(00:00:00) Five minutes now past eleven o'clock. We will spend most of the rest of this hour with dr. Susan Susan or bow director of mental health clinic at the Minneapolis Children's Medical Center. She's a licensed psychologist and she'll be here to take your questions about children and families doctor (00:00:17) about thanks for coming in good to see you good morning (00:00:19) and the phone lines for those of you who would like to participate in our discussion are these in the Twin Cities call us at two to seven six thousand 2276 thousand outside the Twin Cities 1-800 to for to 28 28. Well here we are what three four weeks before school begins around the state of Minnesota summer vacation. It feels as though it's been kind of a long one with the screwy weather. We've been having how much stress is there on on families these days the kids have been out of school for so long. They've got a school year coming up but not for a while. Does that lead to pretty Will situations (00:01:01) well, I think that there are some things about that circumstance that creates stress and others that really are the opportunity for some relaxation and some celebration of the family and its resources on balance. I think this summer has because of the weather restricted some of the usual activities that kids and families would enjoy together and as left people fishing for some ideas about things to do with kids. I think the lack of of the usual routine and structure where's on over the course of the summer so that by August lots of families lots of parents are feeling a little bit distraught about what to do with the kids and with all the time that they all seem to have on their hands and are looking forward to the start of school for many families the prospect of of those longer periods of separation or a little bit stressful and thinking about re-entry to school is anxiety-provoking for some children and for some (00:01:52) families, and of course every year, we've got a new crop of kids going to school for the first time and I would (00:01:57) suspect into to For the first time in big ones going off to college and (00:02:02) or little ones going to structure daycare for the first time that sort of thing and I would think parents are starting to realize they probably need to do a little work in preparation for that. If they haven't done it (00:02:14) already, right they need to get make sure the plan is in place that they know how the routines are going to operate and to begin to help the children to get ready for that more independent functioning at daycare or at school some rehearsal for kids A week or so in advance of the actual beginning of those programs is often helpful. Nobody driving by the place getting a chance to get out and walk around and look at it when it's quiet when there's not everybody around so that at least the place looks familiar, so it doesn't look quite so mysterious will often be reassuring for for kids some kind of practice walking or riding along the route that the bus will take some of those kinds of things and pointing out some of the marks that will allow it. Out to know that they're in exactly the right place. And this is the way it's meant to be can often be reassuring and just encouraging kids to engage with parents in a conversation about how they think it's going to be and what they wonder about what they think it's going to be like for many little children the biggest worries. Will I have a friend right? Will there be anybody there who will like me and and if if you already know what children from the neighborhood will be there that's nice to reassure kids about that. If in fact they are starting with a new group some ideas about how they would initiate friendship with another child and some chances to sort of practice. What do you say after you say? Hello? (00:03:39) Right might help. Well, I'm sure we'll explore this a little bit further. I suspect we'll hear from some of the listeners with questions relating to this material. Dr. Susan ER Bao is here. She is director of the mental health clinic at the Minneapolis Children's Medical Center. If you have a question, you'd like to put to her call us in the Twin Cities is 2276 thousand if you're outside the Cities call us toll-free at 1-844-202-2727. 228 28th at 9 minutes past eleven o'clock. Let's take our first caller here. Hi, what's your question for? Dr. Bob? Hi. Yes. My question concerns. What information do you have about fetal alcohol damage in regard to perhaps more subtle Damage Done to people as a result of exposure prenatally to smaller amounts of alcohol usually referred to a social drinking in other words alcohol use as opposed to alcohol abuse or alcoholism my experience and in research is looking like these people may have normal IQs. But learning disabilities such as add or ADHD poor judgment unrealistic ideas difficulty handling money difficulty with math reasoning problems living only in the present unable to project or anticipate and I'm just wondering if you are seeing more children with perhaps these kinds of problems and being able to relate them at all to prenatal alcohol (00:05:12) exposure there certainly is beginning to be suggestive evidence. I think we can't draw conclusions at this point, but they certainly is suggestive evidence at this point that there are some risks associated with even very moderate use of alcohol during pregnancy and it certainly would seem that the best Judgment of prospective parents under those circumstances would be not to use alcohol at all when they know or suspect that they that they might be pregnant. We have been familiar for some time with the full syndrome that's called fetal alcohol syndrome, which includes some fairly obvious physical. All changes in the development of a baby and and those persist through the life of the child and very significant behavioral and developmental effects. We are now Gathering more and more evidence about more subtle and partial forms of fetal alcohol effects. And there is certainly suggestive