The loss of a child—no matter the age—can be traumatic and can leave family, particularly the parents, reeling in the emotional turmoil that comes with great loss. I have noticed a few commonalities among those parents, one being that the people in their lives do not know how to react or help.

This article is for friends and family members of a parent who has lost a child. The goal is to raise awareness of common mistakes made in trying to provide support and to suggest more effective ways to support parents as they work through their grief.

“It’s time to move on! You have to get on with your life!”

This statement, and others like it, is the first common mistake well-meaning loved ones make. The intent is to help the parent to get back to life and to find meaning again. Watching someone we love go through grief and extreme suffering can be very uncomfortable. We have an innate need to want to help the people we love through life, and if one of our loved ones seems stuck, we have the urge to do everything we can to get them unstuck. However, this message unintentionally invalidates the parent, who may start to question whether there is something wrong with them for grieving for the child.

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Grief looks different in every person. Some people may need to take a leave of absence from work. They may need to lay on the couch all day and allow themselves to ride the roller coaster that is grief, which usually consists of bouts of crying, depression, anger, numbness, confusion, and inward questioning as to how the person could have prevented the loss, followed by perhaps more anger, depression, and numbness. The parent may feel distant from loved ones, which often makes loved ones concerned and anxious and can lead to statements similar to the one above.

There is no time limit on how long it takes a person to grieve the loss of a child. In fact, it is important to acknowledge that huge losses will make an impact on a person’s life forever. This does not mean there is no life after loss. It just means that it will look different.

Giving the person as much time as they need to grieve, and allowing them to grieve in their own way, is very important. Doing so creates safety for the parent and assurance they can do what is needed to do to work through emotions with support and understanding. Saying something like, “It’s OK that you are feeling the way you are … you have experienced a major loss and I want you to know that I am here to listen … take as long as you need,” is a much better way to communicate to the person that you want to help him or her through the grieving process.

“Why are you having those thoughts? They are completely irrational, and of course you couldn’t have done anything to prevent this!”

When someone becomes a parent, they are forever changed. It is like a switch goes off in the brain. All of a sudden, priorities shift, and keeping one’s child safe and happy is a top priority. So when someone experiences a loss of a child, it is natural to start questioning inwardly and wondering what they could have done to keep the child safe.

Even in situations where it is blatantly obvious there was nothing the parent could have done, there is still that wondering. In my experience, parents are cognitively aware of the fact they could not have done anything to prevent the loss, but emotionally they still feel that they failed. Loved ones often want to jump in and challenge these thoughts in an effort to reassure the parent that this is not true. This may be necessary at some point, but how you do this is extremely important.

When you fail to validate the parent’s feelings by failing to simply listen without trying to fix it, a barrier for communication may be created. Part of healing and moving forward through grief is being able to share what the parent is thinking, no matter how extreme those thoughts may sound. Failing to validate feelings can hinder the healing process.

Instead of jumping right to trying to correct a belief that you feel is irrational, validate that having such thoughts is completely normal for a parent who has lost a child. Listen to the person and practice reflective listening skills (example: “I hear you saying that you feel responsible for this”). Make validating statements such as, “I hear you saying you are hurting. I know this is very painful for you, which is completely understandable.” This can help the person realize that you are trying to understand where they are coming from.

Sometimes even irrational beliefs need to be validated. Sometimes more intensive work has to take place. If the latter is true, it is important to help the person to get to a therapist who can help.

“Everything happens for a reason. They’re in a better place.”

This may be part of your spiritual belief system or even the parent’s belief system, but this statement often backfires. Trying to provide an explanation for the loss of a child can lead to the parent feeling as though their anger (or other intense emotion connected with the loss) is invalid. It is important that the parent is allowed to process the loss and can identify meaning, if any, in their own time.

If the parent wants to have a conversation about meaning and the loss, by all means, have that conversation! But let the person decide if that is a conversation they want and are ready to have. Be aware that people feel a lot of things with such a significant loss, and all feelings and thoughts that come up are valid.

Remember, you shouldn’t try to “fix” the pain that accompanies grieving. Something along these lines is a good place to start: “I can’t imagine what you are going through. This must be so difficult. I am here for you and would like to offer my support during this difficult time. I can offer you a listening ear without judgment or advice.”

A support network is an important part of the healing process after the loss of a child. Knowing how you can be there for the parent can make a huge difference in how that person grieves and begins to work toward healing. Seeking assistance from a professional to help guide you through supporting your loved one can be extremely helpful and can help address the discomfort that often accompanies seeing someone you love suffer.

“I hate you!” 4-year-old Carly screams at her mother. Some moms might react by grabbing their daughter and spanking her on the bottom, or screaming, “You are a bad girl!” or telling her, “That’s a bad word, we don’t say things like that,” or starting to cry and admonishing, “You hurt Mommy’s feelings.” There are many ways children learn to think of their angry or hateful feelings as bad even though anger and hate are normal human feelings. Too frequently, families don’t differentiate between expressing these feelings through words and acting on them. When families succeed in outlawing feelings of anger and hate and don’t teach their children appropriate ways of expressing their feelings, they limit the child’s ability to be aware that he or she has these feelings and to use them successfully. These limitations seriously interfere with the ability to become a person who can navigate life and relationships with a full range of feelings and self states.

Several years ago, I received a call from Frank, who made an appointment. In our first session, he was clear that he wasn’t sure he needed therapy, but his wife thought he should see a therapist because he seemed so unhappy with everything. He told me that he thought his wife was probably right, that he wasn’t very happy. “But I don’t think I’m depressed,” he said. “You know, I just do my life. I share responsibility for my 10-year-old son, who I love. I have a job that helps to pay the bills, but I don’t care much about it one way or the other. I’ve been married for 14 years and my relationship is OK, even though my wife keeps complaining that I don’t seem happy. She can be a nag, but that’s fine—I’m used to it. I’m OK.”

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I commiserated with Frank that it seemed his wife had sent him to therapy and that he didn’t really feel that it was something he wanted or needed. He responded, “That’s so true, but I guess I don’t really know what I want or need. My wife always seems to know what I should do more than I do. So I’ll give it a try.”

Frank and I began our work, and since Frank didn’t have any specific complaints, I thought it would be useful for him to tell me his life story.

