What You Say To Your Child & How You Say It Are Important

What you say to your child is important.
Here are some tips to assure that what you say won’t damage your child

Sticks and stones will break my bones,
But names will never hurt me.

Many of us who are now parents understand that this children’s rhyme does not provide true comfort, and that the words of playmates DID hurt us.

Words can hurt children, and the damage inflicted on a child by the thoughtless remarks of a parent or other adult can torment a child–for their lifetime.

In fact, emotional abuse, though it is often ignored, can be far more devastating than the physical abuse that so often captures media headlines.

The emotional abuse of harsh words, spoken thoughtlessly, can lead a child feeling berated, belittled, demoralized. The impact this has on a child’s emotional development is insidious. A child’s spirit can be destroyed, and they may lose any positive sense of self. Emotional abuse destroy’s a child’s ability to feel loveable, to love himself or herself, and has a negative effect on a child’s ability to care for and get along with others. Emotional abuse increases self-destructive and antisocial behavior. Emotional abuse has been linked to eating disorders, promiscuity and suicide.

None of us is perfect, and many of us can recall a time when we’ve lost our self-control, and said something hurtful and demoralizing to our children, over something minor. We might say things like: “You clumsy idiot! You can’t do anything right!”

When words like these are repeated often enough, the child’s sense of self-esteem plummets and he or she begins to agree with his parents’ assessment of him: he or she really is dumb, a jerk, an idiot, a moron. The child begins to learn that love is not without conditions. And since it seems impossible to meet his or her parent’s expectations, the child becomes satisfied with settling for the “loser” role.

In too many homes today, the lights are on but no one is there. People are home but not home. Inattentive and verbally abusive parents are producing children who seem normal but are not what they should be, what they could have been.

There are studies that demonstrate that this abusive, humiliating and demeaning parenting behavior is transmitted from generation to generation, meaning that adults who had abusive parents tend to parent their own children the same way. This pattern will continue until a parent is willing to change their behaviors, change the dynamics, and find a way to interact differently with their own children. They must be willing to see and acknowledge that they are saying and doing to their children.

To change this pattern, treatment often requires treating the parent and the child, helping the parent feel respected and empowered, and allowing them to change the ways they respond to their child.
The problem of verbal abuse is REAL, and COMMON, but difficult to document, and, therefore, difficult to intervene to prevent. Certain stressors can increase the problem of verbal abuse, job loss, marital problems, financial concerns. Often, adults attempt to cope with these stressors using alcohol and other drugs, but this tends to make matters worse. Parents then lose their inhibitions, and may say terrible things to their children that they later regret.

How can you be sure your words build up rather than destroy your children?

  • Guard your vocabulary. There are some words that people in a family should never say to each other. Words like stupid, dummy, jerk, idiot, worthless and freak have no place between parents and their children.
  • Avoid absolute statements such as “You never . . . ” Or “You always . . . ” Have a sense of good manners with your family. This doesn’t mean that you must avoid all conflict or that you can’t set limits.
  • Separate the child’s actions from the child. Instead of responding to a tantrum with a barrage of abusive language, let him know that you love him — but not his actions, which are unacceptable.
  • When things happen that can set off an explosion, take time out. Wait. And then wait some more. When you hold your tongue until the heat of the moment has passed, it’s a lot easier to respond with love rather than anger.
  • Be available. Be willing to stop and peek in on your child’s world. He or she will feel more valuable because of it. Don’t start interrogating the minute the child walks in the door.
  • Wait until you’re relaxed and instead of probing about his day, why not share your day? Instead of accusing, compliment. Instead of insisting, be silent.
  • Active listening refers to a kind of listening and a response that does not judge, ridicule or order. And the more we listen without judging, the more we help our children to accept their feelings, we improve their problem-solving ability and increase their willingness to listen to us.
  • Teach by example. Let your kids hear you acknowledge your mistakes. Risk being humble. Dare to say, “I’m sorry” to your children when appropriate. Apologizing reveals that the truth is larger than your ego and their feelings are more important than your pride.

If you can accept yourself in spite of your limitations, all the while working to be the best you can be, you’ve gone a long way to help your kids value themselves.

Based on the work of Jean Guarino, free-lance writer.