evidence that there may be an association between some of those behavioral and learning and developmental patterns and use of alcohol by mothers during the time that they're (00:06:16) pregnant. Our caller used the word subtler or subtle effects. If indeed they're they're more subtle than the full-blown FAS syndrome, which is can be rather severe. How does one go about separating out whether or not there are related to alcohol use (00:06:33) well and I think at this point that's exceedingly difficult and that's where the confusion exists that there. There are certainly a multitude of factors that could contribute to the same kinds of effects to attention and concentration problems to impulse control. Problems to information processing difficulties of the kinda called learning disabilities and it may be that that alcohol or other chemical exposure during the prenatal period maybe one of a whole variety of factors that may produce the same effects. So it's difficult to demonstrate a precise one to one correspondence that if you do this, then you will always get that effect. The effects may come from a variety of causes. Some people may get lucky and get away with it and not see any of those effects but we're playing with probability. We are increasing the risk and the (00:07:22) recommendation Remains the Same best not to be (00:07:24) drinking expert to be drinking when you're pregnant and best not to be using any medications or chemicals except those that are explicitly approved by your physician if you know or suspect that you might be pregnant. (00:07:34) Let's move along now hear from another listener with a question for dr. Baum. Hi, it's your turn. Good morning. I have a question sort of at the other end of the spectrum with adult children. I are actually soon to be going to college. How does a stepparent stay in touch with children that they have helped raise as they go off to college when it gets complicated in the kids lives when they have so many different friends and relatives that they're trying to see over break if there are there some particular suggestions for step parents. Well, and I might add my situation is probably a little more complicated because I'm recently a former stepparent have divorced their father. And is there anything that that I can do to stay in touch with them that won't make them feel uncomfortable or disloyal to their parents and I might add that they are not encouraged by either parent to stay in touch with me. However when I do talk to them Or see them they're very supportive. They don't seem to have taken sides. I suspect this is not a singular situation. They're probably quite a few people who are wondering about these kinds of (00:08:55) things certainly. Well one would hope that by the time young people have arrived at the age of 18 or 19 at College age that they're able to sustain some friendships and relationships sort of independent of the approval and participation of their primary parents. And that that it makes sense to me to think of young people as benefiting from having a network of supporting and caring adults and that may include people that they're connected to because they've been part of the family somewhere along the way it may also include friends from the church or Community or former teachers or people that they worked for and the encouragement of maintaining those friendships as part of a support network seems like a healthy thing for young people to have available to them. I think that that you can't make the relationships last you can't make them work. You can only create the opportunities and let the young people know that you are available that you're interested in them. And I think you do that by keeping Communication open by sending Letters by sending care packages sending trick-or-treat bundles one helming time rolls around and all the things that just let young people know that you're thinking about them that you know something about them and that you're interested in their development. I think when young people are moving off into college, there are also ways that you can let them know that you're interested in their concerns that if you know what they like to study or you know that their interest is in sports or in international Affairs to let them know that you share those interests to send them a clipping out of the newspaper and say I saw this and thought of you to sort of join and take your cues from what they identify as their Pursuits is just a way to let them know that you're there and accessible to be Friend to invite them to call or or to visit you when they're in town. If you have the opportunity or the privilege of being able to be in the community to call and say can we go go out to breakfast those kinds of things sustain those connections and I think we have to acknowledge that the young people have to have an active part in this that they are no longer the passive recipients of Parental care that they are now Partners in maintaining a friendship or a relationship and we have to respect their choices about that to a (00:11:14) somewhat related matter summer is often the time for children in divorce situation to be moving from one parent to the other for a brief war an extended period of time and then come back to whatever part of their living with during the school year and that may be coming up in the next couple of weeks for families. What should they be in tune (00:11:38) to well those transitions in different forms of probably been going on all summer many kids have I've had a long visit with a non-custodial parent during the summer when they've only had weekends at other times during the year. Some kids will have been traveling across the country some of them unaccompanied to visit with a non-custodial parent and to stay away from their primary home for extended periods of time and those certainly are stressful experiences for all the parties involved and we often do see the signs of that stress before kids go when they first arrive when they return home and I