilt or worthlessness, weight gain or weight loss and sleeping problems (most commonly, waking up around 2 or 3 a.m. or getting up way too early).  Unlike episodic sadness, depression is stronger and seems harder to manage. A person who is depressed cannot simply “shake the blues away” or decide to cheer up. In fact, they feel flat, like there is nothing that can make them happy or give them pleasure. When this state of mind is so intense that it interferes with a child’s social functioning (i.e. she is withdrawing from her friends) and/or academic functioning (i.e. she can’t concentrate, can’t study, is doing poorly in her schoolwork and grades are slipping) and it has occurred pretty consistently for a two week period, it may be an episode of “Major Depressive Disorder.” When the state of mind is less intense (does not interfere with social or academic functioning) and chronic (lasting for at least 2 years fairly consistently), then it may be a form of depression called “Dysthymia.” Of course, diagnoses of either of these disorders occurs when the mood disorder is NOT being caused by something else (like withdrawal from drugs or use of alcohol or a traumatic experience, etc.). The only real way to know if a child is depressed is to have her assessed by a psychiatrist or clinical psychologist. The child’s symptoms may indicate another disorder entirely or the child may be “normal” – just going through a rough time. However, it’s crucial that parents don’t try to diagnose their child themselves. Clinical depression can lead to suicide in teenagers.

Experts believe that depression has a biological origin. While a family history of depression doesn’t automatically condemn a teen to get the disease, it increases the likelihood of depression when other risks factors are present in the child’s life. Risk factors for teen depression include a history of childhood depression (chronic unhappiness in childhood), instability in the family, troubled or weak relationship with parents, poor emotional management skills (too much anger, moodiness or anxiety), lack of social support (good friends and/or loving relationships) and stressful life events like loss (of a significant relationship) or failure (to make the team, or get desired grades, etc.).

How can Parents Help a Teenager with Depression?
It’s ideal if you can establish an open relationship with your child before depression strikes. This way, she is more likely to come to you for help when what she is feeling becomes too overwhelming to ignore. You can help by listening. In fact, it is more important to listen than to talk. A depressed child does not need a pep talk. She needs professional care. Let her talk about her feelings without offering her advice or easy solutions. Instead, use emotional coaching (name her feelings). For instance, you can say things like, “That sounds really hard,” or “I can see how much that’s bothering you” or “I hear how hopeless you feel.” Follow such remarks with, “I think the best help for these kinds of feelings is professional help. A psychologist who works with teenagers knows all about this stuff and knows how to help kids feel so much better. These are such important issues and they deserve the best help that we can find. How would you feel if I asked Dr. Green (the child’s pediatrician) for a referral to a good psychologist?” If the child doesn’t want to accept help, wait a couple of days and raise the subject again. The best help you can give your child is to get her to a mental health professional. If firmness is required, then use it. Do whatever you would do if you suspected that your child had diabetes. (You would do whatever was necessary to get your child to a doctor; do the same thing for this condition). Your child will thank you once she is experiencing an improved mood!

Always Late

Some people are always late. Children, teens and adults can all be afflicted with the lateness syndrome. If you are always late, cure YOURSELF before trying to cure your child. However, if you’re a prompt parent dealing with an always-late child, consider the following tips:

There Are Many Reasons for Arriving Late
First, let’s differentiate between “excuses” and “reasons.” When a child says she was late for school because her alarm didn’t go off, she is giving an excuse. Blaming traffic, weather conditions, alarm clocks, losing things and so on does not actually explain late behavior – these are all excuses. A reason for lateness is a statement that actuallyexplains why the person is late. For instance, “I didn’t allow enough time for bad traffic conditions,” explains why traffic conditions caused the person to be late. There’s ALWAYS traffic conditions! Why does that make some people late while other people are still on time? Because some people allow enough time for things to go wrong and some people leave themselves no “wiggle room” for ordinary life events. Similarly, weather conditions happen all the time. Failing to allow for weather is what causes only some people to be late while others are still on time. In other words, people who arrive on time understand and utilize the principles of time management whether or not they are doing so consciously. They know that you have to allow for “unforeseen events” every time you make an appointment to be somewhere. If unforeseen events don’t happen, they’ll arrive a little early. They can prepare for that eventuality planning for it – bringing some reading material, handheld devices or whatever, to keep busy for a few minutes before the appointed time arrives. Chronically late people don’t want to wait. Therefore they leave at the last minute so that they’ll arrive “just on time.” This does not allow for the necessary “wiggle time” – they will be late a lot of the time.