Talking to Your Child About Sex

Talking to your children about love, intimacy, and sex is an important part of parenting. Many parents feel uncomfortable talking about sex with their children, and so the discussion is avoided, or gets postponed.  Each year about one million teenage girls become pregnant in the United States and three million teens get a sexually transmitted disease.  Children and adolescents need input and guidance from parents to help them make healthy and appropriate decisions regarding their sexual behavior since they can be confused and overstimulated by what they see and hear. Information about sex obtained by children from media sources can often be inaccurate and/or inappropriate.

Experts generally recommend that beginning to have a dialogue about reproduction should begin at age 8. However, preparing to have this conversation can start much earlier, by communicating openly with our children from the beginning, and helping them come to understand their  bodies as healthy, beautiful things that provide them with the resources to experience the world in cognitive, emotional, and physical (sensory) ways. We talk with our children about how wonderful it is to hear beautiful music, to see the pretty seasonal decorations, to feel the soft fur of a puppy or kitten. Most parents have no trouble talking to a toddler about their bodies, and we start to label things for them. “point to your nose.” “where is your mouth?” “close your eyes”.  In these same ways, we need to help them understand the rest of their body in age appropriate ways. This includes being able to name their “private” body parts with real terminology, in a way that we as adults can be comfortable with.

As children start to express an interest in the toilet, we start to talk to them about urinating and defecating. Often these are body processes that can be uncomfortable for parents to talk about, but the more we work on making ourselves comfortable with talking about these things, the better we will do for our children. Finally, though we allow our toddlers to run through the house naked, and to touch their bodies without much concern, we start to talk with them about privacy. The best way to talk with our children at this age is not to begin to teach them that their bodies are something to be embarrassed about, but to talk about how their bodies are very special things, and that they should care for them by choosing the right foods and maintaining appropriate activity levels, caring for our skin with appropriate hygieine,  and  enjoying the parts of our body that can provide personal and private pleasure when we are in private places.

At this young age, we can prepare a foundation for children that their bodies are special things to be cared for, or dirty things to be shameful about.  For example, I often hear from women that they were publicly embarrassed or ashamed by their parents’ public reprimands for touching themselves. I have heard from women who’ve been told to go wash their hands after their parents became distressed when they saw the girls touching themselves.  Many of these women have continued to be ashamed of their bodies, have avoided getting to know their own bodies through masturbation, and have had difficulty with sexual intimacy.

Our own feelings, beliefs, values, and experiences with our bodies and with sexuality can have a profound impact on whether and how we communicate with our children about these topics. I often encounter parents who are so uncomfortable with the subject, or with their own bodies, or who have such substantial sexual issues that they are simply not prepared to have discussions with their children about sex.  If a parent can work through their own concerns related to sex and sexuality, the discussions that they have with their children about sex can be enjoyable and natural – and can build a powerful and deep emotional bond between you and your child that facilitates other kinds of communication and trust.

We will also prepare our children to understand sex within the context of healthy relationships, if we talk to them and model for them the healthy aspects of human relationships, including loyalty, love and commitment. We can share stories about how our families showed their love for one another. We can share,  in an age appropriate way, a little bit about the ways that we have been hurt by disloyalty. We can remind them that one of the most important things in a family is to know that family members love one another, no matter how difficult life’s challenges can be.

Maria Montessori was a psychiatrist who helped to develop the first daycare centers, and who, along with her contemporaries, such as Anna Freud,  identified childhood and adolescence as distinct times in the development of emotions and cognition, and promoted the understanding that children were not simply adult minds in child bodies.  She taught that we should “follow the child”. And this is certainly the right approach to talking about sex with our children. Children have different levels of curiosity and understanding, depending upon their age and level of maturity.  When talking with children about sex, we must offer no more and no less information than the child is asking for, or that the child will be capable of understanding. As children grow older, they will often request more details about sex.  It is important to encourage children to talk about their bodies, and sex, and to feel free to ask questions without the fear of shame or criticism.

Many children have their own words for body parts.  It is important to find out words they know and are comfortable with to make talking with them easier.  It is also important to understand your child’s level of knowledge and understanding. Maintaining your own sense of humor, sharing your own values and concerns openly, and acknowledging your own discomfort will facilitate open communication and trust. Talking about sex is just one of many times that we can talk with our children about the responsibilities that come with making certain choices and decisions. We can talk with them about the value of delaying gratification, and to talk about sex as being related to love, intimacy, and mutuality, as well as respect for oneself and one’s partner.