think it's hard sometimes to keep our balance and interpreting those behavioral signs of stress many parents when they see their kids in rough shape when they come home when they're crabby and irritable and say see I could have told you live with their fathers unbearable. It was unbearable for me. It was unbearable for the kids. He's done something terrible to them. They're in rotten shape and sometimes of course there are difficulties with the family that make that true but more often. It's just the change its the transition. It's the conflict the children feel about Loyalty that get some sort of stirred up its the difference in routine the difference in all the things that support kind of stable functioning for kids that that means that they come home and rougher shape them then they would be in the middle of a long period of predictable life. I think that what we know about how children do in the aftermath of divorce suggests that children do best when they can sustain relationships with both parents. But only if the parents are able to create a sort of a demilitarized zone around the children and to say however, we've disappointed one another we are both committed to the care of these children and the children's interests have to be given light and air and room to grow when parents are not able to do that when they are constantly in intense conflict when they're back in court over and over again when the children are become the the victims and get caught in the crossfire then children do better if they have less contact with the Real parent because the conflict really takes it out of kids. So parents have a tremendous obligation to figure out a way to create that sort of demilitarized zone around their (00:13:52) children. And even when they do I suspect it is difficult at times for the children certainly is just make it all better. Just that the parents agree that you know will do what's best for the (00:14:03) kids kids whose experience all kinds of guilt and conflict in those kinds of situations. Sometimes a child goes away to spend time with the non-custodial parent and does just fine when they come home they have an attack of guilt because it suddenly occurs to them. They didn't think that much about mom while they were away and maybe they should have that Mom appears to have been lonely and unhappy and they weren't very lonely unhappy and maybe they've done something wrong by having a good time. And so kids get caught in all kinds of confusing and conflicting loyalties again. I think the most important thing for parents to do is to is to find out what's what their kids are thinking and to give kids permission. Talk to create opportunities for what was that like for you? How did that feel and to let them know that there is understanding and acceptance of a whole range and mixture of feelings. The kids can have about those situations (00:14:57) 20 minutes past eleven o'clock. We're talking about children and families related matters with dr. Susan ER Bao who's here to take your questions. If you'd like to participate in our conversation, if you have a question, you'd like to put to her call us in the Twin Cities at 2276 thousand 2276 thousand outside the Twin Cities call toll-free at 1-800-321-8633. Two eight two eight The Listener on the line now with a question, it's your turn. Hi there. Hello, I my husband and I recently wrote up a will. We have a little boy and when I was little I lost Father and my mother didn't do too. Well after that. We ended up living with some other family for a while after he died. It was quite suddenly and so is real important to me too. When we had a little boy to have a will and and decide on a on guardianship so that that would be taken care of and not and we you know chose some family members that we really thought were a lot like us and that we really liked their Lifestyles and their attitudes and and that sort of thing. However, we don't see them that often compared to the rest of the family and they were concerned about how the child in our child would adjust and I just wondered if you had any suggestions or had any good reading material to suggest to them because they, you know to have taken a very seriously this responsibility and they really want to help you know, as far as an adjustment if something were to happen to us, which you know, I appreciate I wondered if you had any any suggestions or recommendations in that way. (00:16:42) Well the Chance of loss and separation from a parent or from both parents through something as dramatic as the death of parents is of course a tremendous stress for children. They've done a very thoughtful job of preparing for that for that possibility and as kids grow older, sometimes they have questions about those kinds of things and it's very reassuring for them to know that you have thought about that and to give them the general message that you don't expect or plan for anything to happen to you. But that in any case there will always be someone there to care for them and that you thought about that and that you've made a plan with these friends and that they would be there to help take care of them. If anything should go wrong. I hope my daughter who is a young adult will forgive me for telling her story. But when we had that kind of conversation with her explaining how how it would work should anything happen to us. She was very thoughtful and quiet about it and she went away and and sometime later came back and said Mom remember that story Told me about about how it would be if anything ever happened to you. Well, could you could you tell Dwayne ahead of time if anything's going to happen to you, so he'd surely know it was time for him to take over. It would be pleased planar emergencies. She was she was quite young at the time, but obviously she took comfort from knowing that somebody was prepared to take care of that for people who might find themselves with the responsibility of caring for children who have experienced a loss. There's a very nice little book by a