Frank described his childhood as “the usual—no real problems.” In one session, he recalled, “My mother taught me to be thoughtful about people. She was anxious and always worried about what other people thought. It was most important that I treat her with utmost respect. I always did what she said; I was very aware of not wanting her to feel embarrassed by my behavior.” In another session, he spoke of his mother: “She could get very hurt if I disobeyed or said no in any way. I remember when I was 6 or 7, I wanted so badly to go to my friend’s house to play with these action figures he just got. She wouldn’t let me go because my father was away on business and she didn’t want to be alone. I think I said something like, ‘Please, it’s not fair. It’s only for a few hours.’ She got very upset with me and started crying, ‘How could you be so mean to me and hurt me like this? How dare you say I’m not fair?’ I felt terrible. I couldn’t stand to see her hurt.”

Frank’s father, a successful litigator, was always involved in his work. Frank understood that his job was to be there for his mother and keep her emotionally comfortable. Any attempt to protest or “do his own thing” would be met with the mother’s hurt and Frank’s remorse. He learned early how to be a “good son.” When I asked Frank if he ever felt angry with his mother, he looked startled. “Why would I be angry at her?” he said. “I was the bad one. I hurt her. Besides, I could never feel angry with her. She never said so, but it wasn’t allowed. I think it would have destroyed her.”

Frank’s demeanor in our sessions was usually slouched over, talking quietly, mostly in a matter-of-fact way. When he spoke about high school, he perked up and began to describe doing well academically and feeling good about it. But then those feelings disappeared as he explained, “In my junior year I was thinking about going away to college and started to talk to my parents about it. My mother said I would be better off going to college at home and my dad agreed. I remember him saying that he appreciated my being at home with his being away for business so much and that it would be good for me to live at home and save the family some money.” Frank looked sad and said, “You know, maybe I did get kind of depressed then. I know I didn’t have a choice. It seemed that was just the way things were, not something to have feelings about. I never applied to schools away from home. I lived at home all through college but got my own apartment when I graduated. My parents found one for me in the neighborhood where they lived.”

I asked Frank, “What do you mean when you say you had no choice?” He looked perplexed and seemed to have trouble responding. “I don’t know. It wasn’t something that I would have thought about once they said no. They said no and that was that. I suppose I never gave it a second thought.”

“What do you imagine would have happened if you did give it a second thought?” I asked.

“It’s not conceivable,” he said.

“Just try to let yourself imagine and see what you think of.”

“I don’t know …”

“It’s OK not to know. But I really would like you to try.”

“Well, let’s see. I feel like crying. … Maybe I would have cried.”

“What do you imagine you would have cried about?”

“Hmm. I would have been sad that I couldn’t go away to college.”

“Why do you think you would have been sad?”

“I don’t know. Maybe I would have liked to go away and was unhappy that I couldn’t.”

“I remember you told me about wanting to go with your friend when you were 6 or so and you told your mother that it wasn’t fair that you couldn’t. Do you think this could have been a similar feeling?”

Frank began to cry softly, “Oh yes, yes, that’s it. I couldn’t go with my friend, I couldn’t go away to college, and I couldn’t do a lot of things. It wasn’t fair.” Frank put his head in his hands, and his crying got louder.

“It’s very sad. You learned not to protest and to accept the life your parents prescribed for you,” I said.

After this session, Frank and I began to look at this pattern of accepting what was put in front of him, choosing what was pleasing for others and opting for paths that were least likely to create conflict or stir up feelings of anger.

We are currently talking about Frank’s relationship with his wife and son. He is more curious about his wife’s description that he’s “always unhappy” and is considering what he could be unhappy about. He recognizes that feelings have been accumulating about his life that he has never been free to feel or express. This worries Frank. “What if I know what I want or think or feel? What happens if I start to get angry at the people I love? Oh, my god! What if I even hate them?” These are frightening thoughts, and we are working on Frank becoming more comfortable bringing more of himself into his relationships. Frank had an “a-ha!” moment when it occurred to him that maybe his son doesn’t listen to him because he can’t say no to him. Frank told me with great surprise, “I’ve been afraid to get angry with him, so I just say yes, and I haven’t been tuned into myself. You know, I can see now—I do feel angry!”

Frank is scared but also excited about the possibilities of developing his voice and getting comfortable with his feelings. We have much more talking to do, and we will take it slowly. Frank will be anxious as he grows and develops and tests his new thoughts and feelings in the world. But each success in voicing his authentic self will make his next attempt to be the person he is becoming feel a little less frightening. With continued work, Frank can get comfortable enough with himself in the world.

Frank’s story is not unique. Many children grow up in families where they learn, consciously and/or unconsciously, that feelings of anger and hate are bad. They may be unaware that they are fighting within themselves not to feel these feelings. As they mature, they are handicapped. They can’t know themselves or be themselves or use these feelings to help make choices. For example, they won’t be clear that they are being treated badly, or that it’s OK to compete to get what they want, or, like Frank, that it’s necessary to say “no” to help a child learn to accept “no” and limits.

Children who grow up believing that anger and hate are bad usually believe that if they have these feelings they will DO something bad or act in a hateful or rageful manner. But feelings do not have to be acted upon, or can be acted upon in appropriate and nondestructive ways. If we don’t have a full range of feelings available to us, we are at risk of not knowing what we want and who we are—and of having limited lives and relationships.

Editor’s note: Names in the preceding narrative were changed to protect privacy.

All children want to know about their origins. As their minds develop and their understanding of the world grows, their questions go deeper. Toddlers ask where babies come from; teenagers want to know where they came from. It is part of their identity development. For gay parents (and all adoptive and foster parents), the answers to those questions can be complicated.

Gay parents do not become parents in the usual way (unless they had their children while in a heterosexual relationship). They may use donor sperm or eggs; lesbian mothers may have each carried a child, or all the children may have been carried by one of them; gay male parents may use sperm from both, or just one of the men. And with both gay men and lesbians, they may have used either strangers or people known to them during the reproductive process. Yeah, complicated. So what DO you tell the kids when they ask questions?

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The two most important factors in responding to any questions children have are (1) understanding their age/developmental level and (2) sticking to the truth. (I am reminded of the old joke in which 7-year-old Jimmy asks his dad where he came from. Caught off guard, Dad awkwardly tells Jimmy about the birds and the bees. After which Jimmy replies, “Oh. Davey came from Ohio.”)

Very young children require only a few words to satisfy their curiosity. When your 4-year-old asks where babies come from, they simply want, “They grow inside a woman’s body,” not a sex education lecture. Later, at around seven to 10 years of age, their expanding minds may start wondering how that baby got in the woman’s body. Even then, they are usually satisfied with, “The man’s seed started it growing there.” It is not usually till the preteen years when kids get curious about sex. So, don’t overwhelm your child with what you think they need to know or what you assume they want to know. If you’re not sure what they are looking for, get clarification. Then give them the simplest answers and if they want to know more, they’ll ask.

