I can play in the tent
I can play with these balls
But to have you play with me
Is what I want most of all!
I can play in the tent
I can play with these balls
But to have you play with me
Is what I want most of all!
There needs to be an extra chair now at the table, another place setting, extra fork. The bath requires extra towels. Reading choices necessitate an added pause. There are lively conversations from the bedroom, laughter, whispered dialogue, deep monologues. A seat to save in rides, a window-or-middle deliberation. Opinions of a first-line advisor, a determined intermediate, a confidante.
Granted, he is secretive, selective, and exclusive. It doesn’t mean he isn’t a good friend.
Accepting him is fact, not question. Get used to it. He’s there. He may not show up to explain, but he will not be ignored or shunned. Be nice. He has deep feelings. He has needs. A keen mind.
Should not matter that he is a dragon-human made of magic. Invisible to all but a certain little one.
For The Daily Post
Tamina attended first-grade in a Harlem public school. She was homeless most of that year. Her mother lost the apartment after she lost her job. Sometimes they stayed with relatives but mostly Tamina, her mother and her sister slept in shelters where they could never stay very long. They carried their belongings in thick black garbage bags, protection from the weather. Tamina used to have a teddy bear, but it got left in a shelter and her mother was ‘too tired’ to go back for it. Tamina never got it back.
Tamina had very little. Other children had a home, their own bed, place for their stuff, more stuff. So she stole. Mostly small things: erasers, crayons, hair-pins. Things she could hide in her pockets and later in her black garbage bag. If confronted, Tamina would furiously demand it “was always hers.” I suspected she often believed it and wondered if some items resembled things she once had and owning them was a link to a time when life was less overwhelming. Beyond an overall language delay, Tamina seemed confused about concepts like the difference between possessing and owning: in some shelters cots were ‘first-come-first-serve’ and while you had it, it was ‘yours’ even if it did not remain so for long. You had to ‘watch’ your stuff or have it disappear. Why could an unattended eraser not be ‘hers’?
While children often crave things that are not theirs, Tamina’s stealing was possibly about unmet needs. Her mother was “always mad and cussing” and Tamina could not rely on her for support. Children whose ‘hungers’ are neglected seek other ways: become secretive, dissociate, numb themselves with substances, steal, hoard. These behaviors often further distance them from care and social support, when they in fact communicate confusion, loneliness, anger, loss, and shame.
[The above is an excerpt from “Communicating Trauma” Routledge, 2015]
Homelessness does not necessarily mean neglect, but the realities and causes of homelessness pose many risks, especially to children. In addition to loss and grief, there are increased health and safety risks, along with reduced access to care. Children without homes suffer insecurity, and their caregivers may be too overwhelmed to attend to their emotional needs. Depression, posttraumatic stress, illness, disability, poverty, domestic violence and other life-crises are all too common among parents of homeless children. Any one of these factors can overwhelm a parent and reduce their availability, let alone when such factors combine.
Having no place to call home–in all the forms it takes–can be distressing and occupying. It leaves children anxious and unavailable for learning. Homeless children are often wary and worried, angry or withdrawn. They are three times as likely to require special-education, four times as likely to drop out of school, and almost nine times as likely to repeat grades.
Homelessness devastates. It is crucial we work together to understand it and resolve it as well as support families in crisis and address risk factors before they reach a loss of home, hearth, and heart.
“For children who depend on mentally escaping into their minds to survive, imagination can become both refuge and desert island.”
(Na’ama Yehuda, Communicating Trauma, p. 148)
There are over 1,000,000 substantiated reports of child maltreatment annually in the US alone (US Department of Health 2013). The impact of maltreatment on development and health is indisputable. The last two decades showed brisk research in the area of trauma and dissociation all over the world. It is therefore quite surprising to find psychology textbooks to be so behind the times (and behind the data) on covering child maltreatment. This leaves hundreds of thousands of students a year with less-than-accurate information that may impact their ability to identify or understand the aftermath of child maltreatment.
In an important article (also see full link below), Brand and McEwen review the three leading introductory psychology textbooks and how they address (or not address) childhood maltreatment and its aftermath. The results are distressing in lack of citing of current data (as in many textbooks on psychopathology).