woman named Claudia Jewett that's called helping children cope with separation and loss that that includes some additional references of things that children can read or other things that that caretakers can read to help children deal with the aftermath of that kind of change and loss in their lives, but sounds like you've done a good and thoughtful job of of heading off what for your children. What was a painful experience for you? It's a good (00:18:41) parenting. Do you recommend the parents have that? (00:18:43) Precision with their children. Well, I think that that at some point the children will indicate their Readiness to have that kind of conversation. I don't think it's the kind of conversation that a parent ought to start out of the blue because it might be alarming for children. I wonder if I might think that that parents had a secret that something terrible was coming or something that parents were aware that they were planning to fall off the the Earth and we don't want to alarm children or disrupt their security but there will be a time often around for years of age and again around 8 years of age something like that when kids do get aware of the possibility of death when they do become aware of the possibility that life stops and then something happens to people sometimes and in the context of that conversation, they often do have fears about what would happen to me. If something happened to you what if the people I count on were lost and in that kind of context it's nice to be able to introduce the idea and Sure children that there is a plan but there will always be someone to take care of them that that has been thought of and that that parents would have arranged for their care under any (00:19:54) circumstances sir from another listener with a question. Thanks. You've been waiting patiently and now we're ready for your question. Yeah, I we have a young relative age 14 who's developed Tourette syndrome, and I'm wondering is there any hope of recovery from this? How can he COPE in the public schools? Better? Explain what Tourette syndrome is for those who don't (00:20:15) know. Well, let me say a little bit about Tourette's Syndrome. Tourette syndrome is a relatively rare but but significant behavioral disorder and it's drawn a lot of attention recently and some of that attention is appropriate and some of that attention is a bit of a fad and an inclination to find Tourette Syndrome under under a lot of bushes, and I'm not always convinced that every time somebody says Tourette syndrome is there it really is it really is there in many instances? Tourette syndrome is a movement disorder. It typically begins with some kind of motor or movement pattern that's like a tick usually a head jerk or throat clearing or something like that and when the full syndrome develops that tick progresses from movement to the making of some sounds that often start out kind of like throat clearing or some kind of guttural sound down in the chest May progress to something that seems like barking and in some very dramatic cases proceeds to the formation in the sort of explosive utterance of words and (00:21:16) sometimes particular language sometimes foul (00:21:19) language four-letter words with hard expletives at the sounds at the beginning and end are highly favored in in this sort of expression. It appears to be a neurologically developmentally biologically-based disorder and it is responsive to medication treatment. It is also responsive to behavioral treatment that is Book and develop strategies for relaxation and for voluntary control of some of those movements and sounds so there are a variety of treatments that are helpful in controlling the symptoms and the the sort of damage that the behavior pattern does to social relationships and those kinds of things can be controlled in that way. So this is a treatable condition not all instances of restless Behavior not all instances of impulsive behavior and not all Angry explosive outbursts of four-letter words are Tourette syndrome, and we need to be careful that we've sorted out. What what is that kind of a specific disorder from her past 14 year (00:22:27) old who apparently has been diagnosed. That's a hard time. She The Life just to begin with and then to impose this on top of it. I would think that kids got some some rough times ahead. (00:22:39) Certainly there is stress related most particularly to the sort of social. Act of having that kind of a disturbance of having that kind of behavior that feels out of control that looks really peculiar to other people and educating a young person to be able to explain their problem with their noises their movements and those kinds of things to explain it as a condition for which they are being treated is often helpful. There are support groups and a society that deals with the problem of tourettes disorder. I don't have a particular phone number ready at hand, but it can be tracked down by way of first call for help, which is the United Way information and referral service in the Twin Cities or other social service networks. (00:23:28) You mentioned that in some cases at least it is to a degree controllable and I think of the story of a radio announcer in Iowa City, Iowa who has Tourette's and is able to function just perfectly when he's on the air (00:23:42) it takes Attention and concentration and concerted effort to stop the expression of of the symptoms and so often what happens is that when people are focused and directed and concentrating on doing verbal activity talking focusing they can control that that behavior when they relax and kind of let down their guard. There it is again and it doesn't necessarily mean that people are faking it. It does take effort to suppress the expression of those symptoms. That's not unlike what sometimes happens with people who have a stuttering type of sleep speech to fluency. There are some people whose regular speech is interrupted by stuttering or disfluency, but who can sing or do radio work or perform on the stage and