Are we making our children sick?

I think that this in a way follows on from some of the previous posts. It seems that all the pushing and shoving done by well meaning parents is having the reverse effect. We all see the anxious students as part of our class and lives, and in for the majority we don't really give it much thought until the problem surfaces. In essences schools and parents tend to be in a constant game of catch-up as we handle the effects. Perhaps its time to look a little more closely at the root cause if we are really serious about the problem.

An interesting article in a recent New York Times Sunday review caught my eye. Vicki Abeles used an eye catching headline "Is the Drive for Success Making Our Children Sick?" to grab my attention. I have linked the article here. The case presented amazed and shocked me that we, as a society, could allow this to occur. She cites a study by Stuart Slavin, a paediatrician and professor at the Saint Louis University School of Medicine that uses data gathered from a Californian school. The study found that "54 percent of students showed moderate to severe symptoms of depression. More alarming, 80 percent suffered moderate to severe symptoms of anxiety." The really alarming comment made by Slavin, is that this value could be underestimated and that if this one school provides a realistic view of the nation, then real mental health problems will exist in the future.

It really seems that the problems is getting larger and the problems are now starting to surface earlier. Parents see the push to have a tick box list of activities and actions that need to be completed to get their child into the "best university or college". Students are under constant pressure from homework, service and co-curricula activities and all these other commitments that are part of their daily lives. Sleep deprivation and anxiety seem a natural part of their day instead of the rare occurrence due to a bout of procrastination. The statement by Lawrence Rosen that the push is now in early elementary is a real indictment of the levels to which our society has sunk. The cornerstone of most early childhood education principles and programs world-wide is "play based learning". I wonder how we can even try to justify the lip service that appears to be given this considering the endless hours of tutoring and coaching children go through? Many of the children I see, have their days fully planned out for them from an early age. It has also made it seem almost mandatory to adopt the tutor-based culture that is so rampant in certain cultures. I have even heard parents comment about whether they should enrol their children in tutor programs because all other children in the class were engaged in them and they didn't want to be the only ones not doing it! The voice of the herd over the voice of common sense. Tutoring was once the province of remediation and now it appears to be the province of fashion or fad. Where once it was hidden, now it is proudly announced to the world.

Its quite amazing when you consider the response of some European countries to this trend. Children start school and learn by play, it is not until the child is ready that formal education actually begins. Yet we have children as young as 3-4 spending time at tutoring getting themselves ready to be able to tick the box. At some kindergartens in Hong Kong, academics studies have already taken over! A great pity considering that we are robbing the students of their childhood. The Hong Kong Early Childhood Documents though fully advocate a play based program, but it appears that societal expectations have overridden the document and the will of educators.

This is surely the domain of the parents, to ensure that our young children are not exposed to levels of anxiety. However, in their defence they are only "playing the game" that is begun and perpetuated by out tertiary institutions - but I must say that I find that a pretty feeble defence when you think of your own child's well-being. It is a given that the college process must be changed, but parents must take their share of the responsibility as well. They wonder why their child is experiencing anxiety attacks and behaving differently, wanting to attack or treat the symptoms rather than look for the cause.

While I acknowledge the studies that were done in America, but in all honesty would they be too different if conducted here in Hong Kong or for that matter in any other developed society. I know that the parental expectations here are high and the push towards (perceived) success are also present, so it could easily be a global issue. The side-effect of this whole process is the increased medication of our youth and pre-teens. Is that really the legacy we want to leave?

Parenting problems or being in control

I find that the interesting thing about parenting is that everyone has an opinion. This came to a head for me with the comments made by the UK leader (David Cameron) regarding parenting. It came across all 'Gung Ho' even though his country is one of the signatories on the UN convention on the rights of the child. But as with anything it seems that certain things create a polarity if thought and action, and a pity that it often revolves around an unruly child.

I find that at times it's easy to react rather than respond to unruly child situations. I distinguish react and respond as "responding occurs after some thought, and react simply happens". Being human we also have our own ups and downs and this colours or changes dramatically our usual reaction. Not much difference you might say, but I counter that it's the thought that counts. At the end of a long day hearing the high pitched squeal or yelling of a child or being on a short or long haul flight with a child in discomfort is not everyone's idea of a pleasant experience. Soon the mumbling over 'poor parenting' is heard. But is it really poor parenting? I suppose it depends on which side of the scream you are on!