There Are No Consequences for Arriving Late
If the school does not give detentions or other immediate punishments for being late, children may not feel that they need to be on time. Or, if the detention period isn’t unpleasant, then the child may not care that he or she received a punishment. Schools who are serious about having kids turn up on time, need to have serious consequences for failure to do so. Similarly, parents may need kids to be ready to leave the house at a certain time so that the parents can leave for work. Dawdlers and late risers can pose a threat to the parent’s job responsibilities. A child who causes the parent to be late because of his or her own slowpoke behavior, needs to suffer appropriate consequences. Use the 2X-Rule (explained in detail in Raise Your Kids without Raising Your Voice by Sarah Chana Radcliffe). Tell the child that if he or she makes you late in the future then there will be a specific punishment (name what that will be). Be consistent in enforcing the negative consequence and be sure that the consequence you are choosing is a true deterrent for the child.

Consider Specific Disabilities That Make Time Management Hard
There are various neurological deficits that can make time management hard for a child. Some children just can’t accurately judge the passage of time. Twenty minutes may pass while the child experiences it as if only a few minutes went by. Or the child figures it will take her minutes to put on clothes and make-up whereas it never takes her less than 25 minutes for the task. Some kids can’t judge how long it will take to dress, eat breakfast, clean up and get ready for the bus, despite the fact that they must do it every day. Keep in mind that many adults have the same problem! If your child has conceptual difficulties around time, he or she will need extra help. SIt down with the youngster and ask him or her to make guesses of how long each task takes. The next day actually time each tastk. If the child is overor underestimated, discuss the differnces. Help the child make a more realistic schedule and have him or her check off the times that are actually required for each task. Close monitoring for a few days may reveal a few “leaks” in the system – just a couple of places where more time must be realistically allotted.

Accidental Reinforcement
Sometimes a child gets a lot of attention for being late. A parent might call him, scold him, encourage him, help him, and otherwise be all over him all morning long to make sure he is moving on time. This can be a lot of attention! Children sometimes enjoy all the “help” and attention they get from their parents around the issue of arriving on time. Even if this attention is unpleasant (scolding, reprimanding, threatening and punishing), the child might “enjoy” it, because negative attention is better than no attention at all. So be careful to check your own behavior to ensure that you are not talking to the child a lot in order to help him or her be ready on time. Stop the reminders, the assistance, the threatening and all the other attention. Go have your own breakfast and relax. The child will probably beg for attention in the beginning, so you must be firm in your resolve not to give it. After awhile, the child will realize that no more attention is coming and he or she will begin to act more normally.

Arrives Late

Does your child have a tendency to arrive late to his or her commitments? Whatever reason your child may have for tardiness, it’s important that as parents, you don’t take the behavior lightly. Occasional lateness can easily grow into a pervasive negative attitude about time and punctuality. The sooner you can wean kids out of a tendency for arriving late, the faster you can instill more appropriate behavior.

If your child has a tendency to arrive late, consider the following questions:

Is Your Child Motivated? 
Lack of motivation can be a factor in chronic tardiness. For example, a child who is always late for school may be a child who finds school boring, demanding or just plain awful. A child who is interested in the lessons and the classroom environment, on the other hand, can’t wait to get to class! If you feel that lack of motivation is behind your child’s tardiness, then consider ways to make things more interesting for them. It may be possible to arrange a meeting with teachers. Or it may be possible to give your child a reason to arrive early (i.e. more time to play with the new electronic device you just bought him).

