Vijai P. Sharma, Ph.D
Sometimes we opt for "medication solution" rather too quickly.
I have nothing against medicating children who are truly Bipolar (manic- depressive), severely depressed, obsessive-compulsive or inattentive-hyperactive. But, what about children who do not have a chemical or brain-related disorder but are simply "difficult;" too difficult to deal with?
A difficult child is one who interacts with significant adults in such intense and forceful ways that controlling or regulating him or her poses an enormous challenge. The possibility to consider here is that there may not be an underlying medical disorder to account for such difficult behaviors.
If you think you shouldn't be concerned about such a possibility because medication is prescribed only for children who carry a valid psychiatric disorder, think again. Psychiatric diagnosis is not a science; it is still an art. This is what happens: Parents and/or teachers report a bunch of symptoms and problematic behaviors, a mental health professional makes some observation, listens and determines which diagnosis appears to describe similar symptoms and behaviors. That's it! The child would now carry a diagnostic label.
Unlike a medical diagnosis, which is often based on some objective evidence such as a blood report, X-ray or MRI, a psychiatric diagnosis is often made on the basis of subjective reports and external observations of an organ, completely hidden from our naked sight: our brain!
For an organ, which functions in an extraordinarily complex way and is so well hidden inside that hard bony case, called the skull, wouldn't you agree that we must spend considerable time and effort in arriving at a diagnosis? Often, such is not the case.
According to Howard Glasser, author of Transforming the Difficult Child: The Nurtured Heart Approach, seventy-five percent of children evaluated for conditions such as ADHD and Oppositional Defiant Disorder receive medication on the very first visit.
Note that many children who receive medication on their first visit to the doctor might not have had a previous professional mental health consultation in any form or fashion. The medication might have been prescribed on the basis of a parent's and/ or teacher's complaint.
Some of the children who are prescribed medication on their fist visit might have had a father or a mother who was hardly ever involved in their lives, a parent who brings a new partner every time the child gets to know them or, a step parent who acts as a tyrant from day one.
It's really a "mixed bag" of children showing up at a doctor's office. Some are angry for a good reason and others for none. Some are out of control for a good reason and others are rebels without a cause. Some have a brain dysfunction and others a societal dysfunction. But, every one out of those seventy-five percent gets medication.
When parents, teachers and other social authorities can't control a child, medications are brought in for gaining chemical control. In some cases, medication is not provided for a disorder but for loss of adult control.
Let's be clear about one thing: In most cases, the fault lies with neither parent, teacher or the child! We don't know enough about difficult children. The problem may be that we try methods that work with normal children, but not on difficult ones.
Difficult children have intense emotions and impulses and they are unable to control them. They are stuck in a negativity cycle, and can't extricate themselves. Therefore, conventional methods of parenting and teaching fail with difficult children.
Negative attention such as reprimands, lectures, threats, expressions of concern are likely to make the behaviors worse. That way, a difficult child seems to get more out of their negative behavior.
If you are thinking of utilizing positive attention instead of the negative approach, here is what you might want to do:
At least for the first several weeks, dedicate a couple of minutes at least twice a day to praise your child for not breaking the rules or for not performing negative behaviors.
Example: You observe that your difficult child did not hit his or her younger brother in spite of provocation from the little one. You make a point of acknowledging it by saying, "I appreciate your self-control in not hitting your younger brother even thought I could see you were very frustrated with him."
When you start praising merely the absence of negative behaviors for several weeks, chances are that the relationship between you and your child might begin to change and he or she might start showing positive behaviors.
Now you have more material to work with. Not only can you praise the absence of such negative behaviors as talking back, arguing, fighting or breaking house rules, but also praise demonstration of such positive behaviors as being respectful, cooperative, compliant or helpful.
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Copyright 2004, Mind Publications
Posted August 2004
Dr. Vijai Sharma
Your Life Coach
By Telephone