One can hypothesize why prominent textbooks will not sufficiently cover such an important topic (one would think they would find it essential to cover well if only for the known health effects of childhood maltreatment across the lifespan, in both physical and psychological health, costs, and healthcare utilization). Maybe it is as simple as using outdated resources or not keeping up with research and known data. Maybe it speaks to more widespread issues of denial and minimization of childhood maltreatment. Maybe other reasons. Regardless of why the textbooks are lacking, the reality remains that the textbooks leave students un-informed on the topic.
The good news is that this can be changed! The data is available–it just needs to be included and reviewed better!
Hopefully having more awareness to this will allow students and faculty to challenge the choice of textbooks and to demand better coverage of such a relevant issue. Students are shortchanged when they are under-informed and when data is slanted or may appear to be biased or outdated.
What can you do?
Let your faculty, librarian, and fellow clinicians and students know that our college students deserve a more cohesive review of childhood maltreatment. Share the article below. Talk to professors who teach these courses and support them in seeking better balanced textbooks. The research is available, it simply needs to be included rather than avoided. Let us work together for improving information in education!
In her great blog Adele and the Penguin, Adele Ryan McDowell posts about all manner of lovelies (well worth peeking in!). Her recent post is about sensitivity, about those of us who may be labeled “too sensitive” or “highly sensitive people.”
Reading it made me think–and not for the first time (Adele’s blog posts do that–they touch the everyday in novel and eye-opening and heart-opening ways).
The highly-sensitive people thing? Yep. I can totally relate …
So can many of my little clients.
Personally I don’t see being sensitive as a bad thing. Like any quality, I think the ability itself is neutral. It is how we react to it, what we do with it, how it affects our lives, and whether it adds or detracts from the person we are and can become, that is the most important aspect of it to me.
There seems to be more good than bad in sensitivity. Creative people are often sensitive. Artists, writers, thinkers, inventors. I certainly see more positive than negative in the more sensitive children who come to see me. They perceive the world minutely, they read people amazingly well (even if they don’t always know how to verbalize it), they feel deeply.
They are also, all too often, overwhelmed. There is too much, everything, everywhere, from everyone. In reaction, they snail in, lash out, fidget, shut down, alternate being acutely perceptive and deeply numbed out. They can have spectacular tantrums, meltdowns for seemingly nonsensical slights, go from happy to weepy in a blink of an eye. They get all kinds of acronym diagnoses, sometimes rightfully, often not … They can walk through the days feeling raw, exposed, vulnerable, tender, empathetic, perceptive, disorganized and evocative.
Emotional regulation is a must for all children to learn. Without ability to do so and find a place of calm attention–they will struggle at school, in public, in getting along. All caregivers of children are tasked with the teaching and modeling of emotional regulation to the children in their lives. It is even more crucial for highly-sensitive children … who can tax even the most patient caregiver. The sensitive children need more help, much more help, to learn to regulate, to know when they need to take a break, to recognize the beginning of overwhelm and be able to apply a tool for grounding.
They need more time. To play. To rest. To think. To cuddle. To get bored. To dream. To get used to new things. To gather their courage to try. It is a luxury of time all too many of them do not get these days, in our modern world that does not make it easy to be sensitive.
Our world–and within it the education system and children’s schedules–is currently calibrated for very low sensitivity: there is information everywhere and increased pace galore. Blinking screens, beeping car horns and phone messages, jingles of all manners, multi-sensory bombardment, loud, fast, multitasking everywhere. There is stimulation all the time. Every. Where.
Wake up and rush to school, bend over homework in the car to complete what didn’t get done the night before because there was a birthday party and soccer practice. After a long day at school in a class of 30 and no recess or playground because it rained and a two hour assembly in a noisy auditorium followed by lunch in an equally ruckus lunchroom, grab your bag and gobble down dinner on the way from dance to chess before you go home and try to do homework with the TV in the background, someone angry with tech-support on the phone, the vacuum and the dishwasher rumbling along. Get a math problem wrong and dissolve in tears onto a kicking puddle of misery on the floor. It is not the math problem. It is the everything and that little bump of difficulty simply toppled tolerance. Everyday stuff mushrooming to a thunderstorm.
Sometimes I think that sensitive people may be better calibrated for slower life … for long walks from place to place, bigger nature around them, more connection with animals (and their highly regulating energies), more connection to the earth and its calming breath.
