(00:00:00) It is about 11 and a half past the hour and we are going to be spending the rest of this period talking with dr. Susan herba who is director of Mental Health Services in many apples Children's Medical Center in Minneapolis. Use the chief psychologist at that institution and is prepared to answer your questions today about General kinds of Child Development child behavior. Child mental health things. Dr. Herb all welcome. Thank you for coming in today morning. It's nice to be here. And I think I'd like to start out just sort of I don't know prime the pump a little bit or whatever. You want to call it talking a little about teenage suicide because that has been so much in the news lately. Yes, it certainly has gotten a lot of public attention as a topic of great concern and what are your thoughts about that mean what can parents do to lay the proper groundwork? So their kids won't be tempted by that sort of thing. Well the prevention problem with with the problem of teen suicide has many aspects to it in the worst case prevention in that regard has to With knowing who's on the brink recognizing people who are at risk who are already contemplating a planning that kind of behavior and putting the greatest possible distance between them and the and the tools that they might need to carry out such a plan. So we need Super suicide proof houses. We need careful control over medication. We need careful control over guns and ammunition over all the things that would make it easy for a person losing control over those kinds of impulses to carry out a plan. What are some of the signs in the kid that a parent might be on the watch for well, they're really multiple signs. I think that that we need to recognize that while there may be some signs of a of a youngster who's losing their coping capacity in the short run that there's also some long-range life history kind of build up that really lays the background for that kind of situation, but that in the short run we see kids whose capacity to cope with the stresses and demands of their lives seem to be failing them. We are especially concerned when we see Mark changes in Personality patterns and kids who seem to be losing the capacity to overcome. The stress isn't demands that life hands them and what we see are patterns of behavior that suggests the possibility of depression as one possibility kids who seem sad and withdrawn who seemed unable to experience pleasure or satisfaction who seem to have an attitude of hopelessness about their own capacity to overcome the circumstances that they're they're confronted with we see youngsters who seem to be coming more and more impulsive who are having more and more difficulty controlling impulsive actions who are acting before they think and the reality is that under circumstances of great stress virtually all of us think about the possibility of ending our lives but most of us have some ways to put those impulses back down and to restrain following through on them. So if we see people who are under stress who are not coping well with that stress who are looking depressed and Herb by it and who are becoming impulsive irritable flying off the handle perhaps taking risks that that result in there being injured. We need to be concerned. All right. Let me open up the telephone lines here so we can get some folks on the line and then I'll follow up with a couple of other questions on this 2276 thousand is the number if you have a question for dr. Obata day on childhood development or behavior mental health is kind of thing ranging all the way from the very earliest years on up through the Adolescent years. I guess really 2276 thousand in the Minneapolis st. Paul area and in other parts of Minnesota toll-free one 800 695 hundred down naturally as with all these kinds of things we can't deal with very very specific case history kinds of problems, but General sorts of things and basic ideas about good mental health. Sure. That's the kind of thing. We're looking for now a follow-up question. Number one. What does a parent do when he or she sees some of the symptoms that you've talked about in a kid? Whether it's a parent or a school person or a friend, I think that it's important to recognize that possibility and to open up a conversation and to begin talking about the problem and about what you're seeing. Some people are afraid that if they talk about worries or even about the possibility of self-destructive behavior that somehow our they'll be putting ideas. In other people's minds and I don't think that's much of a danger the ideas are already there and often the freedom to talk about it represents a tremendous relief and the beginning of the solution. So I think the first thing that needs to be done is a direct and warm and concerned approach to the person that says I'm worried about you. It looks to me like things are not going well for you asks questions. Like are you as unhappy as you seem does it get so bad? You don't think you can stand it. Are you thinking about hurting yourself or you are you thinking about killing yourself? If you seen those kinds of signs people who are thinking about suicide will often be putting out Clues will Often be talking about that. They're checking out or that they're getting ready to go or behaving in ways that would suggest they're getting ready to go away putting their Affairs in order disposing of things that are important to them and putting out some of those kinds of Clues and if you see those things the problem needs to be addressed directly. The other thing I think we have someone on the line. I think we do shall we go to our first caller. Let's all come back with another question on this in just a moment. Let's put you on the air though with Susan turbo. Go ahead, (00:05:26) please. Yes. Thank you. My question is completely