Apr 27, 2014

Helping Your Tween with Separation Anxiety

Terry is a 12 year old making the transition to middle school whose worry about going into 7th grade developed into a fear of crying in public and panic attacks, which led to separation anxiety. His parents are worried sick because Terry is having a hard time now even going out to play with friends. His older brother thinks Terry is weird.

Jennifer, an 8 year old, developed separation anxiety in 3rd grade, making school mornings a nightmare for the whole family. Jennifer’s parents face screaming, crying, begging and outright, “I won’t go!” whenever they try to get her out the door to catch the school bus. Jennifer’s anxiety has generalized to play dates and parties, she’s even run out of the classroom. Her sister, in the same school is embarrassed by Jen’s public behavior.

What is Separation Anxiety and Why is My Tween So Afraid?

Parents whose tween develops separation anxiety, an emotional condition where a child experiences distress and anxiety when separated from the primary caregiver, often become worried, frustrated, and even angry in trying to deal with their anxious child’s behavior. It’s hard for a parent to understand and deal with their child who freaks out over going to play at a friend’s house. A normal occurrence during childhood development, separation anxiety generally occurs between the ages of eight months and two years old, though separation fears also develop during other life transitions such as, beginning kindergarten and entering into pre-adolescence.

Parents with anxious tweens ask, “What in the world is happening to my once happy child?” “Why can’t he go to birthday parties anymore?” “Why can’t she let go?” This is a time of explosive growth and change from childhood into pre-teen. Many children have a hard time stepping out into the world and try to cling to the safety of home. Following are some of the reasons:

  • Tween bodies are developing and awareness of body image becomes an issue; the flood of sex hormones affects emotional centers of the brain making it tough for tweens to control feelings and behaviors; areas of the brain that house impulse control and rational thought are still developing.
  • School work becomes harder, homework and testing increases; “fitting in” is suddenly very important; more individual responsibility is expected from parents and school.
  • If anxiety develops it packs a wallop with symptoms that include: racing heart, hot flush and sweating, stomachaches, vomiting and diarrhea, headaches, feelings of dread and of being trapped, the inability to concentrate, think or reason, and panic attacks.

A child with separation anxiety is a child who feels distressed, frightened and out of control. Anxiety is a complex condition, and there are many aspects to helping your child. How you communicate your concerns, respond to your child’s behaviors, and talk about what’s happening will play a large part in helping your child.

Can We Talk?

Communicating effectively can be tricky, especially when you’re trying to talk to your anxious pre-teen who says, “I don’t want to talk about it.” And who can blame your child who wants the disturbing feelings to just go away? It’s not just the words you use, but the volume and tone of your voice matters too. And your body language speaks volumes: Are your head neck and shoulders tight? Is your facial expression one of frustration, worry or anger? Is your posture sagging with fatigue about the situation or rigid with tension? Do you wring your hands without realizing it? Having trouble making eye contact because you feel like crying?

It’s hard to communicate to your anxious tween that you are in control of the situation though he feels out of control much of the time, and when you feel anxious about his separation fears yourself. But that’s what you want to do, and here are tips to help you communicate effectively:

  • Stay Calm-no matter what your child says, no matter how he is behaving you must remain calm, regardless of how you feel. Your composure communicates to your child that you are his “rock” and in control. Learning easy belly breathing will help you to do this.
  • Check Your Body Language-keep shoulders back but relaxed, relax facial muscles and hands, make and maintain eye contact to show you’re engaged and interested.
  • Ask Open-Ended Questions-you want to connect with your child and find out how she feels. To keep the conversation going, keep away from closed questions that only require a yes, no, or a head nod. Say things like: “How does it make you feel?” “Tell me more about that.” “What do you think will happen?”
  • Tone of Voice Matters– speak softly and kindly to show your child how much you care. This will ease any guilt (a common occurrence) your tween may have about his anxiety disrupting the whole family, and will help your child open up to you.
  • Listen-show your child you are interested in his feelings, his problems by: making eye contact, give your child your undivided attention, don’t’ interrupt–wait your turn to speak, nod when appropriate, lean forward slightly and keep hands still, paraphrase what he’s said to make sure you’ve heard correctly and to show that you’ve been listening.
  • Honor Your Child’s Feelings-don’t downplay your child’s fears. For example, never say things like, “It’s silly to be afraid of going to your friend’s house.” Though irrational, your child’s fears are real to him. Anxiety makes kids feel different, isolated from others-judging his feelings adds to that. Telling him it’s okay to feel afraid supports him. Say, “I’m here for you and you’re not alone in this.”
  • Make it Brief-anxiety is hard to talk about, so limit the conversation. Watch your child’s reaction, if he gets upset, end it, comfort him, and say, “Honey, it’s okay, we can talk about this later.”
  • Believe-tell your child you believe in his ability to overcome anxiety and that together you’re going to make things better for him. Your belief that he can succeed is projected onto your child (in the same way your worry is) and will empower him.
Mar 10, 2013

Social Courage

By kindergarten, most kids know the difference between “nice” and “mean.” They still know it by the time they get to middle school. And all high school students can tell you how awful it feels to be treated unkindly. And yet, kids are often disrespectful to their peers and their parents.

Why this disconnect between knowing what’s right and doing what’s right? Part of the explanation is the fact that our children are growing up in a Culture of Cruelty. That sounds harsh, but we can’t change what we don’t see. Consider what passes for entertainment in the media. It’s often mean-spirited. So are many of the conversations we have at the office, on the sidelines at the game, and in the teachers lounge. Character assassination in public discourse is pretty much the air we breathe. So are put downs, gossip, and snarkiness. The resulting pollution is a hazard to our well-being. It’s also a huge problem for parents who want to raise nice kids who do good in the world.