It is not how most children grow up anymore, and it is not about going back to lack of modernity (there’s much to be said for running water, electricity, and even the Internet …). However, it is about helping children–especially sensitive children–learn how to stop, pause, breathe, step away, maintain boundaries.
All children need that. Sensitive children need it even more. Their drama-streak, their tantrums, their meltdowns, their whining, begging, shutting-down are all their ways of communicating to us that they need our help to manage. That they are feeling raw and need a hug, a pause, a hand.
What to do?
First what not to do … It is not about ‘helping them grow thick skin’ or expecting them to ‘suck it up’ or ‘toughen up.’ Shame has yet to heal any sensitivity. Expecting one to be what they are not will not resolve anything other than create a distance and thicker pain, not skin.
What does work?
Try to keep things simple. Establish routines and try to maintain them reasonably consistent (we’re not talking OCD here, just predictability). Make time for quiet. At the very least relegate a certain space in the house that is off-screens: a place to read, do homework, dream. Be aware of competition–of stimuli, that is–if there is much background noise you cannot control, consider noise-canceling earphones for the child to wear when they need to concentrate. Keep it comfortable: temperature and clothing, yes, but also tone of voice and your own emotional regulation. Sensitive kids pick up on your state of mind and internalize it. It filters in. It gets under their skin. They are too young to manage your adult feelings for you … and they already have plenty of their own. Keep it soothing: quiet cuddling, snuggling together with a book or a few precious moments at the end of day, offer comfort when they are distraught. Let them know you see them, hear them, feel for their discomfort. It is real.
Sensitivity is like a fragile gift. It is precious, it is beautiful, it can light up the room and make for excellent potential. It is also delicate and needs some special care. It calls for careful holding in times of transition. It needs a very safe space, for sure.
Have no worries, if you treat your child’s sensitivity (and yours, if you need to) with care and … yes, sensitivity … you will not spoil them. To the contrary, you will teach them how to control and modulate their hyper-acute-perceptions. They will learn from your attuned care how to keep aware without drowning in information, how to keep empathetic without taking on other people’s needs, how to keep their senses vibrating brilliantly without becoming blinded or overwrought. They will learn from you to take time to breathe, to pause, to consider. They will recognize their own cues and clues and find ways to respond to them healthily.
They will blossom like the rare delicate beings that they are. Come fully wonderfully into their own. Sensitivity seen, understood, utilized, known.
An acquaintance once stunned me and a colleague when she noted she believes that, “babies are basically a lump of meat just lying there until they are 10 months old.”
After I collected my jaw from the floor, I went on a long winded explanation (okay, tirade …) about all the things that we know and that prove infants are anything but lumps of meat until they reach 10 months old. In fact, they are active learners and interactively relating beings from the very moment they are born. Babies are so visibly actively engaged that I recall my absolute incredulity at the very notion that anyone can think them “lumps of meat just lying there.”
Well, they are not “just lying there,” not one iota so. Don’t know how the notion got into this acquaintance’s head, but she was wrong.
This fabulous Ted Talk is a great (and I admit far less tirade-like) way of explaining some of how they are very much the opposite. It is well-worth listening to. In it Alison Gopnik describes some things you may not think babies can do, as well as how they might be doing them.
Oh, and don’t miss the adorable ‘little scientist thinker’ video embedded in her talk. He defines “cute”!
Today, I marvel at the universality
At the way deep care connects us all.
And should. And can.
How it forms us.
How it spells the words of heart upon a child’s new soul.
How it breathes hope into desperation.
How it nourishes across languages and color, tradition, race, religion, state, connecting all.
How it writes upon the slate of birth
How it shapes resilience to withstand strife and sorrow.
How it holds through thick and thin, through calm and turmoil.
Today, I marvel at the universality,
At the miracle.
So utterly expected
So innately ordained
So perfectly humane
Yet so often bent by apathy, oblivion, ignorance, senseless hate, violence, disdain.
The very shock we feel at its absence
In itself speaks volumes
Of Love’s natural flow.
Its ingrained, spirit-sustaining need.
The bounty of fortitude and growth that it can seed.
I marvel at the awesome
Universality of love.