different than what you've been discussing but I have identical twin daughters and they are six years old right now and I would like to know what you feel about separating the children. I've tried to create an autonomy in each of the children and I wonder if you think this is more stressful or if it's the way to go. Thank you. (00:05:48) Well the dilemmas of figuring out how to sustain the most positive development in twins have some special wrinkles to them. I think it is important to think about ways to emphasize And permit the individual character of those two people to emerge and in some respects orchestrating situations where they do function separately and where their differences in their individuality can be emphasized and they can make choices that will take them down separate paths is a positive thing to do twins often do form very supportive relationships with one another and we certainly don't want to cut them off from that kind of support. But we also don't want to encourage what what can sometimes become constricting and excessive kind of dependency on one another we want to acknowledge difference and celebrate difference and give individual children, whether we're talking about twins or brothers and sisters that are not twins in the family chances to be really very different people. Talking with Susan herbal Doctor Surgeon herbal, who is the director of mental health services at Minneapolis Children's Medical Center. And if you have a question, we have some open lines to 276 thousand in the Twin Cities and one 865 to 9700 in other parts of Minnesota another topic that seems to be on a lot of people's minds these days teenagers and drugs and what do we do about that? Well again, that's a complex problem that seems to represent a final common pathway a final outcome of very complex factors that that operate over the whole lifespan to make some youngsters more vulnerable than others. They develop Lifestyles about how they cope with stress that are different. They're exposed to different levels of contagion and they have different skills for coping with those kinds of things as they move through the through the life cycle. I think that we need to be thinking not just in the short run about how to bust up these problems. Need to be thinking over the long run about how we can sustain growth and development in children from the very earliest periods of their lives that's going to make them sort of invincible that's going to equip them with coping strategies and decision-making skills and sources of support and success and positive experience in their lives that will reduce their vulnerability to some of those problematic choices that come up later in life. And I think it's it's a multi-faceted problem that needs to be approached in many different ways. We put a lot of energy into drug prevention programs that were focused on the last minute decision about about whether to do it or not do it when you were a teenager and now the emphasis is more and more on earlier and earlier interventions in ways that help to strengthens the stress resistance in children from a much earlier period in their lives and to equip them with more positive skills. Let's move on to some more folks with questions here for a doctor herbal. Hello, you're on with her. What's your question today? (00:08:49) Good morning last year my husband and I moved away from his two children who are now 15 16 years old. We moved quite a distance at the time. Of course, we gave them a choice if they wanted to come live with us. They have flip-flopped kind of back and forth as far as if they wanted to or not, but I think out of Alliance to their mother they stayed with her the situation at home is not good. However, and their behavior is deteriorating and the boy has now definitely expressed a desire to come live with us, but I'm sure they're still that doubt their what is the best way that we can be supportive of them and sit down and come to a decision that will be healthy for everybody without feeling like they're being pressured into something and yet, you know, we want to express our interest in having them. Strongly, you know without pushing what what is your recommendation? Thank you (00:09:48) family configurations that have changed and complex families and Blended families present new challenges for four kids and trying to figure out how they can deal with the problems of conflicting loyalties. And with the grass is greener kind of questions about where to make one's home is a very demanding and stressful experience for kids. I think that that there needs to be as much as possible and opportunity for problem solving that that both sides of the family can participate in and for clearly delineating how much decision power really rests with the kit and I think that that adults have to assume responsibilities for some of that decision-making and not ask kids to make those decisions independently. It's too much for a kid to make that sort of decision. I think that in under those kinds of circumstances we weigh the pros and cons and and along with the other factors. We way we weigh what the what the kids need what what they're looking for in a life situation what's missing from their life situation and examine all the Alternatives about how to how to meet those needs and I think we put kids in real binds when we argue from a an either/or kind of position. You can be here. You can be there. You can take care of your mom or you can come stay with us. You can take care of the people you love or you can take care of yourself. Those are unbearable Kinds of Kinds of conflicts. So I think the most helpful discussion identifies from the point of view of the youngster. What do you need to make your life better? And what are the various ways that we could go about building into your life those things? That'll