Children also want to know about their personal story. They like to see younger versions of themselves in the family photo album. Depending on the family, they may also see pictures of the orphanage they were adopted from, their pregnant surrogate, or their biological parents. This does not “confuse” young children—whatever they grow up with is normal to them. Even when they start school, children accept differences because the adults in their world do. In fact, children have to be taught by older kids or adults that differences are “wrong.” It is then that they may start questioning their origins or the make-up of their family.

It is best to know beforehand how you will respond to your children’s questions so when they come to you, you can be calm and assured. Your children will pick up on your feelings; if you are uncomfortable, they will sense that something is wrong or that this is a taboo subject. They may even transfer that awkwardness to themselves, thinking there is something wrong with them.

Many parents, both straight and gay, avoid the truth in talking to their children because they are not comfortable with certain subjects, or they think there are things the child is better off not knowing. While every good parent wants to protect his or her child, keeping secrets makes it seem like there is something shameful that needs to be hidden. And it is virtually impossible to keep secrets in a family forever. At some point, someone is going to let something slip. Or the adult child may need genetic information, or may find out through testing that he or she is not biologically related to one or both parents. There are few things as destructive to a parent-child relationship as betrayal.

Children can handle almost anything if they are given the information by someone they trust, in a positive way, in words they can understand. You and your partner or spouse should plan for this ahead of time. Sharing the story of how you became a family can be a special bonding experience.

A great deal of what we bring to our roles as parents comes from the way our own parents treated us. This includes the big areas of values and morality, as well as the smaller corners of daily life, such as determining who is responsible for which chores. This is what makes a family a family: the shared values and traditions passed along from one generation to another.

But perhaps there are things our parents didn’t know that might have been helpful to them in raising us. There are things you can learn that will help make you better parents than your parents were, for all their good intentions.

They relate to understanding your child’s emotional and psychological development. If you have a clear understanding of what your child is capable of doing, understanding, and conceptualizing at a particular age, then you will be able to reach the child at his or her own level of capability with your words, your actions, and, perhaps most importantly, your expectations.

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There are some obvious milestones in the development of a child from birth through late adolescence. These include first steps, talking, learning to socialize with other children, completing homework assignments on time, identifying and developing personal talents, meeting the expectations of coaches and teachers, and figuring out enough about personal identity to be able to face the world as a fledgling adult when the day comes to leave home.

What are the concurrent developmental phases that accompany the outward markers of growth and change in your child? These are the areas where insight can help you match your parenting with the child’s age and capabilities, so that you have less stress and the child has optimal support.

Erik Erikson, a great 20th-century psychologist, described what he called the psychosocial stages of development (see Erikson, E.H., Childhood and Society, 1950, or Identity: Youth and Crisis, 1968). His thoughts resonate today and include the following broadly outlined phases of normal development.

In the early years, the child is learning key aspects regarding trust: Who is a reliable and consistent caregiver? Am I safe here? These questions and their answers are experienced pre-verbally, which means that the way you care for your infant through the toddler years—your attention to the basic needs of hunger, thirst, touch, sleep, and physical comfort—all create the child’s sense of how safe he or she will feel in the world. If you are thoughtful and concerned for the child’s well-being at this stage, the world will become a place of caring adults. If child care is intermittent or inadequate, the child’s notion of safety will be compromised. This is a time for consistency.

In the early years of childhood come the first attempts at autonomy. This is when you see a toddler begin to leave the shelter of Mommy and/or Daddy and reach out to make connections with other people. Toddlers can do this only if they feel confident that Mommy and/or Daddy will be there when they return. If they are unsure of this, they will be reluctant to begin to explore the world. Your best efforts here include understanding the child’s needs for security and encouraging the child to move into the world beyond the family structure, knowing that you are there in the background.

Once you have a preschooler on your hands, you are looking at a child who is beginning to see that he or she can actually affect the world. You see attempts at managing the actions of pets and other children. In play, you can see stage managing that demonstrates this newly discovered power of influence. If a child is supported in this and encouraged to step out into the world, confidence will develop. If the child is told he is too bossy, and scolded rather than shown more appropriate behavior at this stage, guilt and shame can develop, along with a reluctance to participate in challenges.

You can help during this phase by understanding that your child’s need to begin to separate as an individual with power in the world is a key component in developing the independence that you eventually want for your child. Your guidance here is important because encouragement and gentle course correction will help the child learn which behaviors are acceptable to you and to others, and which are not.

Once a child starts school, the greatest developmental task is the development of a strong sense of self as a competent person. This comes from successful academic and social experience. Your encouragement in helping a child believe he or she is capable of meeting the demands of the classroom while also navigating the social environment is of great importance during these years. You help a child with homework, but you don’t do it for him/her. You listen to the grievances of playground politics, and instead of immediately taking only your child’s side, you offer for consideration various interpretations of the behaviors of other children, to help your son or daughter begin to see that there are other ways of looking at the same situation besides his/her own. It is still appropriate to support your child emotionally and to make certain that any obvious wrongs are righted, but the real learning at this age is in understanding the social landscape and taking care of oneself while honoring the points of view of others.

With the onset of puberty and adolescence, the game changes for your child on just about every front: the very earth that once felt so familiar beneath his or her feet is now shifting like sand. Not only does the world look different, but he or she has to figure out who he/she is in relationship to it. This is the task of adolescence. This is the chaos you witness in your teenager. It is a time of trying on various roles and affecting different behaviors, in an effort to identify which ones are the best and most accurate representations. This can be a maddening time for parents who just want to tell their children to knock it off.

If ever there is a time for patience in the life of a parent, this is it. This is a period of intensity on all fronts: emotionally, psychologically, and spiritually. Everything is in play. Nothing is certain. The best you can do at this time, in the interest of your child’s healthy identity development, is to continue to provide a safe and supportive emotional environment upon which your child can rely while everything else may seem to tip sideways.

The challenge, of course, is to remember that you didn’t learn anything about being yourself because your mother or father told you who you were. You learned by going through the very same process your own child is going through. If your parents were not patient with you, you might remember the feeling of searing wounds that felt as if they would last forever.

If you remain conscious of where your child is developmentally at any particular age, you can tailor your behavior and guidance to meet his or her needs and abilities to absorb your help. It is not so difficult a task if you bear in mind that a child matures slowly over the years under the warm light of your support.

