This week, I’m taking a slightly different approach. I’ve prepared a series of shareable graphics around a concept that I’ve been grappling with as my children have gotten older and their troubles are more developed than the need to nurse and have a diaper change. Truth be told, I flew into an angry outburst this past weekend and had to do a whole lot of apologizing and reconnecting.
I’m currently in physical therapy for a back injury (a large part of why I’m having difficulty maintaining my composure) and my physical therapist told me something really interesting about the body’s healing process. She said that healing is not linear. What happens is that we’ll have higher pain days and lower pain days. Over time, the higher pain days decrease and the lower pain days increase. I find that’s very similar to how I’ve experienced healing from childhood trauma. When I started out with peaceful parenting, I had a lot of angry days. I tried to avoid directing my anger at my children but I failed a lot. As time has gone by, the better days have become far more numerous. I still have emotional explosions and meltdowns, but they’re cropping up less frequently and I’m able to recover more quickly.
I think a lot of us have really rough days and we feel like we’re failing as peaceful parents, but that couldn’t be further from the truth. We are HEALING. We are doing the best we can. And, through this work, we are equipping ourselves with tools that help us see our children in a more positive light, find avenues of connection, and protect our kids from the things we experienced as children.
I hope this snapshot series will be helpful to you as you work toward a renewed mindset around becoming the parent you want to be.
Text: If you’ve had any encounters within the world of gentle, conscious parenting, you’ve probably heard the mantra, “kids do well if they can.”
Text: While the idea is ancient, Ross Greene brought modern attention to it as a key theme in his Collaborative Problem Solving model.
Text: When we say, “kids do well if they can” what we mean is that children WANT to do well. They WANT to be an integral and accepted part of their social structure, whether that’s family, school, teams, etc.
Text: In other words, when children “misbehave,” it is not because they are manipulative, devious, or bratty.
Text: Rather, children behave in a way that reflects how well their needs are being met, how connected they feel, and how adequately their brains are able to manage their particular circumstances.
Text: This mantra, “children do well if they can,” is pivotal to allowing our adult minds to shift into an anti-childist, respectful worldview around child rearing and discipline.
Text: When we recognize that, every time a child does something we don’t want them to do, it’s because they CANNOT manage otherwise on their own, we can begin thinking in terms of problem-solving with them as opposed to punishing their childlikeness.
Text: And, when we get to the point where our first instinct is to help our kids when their behavior upsets us, it becomes a lot easier to stop yelling, threatening, and hurting them.
Text: Our children will grow in wisdom over time. They will become more and more able to handle difficult circumstances with grace and self-assurance, and we can help them get there.
Text: By modeling gentleness, curiosity, and helpfulness in the face of difficulty, we can help our kids develop the tools they need to operate from a growth mindset wherein flexibility, empowerment, and hope prevail. It’s not easy, but it’s worth the effort.
It takes everything in me not to go off when I see parents in denial about the impacts of their “discipline” methods (read: punishment, since discipline means to teach), shaming and hitting most of all. I have no desire to cut down or berate any parent. My concern comes from my own childhood wounds. Seeing what passes as effective discipline often sends my heart rate soaring as my brain pulls up those decades old experiences with punishment. I find it hard to bear the flippancy of people who announce, “my kids are fine.”
I have had to leave many a conversation in person and on social media, because they so deeply trigger my C-PTSD. And, as bad as it gets for me, I can still move through life mostly successful in the things I attempt to do. All sorts of people are subject to very bad experiences and they grow up to live what appear to be pretty typical adult lives.
Doesn’t mean they are fine.
Adverse Childhood Experiences (ACEs) like bullying, spanking, sexual violence, and the like significantly and negatively impact us. We have objective evidence of this fact. If a parent is harming their kids on a daily basis, those babies are not fine. Not by a long shot. What they are is survivors. And, the brains of survivors do what they must to get by.
When children chronically experience ACEs, they will typically fight, run away, freeze up, or give in. These are the basic human responses to trauma. They are involuntary and protective.
Source: SpiritualSelfHelp.com
The graphic above explains that “most people have one or two dominant stress responses that they typically fall back into as their main mode of reacting to stressful triggers and situations, or perceived threats” and details the four stress responses as follows:
C-PTSD: The Four Stress Responses
Fight
Self-preservation at all costs
Explosive temper and outbursts
Aggressive, angry behavior
Controls others
Bully
Can’t ‘hear’ other points of view
A pronounced sense of entitlement
Demands perfection from others
Dictatorial tendencies
Typically mislabeled as:
Narcissist
Sociopath
Conduct disorder
Flight
Obsessive and/or compulsive behavior
Feelings of panic and anxiety
Rushing around
Over-worrying
Workaholic
Can’t sit still, can’t relax
Tries to micromanage situations and other people
Always on the go, busy doing things
Wants things to be perfect
Overachiever
Typically mislabeled as:
OCD
Bipolar
ADHD
Panic disorder
Mood disorder
Freeze
Spacing out
Feeling unreal
Hibernating
Isolating the self from the outside world
Couch potato
Disassociates
Brain fog
Difficulties making decisions, acting on decisions
Achievement-phobic
Wants to hide from the world
Feels dead, lifeless
Typically mislabeled as:
Clinical depression
Schizophrenia
ADD
DID
Fawn
People pleasing
Scared to say what they really think
talks about “the other” instead of themselves
Flatters others to avoid conflict
Angel of mercy
Overcaring
Sucker
Can’t stand up for the self, say no
Easily exploited by others
Hugely concerned with social standing and acceptance, fitting in
Yes person
Typically mislabeled as:
Codependent
Victim
The vast majority of people who experience consistent, harmful punishment, such as spanking, will experience one or more of these stress responses throughout their lives. We run into trouble when these responses are so present in our lives that they come to be viewed as a part of our personality or as a disorder for which we need intervention. And, it begins in childhood when parents claim “my kids are fine” when, in reality, their children are experiencing an obvious stress response. If we see any of the signs of stress responses in our children, we must be willing to seek help from a mental health professional who can assess what is happening and provide tools for healing.
I experienced harsh punishment as a child, which seems to be unnervingly common for Autistic children. Our behavior is misunderstood and traditional punishment often doesn’t work as intended, so the harshness escalates. Add to that the bullying and exclusion we undergo, and it’s difficult to make it through childhood without deep wounds. My fall backs are fight and flight. I shift between rage and debilitating anxiety as I encounter even minor stressors.
Recently, I felt like punching my husband and walking out after he ate some food I had been saving for myself. I was absolutely infuriated. Heart racing, chest hot, bristly feeling skin. Over a little snack. I don’t want to be this way. It’s not healthy. And, despite years of therapy and an entire professional toolkit of coping mechanisms, my brain refuses to give up these stress responses I developed as a child. But, the reality is that I am improving every year through meditation, reparenting myself, and, yes, even the work of peaceful parenting.
So, I ask every parent to stop saying “my kids are fine” unless you know for a fact that they are. And, if they aren’t, help them. Please.
One of the things whiteness affords me is access to conversations I don’t want to be having. The tiring ones that I know I’m responsible to engage in by virtue of my privilege, my understanding of the stakes, and a moral imperative to betray white supremacy. So, when I see (and hear) white people denying the existence of systemic racism and chalking up the documented differences in opportunity and outcome between white people and Black, Indigenous, and people of color to personal failings, I’m compelled to seek out airtight responses that will destabilize their worldview. I need them upset and unsure, because that’s where growth starts.
To this end, I’ve been following a piece of evidence that popped up on my radar not too long ago. Something that has actually been known for years, but isn’t widely known among white people. First, Black families are among the fastest-growing populations withdrawing their children to homeschool.
Targeted, customized education benefits ALL children.
Black kids are intelligent, despite what white supremacist institutions would have us believe.
When Black kids are not subject to constant racism, they excel.
Decentering whiteness and white history gives Black children a connection to the past and a vision for the future.
And, we know this is the case because, when Black homeschooled children were measured against Black public schooled children, the homeschooled cohort were found to have achieved reading scores FORTY-TWO percentage points higher than their peers, even when controlling for gender and socioeconomic status. Black parents are decisive in their reasoning for homeschooling. A 2015 study in the Journal of School Choice found that the top five reasons Black parents give for choosing homeschooling are:
Providing religious or moral instruction.
Transmitting their worldview to their children.
Developing strong family relationships.
Individualizing education.
Accomplishing more academically than in conventional schools.
Please take note that the first three reasons given are not academic in nature. These parents brought their babies home to build them up, guard their hearts, and give them space to breathe and just be. Most of the parents who are homeschooling do not have education credentials, as is the case for most homeschool teachers. Degreed and certified teachers have an important role in our educational system, but they do not hold the keys to education.
I think about reparations a lot as a white person from a very long line of white people in the United States who have benefitted tremendously from exploitation. And, I wonder what impact we’d have on the future if Black families suddenly became entitled to a guaranteed living stipend to stay home and educate their kids. And, that is exactly the query I want to pose to people who claim systemic racism doesn’t exist. (But the answer is not what a lot of white people want to think about.)
My family has been going through it the past couple weeks. It’s just more of the same 2020 nonsense that everyone is experiencing, but that doesn’t make it any easier. I’ve been thinking about a post on executive functioning, as I can imagine we’re all working a little harder on this skill of late, but also because I recently ran across something that might help our kids be a little more effectual with a lot less work and frustration.
Executive function is the term for the overall management of the brain. It is what allows us to prioritize tasks and get things done and it involves three overarching areas: working memory, cognitive flexibility, and inhibitory control (including self-control). The eight executive functions are self-control, self-monitoring, emotional control, flexibility, task initiation, organization, working memory, and planning & time management.
There are many brain differences that impact executive functioning including things like autism, ADHD, depression, and trauma to the brain. And, if you’ve spent time around kids, you’ll recognize that their executive functioning is still under construction. In fact, executive function develops all the way into adulthood. Kids who are struggling with it might not be able to pay attention, hold onto a series of instructions, transition from one task to the next, or plan out action steps. As a child, I had many, many hours of therapy to help me improve my executive functioning skills, so I was intrigued when I recently ran across a strategy that promises improvements in executive function.
Kristen Jacobsen (MS CCC-SLP) and Sarah Ward (MS CCC-SLP) are two speech language pathologists who have been studying executive function for the past 20+ years and now co-direct Cognitive Connections, a specialty practice in Massachusetts. Together, they created the 360 Thinking™ Executive Function Program that includes a strategy developed by Sarah Ward called Get Ready, Do, Done. This strategy coaches children to identify what needs to be done at a future time, imagine what “done” looks like, work backward to plan out the steps to get there, and then collect needed materials to accomplish the task. It is a way to lay out each step for those whose brains don’t automatically do the planning for them. The model plans backward before taking steps forward.