make it better how might we make life at your mom's house better or if you came to our house. What would need to be there to make your life better rather than focusing on the decision of which house you going to live in? Yeah pretty hard for folks to do that though because they have such a tremendous emotional investment in it themselves and realize it's real hard and sometimes to get a mediator somebody who doesn't have that. Kind of intense personal involvement in the situation. It doesn't wear the kind of sometimes distorting lenses that come from having have trouble sort of history in a relationship with the other party can help to sort out and to keep the focus on what the child needs rather than getting the are clouded with with old history about how come it is that another relationship broke down moving on to another listener today. Hello. You're on the air. (00:12:09) Hello. I have a 15 month old daughter. And for the first year for life for various reasons. She slept in our same bed like temperature of the room and space and stuff. She slept in our bed with us. And now we try to change it to acrobat when she was one year old for the first like four weeks. She was she was alright she like she went to bed and then she learned how to climb out of her crib and she she won't stay in there now she'll scream for hours and or you know our half hour and until we go in and get her and she won't stay in there and she you know, she's not content to be in there anymore and I just want to know what I can do to help her to get to sleep on her own (00:12:47) the emergence of disturbances in sleep patterns in children in the second year of life is a very common problem and children who have been able to make themselves content and comfortable in a variety of ways earlier in life often do come up with problems in settling for sleep in the second year of life. So it's not an unusual problem and not necessarily indicative of any major disturbance in the child or or the family. The trick is to figure out ways to help the child to be sufficiently safe relaxed and comfortable in the situation where they are going to sleep that they can let go and let themselves go to sleep. And I think that the strategies that you want to use are those things that support the child so that the child can learn to make themselves comfortable to be relaxed to feel safe in the place where you want them to sleep. So if they're upset and if they're crying or protesting, I think it's often a good idea for a parent to go into the room and keep the baby comfortable and content in that room and that will be more effective than taking the baby away or taking them to sleep in another bed or in another place. That means that you might put the baby back in the crib and sit by side beside the crib and maybe rubber back or talk to her sing to her those things that will help her to be safe and comfortable right there where she is and then to think about those things that you know are comforting and relaxing to this baby. Is there a favorite blanket or a toy does having a light on in the room make that easier and to set up a situation where you can support the baby and being safe and relaxed and comfortable right there in the place where you want them to sleep when you've got that accomplished with your being there in the room. Then you need to begin to fade from the scene to back off and to keep talking maybe from the next room to say to talk back to the to the baby and to say it's okay. I'm here you can To sleep to say soothing things but to be somewhat less available and to let the baby find ways to settle down. It's a very nice little book. I think it's called solve your child's sleep Problem by an author who I whose name is I think Ferber you can probably get it at the library. If you'd like to read about some of the things that would help you to help your baby get to sleep. It sounds from what you're saying like the babies fussing in the crib has almost nothing to do with the fact that for a while. She slept in the same bed as Mom and Dad. Well, it probably may have something to do with it. But the fact that this baby did okay and that situation for a month's time would suggest that that that transition wasn't so hard when babies get older they begin to have new ways of thinking new awareness has that make it harder for them to relax and at this time in their lives, they are suddenly aware that they very much need the support and help of the people they care about and they notice when they're at some distance and they become very alarmed at that possibility. Woody of separation and it's a while before they begin to trust that the period of separation will come to an end that help will be there that somebody's going to be there to take care of them. And that issue of separation is very important in that second year of Life. How do you tolerate separation? How do you get along on your own and sometimes babies have in the first year of Life sort of don't notice that don't have the capacity to think about it or to or to notice their own feelings or to notice their own experience and as they get more mature they have more capacity to sort of worried themselves with some new things. So we're talking about kids today from infants from babies all the way on up to teenagers with dr. Susan herb or director of mental health services at Children's Medical Center in Minneapolis. And you have a question for her. Go (00:16:28) ahead. Yes, we have two sons ages eight and three and a half and neither my husband. I really believe in physical punishment and it's never been necessary with our eight year old, but are three and a half year old has a much more defiant. And is not usually are always willing to do what we've requested him to do particularly. If we're in a public situation for at relative's house for