I’ve received a query from a parent: “I heard reading to children is good for them. Is it true that it helps language development? How early should I start reading to my baby and how long should I go on reading to her?–Parenting Neophyte…”
It is a good question and one I get often and love getting. It is always worthy of an answer.
Dear Parenting Neophyte,
The facts are clear: Reading to kids is great. Introducing children to books is important for language development, listening skills, later literacy, and general cognitive potential. Stories expand vocabulary, increase imagination, teach social skills, improve narrative. Reading to your children is good parenting and a good investment in their education and future.
As to how early one is supposed to start reading to children and how long one goes on doing that–the simple answer is: “as early as possible and for as long as kids would let you …”
The more detailed reply is that even newborns find interest in clear patterns and drawings, in contrasting colors, in faces (especially in faces), and pictures of familiar objects. They listen. They pay attention. They track. They make connections between sounds and experience. Unfold an accordion book when the baby is playing on the mat. In the stroller. In the playpen. Give them a soft-book to hold in the stroller or to reach for when they loll on the floor during some ‘tummy time’ (check for lead-free paints and non-toxic materials, of course–babies put everything in their mouth!). Certainly introduce picture books as part of every night routine. Talk about the pictures with your infant, point to familiar animals and items. It is not about testing how much they understand or what words they can say or point to. Rather, it is about having reading books become a link in the nightly ritual of cuddling and comfort, connection, familiarity, language, narrative, and stories.
Babies who are read to often gravitate toward books as playing objects, they leaf through, turn pages, pause, look, and ponder, even as they mouth the corners and tear out what they manage to … (all great motor and visual spatial skills, by the way). They also learn to point, to wait, and to associate pictures with words and sounds. They learn to anticipate the next picture, to predict what’s to come. They learn to trust their memory. They rarely tire of adoring the confirmation of seeing the same picture appear as it did the day prior.
For sure, the repetition can be tedious (you’ll know what I mean when your toddler asks for the same book in the two-thousandth time, and wants to read it “again” and “again” and “more time!”), but it is part of children’s normal development during infancy and toddlerhood to like things repeat. So take a deep breath and even as you introduce new books once in a while, and expand the child’s repertoire of stories, do cave in and read “goodnight moon” one more time …
As for the question of “how long to keep reading to children?” The answer truly is to do so for as long as possible. Many professionals recommend reading to children straight through middle school, and certainly throughout the elementary school years.
It tends to surprise parents when I recommend that. Very often they tell me that they’d stopped reading to the child when he or she learned how to read independently–sometimes during the first or second grade. They thought that the move to independent reading marked the end of “needing to be read to” and in fact often had reading time revert into the time of day when the child read to them … It was almost a rite of passage. A mark of moving into the reading world.
Granted, there’s still plenty of bonding potential in cuddling with your child and witnessing their reading progress. It certainly feels good to the parent to measure their child’s progress … and to a child to know their efforts are appreciated. However, being read to is a very different task than reading aloud as decoding practice. The two have very different goals and encompass very different language levels. The books children read are often matched with their decoding ability, rather than their language level. Also, even in later elementary grades, when reading skills allow children to decode most common words, books are chosen with the child’s comprehension level in mind, not necessarily their exposure to higher linguistic material.
Reading TO children is a whole other world of learning opportunity. It is primarily a listening task and allows the child to relax into the story and delve into language while losing oneself in it. Being read to opens space for a child to draw inferences about connections, context clues, idioms, character descriptions, sequence, cause and effect. It is a time for a child to consider possible outcomes, predict to himself what might happen next, check a hypothesis, internalize some of the story characters, discern who they like and who they don’t, who they may want to be, where, how, why. It opens an opportunity for discussion that is very different than the ‘reading comprehension testing’ that happens with school books or those the child reads independently. The books you read to your child become fodder for conversation and self-discovery: what did they like about the book? what did you? why did so and so do this or that? would you so the same? what is your favorite character? which is mine? how come?
Children who are read to through 8th grade, have larger vocabularies than children who are good readers but are not being read to (and we are talking vocabularies that are larger by tens of thousands of words–not just by a small margin!). As a group, they have better listening skills, better auditory processing and auditory memory skills. They have better narrative skills. They use a more varied lexicon in their own writing. They have bigger cache of idioms and expressions that they can infer meaning about. They can converse better and show wider world-knowledge.