Is Your Child Disorganized and Forgetful?
Consider the possibility that your child can use some help in arranging and systematizing his or her schedule. Not knowing where things are, forgetting appointments and schedules, and scrambling to get ready can all be causes for habitual tardiness. Get your child a calendar as well as a to-do list. Help him or her remember commitments through occasional reminders. And instill the habit of checking the night before if everything is ready for a trip. Adequate preparation can go a long way in cutting tardiness among young people.

Does Your Child Respect People’s Time?
Some children, especially teenagers, are prone to arriving late because they don’t value the time of the people they are about to meet. Perhaps they are confident that the other person will wait —- an event can’t start without everyone present, right? Or maybe they just don’t care if the people waiting for them get offended or annoyed. If this is the case, then it’s best parents teach children how important time is to a lot of people. In the same way that they don’t want their own time wasted, neither should they waste other people’s time.

Does Your Child Underestimate Preparation and Travel Time?
Some children are sincere in their desire to come on schedule. The problem is, they have a tendency to underestimate the amount of time it takes to prepare or to travel to a location. For example, they may feel that travel time is just 15 minutes when in fact it’s 30 minutes! If this is the case, then teach your child to be more realistic about their time projections. It would also help to always put a comfortable allowance when setting schedules to account for unexpected turn of events like heavy traffic.

Is Your Child a Conformist?
It sometimes happens that your every lesson on punctuality at home gets negated by a peer group who is always late. Kids don’t want to be the overeager beaver in class – it’s just not cool! If your child is developing a habit towards lateness due to peer pressure, then it’s best to teach him the importance of making decisions based on personal values. Peer pressure may feel very powerful, but it cannot overwhelm a child who values his own mind. Reinforce the positive side of being unique and living according to your principles.

Use Effective Rewards or Punishments
Show your child that YOU value promptness by rewarding prompt behavior or punishing lateness. In the “real world” people can lose their jobs for showing up late. At home, they can lose their privileges. In the real world, prompt behavior is acknowledged in positive work reviews and recommendations. At home, it can earn privileges. Put your money where your mouth is: show your child that you really care about time matters by backing up your words with your actions.

Can’t Get Up in the Morning

Lots of kids have trouble waking up in the morning – especially teenagers. However, youngsters are supposed to be in school by 9 a.m. in most places. Some localities have actually changed the starting time of school to 10 a.m. for adolescents because so many kids in this age group are still groggy at 9! No matter what time school starts, many parents have to leave the house early in the morning so they can get to work on time. For this reason alone, they may need their kids to get up bright and early.

If your child has trouble getting up in the morning, consider the following tips:

Trouble Waking Up Can be Related to the Amount of Sleep Your Child Got
Unsurprisingly, if a child doesn’t get enough sleep, he or she will simply be too tired to get up when the alarm goes off. A lot of kids – and maybe ALL teenagers – go to bed too late. Nowadays, with the constant hum and beep of computers and cell phones, kids stay up to all hours. They’re always “on” and don’t know how to turn off. Of course they’re exhausted!

Getting your child to sleep on time is critical to getting him or her to wake up easily in the morning. Make firm rules about bedtime. Help your child settle down in the half hour before bed by prohibiting stimulating activities like computer games and action movies. Quiet time for bath, stories and tucking in should start long enough before the target bedtime so that the child can be closing his or her eyes at the actual bedtime. Teens, too, need limits around bedtime. Computers and cell phones can be OFF in the twenty minutes before bed. Shower, quiet reading and into bed by bedtime can be the rule for your teenager as well as for your younger child. Failure to comply can cost privileges like use of the family car (“Sorry – I can’t let you drive the car on so little sleep”), allowance, and so on. (See Raise Your Kids without Raising Your Voice, by Sarah Chana Radcliffe for ideas on how to design effective and appropriate negative consequences.)

Trouble Waking Up Can be Related to the Quality of Sleep Your Child Got
Some kids are in bed on time and theoretically sleeping the correct number of hours, yet they are exhausted upon awakening. They can’t drag themselves out of bed. This can happen when the quality of sleep has been impaired. Illness such as ear infections, colds, flu’s and certain chronic physical health conditions (such as sleep apnea!) can affect the quality of sleep. Medications as well as illegal drugs and alcohol may cause morning exhaustion. Chronic mental health conditions such as ADD/ADHD., Asperger’s Syndrome, autism, depression, bipolar depression, and anxiety can impair sleep. Stress and trauma can impair sleep as well.