What will it look like when I am done?
What steps do I need to take to be done? How long will each step take?
What do I need to get ready?
What materials do I need to do the steps?
Time to do the task. Create a timeline and time markers.
When I was little, I used to get frustrated to the point of shutting down when I was told to clean my room. In childist terms, I might have been called lazy or stubborn, but the problem I had was that I simply didn’t know what to do! I needed someone to show me my room clean and straight several times, so I’d have the picture in my mind. I needed to be walked around the room and shown where each item was supposed to go. I needed a step-by-step plan, like:
Get cleaning supplies.
Clear off and make the bed to use as a staging area if needed.
Pick up and put away items from the floor as follows: trash, dishes, clothes, toys, books, and everything else.
Organize wardrobe and trunk.
Wipe dust and grime from surfaces.
Clean glass.
Sweep floor.
That never happened for me. I stumbled through housework until well into adulthood when I came across the organizing and cleaning industries and learned how to properly do housework. Even with small children now, I’m able to keep my house nice and clean. I even put laundry away after it’s dried, which is something I never did as a young adult. Check out this quick video that uses cleaning a room to explain executive functioning:
If you’d like to give Get Ready, Do, Done a try, check out these free resources:
Several weeks ago, I wrote a piece exploring the idea that rewards might be a tool of abuse and, therefore, something parents would be wise to avoid. In the aftermath, I was asked “Isn’t Smiling a Reward?” in the context of pushback from a reader who suggested that there is no way to avoid rewards in parenting. I will grant that the issue is complicated. Of course it is. We’re dealing with human brains! So, I dug a little deeper to better understand if and how rewards might be utilized within the context of peaceful parenting.
The first thing I know innately is that we are social beings. We seek to engage with others of our species as a primitive drive. We use facial expressions and body language to communicate whether other humans are in our circle or not. So, it stands to reason that we would take pleasure from expressions that indicate our inclusion into our preferred social group. With that idea in mind, I took to the science.
Here’s what I learned. Our brains have a reward center that uses the languages of dopamine and serotonin, two crucial neurotransmitters, to translate our experiences into something our minds can grasp physically. Brainfacts.org explains, “Dopamine-producing neurons in the ventral tegmental area (VTA) communicate with neurons in the nucleus accumbens in order to evaluate rewards and motivate us to obtain them.” In simple terms, the nucleus accumbens is a structure in the basal forebrain that scientists believe translates external stimuli into understandable gains, which allows us instinctively to recognize which behaviors are more likely to attain rewards and which ones are not. Check out this quick explanation:
We do not have to think to make the reward center of our brain operate. It is a very basic and very old system that operates behind the scenes. We may not even realize that our experiences are subtly altering our behavior. (And, this is why behaviorism is so effective, albeit harmful, for humans.)
In this sense, yes, a parent smiling at a child does activate the reward center in the brain; therefore, yes, smiling is a reward in the same way eating is a reward and sleeping is a reward and street drugs are a reward and so on. The term “reward” in this context means a reinforcer that encourages a person to return to the same behavior over and over again. However, when we talk about a “reward” in the context of peaceful parenting, what we mean is reinforcer that artificially manipulates a child into behaving in a way we prefer. For instance, providing candy for using the potty or saying “good job” to a child who has cleaned his room. These rewards offer temporary elation and encourage our kids to both crave our attention and unthinkingly submit to our authority.
Peaceful parents do not offer rewards in an effort to mold behavior. Instead of extrinsic (or external) motivation, we prioritize intrinsic (or internal) motivation. We know that extrinsic rewards are demotivating and that children will require more and more payoff to accomplish the same tasks the farther along we go. We don’t bribe our children with candy. If we give them candy, it is not a perk for connecting with interoceptive signals. It is an opportunity to sit around the table as a family and practice eating intuitively. We don’t pay our kids to do chores. If we provide an allowance, it is not an exchange for a job well done. It is an opportunity to learn financial responsibility.
And, we know this is the healthiest way to interact with our children, because science confirms it. A 2009 study found that people with low self esteem who engaged in positive self-statements such as “I am a lovable person” ended up immediately descending into self-deprecation when the self-praise conflicted with their concept of self. Empty praise backfires.
Alternatively, a 2016 study published in Social Cognitive and Affective Neuroscience looked at the effects of self-affirmation, which involves dwelling on values rather than pointing out personal qualities. Participants were asked to “Please think about an experience involving [VALUE].” That exercise was then followed by visualization and thinking about the experience they’d had. The result was an increase in positive self-worth, which was even stronger when participants considered future events rather than past ones.
Turns out that self-affirmation improves function in the medial prefrontal cortex (MPFC) and posterior cingulate (PCC), two areas the deal with self-referential processing (i.e. the parts of the brain that allow us to engage in mindfulness). These increases made the participants more resilient against any negative information that came later. This is why it is always more effective for children when we talk about values and efforts versus toward a future vision than when we talk about personal qualities and snapshot accomplishments. Both affirmations and praise activate our brain’s reward center, but only one insulates us against negative self-worth.
When we smile at our children out of sheer joy at their existence, it is rewarding to their brains, but it is not an effort to coercively manage their behavior. So, please, smile at your kids, hug them, love on them, and affirm them. In doing so, you will build up their self-esteem in a way that can make it unshakeable.
As you might have surmised from my writings, I am absolutely fascinated by all aspects of Peaceful Parenting. I want to know the whys as much as I want to know the hows of it. So, when new information crosses my radar, I’m all over it. That’s what happened when I came across the term inductive discipline.
The Background
Back in 1967, two researchers, M.L. Hoffman and H.D. Saltzstein, published a paper in the Journal of Personality and Social Psychology. They had conducted a study in which they assessed 7th graders on their moral development and correlated that data with measures of parental discipline. Leading into the study, they noted an interest in capturing information about the impact of parental practices on the internalization of moral values and the capacity for guilt. Prior research had studied two styles of discipline in particular:
Power Assertive Discipline which is a “moral orientation based on the fear of external detection and punishment… associated with the relatively frequent use of discipline techniques involving physical punishment and material deprivation” (Hoffman and Saltzstein 45)
Love-Oriented Discipline which is a “moral orientation characterized by independence of external sanctions and high guilt… associated with relative frequent use of nonpower assertive discipline” (Hoffman and Saltzstein 45)
In the simplest terms, Power Assertive Discipline generally relies on force to control children, whereas Love-Oriented Discipline generally relies on neglect. In the 1967 study, however, the researchers introduced another wrinkle. They juxtaposed Power Assertive Discipline and Nonpower Assertive Discipline in order to investigate some discrepancies they had picked up in the research. To do that, they split Nonpower Assertive Discipline in two: love withdrawal and induction. Induction refers to “techniques in which the parent points out the painful consequences of the child’s act for the parent or for others” (Hoffman and Saltzstein 46). And, this is where it gets interesting. Check out what they discovered.
Power assertion was associated with weak moral development.
Love withdrawal was associated with negative moral development.
Induction was associated with advanced moral development.
The fundamental difference among these approaches is that:
…as much animal and human learning research has now shown, what is learned will depend on the stimuli to which the organism is compelled to attend. Disciplinary techniques explicitly or implicitly provide such a focus. Both love withdrawal and power assertion direct the child to the consequences of his behavior for the actor, that is, for the child himself, and to the external agent producing these consequences. Induction, on the other hand, is more apt to focus the child’s attention on the consequences of his actions for others, the parent, or some third party. This factor should be especially important in determining the content of the child’s standards. That is, if transgressions are followed by induction, the child will learn that the important part of transgressions consists of the harm done to others (Hoffman and Saltzstein 54).
I’m going to yield this section to Dr. Gwen Dewar of ParentingScience.com who formulated a clear and compelling case for the use of inductive discipline. This list is fantastic! The entire article is wonderful and I highly recommend you read it.
2. The children of authoritative parents are less likely than the children of authoritarian parents to engage in drug and alcohol use, juvenile delinquency, or other antisocial behavior (e.g., Lamborn et al 1991; Steinberg et al 1992; Querido et al 2002; Benchaya et al 2011; Luyckx et al 2011).
4. Parents who avoid reprimanding kids for intellectual mistakes (e.g., “I’m disappointed in you”) may have kids who are more resilient problem-solvers and better learners (Kamins and Dweck 1999; Schmittmann et al 2006; van Duijvenvoorde et al 2008).
5. Encouraging independence in kids is linked with more self-reliance, better problem solving, and improved emotional health (e.g., Turkel and Tezer 2008; Rothrauff et al 2009; Lamborn et al 1991; Pratt et al 1988; Kamins and Dweck 1999; Luyckx et al 2011).
6. An authoritative approach to discipline may help prevent aggression and reduce peer problems in preschoolers (e.g., Choe et al 2013; Yamagata 2013).
7. Kids with warm, responsive parents are more likely to be helpful, kind, and popular.
How Can We Use This Knowledge?
Let’s start by considering what “inductive” means. You may have heard the phrase inductive reasoning, which means making specific observations that lead to a general theory. For instance, a child might induce from burning their hand on a hot car hood that hot car hoods can be dangerous for people. Induction is an effective teaching method for children, because it gives them room to form hypotheses about their lives. By the same token, it can result in false assumptions, so we have to make sure we’re providing accurate, truthful information alongside our explanations of genuine, logical outcomes. So, what do we do in practice?
Manage Our Own Emotions: While it’s important to be honest with our children, too much honesty about our feelings while emotions are intense can become oppressive. Did your child hurt you deeply? Make you feel you couldn’t trust them? Embarass you? These are big adult feelings and you’re feeling them with your adult heart and mind. It will not serve your child to express your personal disappointment in them, as doing so places the focus on the child and not on the child’s impact. When the crisis has passed, it’s ok to use “I” statements to reflect on the impact your child’s actions had on you. For instance, “I felt hurt when you told me you hated me. I know that you said it in anger. I’ve said hurtful things too when I was angry. Can we talk about what happened so we understand each other better?”
Start with the Three Rs: Regulate (or Co-Regulate), Relate, and Reason. Walking with your child through these steps is the most effective way to diffuse a highly emotional situation and arrive at a place of mutual connection. Check out my post Peaceful Parenting Won’t Work on My Child for an explanation of how the Three Rs work. In short, we must first help our child come to a place of peace and balance. Then, we should empathize with our child in their distress, even when we’re feeling frustrated with their behavior. Then, and only then, can we work through the situation logically and coach our child toward a better response in the future.