Children who are read to tend to enjoy books better than kids who are not read to. They tend to love reading more. They choose a wider variety of books and have a wider foundation in classical literature (read: the books you read to them may not be books they’d otherwise pick up to read themselves … but having listened to them, they may get the ‘book bug’ to look for more classic literature on their own). Want another bonus? Reading to children improves connection with parents and allows children to feel comfortable talking to their parents more, and about more topics (not to mention that stories often bring up issues that they may otherwise not talk about …)
In some families, reading to each other continues as part of family time well into high-school, with teenagers taking turn in reading aloud. Sure, it may seem odd to consider teens today being gung ho about spending an hour “reading boring books aloud” and being commanded to have their thumbs idle (no music, no chat, no texting). However, for families who started early this is often a natural continuation. In families starting a little later (and it is never too late, actually), the benefits are real even if they are grudgingly (or perhaps never verbally) acknowledged. Having your undivided attention is a precious commodity (yes, you have to put down that phone, too …). Knowing you are listening is priceless. It opens yours even as you raise your child to have a more open mind.
Reading to your children builds your relationship with them while also building their relationship with themselves, their inner worlds, the world around them, and their academic and cognitive abilities. It is truly a ‘one size fits all’ intervention. There are no downsides, other than extra cuddle time, honest conversations, and the distinct possibility of difficult questions about life that literature inevitably brings up.
The only warning necessary is … that reading to your child can damage their ignorance …
It was an urgent message.
“I have a little boy. He just turned three, and he suddenly can’t talk!” The mother’s voice was pressed with worry. She forgot to leave a callback number and the number on my caller ID showed as “Private Number.”
She called again the next day and I happened to pick up. I knew immediately that it was the same person who’d left the message–the urgency in the voice was palpable. She was flustered when she realized she did not leave a phone number–she’d been waiting for me to call back all of the day before, late into the evening. My heart ached for her. It does not take much to worry a parent, and a major change in any child’s behavior is alarming.
“He’s always been a little talker, you see,” she said after I asked her to tell me a bit more about what the problem was. “He started talking really early, actually,” pride filtered into the concern, a hint of smile of remembering. “Said his first words even before he was one, and he was putting sentences together before his second birthday. We used to laugh, my husband and I, about how he never shuts up …” her voice caught. “But now he can barely talk! He tries, but it is like nothing’s coming out!” Her own voice rose in worry.
“Can he sing?” I asked.
“What?” My question surprised her. It was intended to, in some way, though I had other reasons for asking it. I didn’t want to describe the boy’s speech for her, didn’t want to put words in her mouth, but I did want to get some information about possible clinical presentation.
“Can he sing?” I repeated gently.
“Yea … actually …” her voice turned pensive, surprised, a little confused. “He sings really well. He’s not stuck at all when he’s singing! He loves singing … It is when he’s trying to tell me something that he gets stuck. He gets all red in the face from trying and I don’t know what to do to help him. He’s repeating the same sounds ‘mm….mm’ or ‘I I I I’ and can’t get a word out. It takes forever for him to say something.”
We spoke a bit more. Apparently this started the week before, though there were days in the week or two before that when when he would “stop” on a word, or repeat the beginning of a sentence a few times before “diving into it.” This first born little boy had no history of medical issues, there were no major changes in the house or in his life recently, no illness, falls, medications, ear infections. His articulation was stated to be “super clear” and his language was reportedly rich. He could tell stories and speak in sentences and “knew a ton of words.” He was a happy toddler and other than the occasional tantrum had an overall jolly disposition, which this ‘inability to talk’ did not mar. For all his red-faced stress, the mother admitted that she did not think that he was all that bothered by it and “just stood there and stayed stuck…” It was her who was alarmed, and her husband. “My husband has a co-worker who is a stutterer,” she said quietly, as if divulging a shameful secret. She did not need to add what she was fearing, what her husband feared–that their little boy was going to become that co-worker. A Stutterer.