Parenting is not for the faint of heart, however; challenges will most certainly arise. The easiest way to think of this is that your child is a young person who needs you to be the adult so that he or she is free to be the child. It is safety and security that give your child the opportunity to learn, make mistakes, and grow. You provide this best by understanding the developmental phase of your child at any particular age.

What a complicated, challenging situation you find yourself in! There is no one way you are supposed to feel. I’d expect you to be more than a bit confused. It sounds as if you and your wife have been able to be open with each other, work things out, and repair your relationship. I definitely recommend calling on the same skills and strategies that have worked for you in the past.

A key question for you to consider: If this child is not biologically yours, will you be able to parent him or her with the unconditional love he or she deserves? I strongly recommend that you dig deep and think about your honest answer to this. It’s tempting to want to be a “good” guy and say sure—but if you don’t think you can do it, you will suffer, your wife will suffer, your relationship will suffer, and this child will suffer.

Regardless of biology, you will be the only father he or she will know. If you are not able to love him or her, if you tolerate this child for the sake of your marriage, it will show in many small ways. Resentments will build, and you may end up losing your relationship down the line. Your wife has been clear that she is having this child. You have to ask yourself if you can get on board or not. This is not an easy question to answer, and I suggest you find someone to talk with to sort through the complicated feelings that come with your situation.

Becoming a parent, even under the best of circumstances, is challenging, and it is a lifetime commitment. It’s not for the faint of heart. It puts stress on relationships. Things will not be the same, ever. It’s incredibly hard. It’s also tremendously rewarding, powerful, and incredibly meaningful. There are many people who choose to parent children who are not biologically theirs, who love them fiercely and devotedly. This is something nobody can decide for you. If you open yourself up to loving this child and commit to being a true father (no matter what the tests say), it will be hard, but it can be amazing. If you don’t think you can do it, you owe it to yourself, to your wife, and to this child to talk about it honestly now.

Best of luck,
Erika

When trying to determine if a child or teen is experiencing attention-deficit hyperactivity (ADHD), it is important to obtain an accurate diagnosis and sense of how he or she is functioning in different domains. This can help guide treatment and other interventions.

As parents begin the process of determining if a child or teen has ADHD, many wonder what is entailed in a formal evaluation by a psychologist—and what benefits it may provide. As a psychologist who provides evaluations to diagnose ADHD and treats the issue through psychotherapy, I thought I could shed some light here. The methods used vary from professional to professional, but here is a general overview of a formal evaluation for ADHD, as completed by a psychologist.

In-Depth Clinical Interview

The time frame may vary somewhat, but on average this lasts one to two hours and provides the clinician with an opportunity to gather comprehensive background information about the child or teen, current symptoms, and other difficulties. The psychologist generally spends time meeting with the child or teen and his or her parents, together and/or separately.

Consultations with Relevant Professionals

Many psychologists consult with other service providers working with the child/teen, including mental health therapists, speech/language therapists, occupational therapists, and psychiatrists. In a lot of cases, the clinician will endeavor to complete a school observation and interview teachers. (Depending on the circumstances and the comfort level of those involved, this may not always be warranted or feasible.)

Formal Testing

The exact measures used and amount of time needed to complete testing vary, to some degree, for a variety of reasons. On average, formal testing for ADHD lasts between four and nine hours. Many clinicians opt to break up testing into two or three sessions on different days.

A variety of standardized measures involving direct interaction between the psychologist and child/teen—computerized measures, self-report and parent/teacher report questionnaires, and other types—are used to look at several areas of functioning, including cognitive functioning, academic achievement in a variety of domains, reading/language skills, attention/impulsivity, visual-motor skills, and emotional functioning.

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Completed Report/Formal Feedback Session

Reports can take several weeks to complete; it takes considerable time to carefully review/interpret results and document it all.

The feedback session is an opportunity to learn about the results of the evaluation and begin talking about specific recommendations to assist the child/teen in improving areas in which he or she is struggling.

Diagnosing ADHD in children/teens is often not as simple as one might think; many issues, such as depression, anxiety, sensory issues, learning difficulties, auditory processing disorder, and even autism spectrum issues, have symptoms that can mimic ADHD. A formal evaluation is helpful in ruling out other issues to ensure an accurate diagnosis.

Nonetheless, depending on the presenting issues, an evaluation doesn’t always lead to definitive conclusions about diagnoses. In these cases, a parent still would come away with a clear sense of how the child/teen is functioning, and would have recommendations to assist him or her.

Benefits Beyond Diagnosis

Aside from obtaining an accurate diagnosis, here are a few possible benefits of having a formal evaluation conducted:

1. Good understanding of the child/teen’s strengths and limitations
2. Recommendations for teachers at school
3. Recommendations for helping the child/teen at home (suggestions to improve organization, time management, behavior, etc.)
4. Information and specific recommendations to help current and future service providers (psychiatrists, mental health therapists, etc.) best assist the child/teen
5. Documentation of the issue that may qualify the child/teen for special education services in the form of a 504 plan or individualized education program (IEP). This may entitle the child/teen to accommodations such as extended time, private or small group testing environment to reduce distractions, use of a word processor in class, etc. Older teens may qualify for accommodations on college board exams as well as services in college. (Not all public school systems/private schools use outside evaluations in the same way, so depending on the school system, ADHD alone may not qualify a child for services.)

If you believe that your child/teen has ADHD and he or she is struggling academically, socially, or in other areas, it is important to get a clear sense of his or her difficulties, determine if it is indeed ADHD, and obtain appropriate treatment.

Disclaimer: The preceding article is intended as general guidance based on the author’s professional opinion, does not constitute an established professional relationship, and should not replace the recommendations of a psychologist or other licensed professional with whom you initiate or maintain a professional relationship.

It is not uncommon for a man with high-functioning autism/Asperger’s to have a child who also has it, because there are genetic components to this brain structure variance that manifests as what we call HFA. These differences are in the prefrontal cortex and the amygdala.

High-functioning autism is not a mental illness. It is not a personality disorder. It is not ADHD, ADD, or oppositional defiance disorder. It is a physiologic difference in the brain with a spectrum of possible manifestations. A father passes on his genetic material to his son. Some of this material can contain the code for HFA.

In my practice, I often see neurotypical women in such a triad. Usually, the pathway for the wife is difficult, as she feels as if she is the outsider as she struggles to be understood and to feel that she is valued in her family.

It is a difficult challenge for a neurotypical woman to put herself in the mindset of the HFA husband or son. She can understand the differences intellectually, but when it comes to feelings, she inadvertently defaults to her neurotypical frame of reference. She tells me she can’t help it. She tells me it is exhausting and, most often, fruitless.

