A DIALOGUE ON TANTRUMS AND TOILET TRAINING

From the NEW YORK TIMES COLUMN: FAMILIES TODAY

By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. You wrote a long article on tantrums — mine will be short.

When our granddaughter was six years old, she and her brother were visiting us. One lunchtime, I decided to clean up some leftovers. My husband asked for more spaghetti. When I reminded him that he was trying to lose some weight, he pretended to cry.

While my back was turned, Shanta said, “It won’t work.” So he “cried” some more. I could hear Shanta sigh, then repeat, “It won’t work, Granddad. I tried it once.”

Volumes have been written on this subject by brilliant scholars. It took a 6-year-old only eight words. When I see a child having a tantrum in a store, my sympathy is with the child, who has been “programmed” to do this — and is not a happy child.

A. What a wonderful story! What a lovely way for your granddaughter to try to help her grandfather learn the lesson she’s learned from your clear, firm messages: that he should respect your clear authority. When parents or grandparents are not clear, a child on the edge of an inner conflict is thrown into more confusion, and a temper tantrum is a likely response.

Tantrums at different ages are the result of different conflicts. In the second and third years, they are normal and are a reflection of the child’s wish to make her own decision, “Do I or don’t I? Will I or won’t I?” For an older child, the reasons may be quite different — such as wanting to get attention or wanting her own way in the face of an undecided parent. This is a time when firm but friendly discipline, such as “Of course you want to go, but the answer is clearly and decidedly no.” By 6 or 7, tantrums should be less common and when they involve physical aggression, we may be well beyond the run-of-the-mill tantrums for which your advice is so pertinent. A child having repeated tantrums, especially at older ages, is surely an unhappy one crying out for help. Your granddaughter sounds wonderful — clear about when it’s no longer her decision or her grandfather’s

Toilet Training

Opinions on toilet-training are forcefully held. Here’s another contribution to the continuing dialogue, prompted by our recent column on the topic. Thanks to the many of you who have offered your creative ideas to help children decide: “I’m ready!”

Q. When my daughter didn’t quite get the hang of the potty, my father thought she could do it if she just gave it a little more effort. He knew she wanted to take ballet classes, so he bought her a leotard and told her that they didn’t make a style that would fit over a diaper. He told her to try out the leotard, and if she could wear it for a day without her diaper, remembering to always go to the potty, then she would be “big enough” to go to dancing school. It worked! She never wore a diaper again.

A. A fascinating strategy! We hope our readers can appreciate the difference between this approach, which leaves the child to discover her own motivation and to decide that she is ready, as opposed to those that put parents in the position of doling out rewards, or punishments.

To a young child just think how different it sounds to be told “you can’t take ballet unless you use the potty” as opposed to what your father almost seemed to be saying: “If they made leotards to fit over diapers, then you could keep wearing them, but since they don’t there may be a way for you to manage without them.”

Part of the secret of success of a strategy like this is that it does not pit the parent against the child — instead, both work together to face a shared challenge. Then, the child needn’t hold onto her diapers to prove that she can resist a parent’s pressure.

There are so many daily conflicts with children that can be turned into opportunities for learning rather than just another struggle when parents can join children in seeing their common goals. “The leotard may help you figure out whether you are ready to make your own decision to be ‘grown up.’ ” Not pressure, but a goal for her grown up achievement. Bravo!


Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton heads the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

 

A BACK-AND-FORTH ON BITING

From the NEW YORK TIMES COLUMN: FAMILIES TODAY

By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

A reader suggests a turnabout-is-fair-play solution to toddlers’ biting.

Q. I can just see your reactions to my solution to the biting problems of toddlers. Politically incorrect? Oh my yes! But as a mother of four, and grandmother of seven, I have a bit of experience on this subject. First, a child rarely tries out this bad habit on a contemporary first. Generally, a parent is the first victim. If the parent shows alarm the child quickly assumes this is a sure-fire attention getter. Instead, if the response is a quickly delivered return bite, the toddler gets the message very quickly that this does not feel good and rewards them with discomfort in return. They are not likely to try this again. On anyone. Of course, I am not speaking of injuring the child in any way. Just a gentle, “See what that feels like.”

A time-out or such might work in the home, but it cannot be applied when the child is not in the care of the parent. They learn what Mom and Dad will not allow but that does not curtail this behavior socially.

Call me old- fashioned but success is a pretty good argument for my case.

A. As you say in your letter, nearly all toddlers go through a stage of biting in the second and third years. First, as infants, they bite their parents. A parent’s first response of pain and surprise is bound to intrigue and confuse a baby. In her attempt to understand what’s going on and to connect cause and effect, she’s bound to bite again. After a few more tries, a less dramatic but unequivocal response _ “I’ll have to put you down until you can learn to stop” _ will suffice to make her stop. Later, as she’s learning to reach out to other toddlers, to attract their interest and entice them to play, or just to get some kind of response, biting is likely to emerge again.