dinner or were shopping somewhere. He has he's asked to do something will say no and we'll stick his tongue out at us. If we ask him to stop doing something and see seems to respond somewhat to standing in a corner or being isolated. But sometimes it's real difficult when when we're in a situation in a store or something like that and I wondered if you had some suggestions for dealing with defiant three and a half year olds particularly in a public setting when you prefer not to use forms of hitting physical (00:17:29) punishment. Some of those little folks have a real talent for really hitting us in our most vulnerable spots and really catching on when they've got us over the barrel the issues of power and control and who's stronger and who can make who do Are very important to the three and a half and four year old child and they are very much into experimenting with their own power and seeing what they can get away with at that point and it's clear that some kids get into it more than others that they are different styles about doing that sort of thing. And it sounds like your two boys are kids with different temperaments and that's some of what you're seeing in this this youngster. Maybe he's unfamiliar because your other child was of a different sort of sort of character. I think what you need to do is is to put your focus on figuring out how you can help this child to be in control of himself. And it sounds like he's tempting you into questions of can you be in control of him? What can you make him do and taking advantage of those circumstances where he sort of catches on that that you're not going to use the most powerful tools that you have at your disposal? And I think that that sometimes we do have to acknowledge that at the moment the child does have and is exerting their power in a negative sort of way. So it means that sometimes we do have to rather than exerting our Superior Power by strength or by what we can do or make the kid do have to acknowledge that that for the moment. Yes. They've got the power but to help them to understand that they're using it in a way that's destructive to relationships and and that that learning to control themselves is going to be a more satisfying outcome. I think that under those circumstances. Sometimes you just have to bite the bullet and say I don't want to do this. I don't want to leave this situation. I don't want to give in I don't want this kid to call the shots. But that using some kind of a timeout procedure some way of removing the child from that situation rather than continuing. The struggle is is the most important thing for you to do to bust up the Sequence that's going on. And we do see those sequences and Grandma and Grandpa's house and just just at the cash register next to the candy counter in the supermarket where kids know that they've sort of sort of got you over the barrel and being able to surprise him and say, well, you know, that's it and we're going to the car right now. I'll come back and finish my shopping later, but this ends the sequence or to take the child out of the midst of the family party and to just say, you know it when that kind of behavior is going on. You can't stay you need to let me know how I can help you get back in control of yourself. When you're ready to be back there. We'll go back and usually don't need to repeat those things endlessly, but I get the point even get the point now the caller brought up the issue of physical punishment. What's your view on that? Anything wrong with spanking a kid when they Jolly well deserve it once in a blue moon. Well the problem with physical punishment is that it just doesn't work very well that it doesn't teach kids what to do and it isn't even very effective in teaching them what not to do. I think that that the only time When any kind of physical punishment and makes any sense to me is when you're dealing with a child who's comprehension doesn't make it possible for you to explain things to them and where you sort of can't get their attention any other way and and I think all of the other Alternatives need to be considered first and then you know one SWAT that gets the kids attention so that you can bust up the sequence that's going on just now the child who is running for the street so that you can stop that kind of dangerous Behavior or behavior that really can't be a ignored or can't be allowed to go on is the only circumstance in which I think that's a helpful thing to do. I think the use of of Time Out procedures the use of positive and encouraging sorts of strategies and many other alternatives for discipline and for helping the child learn to be in control of themselves are much more successful and that punishment, you know, aside from any moral judgments that we make of it just doesn't work very well because it doesn't teach kids better ways to be let's move on. More folks with questions today talking about childhood behavior and development mental health and those sorts of things. Go ahead, please you're next. (00:21:51) I have a six-year-old boy who's just about 7, and I'm having a problem with lying and power and somehow or other. I think the two are interconnected, but I'm not (00:22:03) sure lying and (00:22:05) power. Yes. Okay, he has been lying to me. He's been lying to his teacher at school as well and I don't I mean understanding why he's why he tells the lies and what I can do about it. The problem with the power is that he feels like he should control himself if I tell him to clean his room or it's time to go to bed. It's time to come in from playing. It's me. Why should you be telling me what to do and partly he gets this from the various programs that have been given on child abuse and from mr. Rogers where they say, it's your body don't and you should control it and you shouldn't let adults touch it