Tuesday, March 3, 2015

Tough Stuff Tuesdays: Of Special Concern

Sometimes I wonder if the mothers of June Cleaver's day held themselves as heavily responsible for their children's psychological development as we do today. We have a better understanding of the workings of the brain than we did when I earned my psychology degree nine years ago, but many questions remain. Children are being diagnosed with learning disabilities and autism spectrum disorders at an alarming rate, and the question is, why? Is the frequency of these disorders actually increasing or is the advancement of diagnostic tools allowing such disorders to be recognized more easily? I would like to think it's the latter. Of course, the question that every parent wants answered is why? When exactly do these subtle differences in brain development occur and what is the cause? Most of the time these questions cannot be thoroughly answered, although theories abound.

We know that much of what controls the brain is neurochemical and far beyond our control. The more difficult inquiry is the role of environment. It is almost impossible to tease out exact casual environmental influences on behavior, learning, and social emotional development. I fear that unproven and often times lay person theories only serve to point a finger, which is rarely if ever helpful. As if having a child with special needs is not confusing and challenging enough, parents must be bombarded with information and opinions. Unlike with physical illness, a stigma still exists when we talk about mental health or developmental disorders. Arming themselves with information, parents wonder, was it the vaccines? Was it too much TV? Was it because I chose to go back to work? Was it because I was always home? Did I play with him too much or too little? Was it the Tylenol I took while pregnant? I am not a scientist, but I think it is safe to say that any one of these isolated issues will not cause brain development to derail. All we really know is that some combination of nerobiological processes and environmental triggers influence the manifestation of a disorder. Clear as mud, right? And frustrating for a parent . Don't we all want to know why? Yet the more important question is how? How can we help our children, how can we be advocates, and where do we go from here?

As parents we hold ourselves responsible for our children's development, mistakenly believing that we have complete control. This topic is becoming a personal one for me. My five year old son suffers from anxiety, mostly separation anxiety. While I can drop his two year old brother off in the church nursery without even getting a goodbye, my five year old still complains of stomach aches every morning and resists going in to school. He has improved a lot in a half day kindergarten program, and yet his progress is not where I had hoped it would be by almost the end of the school year. We are also beginning to notice some sensory sensitivities to noise, crowded places, and smells. While he makes friends easily, is able to complete all of his work, and has no social anxiety, he still resists going to school. It is always painful to see regression in your child. He thrived in preschool and I thought the separation anxiety was all but over. He began kindergarten and he was fine for the first week. The curriculum was half day until after Labor Day, and then full days began. My son was very overwhelmed by the long days and the noisy crowded lunchroom where kindergarten through fourth grade all ate together. Every day he cried and kids began to tease him. Being younger than many of the kids by almost a full year didn't help. His teacher, the school principal, and the social worker all assured me in a rather patronizing manner that he was fine and "kids do this". Five weeks in and none of the other kids were doing it.

We moved him to a school that offered half day kindergarten and it has been a much better fit, although he still has difficulty separating. He ruminates a lot and he misses preschool. He doesn't like to be without us. His intellectual maturity far surpasses his emotional maturity. The start of formal education is supposed to be an exciting and bittersweet time for parents and children, but we have yet to taste the sweet. I want my children to gain independence, to need me less as they get older, and to face life with confidence. One of the big questions I ask myself is: are we dealing with a phase or something more? The other question I ask myself is: was it something I did or didn't do? Depression and anxiety run in my family, but I have never been anxious with my children. I encourage them to explore, to run and play and learn new things.But maybe I played with him too much, not giving him time to be left to his own devices. Maybe I didn't push him enough. And the million dollar question: where did this come from?

Where do we go from here? Due to his summer birthday and emotional maturity, we have decided that  he will repeat kindergarten and start first grade at the age of seven. Even at that, is he ready for a full school day? The traditional  treatment for anxiety is operant conditioning, or exposure. In theory, repeated exposure to stimulus over time lessens the response. The cry it out method of sleep training runs on this same principal. Left to his own devices, the crying child will eventually learn he is fine and go to sleep, right? Yet newer and less entrenched theories of attachment parenting advocated by doctors such as William Sears suggest that pushing a child to "toughen up" and separate before he or she is emotionally ready may actually be detrimental. In this school of thought the key is to allow the child to develop a secure attachment to the primary caregiver by meeting all of the child's needs for nuturing and comfort, thus giving him or her the confidence needed to separate. We as adults and as a society have pretty firm opinions about when children should be ready to separate. Kindergarten used to be the bridge between preschool and formal education, whereas now it is a full school day. This is not necessarily a bad thing, but I can't help but wonder, what's the rush? Not all children are developmentally ready for a full school day at the age of five. Parents are encouraged to push kids to separate early and often, but is it really wrong for a five year old to still need extra attention and security? My son has no social anxiety or difficulty learning. Still, I wonder if we will see more regression when he faces a full school day.

The only alternative is to home school him for a year and really work on not only academics but also confidence. I know what you are thinking. How can I teach him independence and confidence by keeping him with me? Wouldn't I just be "giving in" to him, allowing avoidance? Maybe. It certainly seems counter-intuitive. On the other hand, I know my child and I know that pushing him to be where he should be before he is really truly ready tends to backfire. Maybe a year of homeschooling would be a chance to start over, a chance to really work with him so he can restart his school experience with a clean slate. He has it in his head now that school = bad. So far exposure hasn't changed that. Maybe giving him what he needs now will allow him to enter first grade with the normal jitters but also confidence and excitement. I know this sounds like nonsense; like an over bearing mother perpetuating her child's problems. Maybe. I don't have all the answers and on paper I admit it sounds like a terrible idea. Yet I just can't shake this intuitive feeling that it may be exactly what he needs. We have some big decisions to make in a short time. The old saying is that it takes a village to raise a child. Really it takes a strong nuclear family. It takes confidence and advocacy. It takes considering all sources and opinions and in the end doing the best you can with what you have. When your child faces special challenges, typical milestones such as starting school are not so simple. You feel the weight of each decision you must make for another person's future. I wish I had crystal ball. Parenting does not come with a crystal ball, training sessions, or manuals. Parenting throws us curve balls. We have to look at each child as an individual and determine the best path based on the information we have. It is a heavy responsibility. I hope that we can navigate our way over this bump in the road and help our son face his school experience with confidence. The only question left is how? Stay tuned...

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