Our kids are good kids. They really are! But they are also constantly challenged by the less-than-compassionate standards of their peers with whom they are mind-linked 24/7. Today’s t(w)eens suffer from status anxiety at levels no other generation has endured. This compels them to do whatever it takes to fit in, including things they are not particularly proud of. Despite these challenges, we can teach our kids to be people with good intentions and social courage, i.e., the ability and the will to do the right thing.

Adults who live and work with kids often give lip service to the importance of teaching young people to do the right thing. But how much actual teaching is being done at home and at school? If we don’t prioritize character development, we’re failing our kids. We can do better.

Here is a simple way to get the ball rolling in the right direction:

1. Talk with your child. Have a friendly conversation about the concept of a “pecking order” in the animal kingdom. Maybe you’ve observed two dogs or two cats at close range. Often it’s clear which animal is “dominant” or “bossy” and which is more submissive. Talk about how there can also be a pecking order amongst people. We usually feel uncomfortable when we are on the bottom, getting bossed around. But when we’re not on the bottom, we don’t often give much thought to those who are.

2. Listen to your child. Ask your son/daughter about who is on the bottom at school. (Even kids as young as second or third grade have a keen awareness of social strata.) Ask, “Why do you think s/he’s on the bottom? How do other people treat that child? How do you treat him/her? What might happen if you stood up for that child?

3. Challenge your child to be a hero. Encourage him/her to shake up the pecking order by standing up for someone who needs a friend. Take the challenge yourself!

4. Follow up. In a week, have another friendly conversation with your child and share what happened on the challenge. Discuss whether you want to keep the challenge going.

We parents are gardeners. We plant seeds and nurture those seeds through conversations, modeling, and real world experiences. Of course, we are not our children’s only influencers but we can provide the tools they need to do the right thing, online and off. Whether they actually step up, is their choice. But at least we’ll know we’ve done our part well.

Jul 14, 2012

Helping Your Tween be a Critical Media Consumer

Tweens are at a great age to begin learning how to become critical consumers. They have the ability to think about things from someone else’s perspective and they’re growing in their desire to become more independent thinkers. Both of these are important skills in learning to think critically.

To be a critical consumer, tweens need to understand that advertisements and marketing are about selling them something. Even their favorite TV shows and computer games are filled with persuasive messages to either keep them interested in that particular form of entertainment or to get them interested in something else that the same company is promoting. Any form of media is also promoting the worldview of the creator. This doesn’t make marketers and media producers evil, but it does mean that whenever we’re engaging with their content, we have to understand that they are trying to persuade us to adopt their point of view and value system.

A good way to help your tween understand this is to talk about specific examples in their own life when they have tried to get you, a sibling, or a friend to do something. Ask them questions like how they went about convincing that person, what arguments they used, did they appeal to their emotions? Once you’ve been able to identify a few specific strategies that they’ve used to try to get someone to do something, then you can start drawing parallels with how marketers work. Marketers want us to buy their product or watch their show. How do they go about convincing us that we should? They try to appeal to our desires to be cool, to look good, to have friends or do fun things. Ready to try it?

Watch this cereal commercial together and ask the following questions:

1. What words do we hear? What are the people in the ads, the songs, and the words on the screen saying? Jot down the words and put a check by them if you hear them more than one time.

2. What are we seeing? What visual images are being used to sell the product? What activities are the people/cartoons/animals on screen doing?

3. What is the theme of the advertisements for this product? What is the overall message that a child would walk away with? Come up with one sentence that starts with “If I buy _____________, then I will ______________”

This activity gives you and your tween the chance to critically deconstruct an advertisement. Instead of just mindlessly watching, they now have the skills to critique. And, once you’ve done this a few times with your tween, they’ll begin to think of media and marketing from a new perspective. They will be empowered to really think about the meaning behind messages sent by advertisers. This is the heart of being a critical consumer!

It’s also important to help your child to learn to deconstruct and critique the media that they consumer, from TV shows to movies to songs. Like commercials, media is created from a certain worldview, not in a vacuum. The person who created our child’s favorite TV show may have a vastly different worldview than you and your family. It’s fine to explore those worldviews, as long as both you and your child understand that this is what you’re doing. For example, the gender stereotypes that are presented in entertainment targeting your tween may promote very different ideas about what it means to be a boy or girl than you do in your own home. It’s important for your tween to be able to notice that, think about it critically, and then make a decision about what they themselves believe.

In an activity similar to the one that we discussed above, you can watch a TV show or movie with your child and practice being critical consumers together.

1. First, ask yourself a few questions about the target audience: Who does this message come from? Who is the target audience according to the developer? It’s important to really understand whom the target audience is in order to determine if the product/program is appropriate for you or your child.

2. What message is being sent through words, music, images and stories? What about the unspoken messages? Are there impressions that you get very clearly whether they are or are not spoken? In many TV shows aimed at tweens there is an unspoken message that parents are stupid or sometimes basically absent. How are different types of people depicted? Are there messages about how to get what you want? How to be in relationship with others? How to deal with friendship problems?

3. What values are presented? What positive and negative messages come through? How do these compare to your own value system?