See your pediatrician for help in addressing the physical conditions that interfere with restful sleep. Your naturopath, herbalist, Bach Flower therapist, reflexologist or other alternative practitioner might also be able to help. Similarly, have your child’s emotional health assessed and treated by a qualified mental health practitioner. You might also be able to find CD’s for children’s sleep issues to help them get a better quality of sleep.

Trouble Waking Up Can be Related to Power Struggles between Parent and Child
Many parents get pretty worked up in the morning. When their child doesn’t immediately jump out of bed, the parents feel irritated, then annoyed and finally enraged. The child accidentaly discovers a way to passively “get back” at parents. The child can see how easy it is to make Mom and/or Dad “go crazy” in the morning and it’s sort of fun to get them to disintegrate this way! The child may not consciously be trying to provoke parents, but people who are relatively powerless (like kids) do love to discover that they have some power after all!

If your child is getting enough sleep but is unresponsive in the morning, TAKE YOURSELF out of the equation. DON’T be your child’s alarm clock! Instead, get a really loud or effective alarm clock (there are many new ones on the market that do all kinds of neat things to force the child to get out of bed). Try to find a clock WITHOUT a snooze alarm. Children who use the snooze feature can often turn it off a dozen times without getting out of bed! Putting the alarm out of arm’s reach can help address this problem as well. If the child has to get out of bed and climb on a stool to turn the thing off, it is less likely that he’ll fall right back asleep. Be sure not to “help” the alarm by also trying to wake up the child. If the child senses your annoyance in the morning, chances are higher that the problem will persist for a long time. Help yourself stay relaxed by being busy in the morning with other activities. Just be too busy to notice that your child is still in bed.

A completely different approach to ending morning power struggles is to be humorous and playful in the morning with your child. Sometimes coming into the child’s room with a joke book and sitting and reading it aloud for a few minutes, is enough to encourage the child to get out of bed in a good mood, ready to start the day. Or, perhaps giving your child a foot massage (only if the child likes this sort of thing), may help him or her start the day in a relaxed and positive mood.

Trouble Waking Up can be Related to a Lack of Real Consequences
Some kids attend schools that do not immediately punish tardiness. Eventually there may be a number of “late days” marked on the quarterly report card. But who cares? On the other hand, when a school gives an immediate punishment for arriving late (like an after-school detention), children work hard to be there on time. Of course, some parents drive the child to school in order to help the child avoid the consequences of being late; such a practice encourages difficulty getting up in the morning. If the school doesn’t have a policy about immediate punishment, it may be possible to take up this isdea with the classroom teacher. The teacher may be able to let you know on a daily basis whether the child was late and you may be able to construct a punishment at home (a consequence that happens every time the child is reported to be late) or the teacher may be able to suggest a punishment that will occur in school.

Help Create a Morning Atmosphere
It may help to change the night atmosphere of the room to a day atmosphere. Open the curtains and the window – let in some fresh air. Turn on the lights. Turn on the computer if there is one, and put some music on. For younger kids (or teens if they have given you permission), pull back the top layer of blankets so that the child isn’t so warm and cuddly. Start chatting to the child in an upbeat, friendly way.

Offer Incentives
It may be possible for you to offer the child incentives for waking up independently and on time. For instance, chocolate milk may be allowed if the child got up by himself or after the first call. Or, a child might be able to earn cash prizes for each cooperative morning wake-up. Or, the child may be able to earn “points” or “stars” and after accumlating a target number, then earn a gift that he or she would not have gotten otherwise.

Teach Your Child How to Set His or Her Internal Alarm
Teach your child to set an alarm clock and then to tell his or her brain to wake up 5 minutes before the alarm goes off. All the child has to do is send this instruction to his or her mind while in a relaxed state. Tell the child to picture the time on the clock that he or she wants to get up at. The child should see the time and picture him or herself getting out of bed then. Make this a game or a challenge. Let the child know it can take some days before the brain catches on, but it WILL catch on. Right now, the child’s brain is actually programmed to get up late!