I tell her that I understand her position. We talk about feeling alone and alienated. But I also try to bring her to a place of being able to see what it might be like for her if she were in her husband’s or son’s position as individuals with HFA trying to make their way in a neurotypical world.

They are often exhausted, confused, and frustrated. They feel intense anxiety and fears about missing social cues, misunderstanding subtexts in conversations, and taking everything literally, missing the nonverbal aspects of communication.

When I see women married to HFA husbands whose children also carry the diagnosis, we work together on several things: the grief that attends the loss of her dreams and hopes, the reconstruction of her sense of self and the reinvigoration of her personal goals, and ways in which she can retain her newly-regained confidence. We also work on methods she can use so that she can communicate with her husband and son in such a way that they understand cognitively what she is explaining about her emotions.

It is not easy. But with support, the wife in such a situation can learn techniques and strategies for getting her point across that may not seem comfortable to her at first. Once she begins to see that they work, however, they can become second nature to her.

They will never be her first nature, however. Good support along her journey of discovery is of extreme importance for her well-being and for reinforcement that she is doing the best she can. She will also need help decoding things she does not understand and things she has tried which have not worked, or which have backfired. A good therapist who understands the unique position of the woman in this family is an ally in this journey.

The family dynamics are challenging, but they can be managed with care and with the intent to hold the family together.

One of the common themes I come across when working with mothers experiencing depression and anxiety is perfectionism and people-pleasing. Moms get worn out when they are trying to make everyone happy all the time.

There are often good reasons for a tendency to be over-responsible for the feelings of others. Many of us come from families where there was an unspoken expectation that a child must be “good,” because one or both parents were unable to tolerate the challenge of even normal childhood misbehavior. Or sometimes, children develop an unconscious habit of caretaking for others as a way to get their own needs met.

However this pattern develops, it likely served a valuable purpose, which is why it became second nature. Children learn to intuit the moods, thoughts, and feelings of others. They modify their own behavior in an attempt to manage the responses of others. Often, this behavior is rewarded. Who doesn’t appreciate the helpful child who asks her mom if she needs a hug when she seems sad, or goes and plays quietly in her room when there is tension between her parents?

People-pleasing behavior is rewarded by friends and family, at work, and at school. A people-pleaser is there for her friends when they need support and earns the love and trust of her partner. She knows what to say and when to say it, at least most of the time. The cost of this unconscious caretaking is a loss of connection to the self. When your thoughts are focused on intuiting what others want and need, and your actions are focused on pleasing others, there is little space to experience your own feelings, thoughts, and needs. You may not even notice when your needs go unmet or when emotions are pulling for your attention. Sometimes, these unmet needs and unfelt emotions cause physical symptoms—headaches, back or stomach problems, or other tension-related difficulties. These symptoms temporarily draw our attention back to ourselves, making it harder to attend to others and focusing more attention on ourselves and our discomfort.

Having children can push what is already a difficult emotional burden into overdrive, creating anxiety, depression, exhaustion, and even worse physical manifestations. While you may have been able to keep your friends, employer, partner, and family happy before, when a baby comes into the picture, a whole new level of exhaustion ensues. Now you’re sleep-deprived, have a baby whose needs are never-ending, a partner who is stressed out, and it is truly impossible to make everyone happy. This is when, for a lot of moms, things hit a crisis point. Anxiety becomes unmanageable, or exhaustion leads to crippling depression. However, it is also an opportunity to address a long-standing pattern of behavior that has prevented you from taking care of yourself. It is a necessity to learn to increase your attunement to yourself and to let go of unconscious patterns of caretaking.

Looking at how these patterns play out in everyday life can be illuminating. You may discover that ways in which you are caring for others are based on assumptions of what people want or need from you, and that these assumptions are often wrong. You may find that your unconscious perpetual caretaking actually makes you less available when others truly do want or need something from you. So often, people-pleasing behavior leaves us resentful and feeling less generous to those we love. Compulsive caretaking can actually make us less available to others in concrete ways.

One way to begin to address people-pleasing is to become aware of how much of your thinking takes the form of “I should.” It is important to examine all the thoughts about what you should be doing/saying/feeling. Who says you “should”? What will happen if you don’t? What do you really want to do? One way of improving self-care and reducing people-pleasing is to challenge the “shoulds” whenever you become aware of them. Another is to check in with people about what they really do want and need from you, and more carefully balance the stated needs of others with what you truly need to do to take care of yourself. And making conscious choices to do for others is emotionally quite different from unconscious caretaking. It is done in the spirit of generosity, not because it is what you are supposed to do.

Learning to tune into your own feelings and needs and becoming conscious of making choices to balance them against your sense of responsibility to others is one of the most powerful ways to regain a sense of personal power. Regaining a sense of power in your life helps make you a better, stronger, and healthier mom and partner.

Over the course of a decade working therapeutically with adolescents and their families, I have observed countless young people as they reach a highly anticipated milestone in their lives: turning 18. I have also observed the parents of all those young people as they attempt to adjust to the transition that occurs when their “baby” officially becomes an adult. It has been my experience that a child’s 18th birthday is an especially potent event for families, and the ways in which families respond to this event, for better or worse, can form the basis for the launching of their child into young adulthood.

Of course, we all know why the 18th birthday is a really big deal: it’s the one on which Western culture bestows young people with most of the rights they will enjoy for the rest of their lives. These rights include moving about at will without restrictions, curfews, or the like; choosing friends and partners of whom the parents may not approve; signing contracts such as military enlistments, marriage certificates, and leases; borrowing money via loans and credit cards; obtaining or declining medical and mental health care; and quitting or enrolling oneself in educational programs.

Along with those rights, a number of new responsibilities are also bestowed upon each young person on his or her 18th birthday. For example, the young adult must actually uphold any contract that is signed, including paying back loans and lines of credit. Another new responsibility is that, legally, a person—even one who is still in high school—is treated as an adult rather than a juvenile within the legal system. The 18-year-old’s behaviors and choices carry consequences that are far and above what they have ever before experienced.

With all of the cultural and personal implications that hang on the 18th birthday, it is no surprise that navigating this milestone can challenge families. This is an event that can change, literally overnight, the power balances, rules, and expectations between parents and children. Families may spend months or even years nervously anticipating this change; conversely, they may be blindsided by the realities of parenting a child in this brand-new context, and find themselves dealing with unexpected consequences.