Another fun activity that can really open both your and your child’s eyes to the messages being sent through different media and marketing campaigns is making word clouds. You and your child can use Wordle to create word clouds from groups of words that you gather from different advertisements, TV shows, music, etc. Here are some specific ways that you might use word clouds with your tween:

1. Work with your tween to develop a word cloud of the characteristics that they think are most valuable in a girl or boy and compare it to those they see presented in media portrayals. For example, after you help them make theirs, you might look through magazines together, watch advertisements, or TV shows and collect words and themes that you both agree are being used to promote value in a person.

2. Watch a TV show or movie that you and your tween are considering and record the words or themes that you notice. Use Wordle to develop a picture of the overwhelming themes within that show. This will help you decide if the overall worldview presented by the program is one that you want to support

3. Record the words used in music that you and/or your tween consider sexualizing or negative to make a word cloud and compare it to one for music that you both find positive. The visual of the word cloud really allows you to compare and contrast the different messages being sent.

If you’re comfortable with it, it’s okay for your tween to engage with media that promotes a different value system than your own. What’s important is that both of you are able to think and talk about it together. This is a good way to jumpstart a conversation about why your family has certain values in the first place.

These activities will give you a good opportunity to start practicing being a critical consumer of media and marketing with your child. This will lead both of you to feel more empowered to choose your response to media and marketing.

Apr 18, 2012

Tween Obesity – Stop Sugarcoating It, America

Fat discrimination is everywhere, and if you’ve ever known a tween who grew up overweight, it really is no fun. Kids target other kids who are overweight for a variety of reasons, including avoiding being targeting themselves. Georgia’s “Strong4Life” campaign shows exactly how difficult it is to suffer from childhood obesity, and the message is powerful, exactly how it is intended. Georgia knows their tactic of bullying is risky, but they are willing to be controversial if it means they will reduce their ranking as the second “fattest” state for children in the nation.

In the print and TV ads, tweens reveal how painful it is to get picked on by other kids, while others ask their parents “Mom, Why Am I Fat?” The answers are found via the campaign website, oversimplified and things we all know already: diet and exercise. School programs have already failed at trying to reduce childhood obesity, so what’s next? The fact is that the research shows that dieting actually leads to weight gain, and the identification/treatment of emotional eating issues along with lifestyle changes are more sustainable way to combat childhood obesity.

One of the biggest challenges of parenthood is feeding your child: figuring out if your child is eating the right foods at the right times, for all of the right reasons. It’s a daunting task from birth and gets more complicated as nutrition needs grow and change, where well-intended parents use food to soothe and calm, and it becomes a symbol of love and care. As children grow, food becomes a substitute for that “love and care.” Georgia’s ads suggest that obesity is a family issue to resolve, even though it’s cause is much more complicated than that.

As your child ages, feeding becomes more complicated when you notice that your child eats for “emotional” reasons. Feeling anxious, sad or angry, tweens reach for food when they are feeling stressed or alone. Sometimes they may eat out of boredom, becoming a welcome companion when no one else is available. Eating can cover up for insecurities that are not verbalized, an instant fix for what feels unfixable. Soon, weight gain from the extra nutrition gets more complicated when peers or family make comments about the changes in the tweens body. Food further comforts, and the cycle continues.

So, what do you as parents? Identification of emotional eating patterns is essential in interrupting the once helpful, but unhealthy behaviors. Just because your tween isn’t sobbing in their room everyday, does not mean that they are not depressed or anxious. Depression and anxiety can exhibit in a variety of forms from isolation to risk taking behaviors to agitation. Do not dismiss their reactions even if they don’t want to talk to you about their problems. When you stop lecturing and become an active listener, watch their behaviors as well as listen to the conversations they have with those around them, you will learn what your tweens experience is of the world.

How to discover if your child has an eating issue? Become a well-intended investigator. Has food gone missing from the home? Is your child eating when they are not hungry, or just finished a meal? Is there recent weight gain following an observable increase in nutrition intake? Has their been a change in the family, or their environment that was stressful? Disordered, emotional eating comes from irregular eating patterns that are not based on hunger/fullness. Untreateddisordered eating turns into an eating disorder when patterns become solidified and interfere with daily functioning, or medical issues arise as a result of the behaviors. An assessment by a professional can help determine the level of difficulty in your child, as well as provide both support for the behaviors, along with accountability to get through them and into a better way of coping with emotions.

Parents can help support tweens even if your child doesn’t exhibit emotional eating patterns. The following provides some ways in which parents can help to encourage their child’s mental health and create a more connected relationship!

To get your tweens feeling better and more confident, you have to get moving. Set limits on “indoor” time and encourage them to get out of the house to play with friends. Find a physical activity that the whole family can enjoy (i.e. hiking, soccer game, beach volleyball, etc.) Walk as many places as you can, park far away from your destination at shopping centers. Organized sports will not only promote health, but cooperation in teams and boost self-esteem.

Offer a variety of foods and snacks in your home, and encourage balanced eating: ie. four fruits/vegetables to “earn” desserts. Emphasize food as fuel, and a variety of foods to provide the necessary energy they need to grow from tweens into teens. Providing proper nutrients to your body should be as necessary as teeth brushing, and make it on the same priority level.

Make it a priority to sit down with your family for dinner. Turn off the tv, and find out about your tween, all that they are learning and who they are spending time with. Avoid any emotionally charged topics and you’ll reduce emotional eating. Pay attention to how and what your tween eats, and you will learn a lot about their relationship with food and their body.