Help your Child Deal with Academic Failure

A child spends about twenty developmental years in school. He spends more time on academics than any other activity during his growing up years. What happens when his talents and abilities lie outside the academic realm? What is it like to deal with regular academic failure and frustration? Whether a child has chronic and severe learning issues or whether he or she has simply gotten a low score on one particular project, academic failure can be traumatic, especially when it comes after much hard work and struggle. Not being able to make the grade on a regular basis tends to lower a child’s self-esteem; tutors, remedial classes and make-up tests can be demoralizing.

How can parents help their child deal with academic failure and frustration? Consider the following tips:

Intervene Early
It’s important that parents communicate their concern and support as early as the first signs of academic failure. While trusting our children to bounce back on their own is a good thing, parents can’t afford to intervene only when the final report card is released. Ongoing interest in the child’s school performance not only prevents sudden surprises at end of term, but also allows parents to offer emotional support, encouragement and practical intervention. Sometimes a little individual attention from a teacher or tutor can set the child on course. Sometimes boosting the child’s confidence in non-academic areas can buffer the frustration of negative academic feedback. The earlier parents can step in to address the situation, the less “repair” they’ll need to do later on.

Deal with Your Child’s Feelings
Parents understandably get upset when presented with a failing mark. But it’s important to remember that children have strong feelings about failure too — even if they come across as uncaring about their grade. Sit down with your child and ask them how they feel about the situation. Let them vent. And be willing to look past a defiant exterior; insolence can be a mask to hide a child’s feelings of vulnerability inside. Don’t be alarmed if your child “doesn’t care” about his low grades – that’s most likely a neat defence he is building to ward off feelings of shame and failure. Don’t overwhelm your youngster with your own feelings about his grades; instead, ask in a matter-0f-fact tone about how he feels and then reflect his words back to him. “I know what you mean..it IS frustrating when the teacher doesn’t give part-marks…and really annoying when you actually spent time studying and then get a mark like this.” After you “emotionally coach” the child in this way, spare him the lectures. If you have a handy tip to offer, first ASK him if he’d like to hear it and if he doesn’t want to, just leave it for now. He may ask you about it later. You can also offer help and intervention: “Would you like some help in studying next time?” or “Would you like me to ask the teacher to give you a little time after school to go over things?” or “Would you like a tutor?” and so on.

Help Ascertain the Reasons for the Failure
Instead of focusing on the disappointing outcome, focus instead on identifying the factors that contributed to the failure. Usually it’s not one reason, but a combination of many things like learning and/or attention issues, lack of motivation, lack of conducive study spaces or dislike for the subject matter. When academic problems are chronic, a professional psycho-educational assessment is the best venue for determining the cause. Most school boards can arrange this for their students and private psychologists also specialize in providing this service.

Get Your Child to Take Responsibility
Is your child at fault for the failure? Perhaps he skips class or chooses to watch TV instead of reviewing for an exam. If this is the case, it is important that parents get the child to acknowledge that he also has a contribution to the failure. This step is not to encourage self-blame, but to instill responsibility for one’s choices and behavior. And to make responsibility easier to accept, parents can also acknowledge their own shortcomings to their children and how they’ve addressed them over the years. Modeling how to take ownership for the consequences of one’s actions is one of the best gifts parents can give to a child.

Set Learning Goals Together
Parents can help children deal with academic failure by being future-oriented and proactive. Set learning outcomes together with your child, for example decide on acceptable and realistic targets for the next grading period or the next school year. Create a workable map on how to achieve those learning outcomes. Make plans too involving behavioral changes that need to happen in order to facilitate a better academic performance.

Hidden Reasons for Your Child’s Behavior

We are all familiar with visible disabilities: missing limbs, order profound retardation, blindness, deafness, cerebral palsy, speech handicaps and so on. Children with such disabilities will be provided with special education that addresses their special needs. The community will be understanding and supportive of parents who are raising special children; everyone will try to help.

