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Child Psychiatrist Urges Parents To Become "Experts" On Their Children

(with photos)

BY MICHELE HOGAN

Stanley Turecki, MD, promoted a benevolent and practical view on "problem

children" to the 100 or so parents who attended the Parent University at the

Newtown Middle School last Saturday morning.

Dr Turecki opened his talk by telling parents and community members that

today, being an educated parent means having a certain degree of confusion and

anxiety. There are so many conflicting theories of child development, some

based on genetics, others on environmental factors of development, that it is

hard to know what view to trust.

Instead of trusting any theories of "one approach fits all," Dr Turecki

recommended that parents focus on the individual characteristics of their

child, and become an expert on their child -- become an expert parent.

He reminded the mothers and fathers in the audience that being an expert

parent does not mean being a perfect parent.

But it does mean knowing your child and respecting his individuality.

He noted that, among the affluent parents who come to his office, "there's no

such thing as an average child." Parents describe their children in one of

three categories. Either they are "gifted, potentially gifted or learning

disabled." The audience laughed.

If they are LD, parents want medication and a special resource room to help

their child. If they are potentially gifted, you provide a tutor. Gifted kids

will get extra challenge.

He paused, then asked, "When should you go for optimal performance for your

children? Should your child be treated? What for? Treated for an illness?

Treated for optimal performance?"

Dr Turecki said, "Kids sometimes come into my office run ragged -- bags of

books, going to tutors, programs." He said that if you are constantly trying

to change someone, how can they not feel they are fundamentally no good?"

He said we need to "know the strengths and talents of our children and their

vulnerabilities. Then minimize what you do about it."

He said "if you have an intellectual child, who likes reading and imagining,

you go with that. You find a scholastic environment that will nurture and

encourage his strengths." He said that you don't have to sign him up for

sports because you think he needs it; let him use his strengths first.

No Friends

What about the child who has no friends? Dr Turecki said that he is often

asked about this. He said his first question is "Has this child always been

somewhat solitary?" He said that if the answer is, "Yes, he's never had more

than one or two close friends," then don't worry. It is the nature of the

child.

He said that a recent appointee to the Supreme Court, Justice Souter, is an

example of someone who is "primarily alone, happy in the world of the

intellect." Preferring solitude is not a problem to be corrected. It is a

characteristic of some people and it needs to be respected.

Dr Turecki did caution however, that if a child was gregarious from early

childhood, but then later withdrew from friends, then "we need to make some

determination."

He said, "Look at the normal self of the child -- the person she is -- the

more deviation from her normal self, the more need for concern."

ADD, ADHD

Certain characteristics, such as having a high activity level and also being

highly distractible, make some children more difficult than others. If a child

cannot sit still and pay attention to the teacher, he is often diagnosed "ADD

(Attention Deficit Disorder) or ADHD (Attention Deficit Hyperactive Disorder).

Then the disorder is treated.

Dr Turecki questioned the long-standing practice in psychiatry of categorizing

children by abnormalities. He said, "There is a spectrum for each child. And

where that cut off point is, is not scientifically determined. It is highly

open to subjective interpretation." He described how the same child in the

same circumstances might be categorized as having "no capacity to sit still"

by one teacher and as "often moves around," by another.

He said this determination is affected by the teacher's personality,

experience, if he/she is a parent, what she had for breakfast, and if she is

experiencing PMS [pre-menstrual syndrome] at the moment." The audience

laughed.

Dr Turecki said that the drug, Ritalin, is one way to deal with high

distractibility. He said that Ritalin makes anybody, whether identified as ADD

or not, focus their attention in a more linear fashion. Because of this some

parents and children might want the child to use it at certain times. He said,

"You can be a good parent if you do, and a good parent if you don't." He said

it's a philosophical and theoretical decision.

Dr Turecki described a child that was in a second grade class of 22 boys and 8

girls, including four other challenging children. He described the teacher as

rigid. Dr Turecki said that "the child met every ADHD criteria, with criteria

to spare. He needed medication."

But the mom was "a live wire" and found a private school with only 15 children

and a teacher with an assistant. By October of the next year, the child was in

third grade and was still "a hard to handle kid, but by no matter of means did

he meet the criteria. He did not need medication."

The child's fit with his environment had changed for the better. Dr Turecki

was quick to let parents know that characteristics that get defined as

problems in one area of life can become assets in another.

He said he has "never seen a successful commodity trader who was not an ex-ADD

child. A high activity level is essential...[To be good on the floor] you need

to be quick and decisive and to be impulsive to a degree. You need to react.

You cannot sit back and think too long. And a distractible person can notice

hundreds of stimuli going on on the floor and use that information

productively."

Another child, when he was seven years old, needed Ritalin to focus better at

school. He was a "spacey kid." As a senior, he only used Ritalin in class if

the subject was boring to him.

But when studying theoretical mathematics he never took Ritalin. He was junior

state champion of Georgia in theoretical mathematics. Dr Turecki said that "if

he took Ritalin he was too linear in his thinking, and he couldn't see new

connections. He couldn't go wandering around in his mind."

What do you do if you have a hyperactive child at Thanksgiving? Dr Turecki

said that with all the stimulation and activity, he'll ruin it for everyone.

