The Latest Newsletters from Dr. Joe Barber

Be My Valentine

What tools do you rely on to parent your child?

Children are born into this world as perfect beings waiting for connections to be made. Although your child needs food, warmth and protection, mostly your child needs you.

Your ability to connect in a love-filled positive fashion provides a secure attachment which is essential for a healthy mental, physical and spiritual life. The interactions you choose become the grains of sand out of which your child’s social, emotional and cognitive castles are built. Your love and the interdependent relationships you offer teach, inspire and guide your child.

Your child is born with over 100 billion brain neurons and over the next few years hundreds of trillions of neuronal connections are formed. Brain networks form. Connections are pruned. Behaviors and skills modulated by genes and the environment erupt and your child becomes an adult and future potential parent. The parenting strategies and techniques you choose frame your child’s temperament and support your child’s future personality.

Stressed parents filled with fear, anger and guilt often rely on authoritarian parenting techniques built on dominance not love. This is both wrong and dangerous. Parenting is about enticement not force. It is about allowing your child to find and make the right and wrong decisions. It is about genuine praise and heartfelt effort rather than outcome. Parents who focus on demands and criticism command a behavior but run the risk of not teaching cooperation, independence, patience, understanding and acceptance. Providing your child freedom and encouragement are the holy grails of parenting.

One sided conversations do not last. A healthy parent-child relationship must be reciprocal. It must validate on a daily basis that you both value your child and promise to provide the stimulation and interaction fundamental to a secure, stable and organized relationship. For the infant and young child this means love, affection and attention and the fulfillment of basic body needs. For the toddler it means approval of exploration merged with the setting of limits, schedules and routines. For the preschooler the goal is the ability to understand feelings and being able to experience a wide range of emotions.

Your child watches you. Your words, actions and behaviors teach your child you care and are listening to him or her. How you behave teaches your child how to respond and communicate with others. Mirroring your child shows you approve and want those same words, actions and behaviors to continue.

Consider adding some new interactions into your daily routine with your child.  Practice reflection as a skill. Repeat and paraphrase your child’s words.  Invite your child into a conversation with you and see how two-way conversation accelerates both speech and social reciprocity. Report on your child’s behavior by describing what your child is doing. Watch how this increases your child’s attention span and willingness to engage. Imitate your child. Don’t just talk about what your child is doing. Get out of your chair and do it! You will be amazed by the excitement and added effort your physical involvement provides.

These choices are up to you. If you love your child the answer is easy. The power of connection will be the greatest valentine your child will ever receive.

Pregnancy and Influenza

Women who are pregnant and their unborn child are both at increased risk for complications due to influenza. This is due to changes in the immune system, heart and lungs during pregnancy. These changes place pregnant women at risk for complications, hospitalization and even death due to influenza. The unborn child is also at risk for numerous medical problems.

The first step in treatment is always prevention. Everyone six months of age and older should be immunized every year against influenza. Vaccination is the best way to protect you and your unborn baby from the harmful effects of influenza. It is safe for pregnant women to be immunized with the inactivated influenza vaccine during any trimester. It is not recommended for pregnant women to receive the live attenuated influenza vaccine which is also called LAIV. This vaccine is administered via nasal spray.

Receiving the influenza vaccine during your pregnancy decreases the risk your new infant will come down with influenza during the first six months of life. This is especially important since your child cannot receive an influenza vaccine until six months of age. If you are pregnant and you come down with influenza you also place your child at risk for premature delivery or being small for gestational age.

The flu shot is recommended during pregnancy by the Advisory Committee on Immunization Practices and the American College of Obstetricians and Gynecologists. There is a long record of safety for this immunization being given safely and effectively to pregnant women. Millions of pregnant women have been immunized and there is no evidence of harm to the pregnant woman or their baby.

If you are pregnant and come down with influenza you should receive antiviral treatment as soon as possible. You should not wait for a confirmation test. If your doctor suspects you have influenza that suspicion is enough to begin treatment. It is important for treatment to begin within 48 hours of onset of symptoms. This is why it is important for you to see your doctor early in your illness. There is also proven benefits to beginning treatment after this 48 hour period. The medication that is prescribes is called oseltamivir and it has been proven to be safe for your developing baby when given while you are pregnant.

Flu vaccine and antiviral treatment can make a difference for both you and your unborn child. Get vaccinated and seek medical attention if you become ill with influenza symptoms while you are pregnant.

 

Parent-Directed Parenting

Parent-directed parenting strategies are built upon the parent leading the child. They are most commonly used in the preschooler or early school-aged child. This type of parenting is different from child-directed approaches where the parents follow rather than lead the interaction.  In child-directed intervention the focus is on social attention and nonverbal communication. Self-esteem and a positive parent-child attachment are the goals. In parent-directed intervention verbal communication is primary and the focus is on compliance through contingency management, limit setting and problem solving. Reasoning skills are emphasized and clear, concise and consistent verbal direction is delivered by the parent.

Parent-directed approaches involve telling your child what to do rather than what to stop doing. Children are told and not asked what to do. Directions are broken down into small, specific segmented activities. Parents must avoid multistep directions and the specific behavior that is sought must be concrete and developmentally appropriate. Polite and respectful directions are delivered in a non-threatening normal tone of voice and all directions are explained either before a direction is given or after a direction is obeyed.

When a direction is given and your child does not comply then a time out warning is given. The child is again given the initial command and told he or she will have to go to the time out chair if the command is not obeyed. If the child complies praise is given and the reason for the praise is labeled.

