Child Study Center Grand Rounds 10.19.2021
October 29, 2021Praise, Sleep Training, and Other Parenting Controversies: Understanding the Science Behind the Debates
Information
- ID
- 7101
- To Cite
- DCA Citation Guide
Transcript
- 00:02Good afternoon everyone.
- 00:04Uh, greetings and welcome to grand rounds
- 00:09and I am very happy with today's speaker.
- 00:13But before I tell you all about him,
- 00:15let me give you a heads up.
- 00:17Next week we're going to have a biological
- 00:20talk with one of our colleagues at Yale,
- 00:24Dr Mustafa Khokha,
- 00:25who's going to be talking about some
- 00:27of the basic science behind what
- 00:29we're going to be talking about,
- 00:31which is development and parenting.
- 00:33So Kieran will tell us all about.
- 00:36Doctor Coca next week and today.
- 00:40I'm really very happy to welcome a
- 00:44dear friend David were two who is
- 00:47like the first day of kindergarten.
- 00:50He just started school yesterday.
- 00:52This is literally his second day
- 00:54on a new job and he joins us
- 00:57from Eugene OR where he is now.
- 01:00The medical director of Lane
- 01:02County Behavioral Health in Eugene.
- 01:04And Dave has moved there literally
- 01:07last week to start yesterday
- 01:09from Vermont from Burlington,
- 01:12where he was for many years as
- 01:14part of the Vermont machine.
- 01:17One of the most remarkable child psychiatric
- 01:20programs in the country with Jim,
- 01:22who check with Rob Altoff and part
- 01:25of the group that developed the
- 01:28Vermont family based care which is
- 01:31truly inspirational not only in what
- 01:33they're able to do for children.
- 01:35And families,
- 01:36but how they really have moved the
- 01:38needle in terms of preventive work.
- 01:41Preventive care.
- 01:42David, in addition to his work in Vermont,
- 01:46is a force of nature himself and one
- 01:50of the forces of his nature is that
- 01:53he is an excellent communicator and
- 01:56what I mean by that is that Dave
- 01:59has given a couple of Ted talks
- 02:01that are really quite mesmerizing.
- 02:03He has written two books for I would
- 02:06say a sophisticated lay audience.
- 02:09The first one on temperament which was.
- 02:13Uhm, really.
- 02:14The kind of a Tour de force for
- 02:16lay audiences on what temperament
- 02:18is and how important it is.
- 02:20In his second book, recent book came out,
- 02:23if I'm not mistaken,
- 02:24this year in 2021 or 2020 has unmistakably
- 02:27good title of parenting made difficult,
- 02:31and I'm sure that Dave is going
- 02:33to tell us about that.
- 02:34Just two more things about his
- 02:37power as a communicator is that
- 02:39David has for many years had one
- 02:42of the most active blogs in child
- 02:44mental health and child psychiatry,
- 02:46where he has this wonderful tone in
- 02:50communicating with parents with caregivers.
- 02:52And he reminds me in his approach
- 02:55to some of our greats.
- 02:56You know from Doctor Spock all
- 02:59the way back to to Winnicott just
- 03:03that calming presence.
- 03:06With parents and finally David.
- 03:08In addition to his scholarly output.
- 03:12Has been a wonderful mentor in a
- 03:14writing and communication mentor
- 03:16and has for the past several years.
- 03:17Had a column in Jacob Connect Connect
- 03:20is the companion online journal by
- 03:24residents and medical students for
- 03:27residents and medical students,
- 03:29and Dave has had their a column called
- 03:33from bedside from smartphone to bed site.
- 03:36I think I got it right,
- 03:37which is how do we apply the
- 03:40latest doodads in our phones?
- 03:42And how do we apply the latest
- 03:44in terms of high sophisticated
- 03:46science at the bedside so I could
- 03:50continue Singing Dave's praises,
- 03:53but I give you from Eugene,
- 03:55OR where there's a slight delay
- 03:57in the telephone connection
- 03:59polls between Eugene and here,
- 04:02so you might find a little bit of a delay,
- 04:03but the content will be just as good.
- 04:06So Dave will talk to us about praise.
- 04:08You should give a lot of that to your kids.