not be troubled by the stuttering? (00:24:34) We have some phone lines available in the Twin Cities. If you'd like to put a question to dr. Susan Susan Urban call us at 2:00 to 7:00. (00:24:43) Two two seven (00:24:44) six thousand also a couple of Watts lines open. If you'd like to call from anywhere around the region one eight hundred two four to Twenty Eight twenty eight eight hundred two, four two two eight two eight were talking about children and families and related matters. Let's take another call from a listener. What's your question? There seems to be a great division of opinion regarding the importance of bonding and attachment. Now Hennepin County says that it favors removing foster children from Foster families who are not of the same ethnic Heritage as their foster children, even though bonding and attachment may have taken place in what are your views in this matter? (00:25:31) Well, this is a matter of tremendous complexity and importance to the well-being of children who need placement and Care away from their families of origin. The problem that has occurred has come about because there. Been significant numbers of children from ethnic minority groups in need of those kinds of placements and for some of them the first placement available has not been an ethnically matched placement and so children have gone into placements for a whole variety of reasons that are not ethnically matched and then there comes up a conflict of interest between the interests of the various parties to these placement agreements the communities communities of color in particular certainly have an interest in retaining control over their children and that's an important interest for their communities and for the maintenance of those ethnic and cultural communities, the people who have been parents and caregivers both the birth parents the extended families of the birth parents and then the foster parents get to have tremendous interests because of the feelings and and affection and bonds that they have developed with the children those bonds formed by web Foster families or by families. Origin are important to the to the people who are doing the parenting and it's terribly painful for them to have those bonds disrupted those bonds are also of tremendous importance to the children because it's the formation of that kind of emotional bond that leads parents to be protective of children to put pick children's interests ahead of parents interests. And and so parents who are bonded are in a better position to care for children and to do a better job of doing it and the interests of the children will not necessarily match the interests of the community and the interests of the parents and I think that that we always have to give precedence when there is that kind of conflict of interest to the needs of the children as a psychologist. I think there is tremendous importance in the development and maintenance of patterns of attachment from the point of view of children bonding is a kind of spontaneous combustion a sense of Sickness that comes up quickly for for parents and children and make him up for other members of the community. It's a sense of belonging that appears to have lots of roots in genetics and and Instinct and biology as well as in in Tradition attachment grows slowly it grows over time. It's most important to the development of children and being securely attached believing that you are in the presence of the people you count upon and taking comfort from that has tremendous influence on the success of development for children, and we cannot disrupt attachments lightly. Unfortunately looking out of the particular window that they look out of the courts and the legal system have not always perceived this to be as important as people who specialize in child development think it is and it leads them to say well those other interests take precedence will get to attachment later. But first we have to look at the rights of the family the rights of the community and I think that that's not Serving the interest of the children in the best way (00:28:48) back to the phones. Let's take another question for doctor or wow. It's your turn now. Yes my I'm a grandmother of a child who has Tourette Syndrome. I'm also a public school teacher in the City of Minneapolis, and I'm not so much a question. But just some encouragement to their previous caller. I do know that not-too-distant past there was a program on TV dealing with Tourette's syndrome and one of the persons who suffers from Tourette's was a neurosurgeon and who functions perfectly well in the operating room, but has problems otherwise and has learned patterns as the physician as your guest suggested to deal with it. Also the Star Tribune in the more recent past had quite a fine article in one of their Sunday papers dealing with Tourette's syndrome and featured. Family with a child with Tourette's and so forth also the public schools this past this last fall when we had our workshops and so forth. I went to a workshop that was geared for teachers and dealing with children who have Tourette syndrome in the classroom and that kind of thing. So I do think there is a greater awareness and certainly as with everything we want to sometimes lump everybody's problems into one category as we discover a new one or think we discover a new one. But yeah, well, thanks for your call. Appreciate that thank you for (00:30:18) sharing that information. I think it certainly is important to think about the strength at this kind of a disorder puts upon development and to put something some supports in place so that we can protect development with those Protections in place. It is certainly reasonable to expect a highly successful life. Even for a person with with that stress as part of the earth. (00:30:38) Sure. So take another call now another question for doctor about. Where are you calling from? From Cloquet and your question, please. I'd like to go back to the earlier discussion of the add children. My son was diagnosed as