Focus on health and building self-confidence, not weight. Weight gains/losses are inevitable part of the tween growth process, and it should be your pediatricians focus to track and monitor these changes over time. Make long-term health a priority in your family, and reinforce how much better your tween feels when they are eating a balanced diet. Do not give food as rewards for good behavior, focus on internal qualities reward for effort and completion with verbal compliments to build self-confidence. Verbal praise and approvals go a lot further than an ice cream for a job well done!

Stop nagging your tween to change their habits, or you will make it worse. Model good behavior and eliminate the word “diet” from your vocabulary. Be brave enough to remove the scale from your home. Provide them healthy foods in pre-bagged sizes (yes, that you’ve prepped yourself) for convenience on the go snacking. Albeit tedious and time consuming, worth it if your tween will make a better choice.

Advocate for your tween when they are being teased or bullied at school. These are far longer lasting and more detrimental to emotional health, and a main reason for people developing eating disorders. Stress causes people to GAIN weight. Reduce the stress in your home and environment, and you’ll cause your tweens not only to feel better, but reduce emotional eating as well.

Encourage body diversity. Do not make comments about other people’s external appearances, and focus on your tween’s internal self-worth. Promote self-esteem and body satisfaction, and teach children of all sizes to value themselves and their health. Plus, it’s just not nice to say unkind things about other people.

“Stop sugarcoating it, America.” It’s time to change our thoughts and attitude towards childhood obesity, and you should be applauded at taking action towards the mental health of your tweens. After all, isn’t the goal to have happy, healthy kids?

Apr 16, 2012

Tween Bullying and Eating Disorders: Battling the Outer and Inner Attacker

Recent headlines have shown the enormous psychological impact bullying can have on someone’s sense of self worth. If left untreated, bullying leads to depression, anxiety, low self-esteem and suicide. The majority of bullying occurs in the tween and teenage years, where the most sensitive kids are the targets.

A recent study shows that almost 50% of those diagnosed, attributes bullying as a main contributor to the development of an eating disorder. Starting in elementary school, bullies target those people who are most sensitive, the same type of people with the temperament to develop eating disorders. This group tends to over-personalize when others talk about them, and generally have less confidence to stand up for themselves and fight back. Instead, the bullying renders them helpless, and they feel alone in defending against the attacker.

When bullying takes the form of making fun of a person’s weight or teasing about body shape, it contributes to the development of an eating disorder. These senseless comments in the tween years make an impact for years to come and are painfully recounted in treatment, even as adults. Victims of these statements are sent an intense message that they are “fat” equaling that they are unwanted, unloved and unworthy, even if the message is not true.

As a result, the victim develops extreme anxiety at the possibility of future attacks, and turning to food as a means to cope. They find comfort in restrictive eating, in hopes they will lose weight and be left alone. Others binge as a way to self-soothe, where some may purge in an attempt to rid themselves of the extra calories. Obsessive exercise alleviates some of the associated anxiety, but it is often short lived until the next time they are scrutinized by the bully. In boys, hopes of bulking up and intimidating the aggressor are coupled with failure if unsuccessful.

To complicate the experience, disordered behaviors then create an inner bully, a relentless critic that mirrors what they are experiencing in the outside world. The person then seeks and distorts evidence that they are unworthy and worthless. When they abuse themselves, it makes it less painful for when the actual bully attacks. This internal faultfinder may be worse, as it never gives its victim a break from the abuse. All of this done in effort to make the person numb via the criticisms, disordered eating behaviors and poor body image perceptions.

If you recognize some of the psychological symptoms of bullying (depression, anxiety, low self-esteem) or behavioral reactions (not wanting to attend school, having “no friends” or actual reports of bullying) in your child, you must intervene immediately. Research shows that the faster you take action, the less of an impact it has on your child. Stand up for your tween, and help them develop ways to stand up for themselves and others who are being bullied. Adopt a no tolerance policy for the mistreatment, and inform the appropriate authorities. Identify resources in your community to help support your child (Therapists, School Officials, Parents, Friends, etc.) and gain as much information as you can through research on the topic. Further, seek help from professionals when the eating disorder is discovered, so that your tween can commit to recovery from the unhealthy behaviors and learn to live a happy, fulfilled life free of the inner and outer bully.

Apr 14, 2012

Current Trends in Tween Food and Body Image

Disordered eating issues are on the rise, and younger children are being diagnosed at conerning rates.  Current research shows that up to forty percent of 9 year-olds have been on a diet, and eating disorder hospitalizations for children younger than 12 increase by one hundred and nineteen percent between 1999 – 2006.  The sharpest increase in treatment was seen in boys and minority youths.  Anorexia in a young child is more dangerous than in an older teen, mostly because the body is developing at a rapid rate, and both brain and bone development are affected very quickly when calories are restricted.

Treatment for such young children can be difficult as lengthy hospitalization stays can be traumatic when the child is away from their parents and the comforts of home. Plus, children are often not mature enough for traditional talk therapy. For these cases, a medical and family approach can be extremely beneficial: using food as “medicine” to re-nourish the brain and allow the child to think more clearly, while also addressing any family issues that might be contributing to the child using food as a means to cope. Setting boundaries in the family system to not collude with disordered behaviors, as well as having the parents involved and plate out meals to help re-feed their child, sets the expectation that the eating disorder will be defeated.

Currently, there are several emerging and continuing trends that parents should be aware of, and that their child may be exposed to on a daily basis. Keeping these influences in mind may help to protect your child from unhealthy influences, as well as open up a dialogue around curiosities and social stimuli.

