Category: Child development

What makes a child anti-social?

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The media is full of the rise of anti-social behaviour (e.g. violence, aggression, bullying, fighting, lying, stealing, vandalism, fire-setting, drug and alcohol abuse, cruelty to animals) in children and youth offending, but what is the cause of childhood antisocial behaviour and are all anti-social children the same? What is the role of parenting?

Are all anti-social children the same?

There is evidence that not all children with anti-social behaviour are the same. Some children may show a phase of anti-social behaviour in adolescence but this passes and they settle down in adulthood. Far more concerning are children with a life-long tendency to anti-social behaviour. These children tend to be anti-social from a younger age and behaviour is more extreme (e.g. cruelty to animals at age 5 years), but even amongst these children there is evidence of different subgroups. Much research is focused on differentiating groups of anti-social children to see if we can better understand them.

One differentiating factor found is lack of empathy. Empathy is the ability to share someone else’s feelings and experiences by imagining what it would be like to be in that person’s situation. Psychologically speaking, this requires two different types of processes: a “thinking” part: the ability to see things from another person’s point of view; and secondly a “feeling” part: the ability to recognise emotion in others and to feel it in oneself. People without empathy are described as being callous and unemotional. To be anti-social, violent or aggressive is easy if you do not empathise with the victim, so it is no surprise that >90% of children with callous-unemotional traits are involved in some form of anti-social behaviour.

How does empathy affect anti-social behaviour?

Researchers have been interested in children that lack empathy for a while now because of its links to extreme anti-social behaviour, and the definition of “psychopathy/ sociopathy” (this is a criminal justice not mental health term) includes having this lack of empathy. The childhood precursor to this psychopathy label is “callous-unemotional traits” (as it is pretty harsh and pessimistic to label kids as psychopaths), and even this terminology has recently been rebranded as “limited prosocial intent” so that it sounds less pejorative; but this is just semantics, we are essentially talking about the same thing: people that have shallow feelings with lack of empathy and guilt.

My colleague, Essi Viding does research into these traits and wrote a great summary paper (2012), the findings of which I wanted to share as I thought it was fascinating. It turns out that if you study ASBO kids (kids with anti-social behaviour), you will find that 50% of them have these callous-unemotional traits. These children don’t really care about others’ feelings and tend to show no remorse for wrong-doing. It is this group of kids that have the most serious and long lasting problems.

What is the difference then psychologically and biologically between children that commit antisocial behaviour with and without empathy?

In experiments where anti-social kids are hooked up to show responses (for instance heart, skin and eye-tracking monitors or brain scans) to photos/ voice recordings of other people in pain or grief, the children with callous-unemotional traits showed no or reduced physical or brain response. Most people will wince in shared pain if shown pictures or exposed to sounds of others in pain, but these children don’t. When these children were asked to play a game where not following the rules led to punishment, they continued to flaunt the rules and did not seem to learn from punishment. There is biological support for these findings with differences in brain scans in areas of the brain linked to emotion processing and reinforcement learning pathways in callous anti-social children.

In contrast, the anti-social children with empathy showed the same aversive responses as children not involved in anti-social behaviour to pictures and sounds of pain and grief, and learnt quickly from punishment. However when they are shown threatening faces, they over-respond with emotion and when they are shown neutral and ambiguous facial expressions, they identified them as being threatening. Brain scans back up these differences. The anti-social children with empathy tended to have abnormal amygdala development. This is the area of the brain involved in fear and anxiety processing. These anti-social children have normal empathy but have a heightened awareness of threat, which explains why they perceive neutral faces as threatening. In a world where everyone is viewed as threatening, hostile or an enemy, it can make sense to be combative, aggressive and violent. This is that bully in the playground that says “Are you looking at me?” – when you weren’t even looking at them.

Genetic studies have also supported this divide, finding that there is strong inheritance of callous nature, whereas anti-social behaviour without callousness was not inherited but generated by environmental factors such as harsh or inadequate parenting, or an interplay between these environmental factors and genes associated with anxiety or heightened emotion.

Finally, it has also been found that the children in the different groups respond differently to parenting strategies. Punishment and traditional sanction-based strategies (time-out, withdrawal of privileges) works well for empathic anti-social children, but has no effect on callous children. Callous children only respond to positive reinforcement (praise) and rewards.

What causes anti-social behaviour?

This type of evidence has led to different theoretical models for two groups of children involved in anti-social behaviour.

Group 1: Genetic predisposition. Antisocial and callous kids: these children are thought to lack empathy as they do not find other people’s distress aversive and because they fail to be able to learn from punishment. It is easy to be aggressive and cruel if you are unable to feel guilt and if the suffering of others doesn’t bother you. It is easy to continue to behave in this way life-long if you are unable to learn from punishment. These difficulties are often inherited in brain structure.

Group 2: Environmental Causation: Anti-social but not callous kids: these children have abnormal socialisation because they have a heightened sense of threat, and view the world as hostile towards them. They exhibit aggression and cruelty as a result of living in unstable and threatening environments which has shaped their brains and psychology to respond in this way as a means of coping and survival. Their anti-social behaviour is often in the context of a peer group within which there is support and empathy.

What has this got to do with parenting?

Whether we like it or not, parents are the first line defence against anti-social behaviour in society. By better understanding the causes of anti-social behaviour and by understanding our children, we can best adapt our parenting to prevent our children becoming anti-social. Although children in group 1 with genetic predisposition are the more difficult to help, they can be supported by fostering self-esteem. They will respond better to motivation to act in a pro-social way, rather than harsh punishment which will not deter them. Anti-social behaviour in children with empathy can be prevented by strong loving families that place appropriate boundaries and sanctions. For these children, wider society has a great role to play in generating or preventing anti-social behaviour, as tolerant, peaceful and accepting societies can offer protection whilst violent, unstable and alienating societies can fuel them.

Reference:
Anti-social behaviour in children with and without callous-unemotional traits. Viding et al. (2012) Journal of the Royal Society of Medicine. 195-200.

C’mon Kumon?

Maths

As we enter SATS season, I’m on my education rant again. In the Far East, six year olds know their times tables up to 12, a target that has been set by the UK government for children of 11 years. A target that has been required to be set as it has thus far been largely unmet. Growing up, my sisters and I were ridiculed on holidays back to Taiwan when our cousins (subject to the rigorous mathematics curriculum and public adoration of anyone deemed “good” at maths) performed long divisions in their head that had us reaching for our calculators.

“So what?” we would retort, “Why bother when we can use a calculator?”

Shamefully, this is the same retort used by the new tech savvy generation for whom spell-check and mobile phone calculators have deemed a brain unnecessary. Sure, I still agree to some extent that complex maths should be done using a calculator, but basic mental arithmetic and an understanding of mathematical concepts should be basic universal knowledge. A good friend of mine (who is an actuary) volunteers as a maths teacher to adults in a South African township as he believes that it is numeracy and mathematical ability that will take people out of poverty.

Why is the general level of maths so bad?

Actuary blames the lack of availability of good maths teachers, and Banker reckons this is as people that are good at maths can be paid more in the city than in teaching. I blame the bad PR that maths gets in general and society’s acceptance that “maths is hard” and “maths is for nerds”. This rep doesn’t exist in the Far East, as evidenced in the recent film ‘X+Y’, where the Asperger’s boy “anti-hero” who has a flair for maths and is an outcast in the UK, is viewed as a “Hero” and legitimate mainstream love interest by the Chinese girl when transplanted to maths camp in Taiwan. Maybe when we in the UK learn to fancy girls and boys that can solve quadratic equations as much as girls and boys that can write love poems in the manner of Keats, we could have a maths renaissance.

It seems though that things are changing and that I am not the only one disgruntled by the apathy and low expectations for maths even under the supposed hard target-setting “Gove-ian” government, as the number of Kumon centres spreading fast across the UK can attest. When posters at my local tube station are inviting me to set up my own Kumon maths teaching centre in order to earn shed loads of money, one can only imagine that the demand for better maths education is such now that the government should think harder about supplying more and better teaching lest the gap between the Kumon-haves and Kumon have-nots should widen.

The Pros & Cons of Kumon

For those unfamiliar with Kumon, it is a Japanese system of learning maths focused on daily practice of maths using generic maths worksheets targeted at your child’s level. You attend a special “Kumon Centre” to get your worksheets marked and some advice on corrections; then you get set more worksheets to do at home until your next attendance at the centre. For this you pay a not-insignificant subscription fee, albeit less than a personal maths tutor.

You might think that being a maths-ophile that I would love Kumon, but you’d be wrong. Whilst I am a fan of improving mathematical ability, and am in no doubt that practicing maths on a daily basis will significantly improve your child’s mathematical ability, I am not convinced by it enough to send my own children, although I have to admit that I have never set foot in a Kumon centre, but have spoken to many people that use Kumon and have investigated the website and promotional literature.

Can it be in any way fun?

The advertising may suggest that the “centres” are fun places of learning, and that the specially designed worksheets “will make maths enjoyable”, however from what I have seen, the centres are just rented halls where children sit and do worksheets. The worksheets are similar to any other worksheets printable from on-line sites or workbooks purchasable from WHSmiths. There is likely to be added value of having worksheets targeted at your child’s individual ability rather than their chronological age, but they are no more “fun”. Even the Kumon logo depicts an unhappy face. I always wondered if this was supposed to resemble the children going in or coming out of Kumon, neither seemed to send a positive message.