being a DD before he was four years old and at that time I wasn't aware of what's available for them. I refuse to put them on drugs, I guess not understanding what that was about now. He's an adult 19 he exhibits all of the symptoms that you discussed earlier and because of it seems unable to hold a job. It's a specific question. You want to get to here? No help is available to an adult child who has this where you can get it. (00:31:24) Let me say a little bit about the problem of attention deficit disorders in general attention deficit disorder is a condition that affects three to five percent of children and continues to affect substantial number of those same children as they grow up and it can continue to be a problem. As they move on into adult life the difficulty is with being able to direct and control and sustained attention concentration and focus. It means that people who have this kind of a condition or highly distractible. They tend to flit from one thing to another they have a great deal of difficulty with task completion was staying connected with a task, especially a task that requires them to work individually or independently if they can work interactively with another person there or with with some Hands-On kind of activity. They may do a whole lot better with it often. The problem with attention is accompanied by a pattern of hyperactivity restlessness overactivity impulsiveness difficulty complying with rules living within bounds. Those kinds of things often are associated. The problem itself May introduce behavior problems May interfere with learning and is often associated with difficulty in learning to sort of live within the rules of society. And so left untreated many young people who have this problem at the outset have trouble with compliance and authority and getting with the program in schools at work in (00:32:54) Social act very often that leads to legal (00:32:56) troubles courts, and they get into difficulties sometimes with conduct in delinquent behavior problems. And so there are a lot of risks. What we know about attention deficits is that they are responsive to multimodal treatment. That is the use of medication is one piece of treatment, but the use of medication in isolation is not sufficient to really change the outcome. It may make life a little bit easier for the kid and for the people around a child but it doesn't necessarily change the long-range outcome what it takes to change. The long-range outcome is a coordinated program of home school Behavior personal emotional and Medical Treatments, and those those kinds of combined intervention programs can Very significantly improve the outlook for kids who may go on to learn very successfully to become very responsible for managing and monitoring their own behavior and for knowing when they need help when they need to use the medication so they can concentrate and pay attention a young adult certainly if they continue to have problems attributable to attention deficit can benefit both from medical and behavioral treatments and there are neurologists psychiatrists learning Specialists all have access to resources that can help to direct a person toward toward finding that kind of treatment program. Is it reasonable to (00:34:29) expect that an adult with a TD will at some point simply grow out of it? (00:34:35) Well, we used to think that that children grew out of hyperactivity, which we used to pay more attention to at puberty and We've now discovered is that sometimes the restlessness and the behavioral overactivity piece becomes less obvious at that point but not the attentional problem that they may continue to be kind of drifty and and to have difficulty paying attention. They may be less obviously climbing the walls, but they're still having trouble concentrating and and focusing some people learn strategies for managing their own attention and become quite successful with that without medication others continue to need medication or to need to do deliberate kinds of things to manage their concentration and attention. Well into adult life (00:35:20) we have about 15 minutes left in our conversation. If you want to participate give us a call in the Twin Cities at 2276 thousand 2276 thousand outside the Twin Cities call us on the wats line 1-800-222-1222 put your question to dr. Herbal is we talked about children and families. I've got an off-the-wall question for you here one of the major events of the summer was the opening of this ball here in the last week. We have (00:35:53) been (00:35:53) bombarded with (00:35:56) advertising and just all kinds (00:35:58) of information relating specifically to the wall but more generally to retailing and go by this go by that go by the other thing. Have you seen any impact from all of that on children and families and their behavior is (00:36:13) it wasn't any trouble just the current wave of a tremendous sort of marketing push that targets vulnerable young people who were often not in a very good position to make good critical judgments about the information that they're being exposed to the current rate of exposure to media and particularly hot media like television certainly bombards children with with information. And and gives them all kinds of ideas about things to want that they would not have known about under other kinds of circumstances kids are often pretty helpless victims of that kind of total push marketing and really need the support of parents who can help them to filter that information and who can help them to understand what that information is built for and what its goals are and how to evaluate it in a reasonable kind of way. So I think we really need to do some consumer education for little people to help them understand how to how to evaluate that kind of (00:37:20) information not enough green tell the kid. No, you can't have that. You got to go beyond (00:37:24) that. Well, I think that kind of power struggle can be painful for all parties concerned and truly instructive and supportive parent