- 04:10Sleep training and other
- 04:12parenting controversies.
- 04:13Understanding the science behind the debates,
- 04:15Dave, take it away.
- 04:18Thank you Andreas and and
- 04:19thank you for inviting me.
- 04:21It is truly an honor to
- 04:23be able to address you.
- 04:25I know some of you,
- 04:26but most of you I don't and but
- 04:30I'm really excited II so wish
- 04:33that I could be there in person,
- 04:36but I was just moving 3000 miles
- 04:38in the other direction and it
- 04:40just didn't work out for the
- 04:42timing and and COVID so we will do
- 04:44the best we can from from here.
- 04:48So yes, uh, I've been.
- 04:50I worked at the University
- 04:52of Vermont for 20 years, uh,
- 04:54doing some personality and
- 04:56temperament research,
- 04:57running a training program, seeing patients.
- 05:01I'm doing a lot of writing on the
- 05:03side and just yesterday started
- 05:06my new job as the medical director
- 05:09for the Community Health Center
- 05:12here in in Eugene,
- 05:14OR so it's a bit of a whirlwind,
- 05:16but I I'm I'm really thrilled to be here.
- 05:20For those of you who use social media,
- 05:22I'm happy to connect on either
- 05:25Twitter or or Facebook.
- 05:26My handle is a PD site and then as Andreas.
- 05:31Mentioned I have been doing a blog I
- 05:34haven't reported as much as I usually do,
- 05:37but you can find it at on Psychology Today.
- 05:39It's called the ABC's of child
- 05:42psychiatry and I sort of talked about
- 05:44all kinds of different child mental
- 05:47health topics on that on that post.
- 05:52I do need to mention some disclosures.
- 05:55Obviously.
- 05:55You know this talk is directly related
- 05:59to the topic of my book that came out
- 06:02this year called parenting made complicated.
- 06:05UM,
- 06:05so I just need to acknowledge that.
- 06:08And then I also am a consultant for
- 06:10a company called Happy Health and
- 06:12helping them develop a personality scale.
- 06:17But this is what I'd like to do today.
- 06:19Kind of divide it up into
- 06:20three different parts.
- 06:21The first is I want to just talk about
- 06:24kind of the current state of parenting
- 06:26advice so you know how do parents.
- 06:28How do parents get guidance these
- 06:30days and how can we contribute to
- 06:33providing good science based guidance?
- 06:35And then I want to talk about the
- 06:39science behind some of the, you know,
- 06:42just a few selected controversies
- 06:44and debates that have been going on
- 06:47for decades with regard to parenting
- 06:49and sort of give you an idea.
- 06:51Some of you may be familiar
- 06:52with some of these already,
- 06:53but they just sort of give you an idea of
- 06:56what the science looks like and and how.
- 06:58It often doesn't really lend itself
- 07:00very well to sort of quick cut and dry.
- 07:03One size fits all answers.
- 07:06And then in and then Andreas was
- 07:08was mentioned that I I learned that
- 07:10from my family based approach,
- 07:12which is a very.
- 07:15It's an approach to child psychiatry that
- 07:17really encompasses a lot of health promotion.
- 07:19A lot of Wellness activities and a
- 07:21lot of engagement with the parents
- 07:23and their own mental health.
- 07:24And I wanna talk a little bit about
- 07:27how we as clinicians can bring
- 07:30up the topic of parenting,
- 07:31really engage families to talk
- 07:34about this incredibly important.
- 07:36A very challenging topic in a way
- 07:39that can be most productive and
- 07:42and then hopefully we'll have
- 07:43all the time for a hearing.
- 07:45Your perspective and any
- 07:47questions that that come up.
- 07:50So I'm going to start with this slide,
- 07:53which I hope isn't that
- 07:55controversial to to people,
- 07:57but you never know there was an era
- 08:00where you know with the twin twin
- 08:03studies not showing much shared
- 08:05environmental impact that people
- 08:07started to have a doubt about how
- 08:10powerful parenting really was
- 08:11in terms of child development,
- 08:13but I think most of us would
- 08:15agree that this is really a huge
- 08:18force in shaping a child.