for you're not supposed to so he's learned that this is himself and he's expanded that into all fields and can't discriminate. (00:23:06) Yes. I think we hear those that you're not the boss of me kinds of statements from from from kids at those times when they are testing the limits of Their Own. Their own power and again, the the shift is that's not my point. My point is I want you to be the boss of yourself, but I want you to do it in ways that are going to make you a pleasant person to live with that are going to help you to assume your responsibilities for life in the family and in the community and in the world and that that yes, there are expectations about how you can be the best that you can be. There are things about life in the family that are responsibilities that you need to learn to to take up. I think with a kid that that is heavily invested in exerting their own personal power that that we're treading on on somewhat slippery territory when we resort to ways to overwhelm them to take their power away from them to make them submit to break their spirit that those those are and we're all tempted sometimes to say I'm not caving into this little Tyrant. I am going to be in charge here because I'm bigger than he is and I got here first, but but I think if we think about what our real Wishes are over the long haul that we do want to raise kids who have a sense of their own personal power that we want them to be able to direct their own lives in responsible sorts of ways. So I think one helpful thing to do with kids in those circumstances is to emphasize that they have some choices and then to present a range of choices that we can live with and say you can choose among these but these are the only choices let's do practical example. Mom says come in from play and what other choices might be acceptable in that situation you could offer a kid at those moments either you can come in from Play Now or there will be these consequences and you can come now or you can accept those kinds of consequences. No TV or something like that. Yeah, if I think that that you know, if the situation demands that there really aren't any choices that we need to make that clear but we need that too not to be the case all the time. We need to be able to say at some points. Look there are no choices here. This is what the family is going to do. We are getting ready to go. There aren't this is not a spot where you have choices except that you can come on your own or I'm coming to carry in and that's the choice that you can make. Are you coming under your own steam or or you know make me make me do this, but I think that it's important for us to pick those kinds of Showdown situations carefully and not to push to that kind of Showdown when it's not necessary, but to allow kids some of that and some kids at 6. And again in adolescents have terrible need to have the last word and they really resist anything that feels like losing losing face. So that sometimes if we can can give them ways to avoid losing face, they'll be able to make better. Voices and some of those other situations some kids just have a real hard time changing from their agenda to our agenda there. They have important activities and important choices that they're involved in and for us to suddenly blow the whistle or ring the bell and say that's it times up. Now, you're on Mom's agenda really does represent an intrusion on the work of the child and the life of the child. So if we can give them a warning that says, you know in five minutes you're going to need to do this. So so get ready. We can sometimes be more respectful of their needs in that situation. And again avoid The Showdown situations. Dr. Susan herbal with us today director of mental health services at Minneapolis Children's Medical Center. We have some folks on the line with questions also a couple of lines available again in Minneapolis and st. Paul at 2276 thousand 2276 thousand four Twin Cities area callers elsewhere within the state of Minnesota one 865 to 9700. That's our toll-free number and if you're listening in one of the surrounding states, you can call us directly at Area code 612 2276 thousand or I forgot her question about the lying. Yes. I was thinking about that there really are lots of different different kinds of lying and different reasons for lying and sometimes I think it's not lying. I mean we attach a lot of moral significance to to the question of lying and truth-telling and those moral questions. Don't carry much meaning for the the six-year-old child. The moral decision-making about is it right or wrong and why is it right or wrong is slow to develop and won't really be there for a child for several years after the age of six. We sometimes see what we call lying in self-defense to try not to get caught. We often see lying as a way of making oneself look or feel big and important and powerful and for this youngster who's got other ways of showing us as need to feel big and important and Powerful it may be that that he tells tall tales that that that have the potential for making him look or feel big and important and Powerful. So I think we need to understand some about what is the child telling us. What is this behavior mean? How can we understand what that child's needs are and and help to get those needs fulfilled and some more positive ways can help to divert the lying and again the moral judgement and punishment is probably not going to be very helpful to the child in those circumstances. The other thing that's important in addition to being able to do some thinking about what that means and how it works is to help the child understand the consequences for relationships about some of that kind of behavior to help them understand that that close trusting relationships are based on some reliability between two people and