It still relies on parental discipline

I could see the attraction of handing over my innumerate child and being handed back a child that was numerate and confident at maths with no effort from me, but from my observations of Kumon parents, that’s not the case. No, Kumon mums (I don’t like to bring gender into it but I have only yet met Kumon mums and Kumon nannies) are frazzled as they are the ones that need to uphold the discipline to make the said innumerate child do the blessed worksheets throughout the week.

Evaluation is still teacher led

Whilst parents are required to nag children to complete their worksheets, it is the teacher that evaluates and monitors progress and sets the agenda. Maybe I am just too much of a control freak, but I think that parents should have a role in this. Some parents love Kumon (and maths tutors and private schools) and actively avoid “evaluating” their children’s ability. They see it as somehow making a value judgement on their child and this being somehow unhealthy as they should always believe that their child’s ability is SUPER. Some such parents get a nasty surprise if their children underperform and pass disappointment on to their children; others blame the teachers for not getting the best out of their SUPER-able child.

I believe in the reverse. I think that evaluating and monitoring your child’s ability is essential so that as a parent you have an accurate, realistic and evidence-based picture of your child so that you can guide them into the appropriate school/ university/ career. There is no value-judgement as your child IS SUPER no matter what their ability.

Two-tier education

As I alluded to earlier, I believe that Kumon is just another way in which the middle-classes can pull away from the mainstream. We shouldn’t need Kumon; we should be putting pressure on the government for the betterment of overall maths education. The proliferation and promotion of “professionals” in maths tuition undermines the very real and practical advancements that can be made with primary maths learning by parental involvement in reinforcing school maths. Most parents who are sending their children to Kumon have at least primary school level education and should be able to help their children with maths at this level without the requirement of paid professionals. If increased efforts were made to educate parents on supporting their child’s education, children from all backgrounds would benefit.

What did I do?

I am speaking from the middle of my maths journey with my children. I cannot in all certainty confess ultimate success, nor admit to a pain and frustration free experience to date. Most of what I did and am doing is based on trial and many errors. I summate the optimum strategies that I have garnered not the entirety of my experience which contains many expletives, failures and revisions. Although I can confess that both my children are performing at the top end of their respective classes at maths, I cannot negate the real effects of genetics on this outcome. Irrespective of this, I am happy with the choices I made and so am sharing my limited insights with you, in case you may find it of value.

I introduced numbers to my kids at the same time that letters were introduced. Literacy and numeracy are to be given parity in my book. Children are just as capable of learning a sequence of numbers as they are a sequence of letters. From when my children were a young age I carried a notebook around with me and if there was a period of “waiting time”, for instance waiting to be served in a coffee shop, I would draw puzzles (mazes, matching puzzles, counting puzzles) for my children. If they were completed easily, I would make the next one harder. If they were too hard, I would make the next one easier.

maths 1

As the children grew older, these puzzles moved towards proper mathematics. Rather than only being served up in “dead-time”, they were served up daily. Initially this was done in the evenings when I got home from work, but on finding the children (and indeed me) too tired at this time of day, I switched it to the mornings. This worked a lot better as the children were fresh and my over-enthusiastic tendency to set more and more work was naturally curtailed by the requirement to send children to school and get to work on time. The initial protests subsided and they came to realise this was the routine from now on.

Friends looked at me like I was bonkers when I told them that I wrote my own maths worksheets for the kids, but what better way to tailor work for your children? By having daily exposure to what my children found easy and hard, I could not only have an in-depth understanding of their precise ability, but also be in the best position to set and manipulate their next worksheet. If single digit additions were proving easy, then you can bet that double digit additions were thrown into the mix on the next worksheet. However, if there were too many tears and frustrations, the next few worksheets would be deliberately easy to restore confidence. By writing your own worksheets, you can not only tailor your child’s learning but heavily manipulate their confidence.

maths 2

When abstract problems became taxing, I found that re-framing problems into applied mathematics sorted the problem. Big Sis struggled immensely with problems such as “What number is half-way between 26 and 36?” She cried. Many times. I tried to explain it many times unsuccessfully: “You can either add the two numbers together and halve the total; or, you can add to the smaller number half the difference between the two numbers”. Not surprisingly, Big Sis developed glazed over eyes and hands over ears “la-la-la – not-listening” pose much to my annoyance. Then one time, lashing out in desperation I happened to say: “I give you 26 sweets and I give Lil Bro 36 sweets…”, then before I could even finish my sentence, Big Sis declares “That’s not fair! He shouldn’t get more than me! We should both get…(counting)… 31 sweets each” and “Bingo”. The war was won. From then on, problems were made real and Big Sis relished calculating “real world” problems. When Banker ran the barbecue at the school fair, maths worksheets were laden with problems of “Your friend Henry wants to buy 3 hot dogs from your dad. Hot dogs are £3 each, how much does he need to spend? What change must your dad give him from a £10 note?” At birthday time when Digi-birds were requested, “How many Digi-birds can you buy with the £30 your grandma will give you?” Go-figure, self-interest really helps with maths. Maths was made useful if not fun. There were no more complaints.

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Once confidence was gained at maths, we moved on to shop-bought workbooks. If workbooks were a struggle, then the same book would be reworked again, being very easy the second time around, not only to consolidate knowledge but to boost confidence. The message “Maths can be easy”. And because I am evaluating and monitoring progress, as well as her teacher, nothing said at parents’ evening surprised me. I can pick up a Key Stage 1 Maths paper and know almost exactly which questions Big Sis will answer correctly and which she will struggle with.

Why is this important?

When the 11+ exams come around and performance will matter, I don’t need to rely on the opinion of others, I can be (almost) confident about my children’s performance and if I do not think that they will succeed, then they will not sit the exam. The bar will be set at achievable. Expectations can be managed in advance, disappointments avoided, and crucially self-esteem preserved. Self-esteem, confidence and a continued keenness to learn always matter more than the final mark at this age, and arguably at all ages as life is a marathon not a sprint. Contrary to popular belief that children who are being set regular work are “pressurised”, I believe the reverse. The “pressure” comes from the weight of parental expectation not parental preparation.

If you have the time and inclination, give Kumon a miss, roll up your sleeves and give it a go. There are frustrations and discipline required (but this is required of Kumon too) but there is also satisfaction and delight when you witness the penny drop and the passing of knowledge and the instillation of confidence.

I remember fondly my mother teaching me maths (despite my tears and tantrums) and I hope as adults my children will feel the same way.

Managing your child’s behaviour: Can’t behave, Won’t behave?

Incredible years

Over the last few weeks I have been asked by a few people to write something on managing behaviour of children. This is one of the biggest challenges for parents, and yet I had put off writing about this as it is not as easy to give advice on this as it sounds. The “tips” that friends were asking for basically amount to what we in the industry call “behavioural management”. Ways in which parents can magically “change” or “manage” their children’s behaviour. Sadly, there is no magic tip, only all the things that you have already heard of and tried. Behavioural management tries to spell out what is and is not desirable behaviour and strategies try to tip the balance of choice towards behaviours that are desirable. Well known strategies include “the naughty mat” or “time out”, “ignoring” your child’s mild bad behaviour and also the blessed “reward chart”. If you want to read up on behavioural management an excellent book is “The Incredible Years” by Webster-Stratton. I won’t précis what I feel is a thorough account of good behavioural management, but instead ask:

Does behavioural management work?

The answer in theory is unequivocally “yes”.

But, so often in practice is “no”.

This is because behavioural management is easiest to implement when your child is “typical” and has no other problems, and you (the parent) are brilliant, have no problems and are super consistent in everything you do both with your co-parent and school.

Which basically means “no” or only “a bit”– as when does the above situation ever happen?

Here are two reasons why your child may not be “typical”:

Neurodevelopmental problems:

Neurodevelopmental problems, in particular learning difficulty can heavily impact behaviour.  In young children, aggression and temper tantrums are typical responses to frustration, but by school age, some control should have been gained over these behaviours. If a child is developmentally delayed, then their ability to behave should be compared to their developmental age rather than chronological age. A 16 year old boy with the developmental level of a 4 year old; can be expected to behave in line with a 4 year old. For a four year old, temper tantrums and hitting out are common responses to frustration, the trouble is that being hit by a 16 year old boy in a temper tantrum has very different consequences to being hit by a 4 year old, and yet, the child “can’t” help responding in this way. These children are often clients in child mental health services as parenting children with severe learning difficulties can be extremely challenging. Other neurodevelopmental disorders also cause behavioural problems. In ADHD children with problems with attention cannot listen to or follow instructions as well as other children. They will tend to act without thinking and may do things that they regret later because they acted without thinking. Children with Autistic Spectrum Disorder may have behavioural problems as they are having difficulty in understanding what is being expected of them and poor social understanding can lead to many more frustrations on a daily basis. Standard behavioural management may not work in these groups of children and behavioural management needs to be adapted to the child’s difficulties. In general it is harder to implement and with more varied results than in children without neurodevelopmental difficulties.