- 08:21Behavior this and 11 finding that
- 08:23came out a few years ago that I
- 08:27found to be incredibly important
- 08:29and interesting is that if you look
- 08:32at the impact of parenting for kids
- 08:35who have different temperaments,
- 08:37it looks as though children who are
- 08:40have this more sort of challenging
- 08:42or what Thomas and chess called
- 08:44the difficult temperament.
- 08:45Kids who are you know, quick to react,
- 08:48maybe more impulsive,
- 08:50may be harder to soothe.
- 08:52In some ways,
- 08:53people may have assumed that that
- 08:55those are the groups that are sort of
- 08:57most biologically impervious to parenting,
- 08:59and it turns out that it's the
- 09:02exact opposite that these are the
- 09:04kids who can benefit the most from
- 09:06very good and positive parenting,
- 09:08and they can also struggle the most in
- 09:13the context of more negative parenting.
- 09:15And we know these days that that that
- 09:18the influence of parenting as well
- 09:20as any other environmental factors.
- 09:22It's not sort of independent
- 09:24direct effect on behavior,
- 09:27but it works through all of these
- 09:30other different pathways that
- 09:32that shape a child's behavior.
- 09:34So, you know,
- 09:35we know that now there's a lot of
- 09:38interplay between genetics and.
- 09:40And parenting and trauma and poverty, right?
- 09:43So all of these things fit together,
- 09:46and despite the fact that parenting
- 09:49is such a hugely important topic.
- 09:52It's often something that we don't
- 09:54address a lot in in. In our work.
- 09:57I mean, I, I know some people do,
- 09:59but it could be a challenging
- 10:01topic to bring up. It's sensitive.
- 10:02I think psychiatry had an era where
- 10:04we blamed everything on parenting and
- 10:07that probably wasn't our best era.
- 10:09And so we've kind of moved maybe
- 10:12180 degrees from that.
- 10:13And now you know, often,
- 10:15don't talk about it at all.
- 10:16But it turns out that if you look that
- 10:20there not only is there a lot of science.
- 10:23Uhm, regarding parenting,
- 10:24but there's also,
- 10:25you know,
- 10:26quite a bit of variability and I
- 10:29think confusion for parents out there
- 10:31who are sort of looking to try to
- 10:33find the right thing to do and and
- 10:36looking for sources of reliable information.
- 10:39And this is just a little
- 10:40cartoon that I made to sort of,
- 10:42I think.
- 10:43Describe how you know two children
- 10:45who are maybe at young age
- 10:47born to have you know slightly
- 10:50different temperamental tendencies.
- 10:53One child being kind of more irritable,
- 10:55one child being a little bit less.
- 10:58You know how does that?
- 10:59How does that temperament than actually
- 11:03trigger or evoke certain things in
- 11:06the environment that often magnify
- 11:09those differences overtime?
- 11:10So think about a child who you know as a
- 11:13toddler as an infant might be more irritable.
- 11:16You know what does?
- 11:17That kind of tend to evoke out of out
- 11:19of parents and other people you know,
- 11:21and conversely the child who
- 11:23was you know less. Irritable,
- 11:24rewarding, smiling, happy.
- 11:26You know that child.
- 11:28Tends to evoke more smiling, warm,
- 11:30happy things and over time that
- 11:32can then build into, you know,
- 11:35bigger differences in that irritability.
- 11:37And then on you layer.
- 11:38On top of that you know specific
- 11:41adverse experiences and you can see
- 11:44how temperament and environmental
- 11:46factors like parenting often can
- 11:49conspire to make what started out
- 11:52as small differences in behaviors
- 11:54to be much broader and much wider.
- 11:57And that's really what we're.
- 11:58You know, as clinicians.
- 11:59I mean,
- 11:59I think this is the pathway that we
- 12:02are really trying to get involved with.
- 12:04We want to try to maintain,
- 12:05you know,
- 12:06the the snowball effect in a positive
- 12:08way for kids who who are moving in
- 12:11that direction but also trying to
- 12:12sort of prevent this sort of negative.
- 12:15This this this positive feedback
- 12:16cycle moving in a in a negative
- 12:19way for the kids who are moving
- 12:21in the other direction.
- 12:25It's interesting to think when we
- 12:27talk about parenting, why people,
- 12:29parents, the way they do,
- 12:31I I often ask this of families.