Focus on Impact Without Shaming: I hope it goes without saying that angrily berating a child with “LOOK WHAT YOU DID!” is counterproductive even though it focuses on impact. When we express ourselves in this manner, we risk engendering “intense feelings of anxiety over loss of love which may disrupt the child’s response especially to the cognitive elements of the technique” (Hoffman and Saltzstein 55). Instead, it’s important to start from a place of empathy and gentleness. Name what the other person is feeling. Ask the key question, “What did you hope would happen?” and give your child the opportunity to process what led up to the challenging incident.
Here’s the thing. Children learn by watching and doing. They never need to be punished in order to learn right from wrong. When we teach them what is expected of them and demonstrate the impacts of their actions, they learn. They get it. They develop a moral compass. And, then they are internally driven to do what is right, whether or not they anticipate a parent finding out what they’ve done. The science is clear on this: empathy mediates moral internalization. All we need to do is lead by example.
ZerotoThree.org, an organization that focuses on development in the first three years of life, found that 56% of parents they surveyed in 2016 believed that their toddlers had the ability to resist doing something they were told not to do before the age of three. And, of those, 18% believed that children had this ability by only six months of age. Let me be clear in saying that it’s impossible for an infant or a young toddler to habitually exercise self-control. Their brains are incapable of this feat. So, let’s talk about it.
Self-Regulation versus Self-Control
Before we launch too far into this piece, I need to make a distinction for your understanding. As I’ve noted before, self-regulation and self-control are two very different things. Dr. Stuart Shanker of Psychology Today explains,
There is a profound difference between self-regulation and self-control. Self-control is about inhibiting strong impulses; self-regulation, reducing the frequency and intensity of strong impulses by managing stress-load and recovery. In fact, self-regulation is what makes self-control possible, or, in many cases, unnecessary. The reason lies deep inside the brain.
In this piece, I’ll be talking about both.
Birth to Twelve Months
Newborn and very young infants have not yet discovered that they exist apart from their parents. They have no concept of self-control during this phase. They simply communicate their needs and wants in the only ways they know how. During this time, young infants begin to build self-regulation skills through co-regulation with their caregivers.
The development of self-regulation starts young. Very young. As part of an intensive report prepared for several federal agencies back in 1991, researchers conducted an extensive literature review of studies on infant attachment. The goal of the overall project was to critique the literature review, identify research gaps, and build a consensus for an interdisciplinary research agenda, one that has influenced our understanding of infant brain development over the past 30 years. One clear outcome emerged from the literature. Secure attachment results in “ego resiliency,” which is our adaptability to stressors. It is the capacity that allows us to resist lashing out emotionally under stress. And, it all starts at birth.
By the seven month mark, infants begin to realize that they are separate from their caregivers. This early skill is necessary several years down the road when young children begin recognize that other people have emotions. Starting from about seven months, infants also begin to understand that they can control the movements of their bodies and their personalities start to emerge. This is a time of problem solving and much motor development.
At the end of the first year, most babies can understand a wide range of vocabulary and make some speech sounds themselves. They can typically move themselves around their space and recognize basic boundaries. However, they are still too young to be able to control their impulses without adult assistance.
Twelve to Thirty-Six Months
From twelve to thirty-six months, toddlers are really coming into their own. They might express their wants and needs with a sharp “no” or a jolly “yes.” They’re experiencing independence for the first time and it is thrilling. With independence, though, comes more boundaries. And, toddlers don’t quite get the need for them. At this stage, they don’t have the life experience to recognize cause and effect in a way that older kids do. They’re pretty good with simple guidelines when we remind them, but they may not bring them to mind when they’re about to do something we’d prefer they didn’t. Add to that their lack of impulse control and you have a potential conflict between parent and child. However, resist the desire to punish! Understand that your child is doing the best they can. Check out this post about punishment to understand why it’s problematic.
At this stage, toddlers still don’t have reliable self-control, though their self-regulation may be coming along very well. This is the perfect time to deploy the Three Rs in earnest. Toddlers understand empathy and need our understanding to work through their emotions. You can also model your process of self-regulation by talking through your own experiences. For instance, if you’re at the store and you find they’re out of something you were hoping to purchase, you might say, “Oh no! They don’t have what I needed. I feel angry. I really wanted that. Ok, let me think. Maybe another store has the same thing. I’m going to finish shopping here and then go somewhere else.”
Thirty-Six Months and Beyond
Older toddlers and preschoolers have a better grasp on boundaries and limits, but they still don’t have access to the level of impulse control they need to exercise self-control consistently. They still need an adult to help guide them. And, there’s evidence that tells us the effort we put into our children now pays dividends in the future.
A 2016 study published in the journal, Social Development, sought to examine associations between parental responsiveness and executive function, which is a key component of self-regulation. The population they chose is notable. They selected 3-5 year old socioeconomically disadvantaged preschoolers, thereby mitigating many of the confounding factors present in other populations. What they found was that “higher parental responsiveness predicted greater gains in both delay inhibition and conflict EF over time.” In short, warm parenting improved the children’s ability to wait (i.e. delayed gratification) and their ability to choose or not choose to do a task based on who is demanding it (e.g. Simon Says).
It may be difficult to believe, but children do not begin to have the ability to exercise self-control until 3 1/2 at the earliest but typically closer to 4. Again, that’s the start of self-control. We cannot expect a child under the age of 4 to be able to resist doing the things we’ve told them not to do without our supervision and support. With this information in hand, it may be easier for us to approach our children with their developmental stage in mind. We might try redirecting them to other activities, giving directions in simple terms, limiting their access to danger zones, and other similar methods to gently enforce limits around them without putting too much pressure on them to do more than they cognitively can.
How to Support the Development of Self-Control
Start first by supporting your child’s natural development of self-regulation. The most straightforward way to do this is by co-regulating, being there physically with your child as they experience emotions and frustrations. Model ways to deal with upset and conflict. Give unlimited affection. Avoid punishments and rewards. And, give your child time to grow. Your exercise of patience is crucial.
1 Rest and Nutrition! We have all seen how lack of sleep, dehydration, or a hungry stomach can derail a day! If we want to teach kids social-emotional skills, we also need to attend to their rest and nutrition. Sometimes what a tantrum-throwing toddler needs most in the moment is a snack or a nap.
2 Breath[e] in the Fresh Air Provide opportunities for free play and outdoor play. Let the energy out. Increased heart rate = more blood flow to the brain = more brain power. When my older daughter starts to feel emotionally dysregulated, she often takes a walk in the fresh air. As her body begins to fill with happy hormones, her affect becomes calmer. You can also check out these active games that support self-regulation.
3 Blow Away Troubles Blowing bubbles is a kid-friendly way to practice deep breathing — and deep breathing calms the body down. Plus, who doesn’t like bubbles?! When you blow bubbles too quickly or too slow, it doesn’t work. You need to breathe from the belly, at a regular tempo. Speaking of deep breathing, yoga is another great way for kids to connect with their bodies and stay focused and calm. Try adding 15 minutes a day or a quick session after a meltdown.
4 Read All About It! Read books about emotions as a way to discuss all the feelings kids have. I love Todd Parr’s books (including The Feelings Book and It’s Okay To Be Different) and the way he displays an array of feeling vocabulary. In addition, sensory “touch and feel” books can help hold your child’s attention during reading time and stimulate their senses.
5 Listen Up! Calm music can help settle children down. And fun, simple songs can help children remember self-regulation strategies. Check out these Daniel Tiger songs about anger, taking turns, and waiting.
As you’ve read, self-control comes later, around the age of 4. You can help your child practice self-control by playing games like Red Light, Green Light. Help your child reason through difficult situations, all while empathizing with them in their distress. Give your child opportunities to choose between instant gratification and delayed gratification. For instance, “We can go to the park today and get ice cream tomorrow or we can get ice cream now and go to the park tomorrow. Which would you like to do?” And, of course, provide your child with consistent limits and be willing to negotiate those limits.
Did y’all see the study from November 2019 that found screen use greater than the amount recommended by the American Academy of Pediatrics was associated with decreased microstructural organization and myelination of brain white matter tracts that support language and emergent literacy skills? Big yikes! Does that mean screens cause brain damage? That’s certainly a question I’ve seen floating around the internet. Parents are rightfully concerned about screen time when study after study shows these terrible outcomes.
There’s that 2013 literature review on screen time use in children under the age of three. Bad news.
And, that 2015 literature review on the effects of screen time on children’s sleep found. Terrible stuff.
And, that 2018 literature review on the physiological and psychological effects of screentime. You might as well just give up at this point.
And, that whole Research Roundup that seems to exist to fill parents with dread. Oh, the horror!
But, check this out.
The 2013 review found that there is very little research on infants and toddlers and that more research is needed to better understand the environmental, socio-cultural, and behavioral correlates for young children.
The 2015 review found that none of the studies they looked at from 1999-2014 could establish a causal connection, measurement errors of screen time exposure and sleep limited the outcomes of the studies, and factors like characteristics and content of screens was not well understood.
And, the 2018 review found that psychophysiological resilience in children requires the ability to focus, good social coping and attachment, and good physical health all of which could be impacted by “excessive” digital media use. They further recommend more research on duration, content, after-dark use, media type, and number of devices.
In fact, there’s a 2015 literature review on the association of parental influences with physical activity and screen time among young children found that there is a causal connection between the parents’ physical activity and screen use and that of the children. It should come as no surprise that the behavior of parents directly influences the behavior of their children.
And, that first study I mentioned? The one from 2019 about how screens change the brains of little kids? If you look a little deeper, you’ll see that the sample size is both small and homogenous and that the survey and testing scores used in the study did not meet the threshold for statistical significance when income was included in the model. Those details change the story a bit.
Minding the Nuance
The reality is that there is valuable research happening, but we simply don’t understand what’s really going on. That’s why the pediatric organizations that exist to protect our kids are sounding the alarm. They’re saying look at all this data we’re seeing! Something is happening. Pay attention. So, if your family’s lifestyle flows better without any screens, by all means, do what works for you. This post is for those of you who want to incorporate screens without fear.
There are some things we can discern intuitively about screen use.
It can be distracting. Background sounds from a TV at low volume add static to the environment where infants and toddlers play. A measurable impact has been found on the ability of very small children to develop play skills naturally when TVs are used as noise fillers.
It can signal trouble. While we don’t know that screens cause depression, we do know that children who watch a lot of TV often have clinical depression that necessitates medication. So, it’s worth paying attention to what your kids are doing, so that you can intervene if necessary.
It can replace other healthful behaviors. A child who is watching TV or playing video games is not outside running around. And, a child who is watching TV or playing video games is not telling you about the troubles they’re having.