The article in Macleans, gives a perspective to the frustrated onlooker's view of parenting. It appears that the author prefers the 'tiger parent' approach and I'm sure that is adopted in the household! Maybe this is where Mr Cameron gets his ideas, but I wonder if it also shows a lack of tolerance. A teen little own a pre-teen has not the brain structures in place to fully understand much in terms of social intelligence. The child has little control over his (or her) amydala and will quickly "see red" and have act accordingly. It is not until much later in life that they will begin to learn to control their urges and tantrums.  So why try to reason with a child? The idea of tolerance and being put out makes me consider who is really in need of help. The parents are showing restraint and tolerance and providing a role model for the child.  In many ways it is more difficult and challenging to adopt the 'softly-softly approach' than to allow the amydala to take over. 

Well it appears that acting this way has a much wider implications than a simple right or wrong decision implies. I do believe in well-being and positive education, and consider it one of the better advances in education for a while. I was reading an article by Professor Lea Waters from Melbourne University, and in her paper I see that the overall well-being of the child is dependent upon the actions of the parent in establishing the best environment for the child. The thing is that the paper provided real evidence and it was empirical in nature. It also goes on to suggest that it will reduce stress levels on the child, and thus also on the parents. Not ground breaking in many aspects, but at times a reminder is useful in re-enforcing our beliefs. 

However, there are many other things that we must take into account before simply. So the idea of judging the parenting of others is not really a necessary or good idea, and I hope that Mr Cameron realises that old adage concerning people, glass houses and rocks. 

ADHD & our children

I have noticed that in my time as a teacher/educator that the rise of disorders to explain the childhood attention problems that afflict some students. I recall hearing about ADHD (attention deficit hyperactivity disorder) at a meeting one day regarding the academic progress of a student. The initial response of many to these form of diagnoses is probably less than credulous, but the growth of the numbers of teens affected have since removed much of the disbelief. But the rise in numbers does bring into question the accuracy of diagnostic techniques and treatment strategies and I have seen the vacant expression associated with the misdiagnosis or during a period when trying to get the dosage right, and it is almost like watching the personality disappear in front of your very eyes!

According to the CDC  (Centre for Disease Control) in America, "11% of four- to 17-year-olds in the US have been diagnosed with ADHD, a label for those who are disruptive in class and unable to concentrate; just over 6% are taking medication". This seems to be a very worrying trend in our youth, with such high numbers diagnosed and the resultant use of pharmaceuticals by our teens. It is important to note that the drugs used (e.g. Ritalin) are related to cocaine, and there are number of side effects associated overuse of Ritalin including increased heart rate & blood pressure, anxiety, agitation, nausea, hallucinations and confusion.

It seems that ADHD can often be accompanied by other problems including depression, anxiety, bipolar disorder and Tourette syndrome, and I would think that the push to succeed and the self-promotion that is an integral part of the life of most students and teens must make the problem greater. So is it a positive to have a child with ADHD take on a life of drug taking all so that he or she has a greater chance of attaining goals that are largely imposed by society?

The treatment of ADHD seems to vary considerably, with most advocating a combination of chemical (drug) and behavioural therapies. However, figures from the US CDC (Center for Disease Control) seem to suggest that many, in particular the teens and older, are largely treated using chemical means. The graph clearly shows that the sole adoption of behavioural therapies quickly decrease in the pre-teen years when a greater emphasis is placed upon drugs such as Ritalin. However, there is also an increase in the use of a combined approach that seems to remain more of less steady during the teen years.

Even more worrying is the use, and dare I say abuse, of these drugs by "normal" students. It now appears that Ritalin has become incorporated in the recreational college scene as a drug for study. The Center for Substance Abuse Research at the University of Maryland noted that the misuse of Ritalin is becoming more widespread, and that sales of Ritalin increased 500% in the last decade of the 20th century! A surprisingly large increase considering the number of diagnosed cases. The risky behaviour involved is largely an attempt to compensate for last minute study binges that students are known for, in response to the obvious pressures to succeed. Not only do the students want to achieve at a high level, but they also want the engage in all of the social activities available! So the overuse must lie in the misuse of the drug, with the inherent problems associated with addiction. It also appears that the long term effects of Ritalin are largely unknown and not fully researched and documented.