- 12:33I think it's a great question to
- 12:36ask to ask them what their parenting
- 12:38approaches and how they got there.
- 12:40Uhm, if for most people it comes from
- 12:42a lot of different perspectives for
- 12:44a lot of us we are doing, you know,
- 12:47just like those commercials.
- 12:48We're kind of following in the footsteps
- 12:50of our of what our parents did.
- 12:53When we we did,
- 12:54we do a lot of the same things.
- 12:57Others you know,
- 12:58sort of do the diametrically opposed
- 13:00opposite you know they like I'm not
- 13:02gonna go make my kids go through what
- 13:04I had to do and so people take a very
- 13:07strong step in the other direction.
- 13:10Many of us also parents in a way that
- 13:13just feels most natural and instinctive
- 13:15to us and and we don't really think about it.
- 13:18It's it's relatively new that parenting
- 13:20has become sort of a science,
- 13:22and in some areas I would say
- 13:25a competitive sport.
- 13:27And before that, people just sort
- 13:29of did what they felt was right.
- 13:31And and there are advocates that we
- 13:33should move back in that direction.
- 13:35Uhm,
- 13:36we also understand that that parenting
- 13:38and child behavior is a two way street,
- 13:40and so parenting affects child behavior.
- 13:42But child behavior effects parenting.
- 13:45Right,
- 13:45so children will draw out like
- 13:47I was mentioning before.
- 13:48If you have a child who's more
- 13:50irritable that may draw out
- 13:51more kind of possible responses.
- 13:53If you have a child who is,
- 13:55you know,
- 13:56happier and more engaging than a
- 13:58lot of parents can look like a star,
- 14:01even though a lot of it is coming
- 14:03from the child.
- 14:04We certainly get advice from parents,
- 14:06other parents.
- 14:07We get advice from grandparents right?
- 14:09And and in these days a lot of parenting
- 14:12advice is is coming from the Internet.
- 14:15Coming from,
- 14:16you know blogs and posts and magazines
- 14:19and chat rooms and social media and
- 14:22you know that some of that information.
- 14:25A lot of that information
- 14:27can be a little suspect.
- 14:28And somewhere in there,
- 14:31hopefully people are are relying
- 14:33on some science.
- 14:35From what there is out there.
- 14:39We all I often have said this and I know like
- 14:41one of the a lot of people like to say hey,
- 14:43there's parenting is very challenging
- 14:46and it is and there are no manuals
- 14:49out there for raising kids. And in a
- 14:51sense I think that that might be true.
- 14:54But in a sense, I think we're
- 14:56actually overwhelmed with manuals.
- 14:58They're out there everywhere.
- 15:01And the problem is that they all
- 15:03tend to say very different things.
- 15:06Uhm, so and it's a bit ironic because
- 15:09I think probably the first you know big
- 15:12parenting book by the Late Doctor Spock.
- 15:16You know the general message from
- 15:18that book was trust your instincts,
- 15:20but uh, you know.
- 15:21Despite that being the message it kind of
- 15:23ushered in this avalanche of parenting.
- 15:28You know literature and books,
- 15:30and, UM, you know I've.
- 15:32I've read a lot of these in the
- 15:33course of writing my own book,
- 15:35and a lot of these are, you know,
- 15:39they make a lot of sense.
- 15:41But there can be problems,
- 15:43especially when you try to synthesize
- 15:45all of the parenting information that
- 15:48parents are getting bombarded with.
- 15:50I know at the risk of sounding
- 15:52a little bit of a snob,
- 15:54a lot of these books are written by people
- 15:56who really have no background in child
- 15:59development or or child mental health,
- 16:01and that's fine.
- 16:02It's a lot of good books can come from that.
- 16:05Uhm, but uh, you know,
- 16:07there may be some problems
- 16:10there and most books.
- 16:12And advice sort of,
- 16:13almost assumes that everybody is
- 16:15the same set that there are sort
- 16:18of these universal solutions or
- 16:20approaches that you should take.
- 16:23Uhm?
- 16:24And that they are,
- 16:25and that these approaches work
- 16:27equally well for everyone.
- 16:29And very often a lot of these
- 16:31books are written not in like a
- 16:34boring science kind of article,
- 16:35but more like a legal approach.