So take Ritalin at Thanksgiving. "Why should the child go through a day of

suffering, and the family too?" he asked. "It is a child I am trying to help,

not a disorder I am treating." Dr Turecki said that Ritalin can be taken for

events because it is a short-acting drug.

Dr Turecki said that the questions "What is the disorder, and what is the

treatment?" ... " cannot apply to the subtlety and richness of a human being.

Who is this child? Is she suffering? Are they impaired? How do we help them

adapt better to their environment?" These are the questions that should be

asked.

Picky Child

What do you do about the incredibly picky dresser, the child who will only

wear a particular outfit that is a bizarre combination of colors, and made of

soft velour? And what if the child insists on wearing it everyday?

Here Dr Turecki looked at the adaptations of parenting. One mother who is a

good person, loving, formal, and cares about what other people think will make

every effort to make this child wear more acceptable clothing. Battles over

clothing would lead to constant conflict and a vicious cycle resulting in an

unfulfilling relationship between mother and child.

Alternately, a mother who was of the "Woodstock generation" would see being

anti-establishment as a good thing. She would be secretly proud of child's

individual expression in clothes. She'd buy five identical outfits. There

would be a good fit between child and mother, and no problem.

The first mother, according to Dr Turecki, should adapt some of her

expectations and accept the characteristics of her child.

Dr Turecki was quick to point out that there is a difference between "actively

accepting a child" and accepting bad manners in a child.

For example, a high energy child can ask to be excused from the table anytime

he feels fidgety. He can go outside and get his exercise, then return to the

table. He said "But he will not be allowed to indicate he needs to leave the

table by slugging his younger brother!"

A Shy Child

For the withdrawn child, Dr Turecki said that mothers often push a shy child

into playing with other children, then the child resists and the problem

worsens. Another approach, that is much more effective is to give the child

all the time he needs to watch when entering a group. Going to a party, the

mother can stay for a while and "make a secure base." Dr Turecki pointed out

that the mother is tacitly showing the child "I will honor who you are as a

person."

Limit setting is a good idea. The mother will stay, but the child "cannot

behave like a rash on my body."

He reassured parents not to worry if they have made mistakes. "Mistakes are

not irretrievable. Children are not going to be scarred -- although they will

be scarred by abuse, physical or sexual as it affects the child at a deep

level. But, he said, the kind of mistakes most of us will make, are not going

to affect the child.

Negative Pattern

If a child has a problem in one area, such as at home, yet gets along well in

other areas, such as at school, then the problem is a negative behavioral

pattern at home that has developed over time.

Dr Turecki told the group of parents, "If you say `I am always punishing him,'

you are on the wrong track.

"If you say `How many times have I told you!' you are on the wrong track.

Parents must change, because the kids won't unless the parents do first."

He said that if something is not working, "Step back and look at the situation

overall." He urged parents to take into account who their child is, then ask,

"What is going on here?"

He suggests that parents sit down and ask the child to describe how they see

the problem. If the child chronically avoids homework the child may say the

reason is because "I hate it." The parent then, resisting the

"how-to-get-into-Harvard lecture" asks the child why they hate it.

Maybe the child will say they get too much homework, or they get hungry, or

they just want to come home and relax, and, "You're always on top of me."

Whatever the answer, the parent accepts the answer as a lead to finding a

solution. The parent remains in authority and uses the child's suggestions to

arrive at a new structure, a new plan.

Maybe the child can start homework after dinner, or in a different place. Dr

Turecki said that just as the negative pattern took time to establish, a more

positive one needs time to take effect too. He recommends trying a new system

ten consecutive times. If it works two out of ten times, "you have done well."

He said that parents need to remind themselves that basically children are

"decent little people who want to get along with their parents."

A good parent leader reflects on a problem. Then they work with the child to

come up with a new structure that with rewrite an old negative script into a

more fulfilling one.

What if you did this all wrong until now? Dr Turecki said,"The brain is not

fixed in the first three years. Children bounce back."

Delinquency

During the question-and-answer period, a law enforcement officer asked about

delinquency in children. Dr Turecki said that although it is difficult to

determine, there are three predictors: a combination of continual bed wetting,

fire setting, and cruelty to animals.

He also said that if a child's bad behavior is in one setting only, it is far

less worrying than if it occurs in multiple settings.

A parent asked about a strongly emotional child who, at age five and a half,

gets extremely frustrated very easily. If the parent tries to set a limit, the

child might scream or hit herself hard on the head. The child expresses all

her emotions fully, but the screaming, crying and hitting is not done at

school. Dr Turecki said, "You have a performing artist in the making, a

dramatic child. Give her acting lessons. She'll show a talent for it." The

audience laughed.

Again he recommended that the parent sit down with the child and ask her what

would make it easier for her to control her emotional responses at home. The

child has shown one adaptation, running up to her room to be alone. He

recommended that the parent encourage this adaptation, as it fits better in

the home than screaming or hitting herself.

Dr Turecki lectures widely and has also written two books, The Difficult Child

and Normal Children Have Problems Too .

After hearing Dr Turecki, parents attended small workshop sessions with local

child care experts.

This was the second annual Parent University sponsored by the Newtown

Prevention Council and Danbury Hospital.