that that it breaks that faith in a relationship when they say things that aren't true and pretend that they are sometimes I think we just need to acknowledge when the kids told us. What what is obviously a tall tale to be able to say boy. That's a that's a wonderful story and a nice wish and wouldn't it be nice? That were true. And again, I think where we get in trouble when we put kids in circumstances where they might lose faith when we try to get them to confess their lie, and if we know it's a lie, I think it's not important to extract the confession or the apology from the kid but to help them move away from that pattern of behavior. Let's move on to our next caller Shelly. Hello. You're on the air (00:29:24) now. Thank you very much. My question is about my nephew who he has a brother two years younger and he's my sister-in-law and brother-in-law son. And we've seen such a situation with the nephew that he seems so insecure and so unhappy very jealous of his brother very angry will yell at the parents treat them very rudely very out of control to the point now where he's threatening to run away from home and Through the Years on several times. We've said that were concerned about him and we wish that they would look at getting some help to try to help deal with him and help him become a happier child and they at times maybe make a small effort but there seems to be not much consistency and and with his age being 13 hours is still very concerned about what we see happening for this child ahead. And my question is I don't know if there's anything else we can do. Should we keep trying to bring it up? And of course they get angry at us in there seems to be a lot of denial of what we think is the seriousness of the problem or is that all we can do? Is it just a matter? Of showing them that we love them and just letting it be (00:30:33) those matters especially within families are of course very difficult. And it's the sort of King Solomon Solution that's required to figure out. What's the right and best thing to do and I think you have to make some decisions about about how much risk you think is is imminent and immediate I think that the most helpful thing that and caring thing that you can do within your family is to continue in a positive and supportive way your expressions of concern and to continue saying, you know, I worry about about this this youngster perhaps to point out those ways in which you think things could be better the the wishes that you have for how you'd like to see his development proceeding and if you're able to identify or support some resources that you think might be helpful to think about some ways that you could support the family and doing that but you really can't The choice for them. I think that that you can keep the information coming and I would guess that if the child is having as much difficulty as you say that he is that he's having difficulty in other areas too. But there's other information coming back to the family about how it goes for this youngster at school or how this is going in other places and that that mostly you have to be supportive and stick with them over sometime and hope that that the youngster will get some of the attention that he needs increasingly as kids get older. They have some more autonomy for making some of those choices for themselves and and there might be some ways that you could let your nephew know that that there are resources that he could have access to himself that there are counselors and social workers at his school that there are teen programs where he could find someone to talk to where you could let him know that you're worried about him and that you think things could be better for him and maybe free him up to make some choices to do some things on his own behalf. It is about To 15 minutes before twelve o'clock and we're talking with Susan ER ba director of Mental Health Services in Minneapolis Children's Medical Center. She's also the chief psychologist at that institution and you have a question for her. Go ahead, please now. (00:32:42) Yes, I've got a twenty eight month old boy who tends to be very possessive of me as his mother and his dad is his primary caretaker during the day when I am at work and I work full-time and my husband is a is at home full-time and when I come home from work, all of a sudden dad becomes top liver and my boy won't doesn't want anything to do with him. He doesn't want him to pour his milk. He doesn't want him to lift them up in his chair and and at times this is very inconvenient and it puts a lot of extra demands on me and keeps me from spending time with our other daughter and I was wondering how normal is this Behavior should we go along with it and just you know meet his needs. Thor will he grow out of this. (00:33:31) Well, I think there's no guarantees in this in this business. I can say that that's not such unusual behavior for a two and a half year old child to suddenly become very very concerned about again the question of the security of the relationships that are most important to them and the issues of separation and to be very sensitive to needing to keep close to him. And I know that he has access to the people who are so very important in his life and it sounds like he's fairly comfortable that he's got dead any old time but there's some anxiety about about whether he's going to have access to you and that he's really bringing out the heavy artillery to make his demands about have an access to you and getting what relationship and interaction from you he can I think that that you need to walk a line here. Between making sure that if there are ways for this child to have access and relationship and pleasurable interactions with you. I think you need to be a little bit cautious about those only being available when he's acting in