Emotional problems:

Children who are having emotional problems may have difficulties in behaviour. Emotions and behaviour are inextricably linked. When we feel down or stressed out, our behaviour changes. Some of us reach for chocolate, some for alcohol, some people become withdrawn and unsociable, other people become irritable and angry. It is important to assess emotional aspects of your child’s life if their behaviour changes or deteriorates. Children may not always volunteer their states of mind to you. They may not be able to label their emotions, or to express themselves. They may be afraid to talk about these things. Their unhappiness and frustrations are displayed in their behaviour rather than in words.  It is your responsibility as a parent to notice, to ask, to label for them, to give them words, to give them permission to talk about their difficulties. To guess and to investigate from asking teachers and friends if nothing is forthcoming. It may be that they are being bullied at school, it may be that they are picking up on the stress in your marriage, it may be something trivial, but if you don’t notice/ enquire, you won’t know and their change in behaviour will just be called “bad behaviour” or “acting out”.  In these cases, behavioural management will not work well. Rewards will feel irrelevant, ignoring and punishment will feel like persecution, negative attention will be better than no attention and rejection is a welcome confirmation of their own self-loathing. Finding out what is wrong, offering security will work better here. Unattended emotional problems in children can impact personality and aid development of long-lasting traits that can lead to “bad behaviour” becoming habitual and “part of” a person’s personality that can no longer be easily mended.

In children without these additional problems, the limiting factor to good behaviour is usually the parent not the child.

Lack of sustained motivation:

In the defining clinical trial for children with ADHD where they compared medication to behavioural management (The MTA Study), behavioural management achieved equal outcomes compared to medication. But wait, here the behavioural management programme used highly trained psychologists to work with highly motivated parents and teachers to obtain this outcome. Real-life trials (what we call pragmatic trials) using existing services, which tend not to heavily involve the schools (as the Department of Education is separate from the Department of Health), and non-selected patient groups, that have looked at the efficacy of community parenting and behavioural management programmes have netted unimpressive results.  It is not that children’s behaviour cannot be managed; it is that the will of society and parents, is insufficient.

I know this all too well. Big Sis has a weekly spelling test. On the weeks where I have my act together, we sit and learn the words and I test her on the words each day to make sure that at the end of the week, she gets full marks and I reward her for this attainment. This is basically behavioural management in action: co-working towards a set goal that is achievable, achieved and rewarded. This works fantastically well, thumbs up and smiles all around. Once she has done this for a few weeks, I get complacent and I think, well now – maybe I can just give it a skip this week, she and I can both have a relax and we’ll just have a quick look at the words the night before. She gets a couple of mistakes. That’s basically my anecdote for behavioural management. It genuinely works until one day, you can’t be bothered and it all goes a bit wobbly again. The limiting factor is me, not Big Sis.

Parental problems:

Wobbles in my behavioural management can also be seen when I am stressed or distracted. One time when I was very stressed waiting for a phone call regarding a job offer; the children were extremely badly behaved – “for no reason”. I was snappy and shouted at them and they just wouldn’t do what they were told – “it was as if they knew exactly when to wind me up”. Eventually, the phone call came, and I had got the job. That afternoon, they were very well behaved. The change had been in me, and their behaviour merely reflected my state and parenting capability, not something innate in them.

Unrealistic parental expectation:

When we talk about “bad behaviour” we all mean different things and we all have different thresholds as to what is meant by “bad”. Some friends and relatives come by our house and make “tutting” sounds when they see our kids glued to the TV, leave the table at meal times on a whim to dance around the kitchen, bonk each other on the head with cushions and generally shout at each other and at us. To me, this is not bad behaviour – this is just life in our household! Equally, I raise a brow when I see children that never say “please” or “thank you” and run away from their parents on the street, while this is not something that bothers them. When parents complain that their children “Will not do as they are told”, the severity of the issue rather depends on what they are being told to do. If they will not do 60 minutes of piano practice every night, that is rather different from refusing to do their homework, or refusing to stop watching TV; and “good” and “bad” behaviour is sooo dependent on what the  parental and school expectation is. Often there are cultural and generational expectations of how children should behave. A normal child in a school with high behavioural expectations may be deemed to have “bad behaviour”, a normal child in one culture may be deemed badly behaved in another. The behaviour is relative and in order to assess behaviour properly, it is important to first evaluate that the expectations are reasonable. There is a limit to how much a child can “change” and they will not bother to attempt to change behaviour if they feel that the bar is being set too high.

Inconsistency:

One of the main saboteurs of a good behavioural management programme is “other people”. The well-intentioned/ or not so well-intentioned other half who disagrees with what you are doing. By not supporting you, they are de facto sabotaging the behavioural management plan because children are such buggers that they can spot disagreement a mile off and work it to their advantage. Much like MPs claiming expenses and benefit fraudsters, they are not averse to trying to get away with as much as they can. Playing one parent off the other must be a favourite game for children. In my opinion parents who want to succeed at behavioural management need to get on board together, or not bother. A similar conundrum exists with the school. If children are told one thing at home and another at school, the “authority” of “the rules” is undermined. It is a good idea when implementing behavioural management to discuss plans with the child’s school so that the same message is delivered to the child.

So in summary, if emotional problems are excluded, behavioural management delivered consistently and well will definitely improve your child’s behaviour, even if they have additional difficulties; but it is by no means a magic wand. It takes hard toil, stamina, guts, persistence and tears, but can reward you with likeable human beings. Isn’t that the essence of parenting?

If you want to know more about behavioural management please buy/ beg/ steal/ borrow: The Incredible Years, by Carolyn Webster-Stratton. This is the programme recommended by my colleague Professor Stephen Scott OBE of the UK’s National Parenting Academy. I have read it cover to cover and it’s good common sense.

References:

Carolyn Webster-Stratton. The Incredible Years. ISBN 978-1-892222-04-06. http://www.incredibleyears.com

The MTA Cooperative Group (1999) A 14-Month Randomized Clinical Trial of Treatment Strategies for Attention-Deficit/Hyperactivity Disorder. Archives of General Psychiatry. 56:1073-1086

Assess your child’s mental health and other great resources for parents

Little Effra Pictures

This week I have been working on a resources page for the site as there are some great, free resources out there that I think are unknown to parents and under-utilised. The resources page will permanently feature on this site now, so please let other people know about it. I hope to continue to populate this resource page with new and wonderful things so do check back occasionally to the resource page.

Information

FREE Child Psychiatry Textbook

Youth in Mind is a great resource from Professor Robert Goodman a fantastic researcher in epidemiology in children’s mental health who has taught and helped me with research in the past. The website is a bit basic, but don’t let this fool you into thinking it is not legitimate; it’s just that high-flying academics have more time for research than prettying-up a website. On the bottom of the home page, you can access a download of Goodman and Scott’s textbook on Child & Adolescent Psychiatry. All psychiatrists read this book for the Membership exams for the Royal College of Psychiatrists so if you digest this book, it is probably as much as most generic psychiatrists know. Unless you are a budding psychiatrist, I am not recommending you read this cover to cover, but if you want an authoritative and comprehensive view of a particular issue, it’s a really useful reference. And FREE. Robert is a truly generous academic and I know that he negotiated with the publishers for this content to be made free particularly for colleagues practicing in the developing countries, but it does mean that this resource is now available for everyone.

For Parents

Assess you child’s strengths and difficulties

Also from Youth in Mind, you can navigate in your own language to an on-line questionnaire, the Strengths and Difficulties Questionnaire (SDQ) which you can complete on-line for your child. The SDQ is one of the most frequently used screens for mental health problems worldwide and will help highlight your child’s strengths and difficulties in key domains. The web-site will give you specific instructions and will also give you a feedback report about your child’s strengths and difficulties. A teacher version is also available, and the combination of both parent and teacher reports will give a more accurate summary. For teenagers there is also a child self-report version. Of course, no on-line questionnaire can replace a medical assessment if you are worried about your child, but it can prompt you to think about your child broadly and to consider if there are any concerns that warrant further exploration.

For Teachers

Learn how to help a child you work with

For teachers, social workers, youth group leaders and anyone working with children MindED is a great e-learning resource that will undoubtedly help you help the children you are working with. It was set up as a collaboration between the Department of Health and the Royal College of Psychiatrists as well as Paediatrics, so is a good resource.

For Young People

Headmeds

This is a website targeted at young people so that they can get informed about the medications that they may be being prescribed. It is funded by the charity Young Minds and is also very good.

Autism

The National Autistic Society Website

Still the go-to site for autism information for parents. There are regional branches of the NAS and they will give you information about resources, services and support groups locally.

Education

The Book People

What would I do without the brilliant Book People? The majority of presents that we give to other children for their birthdays come from here (Sssshh – they are so cheap – don’t tell). Books make great presents, and the Book People even do cheap but beautiful birthday cards. I hate cheap plastic tat, and so we always give a book as the party-bag present at parties too. At a pound-or-so a book (including greats such as Roald Dahl and Diary of a Wimpy Kid), it beats plastic tat and a glow-stick any day. The full Roald Dahl collection (15 books, potentially a year’s worth of reading) can be purchased for the price of two cinema tickets, and the full set of David Walliams audio-books kept the kids quiet on many a long drive. Great adult and cookery books too!