In some families, the 18th birthday is treated as a full stop to adolescence, and the newly minted adult is expected to (or believes he/she is ready and able to) immediately begin fulfilling many adult-like roles. The adult child may be expected to, for example, begin paying rent to the parents, purchase his or her own vehicle, or find a full-time job.

In other families, the cultural and legal implications of a child’s 18th birthday are treated as irrelevant inside the family fold; the family attempts to keep everything regarding their child, from rules and curfews to roles and communication styles, exactly the same as before.

In still other families, both the anticipation and actual event of a child turning 18 can become a flashpoint for family upheaval and conflicts. The newly adult child may use turning 18 as a springboard for rebellious or ill-advised shows of independence. Likewise, the parents may threaten the adult child with being kicked out, losing financial help, or other withdrawals of support in an attempt to enforce compliance with rules and expectations.

The “real world” is at once enticing and terrifying for emerging adults.

Many young adults have described feeling as if they’ve been thrown into the deep end of a pool once it sinks in that they are truly considered adults, and may often feel quite unprepared to meet the demands of the “real world.” At the same time, they are excited to flex some of their new independence and privileges, and may at times feel driven to act out adult-like roles and scripts the moment that they have the legal ability to do so.

One primary reason for this is that at 18, the young person’s brain is continuing to develop and does not yet function as a fully mature brain does. The brain’s reward system, governing the way that novelty- and pleasure-reinforcing neurotransmitters such as dopamine are released, peaks in activity in the late teen years. The prefrontal cortex—which aids with decision making, problem solving, and impulse inhibition—is not at its full level of function until the mid-twenties. The fact is, a young adult on his or her 18th birthday is not magically wiser, more resourceful, or more emotionally mature than he or she was the day before, and won’t think and act like a fully mature adult until a few years later.

To complicate the picture, there are almost always needs and dependencies that persist between the 18-year-old and his or her parents. For example, an 18-year-old who is still in high school cannot work full time even if he or she wanted to, and even those out of high school usually continue to be financially dependent. Shared health insurance, car insurance, family cell phone plans, and other matters of money and information mean that negotiating the leading edge of your child’s independence can be tricky at best.

Although we in Western societies now experience a more extended period of adolescent development and dependence than ever before, and although we are now more aware of the realities of brain development, the fact is that 18 continues to be the age of majority in the United States. The mismatch between the legal freedoms and the young person’s capacity to exercise them responsibly can create rough waters for families to navigate. Power struggles that exist between the child and the parents around the time of the child’s 18th birthday can quickly escalate into the child threatening to leave, and/or the parents threatening to kick the child out. The child may choose to do things that are legally acceptable, but are not acceptable to the parents who support him or her.

Every family will handle this transition differently, according to its own unique set of strengths, expectations, and history. However, there are a few rules of thumb that parents can keep in mind which may assist them in managing this major milestone.

The boundary around the family must be flexible—neither too diffuse nor too rigid.

First and foremost, resist the urge to threaten to kick your child out. The subject of your young adult child leaving home will often arise sometime within the months around his or her 18th birthday. You may find your child saying things like, “I don’t like your rules. I should go live with my friend where they don’t have these rules.” Often, by talking about (or threatening to) move out, the child is testing out ideas about being an adult, without any actual intention of following through on those ideas. The 18-year-old usually does not have the experience, wisdom, or resources to leave the home in a safe or well-planned way—and he or she knows it.

If your child does threaten to leave home, as the parent it is imperative that your response be one of reassurance that the child is still a part of the family and that the family home continues to be his or her home. Remember that your 18-year-old is struggling to adjust his or her self-concept to include adult-like roles, and mentally trying some of these on for size is developmentally normative. However, when parents respond to limit-testing behaviors by threatening to kick the child out of the home, the child feels insecure about the stability of the family system and his or her role in it; the boundaries become diffuse and the child becomes unsure about whether he or she can count on remaining a part of the family on which he or she remains largely dependent.

Another problem with parents threatening to kick the child out is that systems under stress tend to escalate to the most intense point of conflict during each conflict cycle. Once parents introduce the possibility of kicking the child out, it is likely to become incorporated into every argument that follows—either by the parents or by the child in anticipation of the parents’ threat. This escalation pattern severely disrupts the stability of the family system.

So it’s important that the boundary around who is in and who is out of the family system remains well-defined so that the young adult child feels secure about his or her place in the world long enough to figure out his or her next steps into adulthood. However, it is also important that the family boundary not be so rigid that it inhibits the child’s necessary practicing of adult-like behaviors in safe and appropriate ways. Families who refuse to allow their 18-year-old to make an increasing number of choices and reach increasing levels of independence can inhibit the development of responsibility, self-sufficiency, and life skills that the young adult child will soon need. Therefore, ongoing adjustments to certain family rules, such as curfews, jobs/bills, and friend/partner choices, are essential.

Use negotiation skills to co-create a new set of roles and rules that meet the needs of all family members.

How, then, can parents approach these transitions? One way to help your child learn how to be an adult is to treat him or her like one—at first emotionally, and later more practically. Speaking respectfully to your child, accepting his or her opinions as valid, and encouraging him or her to do the same to you are ways to introduce your child to adult-like, egalitarian relating. Negotiating new rules, privileges, and responsibilities together—“family meetings” are helpful for this—allows both the parents and the child to mutually create adjustments to the rules that are thoughtful, sensible, and predictable. Many families find it helpful to write down the new rules and display them in the home so that all parties remember them (and remember that they agreed to them!).

If any family member feels that the current rules and expectations are not working, they can call a new family meeting at any time to review and possibly revise them. If parents and child reach an impasse, try to be as creative as possible to find ways to meet the needs of all family members. Young adults may be happy to agree to increasing levels of responsibility in the home in exchange for increasing levels of trust and privilege. The family members should keep in mind that flexibility, communication, and negotiation with a goal of mutual agreement will take them smoothly through this period of transition.

It can be helpful for these discussions to begin well before the 18th birthday, so that there is plenty of time for the family members to think ahead, anticipate, and become mentally ready for the changes to the power balance and expectations that will likely occur. A discussion that occurs over the course of weeks or months is more likely to involve all family members, cover more contingencies and “what-ifs,” and result in a smoother transition through the actual birthday.

However, it is never too late. If you find yourself with a child who is already 18, or even 19 or 20, and are experiencing a difficult family adjustment into your child’s young adulthood, it is still advisable to approach your child and create an open dialogue about the rules and roles in the family.