can help their kid by going beyond that and doing some education and making it well informed consumers of their children. (00:37:37) Yeah bunch of people on the line now calling in with the question. So, let's see if we can move through. This batch people pretty quickly hire your first of the bunch. So what's your question? Hi, my question is about the medication that's used for Ada and or add isn't it possible that the person that was on a little while ago that and has a 19 year old son that their son is suffering from the the effects of the medication that he used as a child because I've heard terrible things about (00:38:11) what I understood the caller to say was that she had declined the medication and so I don't think that that that that was the case indeed people do here terrible things about the medication and most of the terrible things that they hear about the medication are not true. This isn't the most typically used medications for the treatment of attention deficit disorders are psychostimulant medications that that increase the capacity for attention. They are not tranquilizers. They don't make zombies out of kids. They are not addictive medications. Ends and and they certainly can be abused but there's no in evidence that they particularly predisposed or increase the likelihood that people will become chemical abusers like taking an aspirin. If you don't have a headache, it won't change your life very much to take an aspirin. If you do have a symptom of a disorder that the medicine will change that symptom. So the medications that are used don't dramatically change Behavior. They normalize Behavior and the effects are quickly observable and I think for parents who are trying to make a responsible decision about this kind of treatment they can Comfort themselves in knowing that you can have a trial with this kind of medication. You can introduce the medication in about a half an hour. You can see some of the changes begin to work. The medication will be gone in four hours. It's not slow-acting long-lasting kind of Vacation you can observe you can with the help of schools and Healthcare Providers develop systematic ways of observing and measuring the effects of the behavior. You can decide to discontinue the medication on fairly short notice if you become concerned about side effects, and there are some side effects, but they're they're not terribly frequent and and they're manageable side effects. So I think it's unnecessary for people to feel frightened about the effects of these medications and when they're appropriately used they are life changing in a very positive way and so allowing ourselves to be scared way and not informing ourselves so that we can make responsible decisions may not be in the best interest of the children. (00:40:34) Let's move on now to another question from a listener. Hi, where are you calling from? Hello. I'm calling from Brooklyn Park Minnesota and your question. Well, I More of a statement actually about a proposed solution that I just heard for dealing with attention. Deficit disorder. Keep it brief if you can I will I just think that it sounds a lot like a brainwash what I just heard taking and addressing these children from every point of their life from medication into family treatment and school treatment special attention here sounds a lot like brainwashing to me. That's very scary. I think instead what people need to do possibly is take a look at the mixed messages that children are getting these days from their peers from their elders and Society at large and I think you might have a better chance of doing some good for these people. Okay, let's get a response. Dr. (00:41:30) Well, I think that the goal of the treatments that I mentioned is not to take control of kids but to put kids in control of themselves and that this is not a political agenda. This is an agenda about facilitating positive. Men and children and helping them to feel in control of themselves helping them to learn strategies that they can Implement to do the things that they want to do to pursue their own goals. I'm always (00:41:55) intrigued particularly in the area of ADD and we got in the medical the rather the drugs and medication side of it and their groups organized and neither side has a (00:42:09) medicine rather than drugs. I think the word drugs carries excess meaning (00:42:12) was trying to stay away from that word, but I'm intrigued the degree to which there are different camps here and they're arguing back and forth and and it really does bring it almost to a political level (00:42:24) and yes, it has become highly politicized in there are some interest groups that that do cast this sort of Paul of Mind Control biological warfare in this direction and I think that's unfortunate. I think that they see these It's are scientifically well-grounded that there is very good evidence, very responsible control in the use of these kinds of medications and that that it doesn't serve the interest of the children. Well for there to be Scare Tactics about about those kinds of aspects. (00:43:02) All right, let's go back to the phones now hear from another listener. Hi, what's your question? Yes, I suppose. I have a problem of trust and I just need the doctor's advice. We have a son who has moved back to the Twin Cities with us who is in his early 20s at about 10 years ago. There was a divorce and he lived in California for that period of time with his mother my ex-wife and he seems to have arrived with a great deal of debt a great deal of personal struggles, and he seems to be running from something. Do you recommend we go to an initial counseling session together? And how would you approach that with my son? (00:43:46) Well, it's hard for me to know what kind of conversations you've already had with your son to let him know that you have these concerns about the kind of shape his life appears to be in and your worries about that. If you've not been able to be successful in getting started with that kind of a conversation on your