an unpleasant way and that maybe you need to anticipate ways that you can fill them up with knowing that he'll have good time with you whether he Tantrums or acts badly or throws himself around or not that that you are going to be with them that there's going to be good time between you and that that he can get what he needs. But I think you need to be careful about inadvertently rewarding him when he acts in the most obnoxious ways. Make sure that you're getting there first and given him time and attention and and the opportunity to be taken care of and to be nurtured to be fed from your hand some of the time not just because that's what he demands but because that's part. Of what get yourself taken care of and no one who loves you is all about. When you too you didn't use the word but an issue for a lot of working couples not the case of this previous caller, but we're working couples is that so-called quality time concept that we heard about quite a lot of the few years ago. What is that sort of discount in our is that still a popular? Well, there's an awful lot of questions about about what new family lifestyles are going to mean for the development of children and whether they are children who are spending a great proportion of their time in daycare and with multiple caregivers and those kinds of things how that's going to turn out over the Long Haul for those for those children and and the information that we do have doesn't clearly indicate the children are damaged by that kind of experience. The issue about quality time does have to do some with some the things that we were talking about. How can a parent really make themselves available to devote themselves to the needs of the child for some fixed period of time? Can they be with the child in a way that gives them undivided attention and gives them the clothes attentive sensitive responsive care of a parent or a person who's important in their lives. There's an important question and and for young children long periods of time may not be as essential as the regularity in repeated nature of some of that kind of experience. Well, honestly more folks with questions here talking with Susan turbot today. Hello, you're on with (00:37:02) her. Thank you. Yeah, I have a friend who is 16 and he's a manic-depressive and he takes lithium stuff. He's having a hard time dealing with taking it because first of all he's a because of his ego is kind of a big kid. He's like a football player and he didn't know his he has to take it to can you know can tell him and he's having a hard time getting back into school was wondering if there's anything I should do as a friend or not too. (00:37:25) Well, the disorder that you're talking about is A mood disorder disturbance of mood that that appears to be a biological disorder, but that certainly has impact on the psychological experience and the relationships and the whole lifestyle of people who are afflicted by that that disorder lithium has been a very helpful part of the tools for dealing with that kind of disorder and encouraging people who benefit from it to use it and to keep using it regularly as an important and positive sort of thing to do. I can suggest a couple of sort of resources for you that you might find helpful. If you call your Agricultural Extension Service and you can find that listed under the Minnesota University of Minnesota Agricultural Extension Service. They have some some handouts that deal with how to help friends who are distressed or depressed or discouraged that are very helpful for teenagers. There's also a very nice little book that's written by a man named Saul go. Sol G ORD oon who is a very wise man. He's a psychologist but he's also just a very perceptive person and he's written a lot for kids. He's written a lot about teenage sexuality and about what it's like to be a teenager and how to survive that experience in a pleasant sort of way. He's written a new book called when living hurts that's that's directed at kids and at their friends to give some some ideas about about how friends can support one another and help one another when the going gets rough how kids can participate in their own recovery and help themselves out during those times and I found that to be just a very helpful resource for young people that want to know how to take care of themselves and how to take care of their friends so you could ask your librarian about whether that's available or if they'd help you figure out how to get it right? We are talking about kids ranging in age from infancy on up through adolescence development Behavior mental health, all those kinds of things and if you have a question Two two seven six thousand. Go ahead, please your next (00:39:31) we have a 14 month old boy in America. One be necessary to change daycare providers. He's only had the one since he was born guess. It's a two-part question. Number one is are there particular things are activities provided by a daycare that would be important at this point is development. And number two is helping you what's a good way to ease the transition into adding new daycare provider. I'll hang up and listen. Thanks. (00:39:57) Well, some of those questions would have to do with whether this child is going from Family Daycare into a group daycare situation or whether there's going to be that kind of kind of change in the in the situation or not. It's hard to figure out how to explain to a 14 month-old what's coming and or what it means when when their routines change and at that age children are very sensitive to disruptions in the routine. They're certainly sensitive to the disruptions of relationships, but but they're also sensitive to changes in the routine. So if to the extent that you can find out what the daily routine has been like in the old day care center And reproduce that in the