Does parenting help chess and poetry?

chess

A few weeks ago I had a conversation with a professor. She asked me how my children were. Being conscious that my part-time status should not account for nothing, I bragged:

“Oh, my daughter is in the final of the Borough Poetry competition and my 5 year old son is playing chess”.

What surprised me was her response.

“Oh – you see, that proves it’s all “G””

(G is the behavioural geneticists’ abbreviation for genetic effect – yes, we behavioural geneticists actually do talk in terms of “G” and “E” (environmental effect) in common parlance rather than actual coherent words).

“Oh” I said, “I was about to say that it proves it’s all “E””.

Of course, we all know that both “G” and “E” play an effect in outcome, but it is funny to see how (even in two people that study it) our interpretation of science is coloured by our own personal view; or perhaps rather, we skew the science to suit our own needs and to support our chosen behaviours.

My personal view is that parenting matters. I would not have gone part-time and sacrificed career advancement if I did not believe that I would be making a significant positive impact on the outcome of my children. I am more likely to see positive outcomes in my children as being directly related to my input, rather than what would have happened regardless if I was there or not.

If you believe that outcomes are solely genetically determined, then parenting no longer becomes important, and you may as well excel at work and farm out childcare. Equally, if you have chosen to excel at work and farm out childcare, it would suit you very well to believe that “it’s all about G”.

So here’s the route to Big Sis’s poetry success and how come Lil Bro is playing chess at 5 years, and you can decide for yourself on the G and E in these instances.

Big Sis:

Big Sis is good with words. She is interested in them and from as young as 3 years she would always ask questions about the meaning of words:

Big Sis: What does imagination mean?

Me: It’s something that you think about in your head.

Later, when I asked her to concentrate on colouring within the lines:

Big Sis: What does concentration mean?

Me: It’s when you use your head to think about something.

Big Sis: No. That’s your imagination.

At that point, I bought her a dictionary so that she did not need to rely on my lack of defining prowess; the point being that she was interested in words and their meaning from a young age and I provided her with the tools to pursue this.

In addition, I read to Big Sis (and Lil Bro) every night from the age of 1 year, until they could read chapter books for themselves, and I will still read to them more challenging books when we are on holiday. I will define (to the best of my ability) difficult words and ask questions to check that they understand what I have read to them.

I have a book of poems my sisters and I wrote when we were Big Sis’s age. My father encouraged us to write them and he had them bound in a fancy book. They are absolutely hideous (all basic rhymes and no substance – “I love school. It’s so cool.” – you get the tragic idea) but strangely appealing to young children. Sometimes I would get this book out and read them to the children.

When I found out that Big Sis was studying poetry at school, I went to Waterstones to buy TS Elliot’s “Old Possum’s Book of Practical Cats”. We have a well-loved cat, and so I thought that this would be an accessible poetry choice for Big Sis. Indeed it was. We read all the poems together. Lil Bro takes to Macavity, Big Sis to the Pekes and the Pollicles. We will soon be taking advantage of the return of the “Cats” musical at the West End.

In one poem, TS Elliot says “How else can a cat keep its tail perpendicular?”

Big Sis asked for a definition of “perpendicular”.

I explained that it means when something is at right-angles to something else. I stand up and demonstrate with my arms perpendicular. At that moment, our cat jumps out from under the bed with her tail up. “There look” – I say pointing, “that’s what it means to have a tail that is perpendicular.” Big Sis understands.

“But”, I say to Big Sis, “I think that Mr Elliot has another meaning when he asks this.”

“Show me what you look like when you are sad or ashamed of yourself.”

Big Sis, the master of drama, slumps and hunches over; slinking away.

“Now show me how you look when you are proud.”

Big Sis sits up straight and tall.

“Look”, I say, “You are “perpendicular” to the ground when you are proud. I think this is what TS Elliot means; he is talking about pride rather than the position of the cat’s tail.”

Later, Big Sis is practising ballet moves in the hallway.

“Mum!” She shouts.

“My leg is perpendicular.”

 

Lil Bro:

Lil Bro has always had excellent spatial awareness. One Christmas just after his second birthday I thought about presents to get him. Being Chinese, the first toys that come to mind are educational ones. I thought I would get him a jigsaw, something he could realistically manage like a 3-piece. His Aunty, who is also Chinese and so of the same “educational toys” mind set also buys him jigsaws – Thomas the Tank Engine ones; only, she has no children and so did not appreciate how many pieces a 2 year old could realistically do – and bought him 6, 10 and 12 piece jigsaws.

One evening, I was cooking dinner so I put Lil Bro at the table with the 3 piece jigsaws. He wanted the Thomas ones, so I put those out as well, just to keep the peace while I cooked. The next minute, I turned around and there he was sitting with the 6 piece puzzle completed. I nearly dropped my saucepan.

“OK, then clever clogs” I thought, here’s the 10 piece.

That was also pretty much consumed.

My Christmas present was a complete waste of money, he never did 3-pieces. By the time he was 3, 24-35 piece jigsaws were no problem. We even played “Jigsaw-offs” – infant versus geriatric; where Lil Bro and my mother would race as to who could finish an identical 24 piece jigsaw faster. Lil Bro was victorious.

By 4 years old 50 and 72 pieces were fine. By that time, I had emptied out several toyshops of their jigsaws.

At weekends, when Big Sis was at her swimming lesson, Lil Bro and I would sit in the coffee shop next door and eat porridge. The coffee shop had chess and draughts sets for customers to play with. To kill the time, I taught Lil Bro to play draughts and then chess. I am not the greatest chess player myself. I tend to take pieces with no overarching strategy; pretty much ending most games with no conclusion as my bishop and king chase the opponent’s knight and king hopelessly around the board. Still, by 4 years, Lil Bro knew how the pieces moved. I installed a chess game on to the ipad at home and encouraged the children to play it.

By chance, there is a chess club that runs in the same community centre that the children go to Chinese classes at (they go to be at one with being “Chinese” – their Chinese is even more hopeless than mine). One day, Lil Bro, aged 4 years said “I want to go there and play chess”. Given that the time clashed with their Chinese class. I said it wasn’t possible, but when it came to the summer holidays, I asked if they wanted to go to Chess Summer Camp for a week.

Big Sis was not keen.

I said to Lil Bro, “Your sister doesn’t want to go. Are you sure you want to go, even on your own?”

He said yes.

I went to check with the Chess Camp leader – wasn’t he too young?

The Chess Camp leader said some of the best players in the club were 5-6 year olds. Still, I wasn’t happy to send Lil Bro on his own and I eventually managed to twist Big Sis’s arm to go with him.

After a week of chess camp, and the initial enthusiasm, we carried on playing chess occasionally now and then. I didn’t think anything further on it. Then 3 months later, Lil Bro says to me “I want to go to chess club”.

Man! I thought. I wrack the local websites for chess clubs that are not going to clash with their Chinese class and are not too expensive. Finally, I find a cheap club on a Saturday afternoon at the local library. It’s good, but there is one teacher to eight children at greatly varying ages and abilities. Plus, smack bang in the middle of Saturday afternoon is not the most convenient time.

I get the chess teacher’s contact details. I ring around a few mothers I know whose children might be interested in chess. I set up a chess club for 3 boys after school in a local coffee shop.

So…what do you make of it?

My view is this: clearly, both Big Sis and Lil Bro have genetic predispositions to be good at certain things. I come from a family of mathematicians and engineers; Banker from a family of lawyers and linguists. Go figure that these genes are knocking about our chromosomes.

But can that be all?

What if I hadn’t been there to notice?

What if I had noticed but done nothing about it?

What if I had noticed it but derided intellectual pursuits and tried to knock it out of them?

I am pretty sure that Big Sis would still have enjoyed and been good at writing and Lil Bro would have found chess by himself at a later age. But would they have been in the final of a poetry competition at age 7 years, and been playing chess aged 5 years?

No.

Do these things matter?

Might they not reach the same end-point in adulthood?

That is the more interesting question that is so hard to answer because of the lack of the counter-factual. But my view is this: if life is a journey and your outcome is your destination; genes will drop you off at the airport. If you are lucky it will be London City Airport, if you are not so lucky it will be Luton Airport Parkway. Parenting provides your back-pack: it can be empty; or it can be full of maps, restaurant and hotel reviews, travel guides, good books, a compass, a thermos of cocoa and a bag of chocolate chip cookies. It might not be everything you need, but it sure helps you on the way.

Ultimately, where you go from there is up to you.

How to choose your child’s nursery

Nursery

It is ironic that for many of us one of the first major choices we have when we become a parent is about who else is going to “parent” our baby. If you are going down the nursery route, this decision often has to be made prenatally depending on the length of time you wish to take for maternity leave and the waiting list time on your local nurseries.

When I first went about looking for a nursery for Big Sis, I didn’t have a clue what I should be looking for. Inevitably, I made a wrong decision and I was unhappy with the nursery (Nursery A) that I initially chose for Big Sis. The problem being that when you are required to make this decision, you are still in the mind-set of someone without children, someone whose priority is themselves and their work. Not yet a parent, whose priority is their child. With this hat on, decisions regarding childcare are made with the priorities of cost, convenience and ease of getting to and from work, not necessarily the priority that you have once you actually ARE a parent.