1. Internet and Social Media Influences: The Internet is filled with an innumerable amount of unhealthy resources. Facebook provides a platform for a life that isn’t reflective of reality, where kids post the best pictures of themselves and provide embellished status updates. Many spend endless hours stalking their “friends” profile pictures leaving them with a strong desire to achieve a look or body that can never be imitated. “Fakebook” creates a false sense of reality, and depression or anxiety when the comparisons to others create insecurities.

“Pro-Ana” websites (those that encourage a low body weight and restrictive behaviors) provide tricks and tips that promote dangerous, disordered behaviors, under the guise of a sense of belonging to such an elite group (i.e. no one else has discipline to achieve an ideal body other than those who are most dedicated to the disorder). Even scarier are the sites such as Omegle or ChatRoulette, where pedophiles and predators try and seduce minors into taking their clothes off, all under the promise of being anonymous. No age requirement or registration necessary, and those that aren’t getting enough attention easily fall victim to such sites.

As much as there are negative influences that are surrounding your children, there are positive ones as well. There are new movements in place (i.e. peer counseling groups in school or church) to help support and prevent disordered eating issues. These groups utilize positive role models as a way to counter negative messages through the media or in their community, and help to develop a healthy self-esteem. Further, the National Eating Disorders recently launched their website www.Proud2BMe.org, to promote healthy attitudes about food, weight and body image, targeting tween, teens and young adults. WebMD also has their own site geared towards children and tweens, atwww.fit.webmd.com/kids.

2. Bullying and Body Image: A recent study shows that almost 50% of those diagnosed, attributes bullying as a main contributor to the development of an eating disorder. Starting in elementary school, bullies target those people who are most sensitive, the same type of people with the temperament to develop eating disorders. This group tends to over-personalize when others talk about them, and they generally have less confidence to stand up for themselves and fight back. When bullying takes the form of making fun of a person’s weight or teasing about body shape, it contributes to the development of an eating disorder. As a result, the victim develops extreme anxiety at the possibility of future attacks, and turns to food as a means to cope. To complicate the experience, disordered behaviors then create an inner bully, a relentless critic that mirrors what they are experiencing in the outside world.

Setting boundaries and developing empathy are two core ways to battle both the inner and outer bully. Stand up for yourself and others with a no tolerance policy for the mistreatment. Create empathy for yourself and commit to recovery from the disordered behaviors. Seek help from adults, authority figures and professionals when needed.

3. Eating Disorders in Boys: Even though 5-10% of those with diagnosable eating disorders are boys, it may in fact be higher due to underreporting rates and current diagnostic criteria (current criteria includes amenorrhea, or lack of menstrual cycle). Boys are often socially isolated because of their disorder, more easily bullied by others, and less supported because they are not expected to be affected by food/body image issues. Boys are vulnerable to the development of an eating disorder due to opportunities to engage in unhealthy behaviors outside of the home (gym/athletics). Boys encourage each other to “work out hard,” and often ridicule those who are “weaklings.” Sadly, this type of bullying behavior is usually dismissed as “guy talk.”

Start a dialogue with your sons at an early age around food and body image issues. Don’t assume just because they are boys that they will not be affected or be challenged with issues of self-esteem. Work with them to develop a strong, authentic sense of themselves, and if you see signs of any emerging disordered eating issues, intervene with concern as soon as possible.

4. Athletics and Performance Pressures: According to the Clinical Journal of Sports Medicine, an estimated 13-42% of athletes are affected by an eating disorder, depending on the sport and the gender of the participant. Athletes face an even greater physical risk to themselves compared to non-athletes due to the stress that they place on their bodies on a daily basis. Those most vulnerable are involved in appearance sports (i.e. gymnastics, swim, figure skating and dance), but eating disorders are also common in endurance sports (i.e. running or cycling) and sports that have weight classifications (i.e. wrestling). Many cases of eating disorders are not reported or handled in secret, due to the pressures on athletes to perform and encouragement of coaches for achievement.

Coaches, teammates and parents should be aware of the traditional physical warning signs of eating disorders, which if left untreated can have serious health risks, including cardiac failure. These consist of:

• Menstrual irregularities or amenorrhea
• Low blood pressure or dizziness
• Decreased stamina in performance
• Weight loss
• Bradycardia or heart arrythmias
• Fine hair on the body
• Swollen or puffy cheeks
• Frequent complaints of feeling cold
• Fatigue
• Hair loss

Parents whose children participate in athletics should make an effort to closely monitor their child for any warning signs of disordered eating. Consistent communication with the coach can help to ensure that the child is being appropriately monitored, and creating an open dialogue about any concerns will also allow the child to be accountable for their actions as they build their talents and strengths. If you notice that your child is becoming extremely competitive, exhibiting a severe preoccupation with their ability level or feeling pressure to perform, intervention may be necessary. Further, consult with your child’s physician to ensure that they are medically stable to perform.

5. Academic Achievement: Expectations New pressures to be accepted into college are creating added pressure for children starting in elementary school. Those tweens with already high expectations for themselves will establish perfectionistic standards that are near impossible to reach. Success of their peers will increase competitiveness, and despite any achievements, there is still some sense of inadequacy. Self- esteem is strongly tied to success, and any real or perceived “failure” produces guilt, shame and a sense of worthlessness. Those with any predisposition to eating issues will try and “control” their environment through food in effort to increase sense of power when feeling helpless in other areas.