  • A 5-year-old may only need a simple answer, such as that babies come from a seed that grows in a special place inside the mother. After the father’s seed combines with the mother’s seed, the baby starts to grow.
  • At age 8a child may wonder how the parents’ seeds combine.  It may be helpful to explain that the father’s seed (or sperm) comes from his penis and combines with the mother’s seed (or egg) in her uterus.  The baby then grows in the safety of its mother’s uterus for until it is strong enough to be born, usually 9 months.

As children grow older, they will want to know more details. It remains important to talk about the relationship between sex and intimacy, love, and respect for oneself and one’s partner.  Talking about sex with our children provides them with an awareness of the beautiful power and positive commitment that can come when a sexual relationship is healthy and right.

  • An 11-year-old may want to know even more and parents can help by talking about how a man and woman fall in love and then may decide to have sex.
  • Adolescents are able to talk about lovemaking and sex in terms of dating and relationships, and may need guidance in dealing with the intensity of their own sexual feelings, confusion regarding their sexual identity, and sexual behavior in a relationship.  Concerns regarding masturbation, menstruation, contraception, pregnancy, and sexually transmitted diseases are common.  Some adolescents also struggle with conflicts around family, religious or cultural values.

Open communication and accurate information from parents increases the chance that teens will postpone sex and will use appropriate methods of birth control once they begin. Ongoing dialogue about the responsibilities and consequences of our decisions is important throughout a child’s development, and as a child becomes a teenager, it is important to speak specifically about the responsibilities and consequences that are related to sexual activity, including pregnancy, sexually transmitted disease, and powerful emotional feelings.

To Summarize:

  1. Prepare the groundwork for discussions about sex by talking with children about their bodies in ways that help them appreciate what their body can do for them and how important it is to take care of it.
  2. Be aware of your own sexual issues, and if they will impede your ability to communicate openly with your child about sex, seek your own therapeutic support to work through those issues and prepare to speak with your child.
  3. When talking with children about sex, we must offer no more and no less information than the child is asking for, or that the child will be capable of understanding.
  4. Create an atmosphere that is not judgmental or critical, and using words that are understandable and reasonably comfortable for the child.
  5. Discuss and model the values of loyalty, love, and commitment, and present sex as a component of a nurturing, loving, and intimate, healthy relationship.
  6. Continue to be available and responsive to your children’s questions as they continue to mature and develop.
  7. Talk with them about things they may be hearing or seeing in the media, and from their friends, about sex and sexual relationships.
  8. Some parents may choose to have a book available to use for the discussions.Two popular options include:
  • Where Did I Come From? by Peter Mayle.
  • An alternative is How Babies Are Made by Andrew Audrey and Stephen Schep. Both of these are candid and clear and have a nice tone of importance balanced with “lightness” so the subject doesn’t seem oppressive.

Parents Medication Guide

If you are the parent or guardian of a child or teen-ager with attention-deficit/hyperactivity disorder (ADHD) or clinical depression, a physician seeking more information, or as a patient yourself, you may be aware of the recent decision by the Food and Drug Administration (FDA) to attach a cautionary label, or “black box warning,” to medications used to treat ADHD, depression, and other disorders in children and adolescents.

The American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry have developed two medication guides designed to help patients, families, and physicians make informed decisions about obtaining and administering the most appropriate care for a child with ADHD or depression.The guides have been endorsed by many national medical, family and patient advocacy organizations, listed below.

ParentsMedGuide for ADHD

ParentsMedGuide for Depression

PhysiciansMedGuide for Depression

The information contained in these guides is not intended as, and is not, a substitute for professional medical advice. All decisions about clinical care should be made in consultation with a child’s treating physician.

No pharmaceutical funding was used in the preparation these guides.

Flexible Parenting Reduces Depression and Anxiety in Kids

A study published in  The Journal of Abnormal Child Psychology has proven what attuned parents already know: “what works for one child doesn’t work for another”.

While parenting advice often focuses on the need for structure and consistency, research suggests that a parent’s ability to be flexible is far more important in raising a well-adjusted child.

Children whose parents are attuned to the child’s temperament–or personality–and tailor their parenting according to the child’s needs are half as likely to develop symptoms of depression and anxiety compared to children whose parents do not take their children’s temperaments into account.

