Month: August 2009
OD: The New ADHD (Part I)
Teachers, parents, social workers, and all who deal with children on a regular basis: listen up. There’s a new disorder on the block, and whether you like it or not, it’s going to change the way you deal with children. The American Psychiatric Association has just completed work on the latest edition of its standard diagnostic manual, labeled the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (or DSM-V for short). Every new edition brings a host of new official disorders; the new 5th Edition is no exception, including a whopping 14 newly labeled emotional illnesses.
2. Despite behavioral cues (such as punishment or social ostracizing), the child is unable to reduce his/her obnoxious behavior.
3. The behavior causes significant distress in relationships with peers or adults, or in the child’s academic performance.
4. The obnoxious behavior is not a result of a general medical condition or of substance abuse.
Train the Brain Not to Drain
Earlier this week, I described the three keys to help nighttime wetters stay dry:
Drink lots of water during the daytime, stopping after dinner.
Void twice before bedtime.
Train the bladder by adding it to the list of organs that the brain controls at night.
I’m going to explain these a bit more now.
First, imagine your bladder is a balloon. If it is empty or has only a bit of air in it, it does not “feel” much pressure. If it is full or near-full, it stretches and “feel” full. Similarly, the more you stretch your bladder during the daytime, the more your bladder will connect that stretching with a need to void (urinate). If your bladder is used to being stretched to a greater degree, then it will not perceive the need to void when it is stretched to a lesser degree. This is what drinking during the daytime provides your bladder. Have your child drink a large glass or bottle of water first thing in the morning, frequent sips throughout the day, and right when he/she gets home from school.
Second, some children do not take the time or concentration needed to properly void their bladder before bedtime. Sometimes patience is key. It is best to try voiding about a half hour before bed, then once just before bed; sometimes letting out that little bit right before bed makes a big difference.
Third, your child can train his/her bladder. It can be trained to do one of two things.
The bladder alerts the brain that it is somewhat full. The brain responds by increasing alertness, becoming semi-conscious, at least enough to get up to void.
The bladder alerts the brain that it is somewhat full. The brain responds by telling the bladder, “Don’t worry, you can hold it until the morning. You know how to do that.”
The child literally speaks to the bladder (I know this sounds nuts, but believe me, it works), telling it that he/she is the boss: “Bladder, listen up! You obey the brain during the daytime. All the other organs obey the brain at night; it’s time for you to follow suit. You need to wake me up if you feel full. Sound the alarm and I will wake up and empty you. Or, I will just tell you to be quiet and stay full until the morning. I know you can do it.”
Over time, the child’s conscious messages will become unconscious and embedded in the bladder’s connection to the brain. It will start to “obey” the brain.
If your child does ALL three of these, he/she can become dry at night, every night. I have seen it many times in my practice.
A recent poll taken by a prestigious polling company (OK, it was me) revealed a massive difference between parents and their children when it comes to feelings about the beginning of the schoolyear. 92% of parents were overjoyed, relieved, or generally excited for their children to return to school; 83% of children were, shall we say, less than exuberant.
Does your child struggle with nighttime wetness? If so, he or she is not alone. A surprising percentage of children continue to wet the bed into their early teens.
The good news is that nighttime wetness will likely resolve itself on its own, sooner or later, without drugs, bells, whistles, or therapy. The better news is that parents can equip their children to take control of the problem and greatly speed up the process of becoming dry at night, every night.
Here’s a sneak preview on how to get your child dry at night. There are three keys (I’ll explain all three in greater detail in my next post):
1. Have your child drink more water during the daytime, through dinner.
It may seem counterintuitive to have your child drink more water; many parents have been taught to restrict water intake, thinking that this will make the child less likely to need to urinate during the nighttime. The reality is that this makes the problem worse!
Drinking more water during the daytime stretches out the bladder (not dangerously; we’re not talking about a balloon that’s about to pop), making the amount of urine that accumulates during the nighttime seem less than it would otherwise. This avoids the cue to the brain to release urine.
2. After dinner, make sure your child voids (empties the bladder) at least twice before bedtime. Get it all out!
3. Have your child practice mind-body control exercise that helps the child gain control of his/her bladder.
Your child can understand that the brain controls many organs and functions during the nighttime, including heart, lungs, digestion, and dreams (yes, dreams!), so he or she can control the bladder during the nighttime. All it takes is time and devoted attention to making the right connection.
Again, I’ll explain this more in detail next time. But take heart: your child can become dry every night, sooner rather than later!
Many parents struggle with the ages between 2 years and 5 years where they want to push their child ahead of the game when it comes to reading. There are many ways to get your children interested in reading and comprehension without forcing them to read a book that is not age-appropriate or pushing them too hard to write words or full sentences.
With all of the new technology out there to help youngsters learn to read and write, let us not forget about some simple activities that can encourage your children without making them feel stupid if they are not where you think they should be with regard to reading and writing.
- Label toys and furniture in your child’s room or playroom (you can also label it in two different languages to help your child become bilingual)
- Point to each word when you read to your child; read slowly and with punctuation
- When your child reads to you, do not be afraid to correct his/her mistakes (practice makes permanent, NOT perfect)
- Make a grocery list and let your toddler or young child help
- Play a rhyming game with your child
- Point out and say traffic signs when driving in the car
- Answer your child’s questions, even when they are repetitive and become annoying or seem inane! Patience, patience, patience!
- Follow your child’s lead—read a page from a book, and when your child sounds like he/she wants to try, let your child have a go and take over again when he/she has had enough.
- Let your child finish the sentence of a book he/she knows from memory. Or, if he/she knows the book from memory, make your child point to each word as he/she recites it.