Now, something that doesn’t get enough air time in these discussions is the economics of restriction. Essentially, by restricting a thing, we increase its value. As explained by Pam Sorooshian, unschooler extraordinaire,
When you only allow a limited amount of TV, then the marginal utility of a little more tv is high and every other option looks like a poor one, comparatively. Watching more TV becomes the focus of the person’s thinking, since the marginal utility is so high. Relax the constraints and, after a period of adjustment and experimentation to determine accurate marginal utilities, the focus on TV will disappear and it will become just another option.
The more you restrict, the more they’ll crave screens. It can feel uncomfortable to loosen the reins and it’s pretty likely your child will consume seemingly impossible amounts of flickering deliciousness at first. But, over time, and in the presence of intentional investment in your child’s needs and wants, screens will lose their luster and become just another activity.
If you’ve been restricting your child’s screen time, because you wanted to do the best possible thing for them or because you felt their screen use was getting out of control, it’s ok. You’re not alone. Not by any means. Just know there is an approach to screen use that is responsible and respectful, whenever you’re ready.
Anti-Childist Screen Use Monitoring
One of the things about the furor over screens that particularly bothers me is the emphasis on cognition and school performance. We’re encouraged to limit our children to a screen schedule of our making, so they can possibly do better in school at some point in the future. But why? Why is academic success the measure of a good life? Why are we not prioritizing our children’s ability to regulate their own behaviors and activities by giving them ownership over the way they choose to spend their time?
We can trust our children to make good decisions when we set them up for success. In our house, I try to limit my compulsion to set rules for everyone. Whenever my kids want to watch TV, I’m ok with it. They have free access to their tablets to use as they wish. But, I also create an environment where they don’t have any desire to obsessively consume that visual stimulation. We spend lots of time outside. We read. We do chores. We play, craft, and bake together. When I see one of my kids struggling to transition from screens to another activity, I intervene. When that happens, it means there’s something deeper going on that needs to be addressed. It doesn’t mean I need to arbitrarily limit screen time. I have some guidelines for my family in the back of my mind to help ensure that I’m providing the most effective mix of activities and the best possible education around the use of screens.
Be Intentional. Consider using screens on purpose. That means avoiding the use of TVs as background noise and trying not to hand your kids screens to keep them occupied. Instead, let your children decide when they want to use screens and for how long. And, have them choose one screen at a time. In general, our TV doesn’t get turned on until 3 PM, if at all. There’s too much other fun stuff to do.
Be Interactive. Studies show that children can learn a great deal from interactive touchscreens when their parents help them and reinforce what they’re learning.
Be Wise. Particularly when it comes to older kids, parents need to prepare children for the risks of predators and dangerous malware. Talk to your kids about these dangers and make a plan together for how to stay safe.
Choose Educational Content. Programs like Sesame Street and Daniel Tiger provide important information and skills to little kids, especially when families reinforce in daily life what the kids are learning online.
Eat Without Distraction. One rule we do have is that our dining table is a toy-free, screen-free space when we’re having a meal. It’s a matter of mutual respect and consideration. Family meals are sacred in my house. They’re one of the few opportunities we have to get together and chat over one of the most fundamental human activities.
Get Plenty of Fresh Air and Exercise. Getting outside is so important for every member of the family, but especially children. They need lots and lots of movement throughout the day to improve focus, digestion, motor skills, and sleep. Rather than restricting screens, think about encouraging more movement for balance.
Practice Good Sleep Hygiene. The so-called warnings about blue light got a little kick in the pants this year. A study challenged the idea that blue light impacts circadian rhythms. We don’t actually know if blue light is a problem. What we do know is that stimulation of any kind interrupts our sleep cycle. In our house, all screens and radios go off at 6:30 pm. That’s our family time and we cherish the ability to interact with each other without distraction. For a great night’s sleep, keep your kids’ room very dark, relatively cool (65 to 68 degrees Fahrenheit), and comfortably quiet.
Like many parents, when I first became a mom, I was hypervigilant about everything. I stressed myself out trying to do everything by the book, until life taught me that wisdom beats out perfection every time. If you want your children to enjoy screens, let them. Formulate some guidelines for yourself and conduct self-checks to make sure your guidelines are working. Talk with your kids about your concerns. Let them know your values and also that you trust them to know what their minds and bodies need. As new evidence emerges, we’ll be in a great position to shift some of our guidelines to better support our children’s development. Screens are ok, y’all. Promise!
Ever have moments when you feel like you’re in sync with your kids and things are amazing? If so, did you know you can have even more of those moments? Kids do well when they can, and you can help them out by understanding better where they’re coming from.
Marriage and Family Therapist, Galyn Burke, put together a fantastic resource on the way children’s brains develop. She explains that the three major parts of the brain (hindbrain, midbrain, and forebrain) develop on different timelines. They have to. Our brains are complex with high energy demands. It takes a while to get everything in order.
The reptilian hindbrain looks like someone dropped a crocodile brain into our heads. This part of the brain serves the most basic purposes including regulating autonomic functions like breathing and instictive behaviors like threat patrol.
The limbic midbrain is our emotion center. It’s what allows us to be empathetic, social creatures. This is the part of the brain where children process their world.
The neocortex forebrain is where our rational mind lives. This part doesn’t fully develop until the mid-20s in humans. We like to think of this area as the logic center, but without the midbrain, our logic is incomplete.
Childhood is an incredibly crucial time in the life of a human being when we learn how to be human. We figure out what emotions are and how to work with them. We learn how to love each other and respect boundaries. And, we learn our personal signs of dysregulation and how to cope. If children are not treated gently and responsively, any of these skills can be hindered.
So, you know that brain development isn’t as simple as 1, 2, 3, but did you know that even babies can think logically before they can talk? Turns out, our ability to reason doesn’t depend on language or understanding. A study that came out a few years back found that preverbal infants notice when something is wrong and try to work out a solution. The scientists figured out that “at the moment of a potential deduction, infants’ pupils dilated, and their eyes moved toward the ambiguous object when inferences could be computed, in contrast to transparent scenes not requiring inferences to identify the object. These oculomotor markers resembled those of adults inspecting similar scenes, suggesting that intuitive and stable logical structures involved in the interpretation of dynamic scenes may be part of the fabric of the human mind.” And our ability to reason explodes from that point.
Alison Gopnik, Professor of Psychology and Affiliate Professor of Philosopy at the University of California at Berkeley and author of The Gardener and the Carpenter, has been studying children for a long time. What she has found is that children have a greater capacity for innovation and creativity than college students all while applying clear logic. She explains that 3-year-olds will offer a stream of consciousness when asked to give us their thoughts, but if you use their own language to ask them concrete questions, the responses will be sensible and surprising.
Check out this piece explaining some of her experiments. You might just find something useful (Hint: Don’t miss the part where the researcher notes that having children explain something themselves increases their understanding of it.)
Now that you know just how brilliant your child is and you know why they can appear to be illogical, you might be surprised to learn that a very simple solution can flip a switch for your child. When a child’s limbic system is on overload, top to bottom exercises can be useful. These are exercises that require movement across both the top and bottom parts of the body. Things like standing stretches and light weight lifting can help your child’s brain regulate itself.
One final thought that comes to mind is Dialectical Behavior Therapy (DBT) with its focus on integration. In DBT, there exists a concept of the Wise Mind, which is “the balanced part of us that comprises our inner knowledge and intuition, where our emotional thinking mind (thoughts driven by distressing feelings) and rational thinking mind come together, the part of us that just ‘knows’ that true reality.”
Many adults need therapeutic intervention to learn to live into their Wise Mind. Children, whose brains are still forming, need direction and practice to find this place. When you recognize that your children are logical, but not logical in the exact same way that you are, it can become easier to learn to speak their language and to offer responses that help them integrate all the parts of their brains. I firmly believe that children are perfectly reasonable and I hope that, now, you do too.
Have you ever heard the term __________ People Time to refer to someone running late? That blank could refer to Black people, Latinx people, or any number of other cultures. Do you know why it’s a thing in the first place? Because of something called “time orientation.” Some cultures don’t have any real investment in the passage of time, some are polychronic, and some are monochronic. Perhaps, unsurprising, it’s been theorized that the less concerned people are about time, the warmer the climate in the culture’s ancient past. The idea is that inhabitants of warmer climates, historically, had to concern themselves less with clothing and food than did inhabitants of colder climates who spent more time on basic survival. If you have a short growing season and a long winter, time will feel in very short supply.
Polychronic cultures are those in which people are lax about time. Their focus in on community and relationships and they value things like relaxation. Monochronic cultures are centered around time and schedules. They work through time in a linear direction and they value things like promptness. So, when I tell you that predominantly white cultures are primarily monochronic, including the colonizers who settled in the United States and built a culture around their values, does it come as a shock? Probably not. Fast-forward to today and people from historically polychronic cultures are made to feel that they are wrong for being late or for talking for too long or for assuming context or for interrupting. However, they aren’t wrong. They’re just different.
The characteristics of any culture arise from legitimate needs during that culture’s history. However, one group’s cultural values, in particular, have obfuscated the valid cultural traditions of people groups the world over via mass colonization: White Supremacy Culture.
As defined by DismantlingRacism.org,
White Supremacy Culture is the idea (ideology) that white people and the ideas, thoughts, beliefs, and actions of white people are superior to People of Color and their ideas, thoughts, beliefs, and actions.
White supremacy culture is reproduced by all the institutions of our society. In particular the media, the education system, western science (which played a major role in reinforcing the idea of race as a biological truth with the white race as the “ideal” top of the hierarchy), and the Christian church have played central roles in reproducing the idea of white supremacy (i.e. that white is “normal,” “better,” “smarter,” “holy” in contrast to Black and other People and Communities of Color.
White supremacy culture is an artificial, historically constructed culture which expresses, justifies and binds together the United States white supremacy system. It is the glue that binds together white-controlled institutions into systems and white-controlled systems into the global white supremacy system.
Dismantling Racism names the following fifteen characteristics of White Supremacy Culture. I will seek to describe each in brief and explain how White Supremacy Culture influences childism, though you will likely see the problem before I get there.
Perfectionism: Inadequacies matter more than competencies, mistakes reflect badly on the person rather than being seen as neutral opportunities for reflection and growth, and problems are more identifiable than strengths.
Sense of Urgency: Schedules are more important than people, decision-making and strategizing are rushed, and results are more important than the process.
Defensiveness: Saving face and not ruffling any feathers get prioritized, hierarchies control for perceived insubordination, and leaders reject constructive feedback as unjust criticism.
Valuing Quantity over Quality: Meeting measurable goals takes precedence, emotions have no place, and completing the checklist wins out over any harm or the actual outcome.