I had chosen Nursery A as it was close to the tube station, was located in a beautiful Victorian house, was brand new and had designer furniture for children, a computer room, a sensory room, a music room and offered baby yoga and science lessons. I was given my own electronic fob to get in and out of the nursery building and on-line access to the nursery’s CCTV cameras allowing me to see what Big Sis was up-to from the comfort of my computer at work. Formula milk, nappies, sun screen etc. were all included in the fees meaning all I had to do was drop off my baby in the morning, and the nursery operating hours were long (early drop off and late pick-up) so I could meet my work commitments. Staff advertised themselves for evening babysitting sessions. Oh, and there was an organic kitchen on-site. Why wouldn’t any working parent choose this nursery?

It was only when I realised my mistake (that I had been woo-ed by aesthetics and meeting my own needs) and moved Big Sis along with Lil Bro to a different nursery (Nursery B) that I realised what a nursery was supposed to be about. The child.

Nursery B was further from the tube station, had more modest grounds, smaller and more old-fashioned classrooms, no designated music room or computer room, no electronic fobs or CCTV, late drop-off and early pick-ups (making getting to work on time pretty hard) and the requirement to provide your own milk, nappies, and sun screen (such that there were regular rebukes from staff when you forgot one thing or another). Yet it had a waiting list a mile long. Both nurseries had a similar fee. I realised that none of the “extras” were relevant. The management and staff at Nursery B were excellent. That is all that matters. Nursery B’s operation was aimed at the children, not designed to suit and woo parents. But how can you tell this when you visit?

Here are my tips for what to look for so you can get it right first time:

Standard no-brainers:

“What is the atmosphere like?”

“Do the children there enjoy going to the nursery?”

“What is the food like? Is it cooked on site?”

“What activities do the children do?”

“What are the facilities like?”

“Where do the children sleep?”

“Are the premises clean, safe, inviting and child friendly?”

“What is the policy for children with special needs/ allergies/ medical conditions?”

“What are the policies for if your child is sick?”

“What are the nursery opening and closing times and how many days of the year is the nursery open?”

“Do the staff appear warm, competent and knowledgeable?”

“Is there any outdoor space?”

“What are the fees?” – I don’t think you’ll forget this one. Remember to bring a hanky as the response will be eye-watering.

Additional gems:

Check the Ofsted Report

I cannot stress the importance of checking out a nursery’s Ofsted report and rating. Ofsted is the government agency that inspects all schools and childcare provisions in the UK. They report on all manner of things from the built environment, health and safety procedures and management. This might all seem extremely mundane and irrelevant when all you want is lovely, bubbly, staff that are going to welcome and cuddle your baby, but for anyone that has worked for any type of institution or business before, the competence of management matters. Within the NHS, it is evident that competent managers can instil high service standards, efficient service and good employee morale. The reverse is also true, and this is as true for nurseries as the NHS. If you can, go for an Ofsted Outstanding nursery. Big Sis’s first nursery had newly opened and had not been inspected at the time Big Sis started, but when it was inspected, it achieved a “satisfactory” ranking (two levels below “Outstanding”) which confirmed my doubts about it and precipitated my moving her to Outstanding nursery B, which lived up to its Ofsted rating. Prior to experiencing first hand the difference between “satisfactory” and “outstanding”, I thought – it can’t make much difference – “good” is “good” right? Well orange squash also tastes pretty good until you try Champagne. As most people choose a nursery and stick to it, they never usually get to know just what a difference a nursery can make. If you feel you have made a wrong choice like I did, it is ALWAYS worth changing.

Experience the management

As well as checking out the objective management ratings on the Ofsted report, check it out for yourself. A well-managed nursery would ensure that the phones were answered promptly and that if they say they will get back to you, they do. How well organised and managed is the viewing that they give you of the nursery? How senior are the staff that are showing you around? If you do not think that these administrative things matter, then think about how much they would matter if your child were at that nursery. What if no one answered the phone when you were ringing the nursery to convey an important message about your child? What if staff tell you they will do something for your child, but they don’t? If senior staff are not there to show you around, are they ever there? The best functioning services are ones where administration and front line staff are both working efficiently under effective and accessible senior management. At nursery B the senior manager was on site every day and knew the name of every child.

Ask about staff turnover

In my mind, effectively looking after young children is not something that can easily be done if you are not happy (if you don’t believe me you can extrapolate this from lots of post natal depression literature). If a nursery has high staff turnover then I cannot imagine that the staff can be very happy working there. During Big Sis’s 18 month time at nursery A, her “mentor” or “Key worker” changed 3 times because of staff resignations. The nursery manager also changed 3 times. This discontinuity of staff cannot make for stable attachments and relationships with the children and indicate that there is something unsatisfactory systemically that is preventing people from wanting to remain employed there. If staff are unhappy in their jobs, how can they provide the highest standard of care for your child? The average time that the key staff had been in place at nursery B was 9 years. As the fees for both nurseries were the same, it was clear that where one had chosen to spend the fee on aesthetics and extras to woo parents, the other had chosen to spend on training, valuing and retaining key and experienced staff. I know which matters more to me.

Ask about incident forms and how they manage difficult children

Big Sis was bitten or scratched by other children in her class at least 10 to 15 times in her 18 month career at nursery A. Other children in her class were also being bitten and scratched and we parents almost had to form a line to sign the incident forms when we collected our children. We would be told that a new toddler had been admitted to the class who had not yet been “socialised” by the nursery but that they would get the child under control soon. Only then, they would admit another “unsocialised” child. Eventually I had to sign an incident form saying that Big Sis had bitten another child (although she never bit anyone at home), and to tell the truth, I was rather glad that Big Sis was retaliating rather than being a teething ring for the other children. After Big Sis transferred to the nursery B she was bitten once and scratched once in a period of 28 months. She didn’t bite anyone. Lil Bro, who has only known the outstanding nursery has never been bitten or scratched and has never bitten another child at nursery. He has bitten his sister at home so it is not as if he is a particularly placid non-biting child. In my experience, biting is a very normal aggressive reaction in children and most children in the 0-3 year age group will do it at some point. Initially when Big Sis was being bitten at nursery, I was sympathetic to the nursery as I am aware that “all children bite”, however, on witnessing how much less this type of behaviour was occurring at a well- run nursery I am pretty sure that the level of biting was related to the nursery’s care (or lack of).

The nursery may not tell you, but it is worth asking about the level of incident reports as this is data that they are obliged to collect, so they should have it (although of course bear in mind that the very worst nurseries will have the lowest levels of incident reports, as they will be negligent on keeping up their reporting).

Examine how well the staff know the children

It is difficult to assess this. All nurseries will put forward their best people to do viewings with prospective parents. It is important to view as many staff as possible and be able to quiz them, and ask them questions, rather than limit questions to the member of staff showing you around, who will have been selected as knowledgeable. In real life, this person will likely have little to do with looking after your child as they are too busy showing other prospective parents around. Try and ask a random member of staff questions like:

“Do you like working here?”

“How long have you worked here?”

“How many children are in your class?”

“How many children are you directly responsible for?”

“How many children in your class have got food allergies, who are they and what exactly are they allergic to?”

Point at a random child and ask: “What’s this child’s favourite activity?”, “Who are his friends?”, “What makes him upset?”

If you have a child with food allergies like I have, it is absolutely paramount that all members of staff know who your child is and their allergies. I have heard of nurseries where children have been given foods that they are allergic to. Nursery B went the extra mile. Not only did all staff know Lil Bro and his exceptional dietary requirements, rather than excluding Lil Bro from cooking activities on account of his dairy, wheat and egg allergies, they bought him his own mixing bowl, and baking utensils. It’s this attention to detail that makes a nursery “outstanding”.

Interrogate parents of children that already attend

As well as confirming the standard information, find out how well the staff know the parents. At nursery A, the majority of staff, aside from the staff in Big Sis’s room had no idea who I was even though I dropped off and picked up Big Sis almost every day. I would have to say “I’m Big Sis’s mum” daily. At nursery B, everyone from manager, kitchen staff, to receptionist to teachers in other classes knew whose mother I was on sight. This is really good, and a credit to the management. You might think this is irrelevant, but it shows stability of staff and how aware staff are of the children in their care. Knowing who mothers and fathers are is important as it shows that they are interested in the children they are looking after and their families. Your child is not just “a child” that they are paid to look after.

Another difference that I found between the two nurseries was that many parents were coming from a very long way to drop their children at the nursery B, whilst most at the convenient nursery A by the tube station lived in close proximity. This makes sense, as if a nursery is very good, then people are willing to travel long distances to go there. If a nursery has many parents travelling a long way to attend, you can take it that this nursery is good.

Ask about the Early Years Foundation Stage

All childminders and nurseries are required to provide “early education” in line with the Early Years Foundation Stage document. If you want to be very mean and test the nursery’s knowledge, you can read the document and test them on it. I personally wouldn’t, but I might just want to check that staff don’t look at me blankly if I mention it .

These are just a few suggestions. In the end, you will have to make up your own mind, but bear in mind that early childcare is an important decision. Many parents spend much time and many sleepless nights researching and visiting a child’s secondary or primary school options, but just put their babies into the nearest nursery to allow them to get to work. I know; I did this. In addition, the research, visits and crucially the decision is often one made single-handed by a heavily pregnant woman who really would rather a sit down and a nap.