Work with your children to attain balance between working hard and setting realistic, achievable goals for themselves. Place importance on having fun, and encourage them to take breaks from any pressures that they place on themselves. If you notice that their anxiety or perfectionism is affecting how they eat, begin a dialogue around how you can be helpful to prevent further issues from developing.

6. Plastic Surgery: With the influence of media sources on a daily basis, a strong emphasis is placed on children starting from birth. We are raised to believe that physical attractiveness and being thin is associated with success. With role models who endorse cosmetic enhancements, the probability that your tween may be curious about how to improve their appearance increases dramatically. The “teen toxing trend,” represents 12,000 procedures done for children 13-19 in 2008, up 2% from previous year. A total of 36,800 cosmetic surgery procedures were performed among teens in 2009, and breast implants or rhinoplasty is being given for sweet sixteen or high school graduation presents.

These procedures send messages to kids that happiness only comes from the outside, and if you are allowing your older children to have cosmetic procedures performed, chances are your tween will be asking for them soon too. Encourage your child to examine what emotions/experiences are driving their desire to change themselves, and you will likely reveal any areas that can be addressed to help enhance their self-esteem.

Hopefully, the information around these trends in food and body image issues with your tweens will allow you to become prepared for the more dangerous and risky influences that your children may be exposed to as teenagers. Setting the expectation that such issues will be addressed, and addressed early in a continued open dialogue enhances the relationship that you can have with your child, as well as sets the expectation that you will continue to be involved with them as they grow up and more independent. After all, establishing a strong, healthy sense of self is one of the most important gifts you can give to your child!

Apr 14, 2012

Males, Tweens and Disordered Eating Behaviors

Eating disorders are equal opportunity invaders. Current research shows that eating disorder hospitalizations for children younger than 12 increased by 119% between 1999-2006. The sharpest increase in treatment was seen in boys and minority youths. Even though 5-10% of those with diagnosable eating disorders are boys, it may in fact be higher due to underreporting rates and current diagnostic criteria (current criteria includes amenorrhea, or lack of menstrual cycle). Many more boys have “partial syndrome,” meaning they only exhibit some of the symptoms and behaviors of the disorder.

Ten years ago, there were virtually no magazines geared towards males, and now more than 20 can be easily found in your local grocery aisles. New media influences (including “six pack” abs, thin male models, body building or fitness competitions, diet advertising on platforms such as Facebook) are creating an environment where being physically fit is expected. A lot of this activity is occurring outside the home, out of parental watch, fueled by social pressures.

On school campuses, discussions of steroid use for muscle growth and enhancement are common. According to the National Institute on Drug Abuse, more than half a million 8th graders are using anabolic steroids, unaware of theassociated risks. Boys are encouraging each other to “work out hard” during practices and weight training at school, and there is a competition to see whom can lift the most. Male “weaklings” are ridiculed and ostracized in front of their peers, and most are desperate to avoid the embarrassment of being publicly humiliated. Still, this type of bullying behavior is usually dismissed by school officials as “guy talk.”

With the current obesity epidemic, pediatricians are becoming more weight sensitive to their patients. A simple suggestion to lose weight, can turn into a deadly quest to be thin, and these kids are not monitored closely enough. Because much of the research regarding boys is still in progress, and we are learning more about this underserved population each year. You should seek professional help if you notice and of the following in your tween: concerning changes on their growth chart, dieting behaviors, comments regarding their appearance, reports of being bullied at school about their size/shape, disappearing after meals or overexercising. The sooner you receive proper treatment, the more likely you are to combat and diffuse the disordered behaviors, and enhance recovery from this deadly illness.

Oct 3, 2011

Your Tween & Substance Abuse: What Every Parent Must Know

Substance abuse among tweens is sky-rocketing across the country. It’s not just media hype– experimentation with drugs and alcohol is no longer just for kids on the fringes and is regularly occurring earlier than most parents realize.

Unlike most parents’ middle school experiences, experimenting with substances in 7th or 8th grade is not uncommon. I work strictly with tweens and teens who share stories with me that their parents would never imagine to be real. In fact, many who begin to dabble with substance use in high school report that they feel they “started late” when compared to their peers.

What’s a parent to do?

First it is important to recognize the science. There is no argument that the human brain continues to develop well into the mid-20s. In fact, some report that the tween brain develops at a pace so rapid that the only more dramatic period of growth is during infancy.

Scientifically speaking it makes sense to take a hard-line on substance abuse, especially during the tween years. Studies are routinely showing that the longer a kid stays away from substance use (and the longer their brain can therefore develop without exposure to drugs or alcohol), the less likely they are to develop a substance addiction in their lifetime.

Second, stay on top of what is trending. For parents today, it requires a serious effort to stay informed about the drug scene. While alcohol and marijuana are still the most popular and drugs like ecstasy are quite prevalent, it’s also worth noting that tweens often abuse easy-to-find OTC cough suppressants such as Robotusin or Coricidin for quick highs. Others will raid their parents’ medical cabinet to experiment with prescription drugs such as Oxycontin, Xanax, Vicodin and ADHD drugs like Ritalin.

The emergence of “designer drugs ” which produce significant highs, are largely legal, and go undetected on drug tests are presenting a new sort of challenge for even the most diligent parents. Substances like synthetic marijuana (known commonly as Spice or K2), salvia (famously used by Miley Cyrus), and even bath salts are as easy to obtain as a pack of cigarettes in many states and are quite popular among the tween population.