new setting that should help your child to make that transition more smoothly. I think the other thing that you can do is that that you as parents can offer yourselves as a buffer to help the child get through the through the transition and if it's possible to make some extra time available so that you can be with the child in the new setting for some of the time to to help the daycare providers and the child get used to each other to give each the reassurance of your presence and to give some information about what you know works and what the signs and signals that this baby puts up probably mean so that the daycare person can be quickly sensitive and tuned in on what the the baby's behavior means that that also would help I think at that at that age of life. Children need more routine and regularity and predictability about their experience rather than needing High degrees of stimulation and change and many people would prefer smaller family based or family like kinds of settings for young children rather than than very large complex kinds of situations for very young children in daycare. We have about five minutes left with Susan ER ba today. Let's see how many folks we can fit in in that time your next go ahead. Please (00:42:10) haven't heard the whole program, but my concern is with Down's Syndrome. I know two children one who is now in the teens, and that was my first experience. But now there is a four-year-old down styled that I have. Repeated chances to interact with and both of these I think were quite fortunate that they were stimulated and had special training from very early on the four-year-old is being taught sign language because doesn't speak yet. And I think that it's difficult for people to include and react and interact with people of this sort. And that is what I'd like your comments on and I'm especially intrigued to find out that with chromosome 21 that downs and Alzheimer's might be related to each other. (00:43:17) Well, there are a variety of handicapping conditions that seem to have genetic or chromosomal factors that contribute to the to the handicaps that develop in the case of down syndrome that are evident from birth and in the case of Alzheimer's that may unfold over the lifespan the issues about our communities responses to handicapped people and to their needs to ways that we can provide for them and incorporate them into the life of the community are certainly important issues for our our community leaders to be be thinking about the variety of outcomes for children with Down Syndrome is tremendous many of these children are very significantly retarded, but some of them are not very significantly retarded and one of the things that that may make a difference in their independence and self-sufficiency and they were attaining a high level of functioning is the very early introduction of stimulation activities and of figuring out alternative means to make sure that they have communication capacities and and ways to maintain their interaction with people around them that stimulate their growth and give them the what all kids need the capacity to have warm and caring Relationships with with people around them the capacity to maintain handicapped people in the community does contribute to their most positive sorts of outcomes and people who experience life in the community in the church and the school and the neighborhood and the family have have a much better Outlook than people that are isolated to less stimulating and less supportive kinds of care. So to the extent that it's possible to keep those folks with us and to enjoy them and to encourage them to be the best that they can be we're contributing to the most positive kinds of outcomes for them. We have time for one maybe two more questions for dr. Baugh today. Hello, you're on with her. What's your question? (00:45:12) Good morning. I would like to know what current information says about having a single child in the family. And also how to deal with Outsiders questions of when is he going to have a little brother or sister? (00:45:26) Well, I those are those are delicate matters that Come up and when they come up and I think that people are often insensitive and not so thoughtful when they introduce those those kinds of questions. I think that you just need to put your boundaries up and answer people with well, you know, we're thinking about that and we will have to make a decision that's best for our family mind your own business. Well, that one is may come up and there's some circumstances as well as as to some some more gentle ways of responding half a minute on the wisdom of having having a single child. Well, I think that there's good news and that there are benefits and and liabilities in that kind of choice and that you have to balance them. The benefits are that these children enjoy the undivided attention of adults and that they become often very skilled and high-achieving people and that there's a over-representation of single children in the outstanding Geniuses and most productive people in the world and two or three disadvantages very, well. The disadvantage is mostly have to do with learning to be part of a A group to learn how to do the give and take in a family. All right, and at that point, I'm afraid we must end. Thank fuck. Thank you very much for coming in a nice to be here. Dr. Susan turbo director of Mental Health Services Administration has children is Medical Center Chief psychologist there as well weekend is made possible by Ecolab Incorporated providing products and services for household institutional and Industrial Cleaning worldwide now stay with us because coming up on the Minnesota Public Radio FM Network in just a minute a live broadcast from New Yorker the Metropolitan Opera and Sport folio on ksjn 1330 AM. It's one minute before noon.