Yet if you work full time, like I did, your children will be spending more hours per year at nursery than at any future school in their life. Further, brain development is at its maximal in the preschool years, meaning the child’s learning potential from its environment is maximal at this age and may have long lasting impact on brain development. Time and time again, research has shown that it is not the “type” of childcare (childminder, nanny, nursery) that matters, it is the QUALITY (see my paper: Liang, 2013).

Shouldn’t choosing a nursery be a serious consideration for both parents rather than a quick decision made by a brain addled, third-trimester mum? Hopefully my tips will help.

Reference:

Liang, H., Pickles, A., Wood, N. & Simonoff, E., (2012) Early Adolescent Emotional and Behavioural Outcomes of Non-parental Preschool Childcare. Social Psychiatry and Psychiatric Epidemiology , 47, 399-407.

Does your school Nativity role predict your future life chances?

Nativity

As parents the world over are turning tea towels into head gear for shepherds and scampering to source angel’s wings for their children’s star turns in Nativity plays, here’s something that might make you think.

Once, before I had my own kids I mentioned to my then Professor (a world class Child Psychiatrist) that my niece had just been selected for the second year running to play “Mary” in the school nativity. “Well” she said “That’s it then, she’s bound for greatness with a start in life like that!” It was a joke of course, but it did make me wonder if there was any truth in this. Does your infant school Nativity role predict your future life chances?

I myself was a Narrator and then a Wise Man in my own school nativities and looking back, I think this is quite apt for who and what I have become, so maybe I have an intrinsic bias to believing that there is some truth. But beyond that, I think that there is actually some scientific basis.

Firstly, the casting of the nativity school play is not a random process, but a choice made by a teacher who knows your child. The teacher will know the personality and developmental ability of your child and will be consciously or unconsciously using this knowledge to cast the play. As personality and ability show some stability over time and are strong predictors of future outcome, it would make sense that your role in the school nativity play has some predictive power over future outcome.

Lead roles will usually be given to “pro-social children”. A pro-social child is basically the opposite of an anti-social child, thus pro-social children are well-behaved, do as they are told, seek to get along with other people, and are polite and helpful. They are usually the class role models. Having pro-social children in the lead roles makes sense as it makes the teacher’s life easier if the children they are relying on to hold the play together can be relied upon to learn their lines, rehearse and critically, turn up on time on the day with their costume! Casting an anti-social child or an anxious child in the lead role is more of a risk as who knows what they will do on the day! The last thing you want is the lead role to burst into tears or have a strop on stage. Sometimes casting an anti-social or marginalised child in a lead role is used as an “intervention”, whereby in the act of instilling the responsibility and limelight of the lead role, the teacher hopes to turn around a troubled child or child lacking in self-esteem. In this circumstance the teacher will have done a lot of background work to ensure that the child is up to the challenge. This doesn’t tend to happen very often.

Depending on the version of the nativity play that is being produced, the “lead role” is variable. Traditionally the “lead roles” are that of Mary and Joseph. Sometimes Mary and or Joseph are required to say many lines and may even need to perform a solo song. In this instance, it is clear that not only does the child need to be pro-social, but they also need to be able to sing and crucially be able to perform in public confidently. Here, therefore you are already selecting for a pro-social, confident child with the cognitive ability to memorise song lyrics, dedication to rehearse, low anxiety levels and likely extrovert nature. These personality factors are likely to be important in predicting future occupation and “success” outcome.

In some versions of the nativity play, Mary and Joseph are diminutive characters that take centre stage, but say very little with the majority of the speaking roles given to narrators who will tell the story. In plays like this, the Mary and Joseph characters are still prized, but the qualities required then are somewhat different. These roles tend to still go to prosocial types; children who are well behaved, look good and are well-liked by others, but are more likely to be anxious about speaking in public; as the extrovert, confident children will be reserved for the speaking roles.

Casting is additionally influenced by personality fit with the available parts. Which teacher could have resisted casting my bespectacled, Chinese, 5-year old self with a penchant for maths as a “Wise Man”? Blondes are more frequently cast as the Angel Gabriel. “Good sports”, “the class clowns” are more frequently cast as the donkey (as others may object to this role and turn it down).

Big Sis is following in my footsteps as narrator in her school nativity. I’m over the moon, not because she may end up as a doctor, but because I don’t need to make a costume.

Hurrah!

Please let me know your previous nativity roles and how you have turned out. It would be really interesting to see if there is truth to any of this!

What’s the problem with maths?

Maths

I know, I know, it’s so cliché. Another Chinese nerd banging on about boring maths. Believe me; I have fought hard to escape this stereotype. Banker and I didn’t get off to a good start as when we first met as students he guessed that I was a maths student. Maths meant to me geeky Asian with no social skills, so I wasn’t much impressed.

However, now as an adult in the working world I am thankful for my maths skills and am only regretful that they are not better. As a mother, I positively lament the lack of emphasis on maths in the infant school curriculum and I think that this is of detriment to our children and indeed our country. Britain has produced some of the world’s best scientists, engineers and economists so it is not for want of genetic stock or tradition. Yet why does the Far East continue to dominate the international student abilities (Pisa Test) League tables for maths and science? Nosing around Russell Group Universities, I found a higher proportion of Asians lurking in the corridors of Maths, Engineering and Science departments than in the Humanities departments. Why?

From my own up-bringing which I may be erroneously extrapolating to the rest of Asia, education is extremely highly valued. Within that, maths and science is valued above other subjects. So much so that my parents dictated to my sisters and me that we had to limit our A-Levels to 3 of: Maths, Physics, Biology and Chemistry. Despite having achieved better marks in Art and History at GCSE than science, I was to be a scientist. Mad and maddening maybe, but my parents had seen a national focus on science, maths and engineering education allow their country (Taiwan) to gain economic wealth, and unprecedented development within their lifetime. On the backs of engineers, Taiwan is now a developed country and a world player in technology, despite being the size of Wales and having started in the 1940s from a much more disadvantaged base.

From a cultural origin of mathematical reverence it is quite bizarre to experience the irreverence to maths in the UK. Whilst an engineer is admired in the Far East, they are depicted as “Anoraks” in the UK. Whilst maths is a subject that both boys and girls are expected to excel in, maths in the UK is for boys, and even then – just for the boys who are born with “that logical, mathematical mind”. Whilst inability to do mental arithmetic is associated with derision and sympathy in the Far East, it is expected, sometimes even boasted about in the UK. I was shocked to find that many fellow well-educated mums were openly admitting that they would struggle to help their children with 11+ maths revision. The reason they were openly admitting this was because they were somewhat proud and not the least bit ashamed to be weak at maths, whereas I doubt anyone would openly admit to struggling to read or write at the level of an 11 year old. This would be regarded as shameful. It has become socially acceptable among the well-educated to be bad at maths. Surely this should not be?

Whilst reading is heavily pushed in infant schools, maths seems to be relatively neglected. In the UK reading and debating is cool. Law and politics is aspirational. PPE at Oxford is the Holy Grail. I have no problem with that, but why does it have to be at the detriment of maths and science? If we are a country that believes that children should be allowed to flourish and become what they want to be, doesn’t this include parity of encouragement for numeracy and literacy so that there is a level playing field of areas within which to flourish?

From a basis of low National aspiration in mathematical ability, it is no wonder that Banker states that the majority of banks are recruiting their quantitative skills staff from Asia. These skills are so sought after that my sister (who possesses a maths PhD) had no problem acquiring a highly paid job within 2 weeks of arriving back from the USA after deciding to return to the UK to be a more present Auntie. I am sure she would have found it harder to find a highly paid job had her PhD been in English Literature/ Greek Philosophy/ Viking History. At the population level one wonders whether the average Joe and Joan Blogs could calculate their expected monthly increase in mortgage repayment if the Bank of England were to increase interest rates by .5%. Yet these sorts of calculations are vitally important to keep roofs over heads and food in mouths. Maths is a vital and sought after skill, why are we not investing in it at the very grass roots?

Probably it is because the people in power don’t value or understand maths and science. Shockingly only 1 MP out of 650 has a background as a primary science worker as reported by The Guardian, and headlines of “Only scientist in Commons alarmed at MPs ignorance [about science]” in The Independent say it all. Only 70 out of 650 MPs are even registered as having “an interest” in science at all (reference here). That’s probably less than the number of MPs who are actively writing history books alongside their Parliamentary careers. I am a great supporter of the arts, but am also a strong believer that the basic level of maths and science needs to be raised and society can change this. As a social observer I see that a culture that values maths produces a society with strong mathematical ability. As a psychiatrist I know that “intelligence” is more likely to have a uniform rather than varied profile (so most children who are good at English should be as good at maths). Children with a varied profile are more likely to encounter difficulty and see a Child Psychiatrist, but over the general population they are a minority. As a researcher in behavioural genetics, I know that “g” (geneticist’s annotation for genetic “intelligence”) is generalist meaning that it applies across the board for all areas of intelligence and children who are genetically advantaged in English are also genetically advantaged in maths. Specialism or differentiation on the other hand is environmentally mediated (Kovas et al 2007). This means that in general, whether an intelligent child chooses to specialize in maths or English is due to its environment (parents, school, society); and even more crucially, where a child performs well in English but does less well in maths, this is also due to the environment (parent, school, society).