own then I think involving a family counselor is a good idea and would be a way to get some support and to put some structure around talking about how you can help this young person manages life. I think it will be important for you. And for your son to Define what the boundaries are about what you're responsible for and what he's responsible for and for you to figure out how you can be supportive without taking over or without enabling him to continue to be out of control or not responsible for his for his own life finding somebody who can mediate That kind of a conversation sounds like a good idea (00:44:48) back to the phones. Let's take another call here. Where are you calling from? And your question a question? I would like to know if I could write to dr. Taber or some other person to get a list of books dealing with add in adults. I have looked in a couple of libraries and they were not available one was listed, but it was not in that particular either particular (00:45:19) Library. Let me suggest a single reference. There's a book by dr. Paul wender. We nder that's called the hyperactive child Adolescent and adult and I think that's the most reliable resource for information about (00:45:35) that problem. And if nothing else if the library doesn't have it you can go to order to restore. Okay, and we'll move on then it's your turn. Where you calling from. We got somebody on the line. Oh, yes. I'd like to respond to that gentleman who thought it was wrong for medicine to be offered for these add. I think that they just don't want to admit that. This is a biological or medical problem and that they need this medicine and he wants to blame it on circumstances or something that happened in the child's life. No, it's a it was just that way. My daughter is a teacher in the Palmer Lake School in Osseo and she has these students that need this and she says it just does wonders for them. So I just like to tell the gentleman that that that's a normal thing for them. (00:46:25) Okay, sort of frightening to sometimes feel that there are forces that feel outside of personal control working in person's life and coming to terms with that that there are biological forces that make things happen that we don't like that. There are social forces that there are political forces that make things happen that we don't like is a sort of universal human Arne and figuring out how we can inform ourselves and help ourselves to feel comfortable and safe and to manage those to the best of our ability is a sort of universal human challenge, (00:46:56) but we ran out of time here. Let's get to one last caller one last question for doctor about where you calling from career and your question. Well, I have a I have a son who's now 13, but it's been reading since he was 13 He Is wonderful with other people but at home, he's just not a real nice person. What can a person do about that? (00:47:24) Well, it's hard for me to understand that an individual case on the basis of such limited information. I guess some to some extent it would it would make a difference whether this is recent onset behavior. And whether you're seeing a developmental transition as this young person moves into adolescence or whether this is a difficult person who's now bigger and louder and and you're running out of steam because you've been doing this a long time, you know, either case. I think that that seeking the advice of a family counselor or of a Child Development specialist who can help you to understand what's normal expectable Behavior. What's outside the normal range what might be reflective of an emotional or developmental issue that your son is experiencing and what might be changed by looking at the family interaction patterns, whether you could get to be a more clever skill for successful (00:48:14) parent so do that on your own first before you try and bring my child and somebody (00:48:19) in to take a for a parent to seek a consultation. And with someone recommended by the school or by their pediatrician to describe the behavior and to get some some expert advice that would help to make the judgment about whether this is normal range to look at parenting education would be possible without involving the kid. It might be that a consultant like that would need to have some opportunity to meet the child in order to be able to make a good judgment about that and then it needs to be explained. Look. I don't know how to take care of you. I need somebody to help me with this and they need to know something about you so they can help me know how to take care better care of you. (00:48:55) Yeah, let's return to our back-to-school theme here where we began before we run out of time and talked for a little just half minute or so about the things family should be aware of is as we get back into the school year and the new routines that need to be established and just that transition from the summer months into the (00:49:12) real work of the school year moving in gradually is important and for many people that means starting to change bedtime and starting to organize space. Things and getting the equipment organized and do a little rehearsing about what is the routine going to be like around here in the morning. And what time are you going to have to go to bed? And when our teenagers going to have to stop staying up till two o'clock in the morning and get to bed so they can get up in the morning doing some some goal-setting talking about what's expected and who can help doing Advanced preparation and doing some gradual warm-up so that that people are prepared for for some of this and then also acknowledging that it's going to take a couple weeks for routines to settle out but that we can always talk about these things. (00:49:56) Thanks for coming and good to have you here. Nice to be here. Dr. Susan turbo is director of mental health clinic at Minneapolis Children's Medical Center our thanks to Alan Baker in the control room Dorothy Hanford on the phones and some help today from the Sasha as lenient as