If your child disobeys for the second time then the child must go to the time out chair for several minutes. The child can be released from the chair after this period by giving a command that describes the quiet sitting and asks the child if he or she is now ready to follow the original command. The command needs to be repeated in the same way it was given the prior two times. If the child answers yes or nods that the command will be obeyed then their answer is acknowledged and the child is released from the time out chair and allowed to resume activities.

If your child gets out of the time out chair without your approval then the child is told he or she will go to the time out room. If the three minute timer is restarted and he or she gets out of the time out hair again without your permission the child is taken to a time out room for one minute and then returned to the time out chair to resume the three minute timer. If the child complies or does not comply then the same routines previously described are followed. For each of the successful steps an obeying behavior is always acknowledged and labeled praise is given.

Many parents find it helpful to perform several 5-10 minute sessions each week of parent directed commands for the preschool and early school age child. These sessions reinforce spontaneous parent-directed interventions and speed up your child’s willingness to comply with directions and strengthens the development of problem solving and reasoning skills.

Child-Directed Parenting

Your ability to anticipate and respond to the behavior of your child determines the type of parent leader you are.  Leadership is an essential part of parenting. As a parent leader you must choose parenting responses and an emotional vocabulary that allow you to listen, connect and respond to your child with unconditional love.

Uncertainty of how to respond and interact with a child is a common dilemma for parents. It is a barrier you must and can overcome by following specific child directed responses. These techniques can reshape the way you respond to your child and improve the way your child responds to you.

Toddlers and preschoolers are at the perfect age for child directed parenting. By respecting their choices and providing freedom and encouragement positive behaviors are supported and negative behaviors are eliminated. The foundation of this strategy is to follow your child’s lead and avoid questions, criticism and both direct and indirect commands.  Questions often have hidden commands and criticism suggest disapproval and not listening to your child. Focus on correction without criticism by avoiding authoritarian command words like: “no”, stop”, “quit”, “that’s wrong” and “don’t”. This eliminates unhealthy interactions which damage your child’s self-esteem, self-worth and self-image.

Unless there is a safety or security concern, ignore negative behaviors and use praise, reflection, reporting and imitation to positively influence your child’s behavior. These techniques decrease the risk of negative interaction between you and your child. It is also important to choose words, a tone of speech and gestures that show your love and enthusiasm for being your child’s parent. Your words and actions must say to your child: “I love being your parent and being with you.”

Praise is the most essential parenting response. It increases positive behavior and like enthusiasm generates a positive attachment between you and your child. Make sure praise is genuine and not reflexive. When giving praise, identify or label what you are praising. An example is: “Thank-you for putting your hat and coat on.”

Reflection, reporting and imitation are three other parenting techniques. Somewhat similar to praise each involves a mirroring of your child. Reflection relies on repeating or paraphrasing your child’s words. This invites your child into a conversation with you. It shows your child you are listening and tells your child you understand what he or she is saying. This type of two-way communication enhances speech and social reciprocity skills and helps you connect with your child. Reporting describes what your child’s is doing and improves your child’s attention span. Imitation is the last technique.  In this technique you repeat and perform whatever behavior your child is doing. Each of these techniques shows your child you are interested in and approve of their words, actions or behavior and want them to continue.

If you make these leadership techniques part of your parenting responses you will change the way you relate to your child and the way your child relates to you.  By allowing your child to lead you signal to your child your approval and stimulate positive cooperative and parallel play which support your child’s ability to give, share and take turns. Child directed parenting techniques are simple to master and easy to perform.  By avoiding questions, criticism and commands and utilizing the above techniques you support the development of a positive attachment between you and your child and encourage positive behaviors in your child.

How to Handle Holiday Stress

Focusing on gratitude, having reasonable expectations and giving rather than receiving will help you deal with holiday stress. Common parenting potholes include excessive pressure to perform, succeed or to be perfect. Past memories can also trigger stress.  When you avoid worrying, focus on realistic expectations and practice expressions of gratitude for what you have rather than what you want – stress is reduced.

Look at your holiday plans and don’t allow gift size and cost inflation to make you feel overwhelmed or inadequate. Think small. Allow success to build your energy and positive outlook. Avoid asking “What if?” questions. Such questions increase stress. Do a personal inventory of your stress and focus on taking action that calms you down. By taking care of yourself first and slowing things down the sensory overload of the holiday season can be better controlled and managed.

Road trips and out of home visits also add stress to the holidays. Sleep and meal schedules change and feelings of control decrease. As you lose self-control your ability to cope decreases and you are more prone to be drawn into stressful situations. Stress affects how you think and how well your body works. It leads to chronic illnesses such as hypertension, heart disease, diabetes and obesity and decreases you and your child’s cognitive performance. Although occasional mild stress can improve attention and performance, chronic and toxic stress is never beneficial.

You are the most important model for your child. How you respond and behave during the holidays instills model behaviors in your children.  By slowing things down and learning how to say no to yourself and to others you are teaching your child the importance of respecting oneself as well as others. Saying no allows you to honor and successfully fulfill your existing commitments without over-extending yourself.

The holidays are a time when you will have many opportunities to connect and communicate with your child. Community and family stories of sharing and giving are the perfect way to incorporate gratitude into the life of your family and your child. In these ways your child learns how to express gratitude. Being able to experience gratefulness improves your mood, energy and physical well-being.

The holidays are not a time of total freedom for your child. Responsibilities do not stop on a holiday. Household rules concerning, chores, screen time, video games, homework, exercise, bedtime and self-care all continue. Time must be saved for family meals and family activities and parents must not view a holiday as a time to catch up on home or work responsibilities. Never neglect or overlook a chance over the holidays to sit down and play a game, watch a movie or discuss a topic with your child. These opportunities present the opportunity to make a lasting memory for both you and your child.