Worship of the written word: Documenting everything accurately is more trusted than putting faith in people, and alternative communication styles are abhorred.
Belief in Only One Right Way: Divining the perfect solution to a problem is the goal and no flexibility exists to apply a fundamentally good solution in ways that address differences.
Paternalism: Only people in power are capable of making the right decisions for the people they rule and little vertical collaboration in the hierarchy occurs.
Either/or Thinking: Binary thinking rules, all nuance is lost, and the agenda of people in power gets advanced.
Power Hoarding: Preserving power toward the top of the hierarchy is key and those not in power are viewed as incompetent and emotional when they defy the power structure.
Fear of Open Conflict: Politeness rules all, conflict is unbearable, and emotional responses signal lack of intelligence or capacity.
Individualism: The ability of the individual is valued over the ability to work as a team, people should solve problems on their own, individuals want credit rather than cooperation, a rampant lack of accountability for those in power exists, and everyone is pushed into isolation as a result.
I’m the Only One Who Can Do This Right: The focus is on concentrating knowledge and effort into individuals, others cannot be trusted to do the thing correctly
Progress is Bigger and More: Progress matters more than process and those lacking power are exploited and excluded.
Objectivity: Neutrality is the priority, emotions invalidate the emotional person, perceived illogical thinking is met with impatience, and out of the box thinking is discouraged.
Claiming a Right to Comfort: Comfort for those in power is emphasized, those who cause discomfort get blamed, and fragility is the result.
Tema Okun, author and social justice advocate explains further that “the characteristics listed [above] are damaging because they are used as norms and standards without being proactively named or chosen by the group. They are damaging because they promote white supremacy thinking. Because we all live in a white supremacy culture, these characteristics show up in the attitudes and behaviors of all of us – people of color and white people.”
We are all influenced. Our worldviews are impacted. And, the way we approach parenting is affected. Here are a few of the ways in which White Supremacy Culture is impacting the way we treat our children.
Signs You’re Buying Into White Supremacy
At this point, your chest might be tightening a little. You might already be convincing yourself of how wrong I am. You couldn’t possibly be buying into White Supremacy Culture! Could you? Let me me the first one to admit that I struggle. I truly struggle. I see clearly where White Supremacy Culture has molded my thinking, even as a Peaceful Parent. The truth is that acknowledging reality and being honest with myself is the only way forward. Not only is it a way to become a better parent, for me, it’s also a way to help me become a better, more responsible white person.
I invite you to read through this list and see if your parenting has also been influenced by White Supremacy Culture like mine has.
Children can’t make mistakes without being punished
They are pulled to and fro by the draw of our schedules
We become incensed when our kids “disobey”
If our children aren’t progressing then they must be falling behind
Preliterate children in particular are infantilized by our communication requirements
We push kids toward the “right” way to do things and ignore their unique ideas
Children have no say in their upbringing
Children are either good or bad
Parents hold 100% of the power in the relationship
We demand politeness over realness
We expect our kids to figure things out on their own (“I’ve told you a hundred times! Go figure it out!”)
We react to mistakes by taking over
We praise progress and criticize mistakes made during the process
We believe we are more objective because we are less emotional than children
We punish children for “embarrassing” us in public
In the beginning of this piece, I looked at the ways in which cultures perceive time to illustrate the legitimate differences that exist across cultures. I talked about White Supremacy Culture and how ubiquitous it is. We are impacted by it without knowing it. I laid out the characteristics of White Supremacy Culture, followed by some of the ways in which White Supremacy Culture affects our children. If we accept that White Supremacy Culture does not contain exclusive knowledge of the only right way to believe and behave, what does that say about the way we treat children as isolated subordinates under the influence of white supremacy?
In 2013, Ghanian researcher, Patricia Mawusi Amos, authored a chapter in a book called Parenting in South American and African Contexts. Her chapter, Parenting and Culture – Evidence from Some African Communities, highlights common parenting practices in Ghana, Nigeria, and Liberia that produce positive results in children. Notably, she includes the extended family system, folktales, and puberty rites. These practices defy the White Supremacy Culture values of Paternalism, as multiple family and community members help care for the children; Sense of Urgency, as time is taken to teach children through storytelling; and Individualism, as children are included in cultural rites of passage.
And, research backs it up. For instance, Tadesse Jaleta Jirata’s 2014 paper, Positive Parenting: An Ethnographic Study of Storytelling for Socialization of Children in Ethiopia, concludes that the tradition of intergenerational storytelling “is a means for parents to accomplish their parenting responsibilities in line with the needs and concerns of their children,” “fosters close social relationships between parents and children and facilitates intergenerational transmission of knowledge and values,” builds “creative child-to-child interactions and help[s] children adapt themselves to their social world.”
So, if you find yourself locked into a White Supremacy Culture mindset, try moving in another direction. Read up on how parenting happens in other cultures. Look to find ways in which you can reduce the childism inherent in White Supremacy Culture. At this point, I should note that simply by engaging in Peaceful Parenting, you’ve already begun the work. One of the most common criticisms I’ve received about Peaceful Parenting is the amount of time it takes to go the gentle route. So, you know what? Go the gentle route! Ready for a final list?
How to Make a Positive Change
It’s one thing to say we want to reject White Supremacy Culture and quite another to actually do it. It’s hard to go against the grain. How about starting with a few resolutions to incorporate into your daily life?
Let children make mistakes without judgment. Check out this really cool research on how allowing people to self-correct their behavior builds executive function.
Slow down and be more choosy about the activities your family will engage in. Psychology Today has a great piece on how to do just that.
Find out how you can support your child’s communication through all stages of development from ZERO TO THREE, a global organization powered by leading researchers and clinicians.
Stop railing against “giving in” to your children and trying giving choices instead. Children who learn early how to make wise choices are better prepared for a lifetime of decision-making.
Understand that people are too complicated to be either good or bad. We are a culmination of all our experiences and all our reflections. Children benefit from being guided toward wisdom rather than being held to the impossible standard of “good.”
Recognize that kids don’t just choose not to do what we ask of them. Their executive function is developing and they need our help to figure things out. Check out this great overview for more details.
Recognize that you are not an objective observer removed from your relationship with your child. Both you and your child have human emotions that should be validated, not shunned.
I know this was a tough post to read. Did it help you see something you didn’t see before? Do you have a game plan for how you’d like to move forward with your new (or renewed) knowledge?
I recently ran across this fantastic article in Psychology Today about nature versus nurture in child rearing. Robert Plomin Ph.D., dives into the research he presents in his book, Blueprint: How DNA Makes Us Who We Are.
What he has found is that our DNA is the driving force behind our psychology from personality to behavior. Your wonderfully sassy kid is probably genetically designed to be sassy. So strap in and hold on for this ride, because that kid isn’t going to change. (Keep that in mind when you’re feeling some type of way about your child’s “attitude.”)
He notes, for instance, that parents who read a lot to their children likely have children who enjoy being read to at a basic psychological level. So, when your mom friend starts bragging about reading 400 books to her daughter over the summer and asking you how many books you read to yours, don’t feel bad that your own daughter was too busy drawing to be bothered to sit for many stories. Your child’s personality is going to be very close to what it already was at conception, save for a major brain event.
On one hand, it’s freeing to know that all the experiences children encounter and process through the lens of their DNA help form their understanding of how the world works. Experiences are important and the field of epigenetics is informing us more every day about just how important they are. What we know for certain is that it’s crucial to develop a relationship with your child to find out their strengths and aptitudes and build on those. That sassy child I mentioned likely has heaps of natural confidence. Consider all the wonderful things they’ll be able to do, perhaps, in the public sphere. They may become an influencer or a politician. When you take note and support their interests, so many wonderful things will happen.
Peaceful Parenting offers the ideal framework and guidance to work with children’s different personalities and needs. It respects the essence of the child and is flexible enough to move with a child’s genetic tendencies without any of the rigidity that can stifle a child’s inborn potentiality.
ABA is an extremely sensitive topic. You may experience intense emotions as you read this piece. I ask that you read through the post in its entirety before you make a final decision on what your perspective will be. If you need clarification, please ask. If you disagree, I’d appreciate your feedback.
It has taken me months to prepare this post for so many reasons, not the least of which is that I’ve been coming to terms with my own very late autism diagnosis. I’m one of the fortunate people who wasn’t subjected to Applied Behavior Analysis (ABA) therapy, but so many Autistic people are not so lucky. I write this post for them and for all the children now and in the future who will undergo this very painful experience.
At the start, I have to make clear that I am not a professional. I’m an Autistic mom of an Autistic child, and I have been in the position of deciding whether or not to put my child into ABA therapy.
I also need my fellow parents to know that I am not condemning you if you’ve chosen ABA therapy. It is the gold standard “treatment” for Autism Spectrum Disorder (ASD), it’s covered by insurance, and it certainly seems to work. Unless you’ve been exposed to Autistic adults and our position on ABA, there’s little reason for you to be concerned. I hope you will hear what we have to say and consider whether you want to continue down this path.
Autism Isn’t a Behavior Disorder
So, why treat it with compliance-based training? Autism is a completely natural, neurological variant. It is primarily disabling in cultures where Autistic people are not included and embraced.
Autistic brains perceive and process the world differently from allistic brains. But, we are fundamentally human beings, like everyone else, with the same emotions and responses to stimuli. If you hear a loud noise, do you not cover your ears? That’s not considered odd at all, right? So, why would it be odd for an Autistic person to do the same? Sure, it might be accompanied by humming and rocking, because stimming is so comforting to us, but we’re doing the same thing you do to reduce the strain of overstimulation. When allistic children relieve intense stress by cutting, we don’t send them to compliance-based training to try and coerce them to stop. We get them into helpful therapies to give them back control and provide relief that doesn’t harm, thereby addressing the problem rather than the behavior. And, that’s what Autistic kids need: acknowledgement that behavior is communication and relief from the underlying problem.
A History of ABA Therapy
Back in the 1970s, UCLA psychologist, Ole Ivar Lovaas, participated in the development of a therapy that promised to alter “deviant” behavior. His involvement in the Feminine Boy Project offered him an opportunity to engage in a form of behaviorism soon-to-be-called conversion therapy wherein gay men would theoretically be converted to heterosexuality. He also used this new therapy in his work with Autistic children.