However, many children are suffering from “invisible disabilities.” These are emotional, physical and behavioural conditions that range from the most mild of dysfunctions to serious handicaps. Teachers may confront these conditions in their classrooms and parents may deal with them at home, without knowing that a disability even exists. Adults may see a child who is “difficult” or “uncooperative” or “unmotivated.” They may see a child who is “inflexible” or “spaced-out” or “over-sensitive.” What they don’t know is what to do about it. Parents raising such children tend to receive criticism rather than support; others assume that poor parenting is the culprit. In fact, various underlying, often genetic conditions, create invisible disabilites.

Immaturity
There are young children who function just a bit behind their age or grade level and who have nothing more seriously wrong with them than immaturity. Their social skills may be lacking and/or their academic performance may be weak. Sometimes social skills counselling can help, but often finding alternate areas of activity and competency can bolster flailing self-esteem. For instance, a socially immature child who receives lessons in art, music, sports, computer programming, cooking, sewing, or any other extracurricular activity, can grow in confidence and self-respect, despite social frustration in the classroom.

Some additional individual attention in academic subjects will often bring immature children to an appropriate level of functioning within a matter of months or a couple of years. Providing this extra help thereby completely removes the “disability.” However, failure to provide the help, can cause the child to remain permanently disadvantaged in the classroom. Not only will his academic performance lag (and thus threaten his adolescent schooling opportunities), but his frustration and boredom may also lead to behavioural and emotional difficulties, actually creating a psychological handicap when there was none to begin with. Similarly, there are some immature adolescents who may need temporary extra help and/or guidance in order to function successfully at the high school level. With such help, they may go on to be outstanding members of the class, and eventually, of the community.

Minimal Brain Dysfunction
An early term used to describe a cluster of behavioural, emotional and intellectual deficits was “minimal brain dysfunction.” The syndrome referred to unexplainable gaps in academic functioning in otherwise normal children. Dylexia (reading disability), discalculaia (arithmetic disability), dysgraphia (handwriting disabilities) and other academic weaknesses were found to exist on their own or in combination with any number of neurological “soft signs” such as fine or gross motor deficits, eye-hand coordination problems, information processing weaknesses, mixed laterality, poor directionality, poor social perception and other symptoms. Today, the term “minimal brain dysfunction” has been replaced with other diagnostic categories such as “learning disabilities,” “auditory processing deficits,” “ADD,” and “ADHD.” In recent times, the nomenclature has included Tourette’s Syndrome with all of its variants of Tic Disorders, Obsessive-Compulsive Disorders, Depression and various other complex disorders of social and cognitive functioning. The field is still evolving and new understandings and categorizations of these dysfunctions will emerge.

Mild and moderate cases of these disorders present themselves as “invisible disabilities.” A child is clearly not functioning up to par. Psycho-educational assessment will often reveal the criteria for a diagnosis of one of the above-named syndromes. Sometimes, a “sub-syndrome” may be postulated – some symptoms exist, but not enough to meet criteria for a formal diagnostic label. In either case, treating the symptoms with appropriate interventions usually yields excellent results. Extra academic support, alternative teaching strategies and occasionally, behaviour modification programmes, can allow the child to prosper within his normal classroom setting. With such help, the child progresses normally and may be able to integrate into the mainstream without further intervention. In more serious cases, the child may require a slightly modified curriculum in addition to the special educational interventions already described. With such help, the child is able to stay within his regular school setting and develop normally along with his peers. Sometimes, psychological support given to the parents and medication or naturopathic treatment given to the child, provides further assistance and ensures the best prognosis. Often, where the child has received appropriate support, the disability becomes a non-issue by the period of adolescence or adulthood. In other cases, the disability remains, but the child has acquired many coping skills and alternate areas of successful functioning that allow him to succeed in life. Only in the most extreme cases of such disabilities, is special schooling required, taking this category completely out of the “invisible handicap” designation.