Finally, try to understand why substance abuse is becoming more common during these formative tween years and discuss it with your kids. Sometimes it’s as simple as a tween modeling the behavior of their older siblings. The majority of tweens want to be perceived as mature and participating is their attempt to be cool. Many tweens are struggling socially. For some kids, becoming a partier gives them an immediate group to belong to. Other tweens are self-medicating for depression, anxiety and low self-esteem.

I cannot covey how many highly-invested, highly-educated parents I’ve worked with who had no clue that their tween was experimenting with drugs or alcohol until something serious occurred.

Here are some tips to help you navigate this slippery slope with your tween:

  • Drug test and breathalyze intermittently but regularly. If your kid knows you are testing, they will often think twice. This also allows your kid an easy excuse to say no when facing tough peer pressure from friends.
  • Take a zero tolerance stance. Tweens don’t typically practice anything in moderation. Think along the terms of red light or green light.
  • Do not tell your tween of your substance use history until they are through high school. Yes, it will be tempting to open up and share with a curious tween, but try to avoid it. While you may be stating, “Yes, but…” all your tween hears is, “Yes!” After all, you turned out okay so how bad could it be?
  • Monitor your tweens cell phone and Internet use. Tweens discuss their interest in substance use with their peers. This is a great way to catch issues either before it occurs or at least before it becomes a serious problem.
  • Have tangible and immediate consequences if you catch your tween experimenting. Yelling or lecturing at your tween is a meaningless annoyance to them. By calmly issuing the consequence for their choice and by following through on your discipline, you set a clear standard.
  • Keep your tween busy. Although you do not want to overload your kids, the more structure they have, the less down time they will have to experiment. After all, bored kids tend to find their way to trouble faster.
  • Know the key terms. Kids have created an alternate vocabulary for drugs and alcohol so that parents do not pick up on their discussions. Visit my websitewww.drjerryweichman.com to learn these terms or follow me on Twitter using the handle @drjerryweichman for additional ways you can help your child.
Oct 2, 2011

How to Nurture True Self Esteem in Your Tween

For several years now, critics of our educational system and parenting culture have been saying that at the same time the academic performance and morality of American youth plummet, these same children and adolescents carry an outsized opinion of themselves. The shorthand goes that they have too much self esteem. However, if you understand the definition and source of true self esteem, you’ll see that our kids are sorely lacking in the stuff.

First, let’s fix on a good definition. Authentic self esteem is based on the self respect that emanates from external reality. It does not come from internal fantasies fed by well intentioned parents showering their kids with unearned praise. Self-esteem and self-respect may appear to be synonyms, but as child psychiatrist Jack Westman points out in our new book The Complete Idiot’s Guide to Child & Adolescent Psychology, they are not. A child’s self-esteem, Dr. Westman explains, can be low or high based on a fantasy he holds about himself, whereas self-respect is based on reality. You can have high self-esteem, and still be a selfish, inconsiderate person.

Kids who have been “spoiled,” whose parents consistently tell them that they are smarter, more creative, athletically gifted, and all around superior to others, can have high self-esteem. But this form of self esteem crashes when they are frustrated or don’t get the sort of approval they have come to expect.

In contrast, self-respect is having a good evaluation or judgment of yourself and having that view validated by realistic accomplishments and experiences with other people. Self-respect gives rise to authentic high self-esteem. This internal feeling is based on external reality.

Because these two words have been conflated in general use, we’ll refer to self respect (as we’ve defined it here) as self esteem but please understand that we are referring to the authentic meaning of this over-used, misunderstood term.

Why Does Self Esteem Matter?

Authentic self-esteem in children is important for a child’s emotional, social, and-now the research makes clear-also for her intellectual development. Sources of self-esteem include the following:

  • A child’s innate temperament helps shape her self-esteem. Easy, friendly temperament children tend to develop more self-esteem than children with difficult, inhibited temperaments.
  • When parents are willing to discuss household rules and discipline with them, their children’s self-esteem rises. A child then internalizes the message that she is important enough for her opinions to be heard.
  • Parents’ consistent warmth, affection, and involvement with their children builds self-esteem. A hug sends the simple message: “You are important to me.”
  • Self-esteem also comes from the peer comparisons a child makes and approval or rejection she experiences from peers.
  • Self-esteem comes from a child’s emerging “belief system” which can be seen as an accumulation of all of the preceding.

The Problem for Tweens

It’s probably not a surprise to hear that the children most vulnerable to low self esteem are 9 to 12 year olds. When measured by psychological researchers, self-esteem is highest in preschool and lowest at the start of junior high school. In a study of 2,000 low- to middle-income children living in the greater Detroit area, 25 percent of this age group had negative self-esteem. Their negative views of themselves showed up on all three scales measured: academic competence, social acceptance, and global self-worth. On each scale, 5 to 10 percent more girls than boys displayed negative self-esteem.

Why is it so tough to be a tween? First they’re undermined by vast hormone-driven body and mind changes. They literally don’t feel like themselves anymore. To add to their emotional challenges, the transition from elementary to high school is when children fall from a secure social position to a new unfamiliar one, and find themselves at the “bottom of the pecking order.” It’s also the age when many are pulling away from their parents, not confiding all their thoughts and feelings, and not allowing as many kisses and hugs as they used to. Still, by understanding the source of true self esteem, and then helping guide their tweens to adopt attitudes and engage in activities that will give them cause to feel good about themselves, parents can help them navigate this difficult transition.