Conversion therapy for homosexual people has since fallen out of favor, for obvious and good reason. However, Autistic children are still subjected to the same behaviorism that we’ve deemed unacceptable for use on other human beings. The reason? It was the same back then as it is now. In the words of Lovaas himself, ABA therapy can make Autistic kids “indistinguishable from their normal friends.” Unfortunately, that so-called progress comes at the price of an uptick in PTSD and suicide among Autistic people. I’m sure you can understand how devastating it is to go through life feeling that the person you genuinely are simply isn’t enough for the people who say they love you. Now, before you decide that my criticism is unfounded, let me make it abundantly clear that Lovaas was a pretty despicablefellow:
Modern ABA might look gentler on the surface; however, at its core, it starts with the assumption that Autistic people are broken and wrong, and it seeks to make our behavior more comfortable for allistic people.
Autistic Perspectives on ABA
Amythest Schaber is an Autistic artist, writer, public speaker, and advocate. Her series, Ask an Autistic, tackles a great many topics that have proved helpful to her many allistic followers. In this episode, she explains what ABA is from her perspective.
The following list includes links to other Autistic writers and advocates, as well as allies, who explain why ABA should be avoided:
Even new, “gentle” ABA therapy is problematic. (Source, source, and source)
Finally, this post from the Non-Binary Intersectionalist (and I must give tremendous credit to this page for the wealth of resources I’ve been able to provide in this post!) describes a recent interaction with a young child in ABA therapy:
If you’re interested in reading some personal accounts of ABA therapy, I encourage you to check out this post on Stop ABA, Support Autistics. If you still aren’t convinced that ABA therapy is harmful, read this post.
What’s the Alternative to ABA Therapy?
To answer this question, we have to consider what well-meaning parents intend to happen when they put their children into ABA therapy. Some of the most common reasons I’ve seen are 1) to help the child be more independent, 2) to help the child navigate society more easily, and 3) to protect the child from danger. There are many, many more reasons of course! These are simply the top three as I’ve understood them.
I imagine you won’t be very surprised to learn that the best alternative to ABA therapy, in my experience and in accordance with my values, is Peaceful Parenting.
Peaceful Parenting achieves each of the three aims I mentioned by instilling self-sufficiency, self-assurance, and boundary recognition in children, as well as improving emotional development and self-regulation, one interaction at a time. Peaceful Parenting does not require thousands upon thousands of dollars or 40+ hours a week of therapy. For symptomatic concerns, there are other wonderful therapies like speech therapy, occupational therapy, and physical therapy. These therapies can help discover and meet needs that parents may not fully understand. And, much like taking an ESL class, they help Autistic kids learn a different culture without coercion.
Autistic kids deserve the same gentle treatment as any other child. If you wouldn’t put your neurotypical child into ABA therapy, there’s no need to put your Autistic child into ABA therapy. If you’d consider Dialectical Behavior Therapy (sidenote: DBT and ABA are not the same) to help your neurotypical child handle the stresses of life, offer the same to your Autistic child. Figuring out how best to support a child – any child – can be complicated. But treating our children with the same responsive gentleness, regardless of neurology, need not be the least bit complicated.
In this TED Talk, Dr. Amy Laurent explains why Autistic people need support in developing emotional skills, not behavior management:
ABA therapy is simply incompatible with Peaceful Parenting. The entire concept hinges on the adult therapist’s ability to coerce a child into compliance by withholding beloved objects and activities until the child “earns” them by obeying the therapist. ABA therapy discourages children from saying “no.” It does nothing to meet underlying, unmet needs and, instead, attempts to force children to ignore those needs while behaving as though the needs do not exist.
If you are a Peaceful Parent who is alarmed by what you’ve read, please know you and your child are enough just as you are. Your connection with your child is the key to comfort and growth. All children want to be heard and understood. Your job, then, is to learn how your child communicates and become conversant in their preferred language. Trust yourself. Trust your child. And, when you need help, find people who are willing to do the hard work of figuring out why your child is suffering and then find ways to relieve that suffering by way of accommodations and modifications. For instance, if your child hits himself in the head in the presence of very bright lights, the remedy is simple. Turn the lights down or off. When you start to see remedies everywhere, the rest falls right into place.
No Autistic child is the same and there are going to be things your child can do that mine can’t. Again, all Autistic people are different from one another. The key is learning what exactly that means for your child and filling in every single crevice in your child’s heart that is aching for your love and attention.
That includes Autistic children who exhibit self-destructive and violent behavior. Remember, all behavior is communication. If a child, any child, is lashing out, something is wrong that the child can’t overcome. Our goal as parents has to be to investigate the underlying cause of our children’s challenging behavior and help to relieve any stressors we discover.
You Want Action Steps? We’ve Got Actions Steps.
You’ll find this to be a very short section, because I’m directing you to the single most helpful post I’ve ever read on helping Autistic kids as a parent. For concrete, comprehensive details on what you can do for your Autistic child without the use of any ABA whatsoever, please read If Not ABA, Then What at The Thinking Person’s Guide to Autism. The recommendations there will support what you are already doing as a Peaceful Parent.
Careful! ABA Ideology Can Wriggle Into Other Therapies
If you’ve gotten this far, I want to make sure you know that ABA ideology has infiltrated all aspects of the way professionals care for Autistic people. Plus, because ABA is so profitable, some professionals use ABA codes to bill insurance even while they claim they aren’t practicing “traditional” ABA. However, don’t be fooled! If it’s called ABA, it is ABA. And, even if it’s not called ABA, the professional could be using ABA tactics to pressure your child into making advances. It can all be very confusing. An excellent post by Autistic Mama describes the red flags that should send you running for the door if you see them in any therapy your child undergoes. Please visit her post directly for a full explanation of each red flag.
Observation is Not Allowed
Indefinite Therapy
Extreme Hours
No Stimming Allowed
Requires Eye Contact
Excessive Reliance on Token Systems and Edibles
Rigid Approach or Refusing to Make Basic Accommodations
Focus on Outward Behaviors, Rather than Functional Skills
Expecting Kids to Perform on Command, Regardless of How Difficult Something is or Where the Child is at Emotionally
Moving too Fast or Not Breaking Down Tasks into Manageable Pieces
Learned Skills Don’t Transfer
Focus on Compliance
Focus on Verbal Communication
Punishment of Any Kind
Presumes Incompetence
You Are a Good Parent
Any parent who would go to the ends of the Earth, at any expense, for their child has earned that title. Please know my intention is not to attack you, though I understand why such an impact could result. You may be thinking that your child’s ABA looks nothing like what I’ve described or that your child loves their ABA therapist. I’m not here to argue or to condemn you. I ask only that you carefully consider the history of ABA, its inherent weaknesses, and the voices of Autistic adults urging caution.
A Thank You to All My Fellow Autistic Adults
This post wouldn’t have been possible without the labor of my fellow Autistics. You are so incredibly valuable and I appreciate you more than I can express. Thank you!
And, reader, thank you for listening.
Update (February 10, 2020): After I published this piece, it came to my attention that Alfie Kohn recently published an outstanding piece regarding new research into ABA. It’s well worth a read!
Disclaimer: Nothing stated in this post should be construed as an alternative to diagnosis and treatment by a medical professional. I am not qualified to provide medical advice.
If you’re anything like me, you’ve heard of the near miraculous wonders of melatonin supplementation. You may have also heard some of the not so great effects. So, let’s get down to the truth with our dear friend, science.
Use the Navigation links below to jump to sections of interest or read through for all the knowledge.
Melatonin (5-methoxy-N-acetyltryptamine) is a fat-soluble hormone that confers widespread health benefits and is produced in the pineal gland of the brain as well as by the retina of the eye and by the gastrointestinal tract. Production of endogenous (meaning made by the body) melatonin is triggered by darkness, and it typically peaks between 11 PM and 3 AM. Our bodies’ ability to produce melatonin decreases with age.
Melatonin “plays the role of a universal endogenous synchronizer” which, in addition to helping to maintain the wake-sleep cycle, also influences hemostasis, glucose homeostasis, phosphocalcic metabolism, blood pressure, and antioxidant defenses. In other words, melatonin stabilizes the circadian rhythms in the body, thereby impacting the body’s ability to coagulate blood, maintain normal blood glucose levels and blood pressure, metabolize phosphate and calcium for functions such as bone mineralization, and defend against the damage caused by free radicals.
Exogenous (meaning man-made) melatonin supplements can be made one of two ways. Either from the pineal glands of animals, which can be dangerous due to the potential for viral contamination, or as a synthetic product that is manufactured in a lab. Most commercial supplements are synthetic. Plant-based supplements are in the pipeline and melatonin naturally exists in the foods we eat as forms of it are produced by living organisms from animals to bacteria to algae to plants and beyond.
Back in 1994, Dr. Richard Wurtman, professor of neuroscience at MIT, led a team that confirmed where melatonin was produced in the body and how it functioned. His team discovered that a dose of 0.3 milligrams of melatonin helped older adults fall asleep faster and get back to sleep if they woke up in the night. However, researchers also discovered that commercial melatonin contained 10 times the effective dose, which, when taken regularly, ultimately overwhelms melatonin receptors in the brain, causing them to become unresponsive. At the time, he warned that “People should not self-medicate with melatonin.”
Studies to date have utilized pharmaceutical grade melatonin that is strictly regulated and certified to contain the ingredients in the appropriate proportions as labeled. Under these controlled conditions, substantive support exists for the presence of a plateau effect in adults with doses higher than 0.3 milligrams; the maximum effect being achieved at low doses with decreasing effectiveness in doses exceeding 1 milligram. In addition, there is some evidence that exogenous melatonin requires dosage over the course of a few days to achieve detectible effectiveness, and that it may increase in effectiveness over the course of time until the benefits plateau. The half-life of melatonin is less than one hour, which means that its usefulness from a given dose is short-lived. Some pharmaceutical grade melatonin medications have extended-release formulations to help improve the usefulness of the drug. It is unclear whether or not single doses of melatonin are effective.
High doses of exogenous melatonin have been demonstrated to desensitize receptors in the brain, thereby eventually making supplementation ineffective. However, without clear guidelines on appropriate dosing, the level at which overdose occurs remains unknown. Unfortunately, a 2017 analysis out of Canada found egregious mislabeling of melatonin supplements with counts varying from −83% to +478% of labeled melatonin. Chewable tablets suffered from the highest variability with one tablet containing nearly 9 milligrams of melatonin when it was labeled as 1.5 milligrams. Capsules suffered the greatest variability among lots. And, liquids had the greatest levels of stability, though they too were highly inconsistent. Oral and sublingual tablets with few ingredients proved the least variable of all the options. However, many of the supplements also contained impurities, including serotonin which has known effects and should not be taken by accident.
There is no known safe dose or dosing frequency for children.