I agreed to see the little guy for an observation and parent consultation, but had no opening till the week following. In the meanwhile I suggested to the mother to just let him be and not draw too much attention to his speech (including refraining from telling him to “start again” or “say it slowly” or “breath deeply”…). I recommended they continue reading to him, regular routines, and listen to him (even if it takes him a long time to get a sentence out) while maintaining interest and without making a big deal out of the dysfluency. I recommended lots of songs and music–for fun, but also because they can give a sense of fluency and reinforce a feeling of success and ease for the boy. We chuckled over how she’d just have to live with listening to the dude’s favorite playlist a few thousand more times…
She called me two days before our scheduled appointment.
“He’s fine!” she called into my machine. “It’s like he never got stuck at all! I don’t know what happened but he just woke up yesterday and he’s not getting stuck! I thought he was doing better but I thought that I was just hoping … but he’s just … talking up a storm! Do we still need to come?”
We decided to defer the consultation, and to have her call me if need be at a later date. I explained that this might have been an episode of “Developmental Dysfluency” or “Developmental Stuttering” and that these sometimes recur, and if so, she can call me immediately, or watch and see what happens for a week or so before she does that. Whichever she prefers.
Developmental Dysfluency (AKA Developmental Stuttering) affects many children. In fact, 75-90% of children between the ages of 3-5 have times of dysfluency in one form or another and the vast majority of them do not continue to stutter. Sometimes dysfluency happens once. Sometimes it recurs. While dramatic, most times it is nothing to worry about. That said, if it recurs, if it continues for a long time, if the child seems upset by it, avoids speaking, seems embarrassed, etc., if there’s family history of stuttering, and if it causes stress and worry in the family; then an evaluation and follow up by a speech-language-pathologist are very important.
Stuttering can become a life-long issue, and it can impact people’s communication. Early intervention helps and can sometimes prevent stuttering from becoming complicated. It is also important to ensure that the speech issues are not related to problems with motor-planning, retrieval, processing, or other issues that need clinical help.
In this little guy’s case, his dysfluency recurred a few months later, and I got to meet him. His mother also brought a videotape of his interactions at home (including the cutest singing in the tub!) and took him to an ENT and had a hearing test done at my request. The boy’s language indeed was superb, and he showed no issues with motor-planning, social communication, or articulation. There were no issues of concern about his development or abilities. He was not bothered at the least by getting “stuck”, and commented to me, unperturbed, “sometimes my mouth gets a traffic jam.” His mother was not so alarmed this time around. The second dysfluency episode passed a few weeks afterwards, and did not return.
There are some theories about what causes dysfluency/stuttering in toddlers and young children. Many echo this little guy’s theory, and state that it is a ‘traffic jam’ of sort–a temporary mismatch between language skills that are improving and sentences that are getting longer and more complex; and motor skills that are not yet up to the challenge–literally too many instructions coming down the pipe for the coordination the child has at present to execute in timely manner.
Stuttering may have a genetic component, but that does not mean that having someone who stutters in the family dooms children in the family to same. Not everyone who is predisposed to stuttering does stutter, and whether one continues to stutter following dysfluency episodes depends on many factors. These include the child’s personality, and ability to regulate frustration, their other communicative and developmental strengths and weaknesses, their age when the stuttering begins, how easily frustrated they become, their life circumstances (e.g. trauma increases the risk), whether there are other speech and language issues, and the reactions of people around them (e.g. if people get worried, the child may become aware that something is ‘wrong with them’ and feel embarrassed or nervous or worse, ashamed), to name a few. The latter reason, especially, is why it is so important for those around the child to get support about how to react, what to do, and especially what NOT to do or say. It is always better to do what this mom did, and reach out to a professional for a consult, than try to ‘fix this’ on your own.
Treatment for stuttering is available, and can be very successful, especially in children (the more years one stuttered, the harder it can be to treat, though even adults can improve and sometimes overcome stuttering after years of difficulty). There are different approaches and methods to the treatment of stuttering, as well as different possible underlying issues that cause it in the individual person. So one size does not fit all–not one method works for everyone–and it is important to look for a clinician who will assess, consider, and match the treatment that is most appropriate to a particular person and be flexible to adjust it as need be.
I got a call from the little guy’s mom not too long ago. He’s starting Kindergarten and is into drama classes and theater. “He still sings in the bath,” she told me, “and sometimes I think that he does not shut up from the moment his eyes open to when they close at night …”
For more information about stuttering, click here.
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