Now I really wonder if we are doing the right thing? The whole idea of medicating children, and especially teens, to suppress their activity level is not something that we should be proud of. As I stated above, staring into the vacant eyes of a student on Ritalin (or similar) is not the answer. The student was not in any real state to be involved in active or even passive learning, and far too often this occurs as an attempt is made to get the dosage right. Initially I thought that the ADD and ADHD label was being used to as an excuse for parenting skills. But with the increased rate of incidence and diagnosis being recorded, one has to wonder about the real causes. We also need to consider the effects on future generation if the incidence continues to rise - particularly as it is much more likely to occur in boys than girls (I recall a figure of about 3:1 more prevalent in boys than in girls). With the accompanying ailments and mental problems, this is truly a very worrying trend, and it makes me wonder why there is not a huge groundswell to find an alternative way of treating it, and even finding the root cause.

For more information about ADHD I suggest you visit the National Institute for Mental Health site or the Kids Health site, as both provide a good introduction. 

Further Reading
Generation meds: the US children who grow up on prescription meds - http://www.theguardian.com/society/2015/nov/21/children-who-grow-up-on-prescription-drugs-us?CMP=Share_iOSApp_Other 
National Institute for Mental Health: Attention Deficit Hyperactivity Disorder - http://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml
Kids Health: What is ADHD? - http://kidshealth.org/parent/medical/learning/adhd.html#

The ongoing affects of stress

As we find out more about our bodies, we are learning that stress has ongoing affects on us all. I have touched on the stress levels that we are placing on our children and especially teens to create winners. We have also looked at the negative aspects in terms of behaviours and even depression, but could there be other long terms implications of this stress? There are of course the obvious physical effects that we know, but a recent link to Alzheimer's and memory loss is a little unexpected. So for just a recap, lets firstly remind ourselves of these physical affects of stress on our bodies:

1. muscle and skeletal pain
2. breathing problems and hyperventilation
3. cardiovascular disease
4. blood sugar problems
5. gastrointestinal and stomach disorders
6. reproductive problems

I have only skipped over the physical affects as I am more interested in the possible effects on brain function, but a more detailed examination of stress is offered by the American Psychological Association website. I would encourage you to visit the site if you require more information.

We tend to think of stress in the terms of "here and now" and not many of us will be concerned about the possible future problems that may arise. We are even told that a mild amount of stress is good for us, and in some cases that it is an evolutionary response that helps us survive. However, a new study seems to suggest that the affects of stress can have a real impact on later life and especially the onset of cognitive impairment. The link between stress and Alzheimer's is not really as well defined as suggested, but these issues make me wonder if the stressful lifestyle of teens can have an impact on early onset of this disease? The transfer of stress to the younger members of our society makes this an even more worrying thought.

It appears that the stress and brain degeneration are linked through chemical means. When the body encounters stress, cortisol is released into the blood system. This is the chemical messenger that prepares us for the "flight or fight" response to these stressors. But cortisol also has affect on the brain. According to the Alzheimer's Research & Prevention Foundation, in excess, cortisol "damages cells in the "memory centre of your brain. It stops glucose from entering your brain cells. It blocks your neurotransmitter function and causes brain cells to become injured. High levels of cortisol also impact your ability to learn and retain new information (this is called short-term memory loss)". I suppose though that the one positive that exists is that our brains have neuroplasticity. In essence it means that if there is no long term damage, the brain can repair and respond.

I suppose we go back to the old adage of "healthy body, healthy mind", and the reduction of stress and maintaining a healthy lifestyle (and diet) a greater imperative. Yet we continue to pile the stress onto our children and teens without thinking about the long term implications. 

Further reading on the subject can be found at: 
High Stress Levels Can Dramatically Increase Your Risk for Alzheimers by Carolyn Gregoire (2015) - http://m.huffpost.com/us/entry/56708edee4b0688701db7097?ncid=tweetlnkushpmg00000067

Stress and its influence on Alzheimer's disease - http://www.alz.uci.edu/stress-and-its-influence-on-alzheimer%E2%80%99s-disease/