Mary-Lynne, the 10-month-old baby in a video called “Emotional baby! Too cute!” (see below) feels her mother’s musically expressed emotion very strongly. As her mother soulfully sings the 1988 Rod Stewart song “My Heart Can’t Tell You No,” Mary-Lynne’s facial expressions move from wide-eyed wonder to scrunch-faced smiles to streaming tears to what appear to be grimaces.

Since being published on October 18, 2013, the video has gone viral with its over 16 million views and 100,000-plus “likes” (and counting), with most of the YouTube comments consisting of things like “cute baby,” and “this is the cutest thing I’ve ever seen.” But with over 3,000 “dislikes,” there are also some who insist that the video is “not so cute”; one of these is Tere Peman, who comments, “The baby is scared of mom[’s] unusual voice. [S]he begin[s] to smile when [the] mother seems to stop singing.” Peman, who says in her comment that she is a mother, too, goes on to suggest that the baby is, in fact, “suffering.”

Even the mother, Amanda Leroux, acknowledges this toward the end of the video when she stops singing and says to baby Mary-Lynne, “Oh, you feel the pain in the song, yeah honey? Big tears. Are you crying? Oh, you’re crying, monkey. OK, mommy’s done. … It’s just a song.”

In a Skype interview with The Today Show on Tuesday, Leroux says she’s been singing to Mary-Lynne since she was in the womb, and was just trying to capture video of her baby’s particularly potent emotional response to the song to share with her husband and family (Schlosser, 2013). Her intention was not for the video to go viral, and she probably couldn’t have imagined that multitudes of people would be commenting on what she presents as an intimate moment of bonding with her child. Such is the nature of social media, though.

And considering the widespread viewing of this video as well as the mixed, predominately positive responses of those who have watched and commented on it, GoodTherapy.org decided to check in with Ruth Wyatt, LCSW and child psychology Topic Expert, to see what she thinks of the video “Emotional Baby, Too Cute!”

A Child Psychology Expert Perspective on ‘Emotional Baby’

Wyatt’s immediate response was that Mary-Lynne, although an adorable baby, is not at all happy. “Clearly, this mother is wanting to share something with her daughter. Sharing our feelings with our children can be a very important way we connect to them,” she says. However, Wyatt adds, “As beautiful and important as it is for us to share our feelings with our children, we need to understand where our children are developmentally and what they can handle.”

Noting how Mary-Lynne smiles when her mother stops singing and cries when she starts again, Wyatt says, “My sense is that the baby [is] in some distress and that she [is] confused by her mother’s singing, hence the shift in affect.” She adds, “Perhaps picking up on the sadness of the song or responding to the altered state of the mother, the baby does not seem to feel safe. My sense is that she wants the calm, soothing mom to return.”

She goes on to say, “Babies have no language but they can feel and take in the cadence of our voices, our feelings behind our words. I think this mother just needs to tune in a bit more to these aspects of her baby and maybe save the sad songs for when the baby is a bit older.”

Have you seen the video? What do you think? Is “emotional baby” cute, or not so cute?

Reference:

1. Leroux, A. (2013, October 18). “Emotional baby! Too cute!” YouTube . Retrieved from http://www.youtube.com/watch?v=nIsCs9_-LP8
2. Schlosser, K. (2013, October 29). Baby girl moved to tears by mom’s singing in viral video. Today.com. Retrieved from http://www.today.com/moms/baby-girl-moved-tears-moms-singing-viral-video-8C11487730

Play therapy has become a very important element of my work with families and children. In this article, I hope to give you parents some idea of how powerful play can be as an intervention as well as some ideas of how to utilize play with your own children.

Play Therapy at Work

It is Father’s Day as I write this article and I am reminded of one particular case where play therapy had a profound impact on a family. This family had a child with severe autism. They were unable to manage him at home and he was living at the residential treatment facility where I worked. The child in question was very routine-oriented, and he had an extremely restricted range of activities in which he would engage. If he wasn’t repeatedly watching small snippets of Disney videos, he wasn’t happy.

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To make matters worse, if he wasn’t happy, he tended to throw tantrums, or hit and bite those around him. As a result of these behaviors, not only could he not live at home, but the family was challenged to even have him home for short visits. They had to put the entire house on lockdown to prevent their son from wandering away, and at least one of them had to take time off of work to stay up all night to supervise their son.

When this child came onto my caseload, another therapist and I decided we wanted to work with the family to improve the quality of their interactions with their son and make their time together less stressful and challenging. We decided to use a therapy called Theraplay to accomplish this. We did several sessions with the child in which we exposed him to various new activities. We made note of what he liked, what he disliked, and what he just didn’t seem to get (but didn’t hate).

We expected to see a lot of behaviors due to the change in routine, but that wasn’t the case. We quickly found that there were a number of activities that the child seemed to enjoy. Furthermore, we found that a number of activities that he didn’t understand at first he learned and started to enjoy in subsequent sessions. Pretty soon, we had a list of about 20-or-so activities that required minimal material (about $20 of stuff from the dollar store) that he enjoyed. We could easily keep the child happily engaged for over 30 minutes at a time.

We then started doing sessions with the family at their house. First, they watched as we played with their son. Then we started showing them how to do the games. During the course of this session, we were demonstrating a modified version of catch. The child tended to want to catch the ball when thrown to him, but would then walk over and hand the ball back to us instead of throwing it. We learned that playing catch over a table got the child to actually throw the ball back.

As we were demonstrating this, he started throwing the ball to his dad and playing catch with him. Dad immediately started tearing up. He said, “This is the first time I’ve ever had a catch with my child.” There was not a dry eye in the room after that. What father doesn’t want to have a catch with his son? Imagine having to wait 17 years to make that happen. It was an unexpected, but awesome outcome of our therapy.

The Importance of Play in Development

Play is one of the fundamental ways in which children learn. Through play, they learn to how to connect or form secure attachments to others. The quality of the relationships children have growing up will impact the quality of the relationships they form as adults. So it stands to reason that good, quality play as a child can lead to quality relationships in adulthood.

Through play, children learn how to self-regulate. We get excited as we play games with each other, but then we learn how to self-calm and soothe to continue to excel at the games we play. We learn when it is appropriate to get excited and when we need to calm. In fact, I find that using play with children who have problems with regulation is a fantastic way to teach them impulse control and self-control.

Finally, through play, we learn how to socialize. We learn such things as taking turns, cooperation, and competition. We learn about rules and creativity. Through play we develop the basic skills that allow us to navigate the challenges that life presents us. Kids who don’t play are often at a great social disadvantage compared to kids who play.

Guidelines for Play

Ok, so play is important. However, the best play has some structure. To maximize the impact of play on your child’s behaviors, here are some basic guidelines to follow.