It will also appear when a toddler is pushed over the edge by desire (for the toy she can’t have), frustration (that another child won’t pay attention), or anger (over the toy that the other child grabbed from her). Biting at these ages is a natural step in a toddler’s effort to sort out her role in interacting with others.

One pediatrician we know says that a toddler’s bite is just the flip side of a kiss _ another try at communicating with her mouth! But when it stirs up hysterical responses in the adults nearby, biting is bound to take on a life of its own. A toddler’s simple effort, once again, to figure out what the fuss is all about.

When a child bites another child in a childcare center, parents and teachers are often, understandably, incensed. Even if their children have been biters in the past themselves, parents want their child buffered from the current carnivore on the loose. Perhaps they fear that their own child will go at it again.

Yet parents and teachers would be wise to use a straightforward teaching response to a toddler’s bites (stop the biter, separate the children, remind them it’s not acceptable, without overreacting to them and tempting them to try it again), not a punitive one like the one you suggest.

A parent who bites is getting down on the level of the child and is no longer a parent. Most common behavioral challenges defy the “logic” of a parent inflicting a child’s misbehavior on a child so that she’ll “know what it’s like.” Should a parent steal from a child who steals so that she’ll get the point? Should a parent lie? Cheat? Would you suggest we also scratch, hit and kick children who need to learn not to? This is not teaching. This is not problem solving. This is not parenting.

We’re happy to share your disdain for the “politically correct” if you’ll think through the issue you raise with us rather than pigeonholing our response in advance. Freedom from “political correctness” is a pretty handy posture to strike these days in defense of just about anything. But it is a distraction.

The problem is that biting back is a primitive response _ one we’d understand in animals in the wild but not one we’d want to model for our children. No doubt you’ve caused no serious harm with the little nibbles you describe, but we want to assure our readers that you wouldn’t apply your logic to the broader challenges of raising a child.

We’d like to see children to be raised into adults who can show each other enough respect to work to understand each other when they disagree rather than to just throw labels at each other. Perhaps all the pigeonholing in politics these days that shuts down healthy debate before it starts is an adult equivalent of the limited social skills of the toddler who bites, or bites back.

We certainly respect all of your experience but must differ with your conclusion that simply stopping a behavior proves your method to be successful and justified. Raising a child is not about simply stopping unwanted behaviors in the short term. It’s also about teaching the child self-control, respect for herself and others, what’s right and what’s wrong, and what it means to be human. We doubt that arguments such as “do it back so she’ll see what it’s like” and “if it stops the behavior, it works” will accomplish these fundamental goals for raising a child.


Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton heads the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

 

6 YEAR-OLD WHO WON’T EAT MEAT

NEW YORK TIMES COLUMN: FAMILIES TODAY:
6 YEAR-OLD WHO WON’T EAT MEAT
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. My 6-year-old son will not eat meat, chicken or cheese. Is half a peanut-butter sandwich, one yogurt and one glass of milk enough protein for a day? He eats plenty of fruits and several vegetables.

A. A few simple rules apply to nutrition and growth.

A child whose height and weight stay on his growth curve at each checkup is consuming enough calories.

For example, a child who has always been at the 25th percentile for weight on the standard growth chart should continue on that percentile over time. If he drops below it, he may not be eating enough calories, or may have a medical problem interfering with growth. A child’s height is determined not only by nutrition but also by his parents’ height.

Children are naturally programmed to seek the foods they need for healthy growth and nutrition. Processed foods that are unnaturally sweet, salty or fatty undermine that ability.

Around the world, a robust variety of healthy diets balance human needs with local foods. These diets typically include different kinds of foods. Many cultures have developed diets with small amounts of meats (the most costly protein source) and larger amounts of vegetables and grains.

Children’s taste preferences mature and broaden with time. A child who rejects a food early on may learn to like it later. Many children need to be presented with the same food up to 15 times before they’ll even try it.

Children’s interactions with the adults who feed them also drive what and how much they eat. Parents’ sense of urgency about feeding their child can backfire. A child is bound to react to pressure by becoming even pickier.

The menu can turn the kitchen into a battlefield. But healthy eating is more likely when mealtimes are relaxed occasions, with no pressure about food.

If the otherwise healthy child doesn’t like a particular food, he’ll just have to eat what’s on his plate or wait until the next meal.

A child’s nutritional requirements vary by age, gender, height, weight, metabolism and activity level. Protein requirements also depend on total daily calories.

Eating enough calories every day allows a child’s body to use proteins for growth instead of breaking them down to provide energy.