How to Give Praise

Authentic self-esteem in children does not come from adults offering unearned rewards or praise-simple, right? Apparently not, because in one national survey 85 percent of parents said they think it’s important to tell their kids-early and often-how smart they are.

The problem is this approach backfires. Kids as young as seven know when they’re hearing an untruth about themselves. For instance, if an adult tells a child how fabulously he just did at bat after he struck out, he’ll sense the adult’s false praise.

So what is effective praise? What works with children is the same as with adults. Praise works when it is:

  • Specific to an accomplishment
  • Sincere
  • Intermittent

A child can get addicted to false praise. The reward system of the brain will anticipate it and begin sending out dopamine when praise is received. Not receiving praise then becomes a problem for the child. The child who depends on unearned praise will not take risks and will care only about getting good grades. He is more likely to cheat on tests. In other words learning loses its intrinsic value; it’s all about performance and how good he looks to those whose praise he covets.

Meanwhile, the ability to sustain a task and accept a certain amount of frustration and failure is essential to learning and creating in school and in life. When a child is too afraid of failure and too dependent on false praise, she is at greater risk for failure. Praise should be given for sustained effort and rewards should come only with success, not a near miss. From these experiences a child will develop authentic self-esteem and a solid core of emotional resiliency-the all important ability to bounce back from failure or adversity.

Jun 17, 2011

Staying Connected to Your Preteen

Have you noticed your preteen spending more time away from you when just a few years ago they were asking you to stay longer at drop off? Now they are preoccupied with the dramas going on between friends, spending more time with each other on the computer, and telephone. (Texting of course; no one seems to talk much any more!)

While you might feel that your preteen is moving away from you, it is important to know that this is normal and a vital part of their development. Toddlers do this thing called ‘refueling’. They go back and forth, physically, from the parent. You can literally watch them move away, then come back for a hug or a sit on the lap, and then to turn back once again to the outside world after they have ‘refueled’ on comfort.

Your tween needs to ‘refuel’ as well. They need you to be able to adapt to their growing world and recognize that the ways to remain close to you are changing, but the need to do so remains the same. If you find new ways to connect, you will be able to help their growing sense of identity and strengthen their feelings of competence and mastery, all aspects of good self-esteem. At the same time, learning how to communicate and adjust to their changing needs will help you set the stage for the teenage years, when the time away from home increases, and the issues get trickier.

Active Listening

Staying connected requires ‘tuning in’ and ‘active listening’. By being aware of what your preteen is going through, you will know how to ask the right questions, or offer them comfort so that they can build confidence in themselves. Following are some tips to improve that skill:

  • Observe your child’s face or listen to their tone of voice. If it is very upsetting to you when you see your child upset or anxious, try to calm yourself down and trust that they will be okay. It is your job to let them know that you are there to listen, while remembering that it is okay for your preteen to manage their unpleasant feelings. They need to know that you have confidence that they can handle powerful emotions. This is a big part of soothing and will help them remain open to speaking up about what is upsetting them without worrying that you can’t handle it or will need to ‘fix’ it.
  • If they aren’t speaking, but you can see that they seem upset, you can say, “You look a bit down; what’s up?” Take a moment to observe their reaction. If they don’t seem to want to talk, but aren’t going off to be alone, you can ask them to help you with a task. Offer an activity where they can feel close to you without feeling like they have to talk. By doing this, you “hear” that your preteen wants comfort, but needs to work out their feelings on their own first. After some time, they may be more open to talking about what is going on, when their feelings are less hot.
  • Ask open-ended questions instead of questions that end in a “yes” or “no”: “What was recess like today compared to last week?” What did you guys do?”
  • We often feel that we have to “teach” our kids things. Try to listen without being judgmental. Our kids need to feel that we are their allies and understand their position. Validate their responses. You can always help them problem solve later.
  • Mirroring and identifying with how your preteen feels is an important part of active listening. By repeating back what your child says, you can gain a better understanding of the problem that your preteen is trying solve and help them clarify their feelings. It often helps to start your sentences with, “It sounds like you feel…”

Golden Moments

As we get less ‘face time’ with our kids, the challenge becomes to adapt and find new moments to connect. Here are some tips on seizing these ‘golden moments’:

  • If you are the one who picks your preteen up from school, observe their face. At pickup time you will get a lot of information by simply observing their expression, tone of voice, and how they interact with their teacher and friends.
  • When you take your preteen and their friends to activities be a “fly on the wall.” Listen to the chatter. Pay attention to your child’s behavior and how they act around different friends. You will get a lot of information about how they experience different people. Do they change? Do they tend to be assertive at home, but deferential to certain friends? This is a stage where it is common for girls in particular to become less self-assured as they worry about being ‘left out’ or hurting other people’s feelings.
  • Mealtime is key. Even though many families can’t eat together until the weekend, try to find at least two times during the week when you can get home early enough to enjoy dinner with your kids. Rules about meals should include no television and no cell phones, adults included. Use this time as an opportunity to unwind, share a laugh, and talk about the days’ events. You will be amazed at how much comes out and how this can keep you ‘in the loop’!
  • You may no longer be reading a book to your child at bedtime, but you can still spend that time together, each enjoying your own books. The bonus of a foot or backrub are ways to offer comfort and connection without talking.

Finding new opportunities to connect with your preteen and giving them space to work out their problems says that you respect and trust their growing ability to figure out their own issues while allowing you to be there if they need you. The ‘back and forth’ of “refueling” may look different from when they were toddlers, but their need for connection and comfort, remains the same.