1. Play with your child. When engaging in play, do things that involve interaction between you and your child. It’s not enough to simply be in the room (what I call proctoring). It’s great to sit with children as they do a puzzle, but it’s better to do the puzzle with them. You want to promote that social-emotional connection with you. You want to make yourself a source of never ending reinforcement in your child’s eyes. So, do activities that promote things like touch and eye contact (something the typical child with autism might be struggling with and need practice to do or tolerate). Make the time your child spends with you silly and fun; watch how your child positively responds to you in other situations.
2. Keep it simple and developmentally appropriate. Make sure the activities you do with your child are geared towards their mental and emotional age. In the example at the beginning of the article, even though the child was 17, he enjoyed things like holding hands, rocking, and singing “Row Your Boat.” He enjoyed the sensory nature of the rocking, as well as the familiarity of the song. Other teenagers might enjoy singing and dancing with you to music they like. Again, focus on enhancing the connection between yourself and the child.
3. It’s ok to be silly (in fact, it’s recommended)! The games I play with my kids (at home and at work) aren’t complicated. In fact, on the face of it they are pretty silly. I find that even with more resistant, morose children, silliness draws them in. There’s something about being silly with someone else that just brings down defenses. Besides, taking time to relax, laugh, and be a little silly is FUN! It’s a marvelous way to spend some time.
4. Inexpensive is better! It’s very easy to spend a lot of money on toys. Heck, expensive toys can be great (I adore my Xbox). but for the types of interaction I’m thinking about, expensive toys are unnecessary. Blowing a feather back and forth, blowing bubbles, playing clapping games, or playing “red light, green light” require very little in the way of materials. Be creative and see what kinds of things are sitting around your house and look to those for inspiration. Have you ever seen a young child at Christmas? They open up all their expensive presents and spend most of the time playing with wrapping paper and boxes. Tap into that instinct with your child and you will be well on your way to successful play.

Ways to Use Play Therapeutically

Here are some more ideas on how to structure play sessions with your child to get specific results.

Planned sessions to increase engagement: While my usual play style is typically to improvise with whatever is at hand and make things up as I go along, I find that planning out sessions can be helpful when trying to engage with a child. I simply make a list of 5 to 10 activities that I want to do before I do the session and try to at least get through those. I make note of what activities seemed to get the child to respond positively to me so I can use them again later. If I don’t do this, I tend to more easily get shut down by the child if he/she doesn’t immediately engage with me. I focus on activities that promote touch, eye contact, and positive sensory experiences. Good examples are singing/clapping games, blowing up a balloon while the child holds the balloon, and blowing a feather back and forth between your hands and the child’s hands.

Repeated sessions to increase skills: If I am trying to help a child acquire or improve a skill, then I want to focus on repeating activities between sessions instead of changing things up frequently. Repeated exposure is good for skill acquisition. For example, I often use play to teach deep breathing through things like blowing bubbles, singing, and a game called “monkey ride” (in which I put a stuffed monkey on the child’s belly and then have him take a deep breath in and give the monkey a “ride” up to my hand which I place a couple of inches about the monkey’s head). I will repeat these games and variations of them through several sessions until the child has mastered belly breathing.

Short sessions for planned breaks from difficult tasks (The head cooler): When a child gets upset, frustrated, or anxious during specific situations, play can be a great way to manage this. For instance, a lot of my kids have problems around homework. They get upset if there’s too much, or if they don’t understand it. Some can’t make themselves take a break before the homework is complete. These children then get so upset they couldn’t do the work even if they wanted to. The poor parents are stuck not only trying to calm an upset child, but also facing daunting task of getting the child to return to finish the dreaded homework. Hours of this every night can be a major stressor for the whole family.

To counteract this, I suggest trying many short spurts. The parent works with the child to do homework, but also watches the child for the initial signs of agitation, frustration, or upset. As soon as the parent or child notices those signs, they take a short break. During the break, they spend just a few minutes doing something fun and silly (no video games or other major distractions). The goal of the activities is to allow the child’s head to “cool off.” Once calm, the child returns to the homework with a clear head. Families that have been successful in doing this find that not only are there fewer fights and tantrums around homework, but that more homework is getting done in less time.

The bottom line is that play is important. The more challenges you face with your child, the more important it is to put time aside every day to have some positive interactions. Be silly and have fun. Please share in the comments section your ideas for play or any questions you might have. In the meantime, play more with your kids and remember to BREATHE. You’ve got this!

Conduct issues are becoming a global problem for parents, educators, and children. They usually first appear and early childhood and can be identified through behavioral and psychological screenings, such as the Strengths and Difficulties Questionnaire (SDQ). The issues that arise from conduct problems include anger, aggression, hostility, academic challenges, social problems, and other behavioral and emotional issues.

Although the SDQ has been shown to be effective at identifying symptoms of conduct disorder, it is lengthy and time consuming. Therefore, Melissa E. Duncombe of the Psychological Sciences Department at the University of Melbourne in Australia wanted to see if an alternative brief assessment would be as effective and provide results that are equal to that of the SDQ.

For her study, Duncombe used the Conduct Problems Risk Screen (CPRS), a seven-item scale, to identify conduct problems in a group of over 4,700 elementary school children. Because traits found in oppositional defiance (ODD) and attention-deficit hyperactivity (ADHD) have been shown to be precursors for later conduct problems, the CPRS was designed to reveal any specific inattentive or aggressive behaviors as well.

Parents and teachers reported their evaluations of children, and Duncombe found that although there was a much higher rating of conduct issues in the parents’ reports, the overall consistency between the two groups was high. Duncombe believes that parents may witness more behavioral problems and may also incorporate family reactions, disciplinary consequences, and other factors into their assessments when filling out the CPRS. Teachers, on the other hand, can only report on what they witness and experience during the school day.

Another strength of the CPRS is that it only takes a few minutes to administer. Unlike the lengthy SDQ, the CPRS can be completed in under two minutes, and may be viewed as more applicable tool with younger children. This can be especially important for early identification of the children at risk for later conduct, ADHD, or ODD issues. Dunscombe added, “The CPRS is a valid and reliable instrument and could be used effectively as a screening tool to identify those children at risk of developing conduct disorder.”

Reference:
Duncombe, Melissa E., Sophie S. Havighurst, Kerry A. Holland, and Emma J. Frankling. (2012). Psychometric evaluation of a brief parent- and teacher-rated screen for children at risk of conduct disorder. Australian Journal of Educational & Developmental Psychology 12 (2012): 1-11. Print.