Milk, yogurt and peanut butter all contain proteins, as do eggs. Alternative sources include soy foods (soy milk, tofu, tempeh and ice cream). Children who don’t eat meat, fish, poultry, eggs and dairy products may need 1 to 9 grams more of protein per day than those who do.

Check with your pediatrician about your child’s protein requirements.

Children’s daily nutrition guidelines:

“The Pediatric Nutrition Handbook,” edited by Ronald E. Kleinman, M.D., offers these daily nutritional guidelines for 7- to 12-year-olds:

  • 24 to 32 ounces per day of milk or other dairy products. 1/2 cup of milk can be replaced with 1/2 to 3/4 ounces of cheese, or 1/2 cup of yogurt, or 2 1/2 tablespoons of nonfat dry milk stirred into other foods the child likes.
  • 6 to 8 ounces per day of meat, fish or poultry are recommended. 1 ounce of meat, fish or poultry may be replaced with 1 egg, 2 tablespoons of peanut butter, or 4 to 5 tablespoons of cooked legumes such as peas, beans or lentils.
  • 3 to 4 servings of vegetables (each one about 1/4 to 1/2 cup) per day should include a green leafy or yellow or orange vegetable.
  • 1 medium-size portion of fruit or 4 ounces of fruit juice (avoid added sugar, corn syrup or high-fructose sweeteners).
  • 4 to 5 portions of grain (especially whole grain) products such as bread (1 slice equals 1 portion), cereal (1 cup equals 1 portion), pasta, macaroni or rice (1/2 cup equals 1 portion), crackers (5 pieces equals 1 portion), English muffins or bagels (1/2 equal 1 portion), corn grits and the like.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton heads the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

PEACEMAKING IN LARGE FAMILIES

NEW YORK TIMES COLUMN: FAMILIES TODAY:
PEACEMAKING IN LARGE FAMILIES
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

(NOTE: This article is adapted from Understanding Sibling Rivalry: The Brazelton Way by T. Berry Brazelton, M.D. and Joshua D. Sparrow, M.D., published by Da Capo Press, a member of The Perseus Books Group).

It’s no surprise that siblings in a large family often have quite different experiences from those in a small one.

In a large family, the first and last children have special roles. But, if you look closely, so do the middle children. Gender and age differences, along with temperament, can make for unique roles for each child and distinct relationships among siblings.

Large-family siblings must become self-reliant – while relying on each other and managing many relationships simultaneously. They learn about themselves from the others.

The siblings know they are a group and pride themselves on it. When rivalry surfaces, the group either handles it or shoves it underground. At times, though, pride in the pack may be balanced by other feelings: “I get so sick of my brothers and sisters. They’re always around. I wish I could be on my own.”

Others may quickly long to reunite with their siblings. This feeling partly depends on how parents guide their children’s interactions and individuality.

We know a woman, now in her 50s, who was the fifth of eight children, and the only girl: “Daddy made sure we all were at dinner together every night. We went around the table and he asked each of us about our day. Each of us had this time to be special to him.

”When one of us got in trouble, we all paid the price. If it was one kid’s fault, sure we’d be mad. But only for a little while, because we all knew that it could have been any of us. So we’d always stick up for each other. That was what Daddy wanted. “

She and her brothers still live within a few miles of each other. At Christmas, more than 100 children, grandchildren and cousins gather at her father’s house.

One child in a big family may call up a parent’s own memories and experiences, which can become the child’s way of attracting special attention – good or bad.

My wife was a third daughter. She identified with our own third daughter. The other children recognized it: ‘‘you treat her so special.‘` To me the treatment didn’t seem obvious. But a bond linked mother and daughter, left over from the past.

SPECIAL RELATIONSHIPS

Often each sibling has a favorite in the family – based on gender, temperament, birth order or other factors. Favorites single each other out for help and confidences.

When one sibling is emotionally unstable or difficult for peers to accept, siblings in a large family may try to fill the gap. Siblings often connect strongly to such a child and have an uncanny understanding of his needs.

The parent of a 3-year-old with autism always brought an older sibling with him to my office: ”He’ll do things for his brother that he won’t do for me or you. “

Such a channel may not exist. When a child is always on the sidelines and routinely made a scapegoat, parents should seek professional help for him.

FRIENDS AND RIVALS

Sibling rivalry may seem to submerge under the daily hubbub – but it hasn’t vanished. The rivalry in large families may be just as intense as in small ones. Rivalry may even be magnified if the other siblings take sides. The meltdowns are just as disruptive, but when only two siblings are involved, other family members may not pay much attention.

Sometimes two siblings may tease and torture each other so mercilessly that parents have no choice but to step in and break the headlocks.
If the other children have not taken sides, the parents can more easily separate the adversaries and set them to tending chores with a different sibling.