Back in the Shrink household. Big Sis’s state primary school pushes reading. So they should. All parents are expected to read with their children every night. The school challenged Big Sis at reading so much so that in Reception she was given “chapter books” to take home for her to read to me. At 5 and a half she was expected to read books containing the word “obsessed”. She could read the word but had no clue what it meant nor was she able to understand it when I tried to explain it to her. Big Sis began to hate reading and cried every night when I asked her to read to me. I persisted in thinking “if her teacher has given her this book, she must be capable of reading it”. After a few weeks of this, I gave up and thankfully went with my own judgement that these books were frankly too hard. I must be the only “Chinese Tiger Parent” to have written to the class teacher to say “Excuse me, but I think that you are over-estimating my child’s ability, can you put her reading books down 3 levels please”.  At the same time, while we parents were expected to battle to help children achieve advanced literacy, there was no expectation on us to do any numeracy with our children regularly. I don’t blame the school (it’s a great school), it’s not in the National Curriculum, no state school that I know in the UK encourages numeracy in this way, but I am pretty sure it happens in the Far East.

When I received Big Sis’s report card from Reception, she achieved “exceeding” scores in literacy but achieved “expected” scores for maths. My initial response was “How is this possible? She comes from a family of scientists and mathematicians! Maths is a family tradition.” Truth be told, I would have been happier with “expected” scores for literacy. To make matters worse, when I asked Big Sis if she was struggling with maths, she said “Maths is too hard. Maths is for boys”!

Rather than accept that “maths is hard, and she has not been born with a mathematical mind (she is a girl after all)” I set about setting Big Sis a few counting and maths problems every morning, to balance the reading that was set by the school every night. My view was that of course Big Sis’s literacy was better than her numeracy – I was required by the school to support her literacy on a daily basis but not required at all to support her numeracy. Since then, Big Sis’s maths has come along and she was rated of equal ability in maths and literacy by the end of Year 1. She will now confidently say “I am good at maths”, and attempt maths problems rather than avoid them. The solution was so simple, yet why are schools not breaking down maths to simple parts and pushing numeracy in line with literacy from reception? I’m not talking about solving quadratic equations, but if children are encouraged to count and add sweets/ pocket money/ count the number of days until Christmas etc. daily from a young age, does this not take the “difficulty” stigma out of maths?

I have found that the majority of children enjoy doing the things that they are good at. Some children are naturally good at certain things (Lil Bro is maths minded and will seek out for himself mathematical problems; he was a voracious consumer of jigsaws), however this is rarer and the majority of children become good at things. Once a child is good at something, then they will invest in doing these things and become even better at them. By the time that the National Curriculum suggests that children start doing the core of maths, their expertise and skill in literacy is far ahead of their mathematical ability. At one stage Big Sis was reading Roald Dahl’s “Fantastic Mr Fox” at school but did not know what 2 x 2 was- to me this seems completely unbalanced. Literacy and English become the favoured subjects and maths will be relatively challenging and therefore more unloved.  The opportunity to sell maths to children is hijacked by literacy being given the advantage of earlier exposure and active encouragement. In the Far East, 5-6 year old children will learn their times tables up to 12 by rote. Before you utter “We in the UK are not rote learners”, think about the reception classes up and down the land chanting their jolly phonics sounds “igh, igh, igh”; “Ph”, “Ph”, “Ph”; “ee”, “ee”, “ee”; “ai”, “ai”, “ai”. This is rote learning as who could fathom that “igh” is pronounced “i”?? Once the connections are entrenched by rote learning, it is possible to learn about the Latin and Greek from which words are derived, in the same way the meaning of relationships between numbers can be learnt. The rote learning gets you started.

I am pretty sure that had I not taken action to support Big Sis’s maths in the same way that I was required to support her literacy that Big Sis would not now confidently declare that she was “good at maths”. Without a sound understanding of maths, the enjoyment of the sciences would be in jeopardy. Isn’t it time that we put numeracy on equal footing to literacy in early years education, as only then can we really say that we are allowing our children equal opportunity to select for themselves their strengths be it science or the humanities?

References:

The Genetic and Environmental Origins of Learning Abilities and Disabilities in the Early School Years. Yulia Kovas, Claire Haworth, Philip Dale & Robert Plomin. Monographs of the Society for Research in Child Development, Serial no.288, vol 72, no.3, 2007.

All You Need is Love

Love

Simple isn’t it?

Cheesy as it is, I believe in this; so much so that this was the song that was played as my husband and I exited the church at our wedding. But if love is all you need, then in terms of parenting how and why do we sometimes get it wrong?

I think that sometimes people forget that “love” is like money; it’s no good in theoretical or inaccessible form. Having a million pound Trust Fund accessible when you reach the age of 85 years is not of much use to anyone; ultimately you need to be able to FEEL the power of it for it to have value. In my line of work, almost all parents will say that they love their children and I believe this to be true. However, the percentage of children that FEEL that their parents love them is way lower. It is therefore one thing to love your children. It is another to make them believe/ feel in their hearts/ know to the core/ have no doubt of the fact that they are loved. The former can be done from the office or at the kitchen sink; the latter is much harder work.

Knowing that you are loved/ lovable is at the core of our function. In Cognitive Behavioural Therapy for depression in both adolescents and adults, when we search back with clients for “core negative beliefs” (the fundamental cognitive processing bias in people with depression), it is amazing how predictable and limited the core beliefs are that cripple so many good people; the most common being “I am not good enough/ I am unlovable”.

When are these core beliefs formed?

In early childhood.

Who/ what contributes to the formation of these core beliefs?

Parents.

I think that sometimes parents get confused about love. They confuse it with something that needs to be earned, won or is conditional. They think that unconditional love is excessive; an extravagance that will “spoil” children, denying it may be a motivator. They, and in turn their children come to believe that achievement (or something that they need to be or do) leads to love. Many great and successful people have grown up believing this model. It makes sense that achievement leads to “being worthy of love” and self-esteem is built on achievement and love. Many people are driven to success with a desire to “make their parents proud”.

Love Model 1

But there is a second model where a fundamental core of love (unconditional and for no reason other than being) can lead to self-esteem in its own right and this self-esteem on a basis of love can drive achievement all on its own. The unconditional love and support of parents is commonplace in acceptance speeches for awards of all kinds from Nobel prizes to Oscars.

Love Model 2

This second model is infinitely stronger than the first model presented. In the first model if love is dependent on achievement, it can be a very bitter pill to swallow if achievements wane and self-esteem and love (which was built on the rocky foundation of achievement) is lost, leaving people in effect stripped of everything. Some parents of course will never be proud of their children, they don’t have it in them and people are left chasing a dream. This type of model can explain how many successful and amazing people can feel they have nothing or are perpetually “not good enough”. In the second model, even if achievements wane and the self-esteem is dented, love is untouched and the source of everything lives on.

Making some one feel loved is hard work, but for parents I think it is important to stress that the effort in love is front loaded. Just as at the start of a new romance you might abandon the grey bloomers for lingerie, refrain from passing wind, frequently ask about your new partner’s day, always go on holiday together, so “romancing” (putting extra elbow grease into making someone feel loved and special) your child is also required at the start. Once a secure loving relationship is established, then inevitable liberties will be taken, but if the work of the early years has been solid, then nothing can shake the secure foundations of love.

As I mentioned I am a great believer of the fundamental importance of love and with regard to my own children I am operating on the basis of the second model. I want my and my husband’s love to be the fuel for our children’s success (or failure, we will love them anyway). As a parent it is difficult to know “How to make children feel loved”, and believe it or not this is not a topic covered at medical school, in a psychology degree or psychiatric training. There is no scientific basis and don’t let any pseudo-science, pop-psychology book tell you otherwise. We as parents are all left to figure this out for ourselves and enact in the best way that we can. The things I figure are listed below:

1) Cuddles are good. Surely nothing says love as much as kisses and cuddles? Sod the Victorians and stiff upper lips, I’m for open affection. Often.

2) Laughing is good. What says “love” more than enjoying each other’s company? One of the vows I made when I worked full-time was that I would laugh with my children every day, and we did, and we still do.

3) Being there is good. I know that I can’t always be there for my children but I make sure that I (or my husband) am there every time it matters. School plays, sports days, class assemblies, concerts and parents’ days – we haven’t yet missed one. I wave like a frantic loon to ensure that they KNOW I am there. Embarrassing I know, but why take time off work to go if they don’t even know I made it…?

4) Being really there is better. It can’t be right just to show your face on the special occasions, part of “love” is about sharing the mundane. Being around at least some of the time to catch the joke, the thought, the upset in real time. Some things are lost in the re-telling. You can love from a distance but can you make someone FEEL loved without really spending much time with them?

5) Understanding matters. What says love more than knowing what the other person is thinking? I often finish Banker’s sentences; I can do this with the children now too. Talking about, listening and exchanging experiences and feelings regularly is the basis of being able to know and understand someone. Children’s experiences and feelings are just as significant as adult experiences even if they might seem less important. A child being told off by a teacher will hurt as much to them as an adult being told off by their boss.

6) Respect matters. I don’t think you can engender love without respect. This means listening and valuing your children’s opinions, even if they are wrong and never denigrating or humiliating them.