For example, when it comes to deciding how much independence or autonomy a child should have, the child’s disposition should guide the parenting decision. Some youth may flounder if given ever increasing amounts of independence, while others may rise to the challenge.

Researchers tracked 214 families whose children were in the third to fifth grades, with an average age of 9 for 3 years. ,They visited the families monthly, and instructed parents and children to have two conversations: the first a neutral chat about their day and the second a dicier discussion about a challenging topic — chores, for example, or homework.

Researchers assessed the interactions based on factors including the warmth and engagement of the parent, negative affect — being harsh or critical toward the child — and to what extent a parent granted a child autonomy or took the lead in the conversation. They also asked parents and children to describe the children’s temperament.

Each year, researchers gauged children’s symptoms of depression and anxiety. When all the information was combined, they found that certain temperaments combined with specific parenting approaches made kids more — or less — likely to develop anxiety and depression.

  • Most significantly, children who displayed more effortful control — the ability to self-regulate, focus and stay on task — had greater symptoms of anxiety and depression if their mothers were more authoritarian or controlling.  The study’s principal investigator, Lilliana Lenguna, explains that children who are capable of making healthy decisions and are not trusted to do so, do experience this as a lack of trust in their judgment and abilities.
  • Conversely,  children with less effortful control displayed less anxiety when their mothers provided guidance and structure, and their anxiety symptoms doubled if their mothers were more laissez-faire (left the kids to make their own decisions). Again, Lenguna explains, that while a parent’s goal should be to help their children navigate life’s challenges independently, children who have more trouble with self-management and self regulation need more structure and guidance to get there.  Parents might need to respond by defining a situation more clearly, offering more instruction and possible solutions, and rewarding their child for cooperation and success.
  • Children with low levels of fear whose parents related to them gently had the lowest levels of depression.
  • Low-fear kids whose parents interacted harshly with them had the highest levels of depression.
  • Surprisingly,  fearful kids with parents who tended to be more critical also had low levels of depression.  Lenguna is able to explain this in a way that makes sense. With fearful children, it is important to balance validating their emotions without over-supporting their worries and fears  (such that parents validate and strengthen those fears).
  • Not suprisingly, among kids who are prone to irritability and frustration, researchers found that parental anger and criticism led to an increased likelihood of depression and anxiety. This supports what is probably intuitive to most parents: If a child tends to be irritable and frustrated, it is important for the parents to manage their own negative emotions to reduce their children’s risk for anxiety.

CITATION:

Temperament Variation in Sensitivity to Parenting: Predicting Changes in Depression and Anxiety

Cara J. Kiff, Liliana J. Lengua and Nicole R. Bush

Journal of Abnormal Child Psychology, Vol 39 August 2011

Does My Child Need a Psychiatrist?

Parents are usually the first to recognize that their child has a problem with emotions or behavior. Still, the decision to seek professional help can be difficult and painful for a parent. The first step is to gently try to talk to the child. An honest open talk about feelings can often help. Parents may choose to consult with the child’s physicians, teachers, members of the clergy, or other adults who know the child well. These steps may resolve the problems for the child and family.

Following are a few signs which may indicate that a child and adolescent psychiatric evaluation will be useful.

YOUNGER CHILDREN

  • Marked fall in school performance
  • Poor grades in school despite trying very hard
  • Severe worry or anxiety, as shown by regular refusal to go to school, go to sleep or take part in activities that are normal for the child’s age
  • Frequent physical complaints
  • Hyperactivity; fidgeting; constant movement beyond regular playing with or without difficulty paying attention
  • Persistent nightmares
  • Persistent disobedience or aggression (longer than 6 months) and provocative opposition to authority figures
  • Frequent, unexplainable temper tantrums
  • Treats to harm or kill oneself

PRE-ADOLESCENTS AND ADOLESCENTS

  • Marked decline in school performance
  • Inability to cope with problems and daily activities
  • Marked changes in sleeping and/or eating habits
  • Extreme difficulties in concentrating that get in the way at school or at home
  • Sexual acting out
  • Depression shown by sustained, prolonged negative mood and attitude, often accompanied by poor appetite, difficulty sleeping or thoughts of death
  • Severe mood swings
  • Strong worries or anxieties that get in the way of daily life, such as at school or socializing
  • Repeated use of alcohol and/or drugs
  • Intense fear of becoming obese with no relationship to actual body weight, excessive dieting, throwing up or using laxatives to loose weight
  • Persistent nightmares
  • Threats of self-harm or harm to others
  • Self-injury or self destructive behavior
  • Frequent outbursts of anger, aggression
  • Repeated threats to run away
  • Aggressive or non-aggressive consistent violation of rights of others; opposition to authority, truancy, thefts, or vandalism
  • Strange thoughts, beliefs, feelings, or unusual behaviors

If problems persist over an extended period of time or if others involved in the child’s life are concerned, consider a consultation with a child and adolescent psychiatrist or a trained mental health professional.