Clinical Guidelines
In 2017, a task force from the American Academy of Sleep Medicine conducted a systematic review of the available literature to identify randomized controlled trials. Based on the evidence, this task force established recommendations for use by medical professionals. The task force listed 14 types of sleep aids and noted whether they were recommended for use or not. They advised clinicians not to use melatonin as a treatment for sleep onset and sleep maintenance insomnia.
Also, it is unknown whether melatonin supplements are safe during pregnancy or breastfeeding. High doses of melatonin may present fertility problems by affecting ovulation.
Possible Safety Issues
In 2015, Dr. David Kennaway conducted a review of the evidence for melatonin use in children, which was published in the Australian Journal of Paediatrics and Child Health. He determined that melatonin can produce “small advances in the timing of sleep onset” in both adults and children, but that there have “no appropriate studies to show that melatonin is safe in the long term for children or adults.” Use in children is always an off-label application of this hormone. He noted that, as a hormone, melatonin directly impacts the endocrine system and that long-term use may result in future “endocrine or other abnormalities.” He recommended that melatonin be prescribed only following a “biochemical diagnosis of an underlying sleep timing abnormality and after full disclosure to the carers of information about the known actions of melatonin on reproductive and other systems.”
In the United Stated, melatonin is considered a supplement. Therefore, it is generally unregulated by the Food and Drug Administration (FDA) and consumers have no guarantees regarding the safety of the commercial melatonin they purchase.
The Studies
When I began to seek out studies, I discovered thousands of papers that mentioned the term “melatonin.” In order to refine the list, I began by excluding studies published before 2009 and including only studies conducted on humans and written in/translated into English. From this list, I sorted by relevance and chose 175 to skim for abstracts. Then, I selected 80 to read in full, which resulted in a final resource list of 23 papers having targeted relevance. These studies involve research in countries around the world. I have grouped them by year for ease in assessing the progression of the research and recommendations.
2009
The effect of prolonged-release melatonin on sleep measures and psychomotor performance in elderly patients with insomnia https://www.ncbi.nlm.nih.gov/pubmed/19584739 doi: 10.1097/YIC.0b013e32832e9b08
OBJECTIVE: To investigate the effects of prolonged-release melatonin 2 mg (PRM) on sleep and subsequent daytime psychomotor performance in patients aged 55 years and older with primary insomnia.
FINDINGS: By the end of the double-blind treatment, the PRM group had significantly shorter sleep onset latency and scored significantly better on a psychomotor performance test than the placebo group.
2011
Melatonin for disordered sleep in individuals with autism spectrum disorders: systematic review and discussion https://www.ncbi.nlm.nih.gov/pubmed/21393033 doi: 10.1016/j.smrv.2011.02.001
OBJECTIVE: To provide a systematic review of efficacy and safety of exogenous melatonin for treating disordered sleep in individuals with ASD.
FINDINGS: The literature supports the existence of a beneficial effect of melatonin on sleep in individuals with ASD, with only few and minor side effects. However, these conclusions cannot yet be regarded as evidence-based. Randomized controlled trials and long-term follow-up data are still lacking.
Prolonged release melatonin in the treatment of primary insomnia: evaluation of the age cut-off for short- and long-term response https://www.ncbi.nlm.nih.gov/pubmed/21091391 doi: 10.1185/03007995.2010.537317
OBJECTIVE: To evaluate the age cut-off from a previous study for response to PRM and the long-term maintenance of efficacy and safety by looking at the total cohort (age 18-80).
FINDINGS: At 3 weeks, significant differences in favor of PRM vs placebo were found for the 55-80 year population but not the 18-80 year cut-off which included younger patients. Other variables improved significantly with PRM in the 18-80 year population more so than in the 55-80 year age group. No withdrawal symptoms or rebound insomnia were detected.
2012
Melatonin for sleep in children with autism: a controlled trial examining dose, tolerability, and outcomes https://www.ncbi.nlm.nih.gov/pubmed/22160300 doi: 10.1007/s10803-011-1418-3
OBJECTIVE: To assess dose-response, tolerability, safety, feasibility of collecting actigraphy data, and ability of outcome measures to detect change during 14-week intervention on children aged 3-10 years with a clinical diagnosis of an autism spectrum disorder who were free of psychotropic medications and whose parents reported sleep onset delay of 30 minutes or longer on three or more nights per week.
FINDINGS: Researchers documented an improvement in sleep latency with melatonin treatment. Because the study criteria were designed to enroll children with sleep-onset delay, they could not definitively comment on the effects of melatonin on sleep duration or night wakings.
2014
Optimal dosages for melatonin supplementation therapy in older adults: a systematic review of current literature https://www.ncbi.nlm.nih.gov/pubmed/24802882 doi: 10.1007/s40266-014-0178-0
OBJECTIVE: To define the optimal dosage of exogenous melatonin administration in disorders related to altered melatonin levels in older adults aged 55 years and above by determining the dose-response effect of exogenous administered melatonin on endogenous levels.
FINDINGS: Based on a systematic review of 16 articles from 1980 to 2013, nine of which were randomized controlled trials, the best applicable dosage for melatonin for older adults still cannot be adequately determined, as endogenous melatonin levels are subject to altered pharmacokinetics and -dynamics. This causes the risk of prolonged and elevated endogenous melatonin levels after exogenous melatonin administration in older adults. The researchers advise the use of the lowest possible oral dose of immediate-release formulation melatonin to best mimic the normal physiological circadian rhythm of melatonin and to avoid prolonged, supra-physiological blood levels.
The effectiveness of melatonin for promoting healthy sleep: a rapid evidence assessment of the literature https://www.ncbi.nlm.nih.gov/pubmed/25380732 doi: 10.1186/1475-2891-13-106
OBJECTIVE: To critically assess the available peer-reviewed literature on the use of melatonin in military service members and in healthy subjects to determine whether melatonin might be useful in military populations.
FINDINGS: The use of melatonin by healthy adults shows promise to prevent phase shifts from jet lag and improvements in insomnia, but to a limited extent. For the initiation of sleep and sleep efficacy, the data cannot yet confirm a positive benefit.
Melatonin in children with autism spectrum disorders: endogenous and pharmacokinetic profiles in relation to sleep https://www.ncbi.nlm.nih.gov/pubmed/24752680 doi: 10.1007/s10803-014-2123-9
OBJECTIVE: To describe overnight endogenous and PK melatonin profiles in children aged 3-8 years with ASD participating in open-label trial of melatonin for sleep onset insomnia.
FINDINGS: In children with ASD and insomnia responsive to treatment with supplemental melatonin, evidence exists for normal endogenous melatonin profiles. Furthermore, despite a relatively short duration of action of supplemental melatonin, night wakings improved in most children with treatment. This raises the possibility that supplemental melatonin may be influencing sleep onset delay and night wakings by mechnanisms other than simply replacing melatonin.
2015
The effect of melatonin treatment on postural stability, muscle strength, and quality of life and sleep in postmenopausal women: a randomized controlled trial https://www.ncbi.nlm.nih.gov/pubmed/26424587 doi: 10.1186/s12937-015-0093-1
OBJECTIVE: To document the safety of melatonin in postmenopausal women given evidence from previous studies that suggests a protective role of melatonin against osteoporosis through an increase of bone mineral density.
FINDINGS: Melatonin in a daily dose of 1 or 3 mg is safe to use in postmenopausal women with osteopenia. There is no long term hangover effect causing a reduction in balance- and muscle function or quality of life. In women with poor quality of sleep, small doses of melatonin trended towards improving quality of sleep.
OBJECTIVE: To establish a consensus on the roles of melatonin in children and on treatment guidelines at a conference in Rome in 2014.
FINDINGS: So far, the best evidence for the indication of melatonin treatment in children is for insomnia caused by circadian rhythm sleep disorders. Because insomnia due to other situations and disorders, including bad sleep hygeine, ADHD/ADD, personality disorders and depression, can mimic insomnia caused by circadian rhythm sleep disorders, the diagnosis should only be made after careful clinical assessment and possibly measuring dim light melatonin onset (DLMO). Melatonin can be effective not only for primary sleep disorders but also for sleep disorders associated with several neurological conditions. Controlled studies on melatonin for sleep disturbance in children are needed since melatonin is very commonly prescribed in infants, children and adolescents, and there is a lack of certainty about dosing regimens. The dose of melatonin should be individualized according to multiple factors, including not only the severity and type of sleep problem, but also the associated neurological pathology.
OBJECTIVE: To provide a succinct summary to help inform clinical and research practices for children with developmental disabilities (i.e. children with unspecified developmental delays or cognitive impairments and specific disorders/syndromes including ASD, Smith-Magenis syndrom, Angleman’s syndrom, fragile X syndrom, Down syndrom, and Rett syndrome).
FINDINGS: Following a review of a number of studies and a meta-analysis by Braam and associates, researchers determined that melatonin treatment yields beneficial effects with minimal side effects. However, melatonin is not approved by the US Food an Drug Administration and no drug is approved for use in pediatric insomnia (as of the time of this study).
OBJECTIVE: To provide information on the documented actions and properties of melatonin outside its ability to alter sleep timing that have been widely ignored but which raise questions about the safety of its use in infants and adolescents.
FINDINGS: Melatonin is increasingly being prescribed off lable for children and adolescents for difficulty in initiating and maintaining sleep. There is extensive evidence from animal and human studies that melatonin acts on multiple physiological systems, including the reproductive, cardiovascula, immune, and metabolic systems. Long-term safety studies on children and adults are lacking. Prescription of melatonin to any child whether severely physically or neurologically disabled or developing normally should be considered only after the biochemical diagnosis of an underlying sleep timing abnormality and after full disclosure to the carers of information about the known actions of melatonin on reproductive and other systems and the disclosure that there is a lack of appropriate studies conducted on children. Should endocrine or other abnormalities appear in the future in children previously treated with melatonin, it will not be tenable to argue that were were surprised.
OBJECTIVE: To present and evaluate the literature concerning the possible adverse effects and safety of exogenous melatonin in humans and provide recommendations concerning the possible risks of melatonin use in specific patient groups.
FINDINGS: A substantial number of both animal and human studies document that short-term use of melatonin is safe, even in extreme doses. No studies indicate that exogenous melatonin possesses any serious adverse effects. Also, randomized clinical studies indicate that long-term administration only induces mild adverse effects comparable to placebo treatment. Due to a lack of human studies, pregnant and breastfeeding women should not take exogenous melatonin. Also, long-term safety of melatonin in children and adolescents requires further investigation.
Melatonin Supplementation for Children With Atopic Dermatitis and Sleep Disturbance: A Randomized Clinical Trial https://www.ncbi.nlm.nih.gov/pubmed/26569624 doi: 10.1001/jamapediatrics.2015.3092
OBJECTIVE: To evaluate the effectiveness of melatonin supplementation for improving the sleep disturbance and severity of disease in children with AD.