7) Saying it out loud matters. I am a big believer of the three words “I love you”. I think it is necessary even if it is not sufficient. Banker is shy of these words but if you want to engender unquestionable love why hold back? Go the whole hog. Say it every day, 5, 10, 20 times a day if you like – contrary to popular belief if you say it continually to the same people, the power is not diluted. At this age, children may not always understand nuance and behaviour and verbalising your emotions and intentions help to bring things home. Once after telling off Lil Bro, he cried and said “You don’t love me anymore”. Since then I have been extra good at verbalising and spelling it out:

“I will love you if you are clever, I will love you if you are not, I will love you if you are fat, I will love you if you are thin. I will love you if you are nice to me. I will love you even if you are horrible to me. Even when I am shouting at you, I love you. I love you for being you. You will always be beautiful and smart in my eyes. I am proud of you for being you. You will always have my support. I am always here for you. Nothing will change that. I love you.”

For an adult it comes across a bit stalker-ish I know, but for young children it’s good and clear (I hope).

This is by no means a correct or exhaustive list and until Big Sis and Lil Bro are adults, I will have no idea whether my list is effective at all. My consolation is that given that my intentions are blogged, they cannot say I didn’t think about this, and if I failed to let my love be truly felt, they will know that I failed trying.

Fear and Phobia in Children

pumpkin

It’s Halloween, so what better time to think about children’s fears? Clearly, for most kids, the idea of dressing up as a zombie, blood sucking vampire or evil witch is fun and funny, so what do children find frightening and why?

There is no easy answer to this, as you get some children with very strange fears (for instance I have met children who completely freak out at hairs in the bath or the texture of flour), but I will try and describe in general the progression of fears common to most children. Fears typically vary depending on age and intellectual capacity, moving from almost “instinctive fear” in babies to sophisticated fears of abstract concepts in adulthood, that require more elaborate thought processes.

For babies and toddlers, whose cognitive capacity is still basic, fear is more of an “instinct” than involving much active thought and cognition. Evolution has honed humans to have brains that are hardwired to fear certain things that have served our ancestors well in the past: for instance loud noises (which could have denoted a falling tree, an earthquake, a sabre toothed tiger or any manner of danger) and heights, which if not avoided could lead to untimely death. If you make a loud unexpected noise next to a baby, they will most certainly startle and most will start crying. So aversive are loud noises to babies that it is possible to induce a phobia in babies by using a loud noise.

A phobia is an extreme fear associated with an object or situation. Clinically speaking, it requires that the fear leads to avoidance of the object or situation causing disruption to a person’s day-to-day function. “Little Albert” is a classic case in the psychology literature of a phobia being induced in a baby using loud noise. Little Albert was a 9 month old boy who was not afraid of rats and was given a rat to play with. A dastardly psychologist John B. Watson wanted to see if it was possible to cause a phobia of rats. Every time little Albert touched the rat, a man stood behind him and banged a piece of metal with a hammer making a loud noise scaring little Albert. Needless to say, after a while of this, Albert became afraid of rats and stopped going near them, proving it is possible to induce a phobia. Thankfully ethics boards no longer allow this type of research.

Interestingly, there appears to be an evolutionarily hard-wired biological predisposition to phobia development to things which are traditionally harmful. Thus even in adults, it is easy to induce a phobia for things like rodents, snakes and spiders but very difficult to induce a phobia to cars, guns and knives which are more likely to be a real threat in the modern age.

Although it is hard to prove whether a fear of heights is innate in babies, supporting evidence comes from Eleanor Gibson’s visual cliff experiments of the 60s which tested 6-14 month old babies. Here babies were encouraged by their mothers to cross a floor that had a section partway made of transparent Perspex over a ditch. Most babies would not crawl over the Perspex even though they could feel the floor was solid with their hands. Some babies cried as they “could not” get to their mothers for fear of falling into a ditch. Some fearful babies that did not dare cross rolled onto the Perspex part by accident, good evidence that fear, does not necessarily prevent accidents and proving that babies should not be left near real cliff edges! A few other babies, whether due to fearlessness or ignorance crawled over the Perspex. The dumb and fearless – either bound for greatness or an early exit.

At this young age, babies (at least baby monkeys) are also primed to fear what others fear. This evolutionary trick allows babies to quickly pick up the dominant threats in its environment, as if others feared something; it would probably do them good to quickly learn to fear it too. Mineka showed this clearly in Rhesus monkeys who were laboratory raised and did not fear snakes. After showing the monkeys videos of wild monkeys showing extreme fear to snakes, the baby monkeys became afraid of toy snakes in the laboratory, despite never personally having had an unfortunate encounter with a snake. Babies and young children are also primed to attend to their parents’ fear. I acutely remember breast feeding Big Sis while watching a horror movie late one night. At one point, I held my breath in anticipation of something horrible happening on screen. It would have been imperceptible to most people as I did not move or make a sound, and yet, Big Sis stopped suckling, tensed and looked at me. She could not yet sit up, walk or speak, and yet, she could sense my “fear”.

As toddlers grow into infants, they begin to develop cognitively. With this comes the beginning of understanding about the world and of imagination. They can start thinking about things that could happen beyond their own direct experience. At this age “The dark” and “monsters” are quite common fears. Often the children’s fears are completely unrealistic and may come from the strangest of places. When I was a young child, I couldn’t sleep one night and walked downstairs to find my parents. They were watching “Jaws” and I walked in at the inopportune moment when someone got munched. For several nights after this, I had nightmares that “Jaws” would come through my bedroom window and munch me. My parents found this hilarious and at the time, I didn’t quite understand why. Recently, my own children’s fears have been a source of interest and amusement to me, although I try to take it seriously and not be amused in their presence. Big Sis, while having no problems with the Maidmashing and Bonecrunching giants when we read Roald Dahl’s “The BFG”, refused to continue with “Maltida”, for fear of Mrs Trunchbull. Several nights of sleep for Big Sis and disturbed evenings for us lay at the hand of Mrs Trunchbull. Lil Bro on the other hand, took grievance with Violet Beuregarde. For some reason, being turned into a blueberry was the stuff of nightmares. Her return to normality by means of juicing fuelled rather than quelled the fear.

At this age, what parents fear are real fears are often not well understood. The ever-present fear of parents: “How will my children cope if I die?” is not at all a concern for children at this young age. They neither comprehend death nor a realistic meaning of time. Once when I uttered out loud my fear of “What will happen to you children if I die?” to my chagrin, Big Sis with typical “matter-of-fact” style replied “Oh, it will be fine, we will still have Dad”. By the age of 5-8, however, children come to understand the meaning of death and fear of death becomes a common fear in this age group.

The middle childhood years (6-12 years), are also the peak age for acquiring fear of animals. Dogs and spiders are pretty common fears for children. Sometimes, a child will develop a fear because of a specific experience with an animal, but other times, they may have a fear even without a direct upsetting experience as evolution has predisposed our brains to accepting that animals are potentially dangerous. In reality, cars kill more people than animals, and yet, practically no one develops a phobia of getting into a car without a direct traumatic experience. As children reach adolescence, fears become more similar to the fears of adults: fear of failure, fear of humiliation, fear of rejection, fear of war, illness and crime come to the fore. Whilst on the one hand, these fears are more “realistic” than the “boogie man” fears of infancy, one can also make the argument that many adult fears are also unrealistic. Fears about an ebola outbreak in the UK are probably over and above the realistic risk.

It should be remembered that fear is a natural response and it helps to serve a vital function. Without fear, our species would likely not have survived, by putting ourselves in the direct line of danger without regard. The fear response allows not only the bodily preparedness to fight or flight, but also the brain response to pre-empt adversity, plan and avoid. People who show low levels of fear often show high levels of “risk-taking behaviour”, and often end up in trouble one way or another whether it is in a high-speed car accident, audacious robbery or in bringing down the banking sector. However, fears should be based in reality and the work of psychological treatment for anxieties and phobias includes anchoring fears in reality.

As a parent we cannot shield our children from all adversity and helping children to understand and deal with anxiety and fear is part of our role as parents. Teaching children to accept and have the confidence to know that they can handle fearful situations when they arise is more important than preventing fearful situations arising or promoting gung ho “bravery”. Security and reassurance is the key; but sometimes it is easier said than done.

When Big Sis was in Year 1, she studied Edward Jenner and small pox at school. The idea of small pox put the fright into Big Sis like nothing before. Not only was her sleep disturbed, but even in the day she would get tearful thinking about the family being killed by small pox. This went on for a week, and despite my reassurance that small pox no longer existed in England anymore, she was still tearful and upset. I eventually went to school to see her teacher to tell her of the situation. When I picked up Big Sis from school that day, she declared to me that she was no longer afraid of small pox.

“How come?” I asked having given reassurance all week to no avail

“Because the teacher told me about the small pox vaccine.”

“Er –haven’t I been telling you about that for the past week?”

“Yes, but you’re just mum, she is a TEACHER.”

Guess that medical degree doesn’t count when you are just a mother…

 

References:

Gibson, E. J., & Walk, R. D. (1960). The visual cliff. Scientific American, 202(4), 64−71.

Mineka, S., Davidson, M., Cook, M., & Keir, R. (1984). Observational conditioning of snake fear in rhesus monkeys. Journal of Abnormal Psychology, 93, 355−372.