CALMING THE RIVALRY IN LARGE FAMILIES

  1. Maintain perspective. Be mindful of the closeness and mutual dependence beneath sibling struggles.
  2. Watch for the nurturing that the older ones have learned from you. Praise them for it.
  3. Try to make a special time for each child once a week, a ”date“ with one parent or the other, when nothing can interfere. The time need not be long – but keep the promise.
  4. Regular family meals bring everybody together – without the television.
  5. Plan family meetings to share ideas, gripes and rewards. Lay out the family chores and let each child choose one.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton heads the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

WHEN A 3-YEAR-OLD BOY INSISTS HE’S A GIRL

NEW YORK TIMES COLUMN: FAMILIES TODAY:
WHEN A 3-YEAR-OLD BOY INSISTS HE’S A GIRL
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. How concerned should I be that my very imaginative 3-year-old son insists he’s a girl? I want him to express himself however he’s most comfortable, but I also want him not to be teased.

The kids in his pre-school class already seem to have rigid ideas about gender identification and I’m not sure how (or whether) to approach this with my son.

A. Without knowing your son, we can’t tell whether he is simply trying out different gender roles. Most children this age dress up like Mommy and Daddy, imitating familiar gestures with hats and high heels as props. Afterward, they switch back.

Gender identity, though, is an individual’s strongly felt, persistent sense of gender, which settles in surprisingly early, between ages 2 and 3, according to researchers.

Over the years, parents and mental health professionals have tried many strategies to change children who think of themselves as the opposite gender. When “success” is defined as pushing or punishing a child into hiding his deepest feelings about his gender, a miserable child and unhappy adult typically result.

The best possible outcome is for the child to understand himself, to accept himself and to know he is accepted by the most important people in his life.

At the same time, parents and teachers must help the child learn to protect himself from the judgments and mistreatments of those who don’t understand him or who feel threatened by him.

Even at 3, a child can be warned that certain actions are likely to lead to teasing, although it may be too much to expect him to succeed in limiting them to private times at home.

Teachers can help by upholding the standard that the teasing and bullying of any child will not be tolerated and that differences will be respected and valued.

If you were to bring up the gender issue with your imaginative son, your goal could be to let him know that you love and accept him no matter what, and that you want to be on his team, helping him figure out how to avoid teasing and how to survive it when it is unavoidable.

Gender resources

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton heads the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

READING TO A TODDLER

NEW YORK TIMES COLUMN: FAMILIES TODAY:
READING TO A TODDLER
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. I read a lot to my 2-year-old grandson, including “Mother Goose” and Maurice Sendak’s “Where the Wild Things Are.” We’re beginning to read toddler versions of “Grimm’s Fairy Tales.”

I know his parents have reservations about the violence in these stories. Can you refer me to evaluations of how these tales affect a child’s psychological development?

A. A classic is Bruno Bettelheim’s “The Uses of Enchantment: The Meaning and Importance of Fairy Tales.”

To Bettelheim, the upsetting events in fairy tales – children lost in the forest, a grandmother swallowed by a wolf, and worse – help young children master their fears by giving form to them.

Toddlers have a limited understanding of their world, their feelings and those of others. They explain troubling events in terms of themselves: “The thunder is rumbling because I made Daddy mad.”

Children can feel anger, jealousy and even rage as strongly as adults. But they’re less sure what these feelings might make them do.

After age 3 or 4, children become aware enough to judge their feelings: “I am bad for feeling so mad.”

This is the age when nightmares with monsters and witches spring from the child’s own “bad” feelings and fear of them.

Fairy tales with wicked stepsisters, poison apples and pinpricks help children see they aren’t the only ones to have these feelings. And they can distinguish their reactions from those of the “bad” people in the stories.

By 4, children know that make-believe isn’t reality, although their ability to tell the difference may still be tenuous.

At 2, though, children don’t understand the concepts of real and make-believe. The violence in a fairy tale may seem as real as the two of you sitting together – and, thus, it might be too terrifying.

Your grandchild can wait a year or two before listening to you read violent fairy tales. Until then, you have plenty else to read. And besides, if you can stand it, 2-year-olds love to hear the same story over and over and over.

Repetition shows them something powerful and unique about books. Unlike the words that come from mouths, you can always count on those mysterious black squiggles on the page to say the same thing, over and over and over.
These experiences prepare children for literacy. Most important: the pleasure and joy of being read to.

Nothing motivates a child to learn to read like warm memories of doing so with parents and grandparents. Once fairy tales become thrilling opportunities to master fear, reading them together can be a pleasure – but not while they’re just plain scary.

Reading together is a time for closeness and cuddling, for tuning in to each other: “Do you see that cow? Did you see all those spots? Do you think she’s saying ‘moo’?”
A 2-year-old knows you are reading and talking only to him, and when he answers, he is also telling you that in this moment, all that matters is you.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton heads the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

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