Disorders of Mood and Motivation
There are also children with a wide range of emotional and behavioural difficulties that become invisible handicaps. The “unmotivated” child may be a perfectly normal youngster who daydreams or has interests in non-academic endeavors. This can also be the “gifted” child who is not sufficiently challenged within the classroom setting. Without intervention, these children may fall further and further behind in their studies. Eventually, lack of academic success may lead to behavioural difficulties, as described above. However, with minimal intervention such as classroom withdrawal for extra academic attention specifically geared to their unique learning style, these children can be redirected to a successful learning path. Bach Flower Therapy offers many remedies that treat disorders of motivation (you can find more information about Bach Flowers online and on this site). In more persistent cases, psychological counselling may be helpful as well.

The “behaviour problem” child may be suffering from low self-esteem, depression, chemical and brain disorders, family problems, problems of impulse control and/or immaturity, or other physical or emotional challenges. Left unattended, this sort of child may enter a cycle of failure in which teachers give up on him and he gives up on himself. Eventually such a child is at great risk academically, emotionally and spiritually. However, in-school treatment can make a huge difference. Extra attention, opportunities to shine both academically and non-academically, behaviour modification programmes can all be combined with outside-school interventions such as psychological counselling, nutritional and naturopathic interventions, medical interventions and so forth.  Often, parent counselling is an invaluable component of the child’s wellness programme, as parents are provided with at-home interventions that can impact powerfully on both family and academic functioning. When the needs of the child are met, the best outcome will be achieved.

Similarly, children who have early-stage mental health disorders such as OCD (obsessive-compulsive disorder), anxiety disorders or depressive mood disorders (which can be expressed both as sadness and as intense irritability in children), can be kept in their school environments while special allowances are made for their unique needs. This may involve arranging exemptions for medical and/or psychological appointments, altering curriculum demands or schedules to reduce pressure, and providing extra academic support as needed. Without such support, these disorders may worsen significantly due to intolerable levels of stress. They then become “obvious handicaps” rather than “invisible” ones. However, with support, many mental health disorders will become less disruptive or even improve significantly, enabling the child to lead a normal life.

Being Singled Out
Some parents are concerned that children will suffer from being singled out for special attention within the school setting. As we have seen, greater suffering may result from leaving minor problems unattended. Moreover, it is important to note that children generally enjoy the special attention that they receive. Most children, for example, look forward to spending time with their tutor, therapist, resource room teacher or guidance counselor. These professionals are all trained to make children feel successful. The withdrawal experience is thus a very positive one for youngsters. With parental endorsement and support, youngsters can actually feel privileged to receive this help. Making extra help a normal and common part of school experience by providing it to more children more frequently, will also help to reduce any sense of embarrassment or discomfort on the part of individuals.

Our attitude as a community is very important. We must become comfortable with the concept of providing educational and emotional support for children as a primary intervention. We must also understand that the emotional and behavioural profile of children changes dramatically from the period of kindergarten to the end of high school and beyond. A “wild” six-year-old can turn out to be a well-functioning adolescent and adult – especially if he has received the help he needed along the way. Providing a child with help does not make the child “sick” – but failing to provide that help might very well do so. Sometimes professional assessment is an important part of a child’s health plan. Having a child assessed and labelled, does not “doom” him; rather, diagnosis and assessment guides parents and educators to choose the best interventions to help the child grow up “normal”! Lack of proper assessment can sometimes cause a child to miss the earliest intervention that would produce the best outcome. Moreover, the delay of professional assessment may result in a child with entrenched negative patterns that are much harder to uproot. Parents who refuse to have their child assessed despite expressed concern from teachers, are sometimes functioning like people who are afraid to go to the doctor when they are experiencing worrying symptoms. If they went to the doctor early enough, their health could probably be saved. Refusing to obtain a diagnosis for fear that something will be found, is understandable – but self-defeating. It is the diagnosis that permits the healing to begin!

Our job as parents and educators is to help children develop to their potential. Meeting their unique needs helps accomplish this goal. The more help we give, the less stigma we experience. The more help we give, the less dysfunction will exist. The more help we give, the more adults we can produce who are healthy, whole human beings – the products of our educational system and our community.