You may wish to complete the pediatric symptom checklist for your child. Scoring:

never=0

Sometimes=1

Always=2.

scores greater than 24 suggest you should consult a clinician if your child is 4-5 years old

Scores greater than 28 suggest you should consult a clinician if your child is 6-16 years old

Coping When Your Child Comes Out as Gay, Lesbian, Bisexual, or Transgendered

How to respond to your child if they come out as gay,lesbian, transgendered, or bisexual:

Having a child come out is essentially the same as any other parenting challenge. Parenting requires that parents be adaptive. Parenting goes best when you are  attuned to your child, and respond to THEIR needs. Parents must let go of the expectations that they have for their children, that are based on what the parents want for their children. Remember that your child is still your child. He or she is not a different person. He or she just shared something with you that was very personal. This means that you have, up to this point, kept the lines of communication open. Your child is talking to you. About sexuality! Even if your child is no longer living at home, ask questions, and show your child that you’re interested in a loving way: ‘Are you dating anyone?’ ‘I hope you’re practicing safe sex.’ ‘I hope that you’re in relationships that are respectful and loving and supportive.’ ”

  • Be sure your child knows you love him or her.A parent’s first response should be to remind their child that you are there for them, and love them, and support them. “I love you, you’re my kid,”
  • Reaffirm your values. If you do not feel that teens should have sex with other teens, this is still your value, and you should still guide your child as their parent.
  • If you have made anti-gay statements, it is time to be a good model. Acknowledge that you have a prejudice. Discuss the need to treat all humans with respect and dignity. Discuss the need for tolerance.
  • Remember that children will also have questions. They have not lived in the world as a sexual being, and will benefit from a parents’ willingness to talk openly and to ask questions.
  • Adolescents worry about being accepted–whether it is because they are not good at or interested in sports and this is something their parents value, if it is because they are not good students, and this is something their parents value, or whether it is because they are homosexual, children need to be reassured that they will be loved by their parents.
  • Re-examine your assumptions. A parent of a child who’s just come out may think may worry that they may never have grandchildren, for example, and this is not necessarily true.
  • Get support. One of the best resources is Parents, Friends, and Families of Lesbians and Gays: http://community.pflag.org/Page.aspx?pid=194&srcid=-2
  • Protect your child. Because of the social stigma that homosexuality still carries, the risk of suicide in Lesbian, Gay, Bisexual and Transgendered youth  is much higher. Parents can  help by doing the same things they would do if their child was straight. Have a connection with them, find them support, make sure they are able to feel safe and loved in their home.

If you believe that homosexuality is fundamentally wrong, then remember these other values:

  • Hatred  is not a value, and your child is still your child.
  • Treat others as you wish to be treated.
  • Seek the support of a trusted mentor or support group. Find out how other parents have managed to cope with their child’s sexuality when it conflicts with their beliefs.
  • Remember that your child has done things in the past that you disapproved of, and you still loved them. As a parent, it is your responsibility to let them know that though you disapprove of homsexuality, you still love your child.
  • There is nothing that you need to DO about this. You will need some time to process the shock. Many parents are surprised to learn that their children are homosexual–because it is simply not as common as having a child who is heterosexual.

Attachment Parenting and Discipline

I am a proponent of Attachment Parenting. Here is an excerpt from the website http://attachmentparenting.org

The goal with attachment parenting is  to raise children who will become adults with a highly developed capacity for empathy and connection. It eliminates violence as a means for raising children, and ultimately helps to prevent violence in society as a whole.

The essence of Attachment Parenting is about forming and nurturing strong connections between parents and their children. Attachment Parenting challenges us as parents to treat our children with kindness, respect and dignity, and to model in our interactions with them the way we’d like them to interact with others.