FINDINGS: Sleep-onset latency shortened by 21.4 minutes after melatonin treatment compared with after placebo. Melatonin supplementation is a safe and effective way to improve the sleep-onset latency and disease severity in children with AD.
OBJECTIVE: To assess the evidence base for the therapeutic effects of exogenous melatonin in treating primary sleep disorders.
FINDINGS: Results from the meta analysis showed the most convincing evidence for exogenous melatonin use was in reducing sleep onset latency in primary insomnia, delayed sleep phase syndrome, and regulating the sleep-wake patterns in blind patients compared with placebo.
OBJECTIVE: To quantify melatonin in 30 Canadian commercial supplements, comprising different brands and forms and screen supplements for the presence of serotonin.
FINDINGS: Melatonin content was found to range from -83% to +478% of the labeled content. Additionally, lot-to-lot variable within a particular product varied by as much as 465%. This variability did not appear to be correlated with manufacturer or product type. Furthermore, serotonin was identified in eight of the supplements at levels of 1 mg to 75 mg. Melatonin content did not meet label within a 10% margin of the label claim in more than 71% of supplements and an additional 26% were found to contain serotonin. It is important that clinicians and patients have confidence in the quality of supplements used in the treatment of sleep disorders. To address this, manufacturers require increased controls to ensure melatonin supplements meet both their label claim, and also are free from contaminants, such as serotonin.
OBJECTIVE: To explore the evidence for using exogenous melatonin in the treatment of sleep disorders, both primary and secondary, in children and adults.
FINDINGS: There is evidence for the efficacy of melatonin in the management of insomnia and some intrinsic disorders of circadian rhythm in adults and children as well as in reducing sleep onset latency in jet-lag and shift work disorder in adults. Melatonin is used routinely in the treatment of rapid-eye movement sleep-behaviour disorder despite limited trial evidence. Increasingly, dual melatonin receptor agonists are being trialed in a variety of sleep disorders. Long-term adverse effects are currently not fully identified.
OBJECTIVE: To discuss the normal sleep development and needs in children, and we will provide an overview of sleep disorders, based on the 3rd edition of the International Classification of Sleep Disorders [ICSD-3].
FINDINGS: Melatonin is an effective, safe, and well-tolerated agent, particularly in cases of sleep-initiation insomnia caused by circadian factors. Several placebo-controlled studies of melatonin in adults and children (in some studies, as young as 3 years of age) showed that melatonin administered at bedtime reduces sleep-onset latency time and increases total sleep time.
OBJECTIVE: To review pharmacological treatment options for children and adolescents with ASD, with emphasis on recently published studies since our previous published update. We focus on randomized double-blind placebo controlled (RDBPC) trials, with at least 10 subjects. We also discuss CAM treatment options used in children with ASD.
FINDINGS: In addition to its effect on sleep, a few RDBPC trials have shown that melatonin can improve communication, rigidity, and anxiety in children with ASD.
Pharmacological and non-pharmacological interventions for non-respiratory sleep disturbance in children with neurodisabilities: a systematic review https://www.ncbi.nlm.nih.gov/pubmed/30382936 doi: 10.3310/hta22600
OBJECTIVE: To assess the clinical effectiveness and safety of NHS-relevant pharmacological and non-pharmacological interventions to manage sleep disturbance in children and young people with NDs, who have non-respiratory sleep disturbance.
FINDINGS: It was not possible to draw conclusions about the effectiveness of non-pharmacological interventions for managing sleep disturbance, and although there was some benefit with melatonin the degree of benefit is uncertain. There is some evidence of benefit for melatonin compared with placebo, but the degree of benefit is uncertain. There are various types of non-pharmacological interventions for managing sleep disturbance; however, clinical and methodological heterogeneity, few RCTs, a lack of standardised outcome measures and risk of bias means that it is not possible to draw conclusions with regard to their effectiveness. Future work should include the development of a core outcome, further evaluation of the clinical effectiveness and cost-effectiveness of pharmacological and non-pharmacological interventions and research exploring the prevention of, and methods for identifying, sleep disturbance. Research mapping current practices and exploring families’ understanding of sleep disturbance and their experiences of obtaining help may facilitate service provision development.
OBJECTIVE: To summarize some of the current knowledge about the potential effects of exogenous melatonin on puberty
FINDINGS: This review suggests that the role of melatonin in sexual maturation and the timing of puberty is understudied in humans. The three human studies that have examined the question have done so as an ancillary research question in small samples of children and youth, some of whom had neurodevelopmental disorders. This limits the generalizability to the general population and is insufficient evidence to draw conclusions for patients with mental health and neurological disorders. Further experimental studies on the impact of melatonin on puberty, notably in non-seasonal mammals, and advances in the research about the intermediary processes between melatonin and kisspeptin activation, could ultimately inform us about the potential influence of exogenous melatonin on puberty.
The effects of melatonin administration on disease severity and sleep quality in children with atopic dermatitis: A randomized, double-blinded, placebo-controlled trial https://www.ncbi.nlm.nih.gov/pubmed/30160043 doi: 10.1111/pai.12978
OBJECTIVE: To determine the effects of melatonin administration on disease severity and sleep quality in children diagnosed with atopic dermatitis (AD).
FINDINGS: Following 6 weeks of intervention, melatonin supplementation significantly improved SCORAD index, serum total IgE levels, and CSHQ scores. Though melatonin had no significant impact on pruritus scores, high sensitivity C-reactive protein, sleep-onset latency, total sleep time, weight and BMI compared with placebo. Overall, melatonin supplementation had beneficial effects on disease severity, serum total IgE levels and CSHQ among children diagnosed with AD.
2019
Exogenous melatonin as a treatment for secondary sleep disorders: A systematic review and meta-analysis https://www.ncbi.nlm.nih.gov/pubmed/29908879 doi: 10.1016/j.yfrne.2018.06.004
OBJECTIVE: To determine the efficacy of exogenous melatonin versus placebo in managing secondary sleep disorders.
FINDINGS: Meta-analysis of the data from a series of studies with small sample size demonstrates that exogenous melatonin improves the sleep quality of secondary sleep disorders. Based on the current advantages of melatonin in the management of secondary sleep disorders, it is hoped that there will be a tremendous growth in the use of melatonin application worldwide. Besides, little evidence is available regarding the adverse effects of long-term use of melatonin. Clinicians should be alert to these shortcomings but also aware of the potential role of melatonin in clinical psychiatry and sleep medicine.
OBJECTIVE: To review the role of melatonin in the circadian regulation of sleep and mood and the phase-shifting and sleep-promoting properties of exogenous melatonin and melatonin agonists and outline how melatonin and melatonin agonists might be used for treatment of various sleep and mood disorders.
FINDINGS: The phase-shifting and sleep-promoting effects of melatonin plus additional effects of melatonin agonists on melatonin and serotonin receptors have shown promise for novel treatments for a variety of circadian, sleep and mood disorders. Importantly, the main advantage melatonin and its agonists offer over traditional sleep and depression treatments is that they assist to restore circadian function which is often misaligned in these disorders and which is increasingly thought to be a causal mechanism and part of the aetiology of sleep and mood disorders. Treatments that fail to address the misaligned circadian system present in sleep and mood disorders may not fully address the underlying causes, and for this reason, further investigation on the potential for melatonin-based treatments should be undertaken.
Assessment of the Evidence
Endogenous melatonin provides widespread health benefits for the human body across many functional systems. Exogenous melatonin is strongly evidenced as an effective sleep aid for sleep onset (meaning, falling asleep) and less strongly for night wakings and other other sleep-related applications in adults aged 55 and older.
However, the literature is glaringly lacking in randomized, controlled trials as well as research on younger adults, teenagers, adolescents, children, and infants. Existing studies utilize small subject pools and short- to medium-term time frames for research, most stopping short at 3 months and few-to-none lasting more than one year. There is no evidence yet that consistent long-term use is safe for any age group. Dosing remains a challenge and a standard dosing table does not yet exist, although it has been long established that overdoses cause receptors in the brain to become unresponsive and supplementation to be rendered useless. Given the lack of information about dosing, it is impossible to determine what amount constitutes an overdose without investigative blood work. Melatonin supplements are almost entirely unregulated in the United States, so high doses are regularly consumed. While high doses don’t appear to have extreme deleterious effects on humans, the fatal dose is yet unknown. Future studies are needed to ameliorate concerns about safety, dosage, and pediatric use.
Promoting Better Sleep
While I cannot make any formal recommendations to you about whether or not to give your child melatonin, I can suggest some solutions to help with sleep outside of melatonin supplements.
Eating lots of fresh fruits, vegetables, whole grains, and low fat protein sources provides plenty of tryptophan as well as group B vitamins, minerals, and unrefined carbohydrates, all of which supports healthy sleep. Reach for things like salmon, poultry, eggs, spinach, seeds, milk, soy products, and nuts to get a good dose of sleep-promoting nutrients. (Source and Source)
Tart Montmorency cherries contain high levels of phytochemicals including melatonin. Cherry juice is a natural source of plant-based exogenous melatonin and may help support good sleep. (Source)
Exercise in the mornings can improve the quality of nighttime sleep by “increasing parasympathetic nerve activity.” However, high-intensity exercise in the evening should be avoided. Getting your child out for some fresh air every morning may make your bedtime routine a breeze. (Source)
Common wisdom says to help your child avoid blue light LED sources like smartphones, tablets, and TVs near bedtime as this type of light may suppress endogenous melatonin. (Source) However, there is also evidence that such recommendations may be misguided. (Source) Use your best judgment as you watch how nighttime blue light stimulation impacts your child.
In one of the studies referenced in this Guide, a young girl did not respond to melatonin treatments but was later diagnosed with bipolar disorder, medicated with risperidone, and subsequently experienced improved sleep. If your child is really struggling, it may be worthwhile to seek out age-appropriate therapy to rule out other treatable sources of difficulty. (Source)
The Bottom Line
Do melatonin supplements help your child? Unless you’re using pharmaceutical grade supplements under the strict care of a physician, my best answer is maybe. But it’s hard to know what your child really needs in the way of a dose without extensive blood work . The placebo effect is also in play to an extent. If you and your child believe the supplement works, it’ll probably work even better than the actual physiological impact, if there is one to begin with.
Will melatonin supplements seriously harm your child? Probably not, but there’s no guarantee and there are other effective options that don’t involve using unregulated supplements with potentially harmful impurities.
If you discover any errors in my work, please contact me at peacefulmom(at)peaceigive.com.
PEACE I GIVE 