Attachment Parenting isn’t new. In many ways, it is a return to the instinctual behaviors of our ancestors. In the last sixty years, the behaviors of attachment have been studied extensively by psychology and child development researchers, and more recently, by researchers studying the brain.

Children Learn What They Live: (Dorothy L Nolte said this best):

  • If children live with encouragement, they learn to be confident
  • If children live with praise, they learn to appreciate
  • If children live with approval, they learn to like themselves
  • If children live with acceptance, they learn to find love in the world
  • If children live with recognition, they learn to have a goal
  • If children live with sharing, they learn to be generous
  • If children live with honesty and fairness, they learn what truth and justice are
  • If children live with security, they learn to have faith in themselves and those around them
  • If children live with friendliness, they learn that the world is a nice place in which to live.

If you agree with these principles, then read on–there are some solid and positive ways to incorporate attachment parenting into (positively) disciplining your children.

The Dangers of Traditional Discipline

  • Instilling fear in children serves no purpose and creates feelings of shame and humiliation. Fear has been shown to lead to an increased risk of future antisocial behavior including crime and substance abuse
  • Studies show that spanking and other physical discipline techniques can create ongoing behavioral and emotional problems
  • Harsh, physical discipline teaches children that violence is the only way to solve problems
  • Controlling or manipulative discipline compromises the trust between parent and child, and harms the attachment bond
  • It is a sign of strength and personal growth for a parent to examine his or her own childhood experiences and how they may negatively impact their parenting, and to seek help if they are unable to practice positive discipline

A Gentler Approach to Discipline

  • The bonds of attachment and trust that are formed when parents consistently and compassionately respond to an infant’s needs become the foundation of discipline
  • Positive Discipline involves using such techniques as prevention, distraction, and substitution to gently guide children away from harm
  • Help your child explore safely, seeing the world through his eyes and empathizing as he experiences the natural consequences of his actions
  • Try to understand what need a child’s behavior is communicating. Children often communicate their feelings through their behavior
  • Resolve problems together in a way that leaves everyone’s dignity intact
  • Understand developmentally appropriate behavior, and tailor loving guidance to the needs and temperaments of your child
  • Children learn by example so it’s important to strive to model positive actions and relationships within a family and in interactions with others
  • When parents react in a way that creates tension, anger or hurt feelings, they can repair any damage to the parent-child relationship by taking time to reconnect and apologize later

Tools for Positive Discipline

Again, this is excerpted from http://www.attachmentparenting.org/principles/disc.php

Please look at the API website to learn more about Attachment parenting at all stages of development.

  • Maintain a positive relationship
  • Use empathy and respect
  • Research positive discipline
  • Understand the unmet need
  • Work out a solution together
  • Be proactive
  • Understand the child’s developmental abilities
  • Create a “yes” environment
  • Discipline through play
  • Change things up
  • State facts rather than making demands
  • Avoid labeling
  • Make requests in the affirmative
  • Allow natural consequences
  • Use care when offering praise
  • Use time-in rather than time-out
  • Use time-in as a parent, too
  • Talk to a child before intervening
  • Don’t force apologies
  • Comfort the hurt child first
  • Offer choices
  • Be sensitive to strong emotions
  • Consider carefully before imposing the parent’s will
  • Use logical consequences sparingly and with compassion
  • Use incentives creatively with older children

ADHD?! But my child can watch TV for hours!

Sometimes I think ADHD should be called “Interest-based Attention”

Many parents will tell me that their child can attend to television, video games, or other enjoyable activities four hours on end.

  • This does not mean their child does not have ADHD. Children with ADHD can focus when the activity is something they enjoy.
  • It doesn’t take as much “mental energy” to focus on something that is interesting to us.
  • This is also why some children do better in classes with teachers that they “like”.

Need for more frequent feedback and reward:

  • Parents will also tell me that their child is lazy, or choosing not to do their homework or classwork, because when an adult sits with them, they are capable of completing the work.
  • They may also observe that their child can persevere at a video game but not to other things. 
  • Most children with ADHD require more immediate feedback and reward that other children to maintain their attention and their behaviors.
  • A 1:1 setting provides more structure, and more frequent and immediate feedback and reward.

Video games provide almost constant feedback and reward.

This need for frequent feedback and reward has important implications for parenting and teaching; remember to provide regular, frequent feedback–and praise!

For more information, contact www.CHADD.org