- 16:37In other words,
- 16:38you know that they're written
- 16:39with the idea that you want that,
- 16:41that that the author is trying to
- 16:44persuade you to kind of move to this.
- 16:47Approach or use these techniques.
- 16:49It's like a legal argument where they're
- 16:51trying to sort of get you to to buy in.
- 16:55And often it's like, well,
- 16:57you know, my kids turned out
- 16:58pretty well with this approach,
- 17:00so you know you're you're should as well.
- 17:02And and a lot of these books
- 17:05studies are cited,
- 17:06statistics are used.
- 17:08But you wouldn't necessarily say
- 17:10that it's it's balanced if if
- 17:13there's studies or or literature.
- 17:15That's kind of argue against the.
- 17:17The main thesis will often those
- 17:20those studies are are kind of ignored.
- 17:24So I I sometimes say there's kind of no,
- 17:26nobody more confident in their
- 17:28parenting than the person who's
- 17:30written read one parenting book
- 17:31and no one less confident than
- 17:33the person who just read two.
- 17:35And.
- 17:35And that's often because of the
- 17:36way that sort of science gets used,
- 17:38or sometimes.
- 17:40Manipulative.
- 17:43And it's it's easy to do.
- 17:45I mean, for those of you who have
- 17:46have looked in this, it's it's very
- 17:48hard to get definitive answers when
- 17:50it comes to parenting studies, right?
- 17:53I mean there. They're all all the.
- 17:55The studies are almost always naturalistic.
- 17:59You know, and and they and
- 18:01they have to be right?
- 18:02I mean like we know what would
- 18:03be the the what would provide
- 18:05the more definitive studies.
- 18:06But we could never do them like if
- 18:08you wanted to find out the effect of
- 18:10say you know, corporal punishment.
- 18:12You know the perfect study would be,
- 18:14well, let's you know,
- 18:16randomize 1000 people from all
- 18:18different backgrounds and and
- 18:19flip a coin and tell half of them
- 18:21that you could never spank for the
- 18:23next eight years until the other
- 18:25half that you have to under these
- 18:28very specific circumstances.
- 18:29And who would who would sign up for that,
- 18:32right?
- 18:32So we end up having to sort of make the
- 18:35most of these kind of naturalistic studies.
- 18:38And then when you have to decide what well,
- 18:40then what and what's your outcome,
- 18:42is it you know what's what?
- 18:44What's a positive outcome, is it?
- 18:46Kids being happy is a kid
- 18:49succeeding at school.
- 18:50Is it, you know, you know,
- 18:53all these measures that you can,
- 18:55that you can sort of,
- 18:56but there are subjective
- 18:57and their dimensional,
- 18:58and so this is the literature.
- 19:01This is the world that we live in.
- 19:02I think it's true of of sort of
- 19:04behavioral research in general,
- 19:06but I think it's a you know,
- 19:08very true when it comes to.
- 19:10Comes to parenting,
- 19:11and so again, it's just.
- 19:13It lends itself to a lot of
- 19:16subjectivity and judgment,
- 19:17and in some cases manipulation.
- 19:21So how can we kind of move this
- 19:23along in a positive way when when
- 19:25parents are sort of stuck in this
- 19:27very chaotic world where they just
- 19:29are kind of bombarded by information?
- 19:31Well we can do our best to understand
- 19:34that science and try to synthesize that.
- 19:37And in my view,
- 19:38I think we have to move away from kind
- 19:42of these rigidly applied one size
- 19:44fits all approaches and and understand.
- 19:47That kids are different.
- 19:49Parents are different and that the
- 19:52quote correct answer for a specific
- 19:55challenge you know really may
- 19:58not be not the same for everyone
- 20:00and and so we get to that answer
- 20:02of it depends which you know.
- 20:04People hate that right,
- 20:06like and and but it depends it is it?
- 20:10It truly is a terrible place
- 20:11that to sort of end an argument.
- 20:14You know,
- 20:14if you're ever talking to the
- 20:15press and you say it depends,
- 20:16you know their their eyes just.
- 20:17Well, I can't you say anything more,
- 20:19but it actually is a really good
- 20:21place to to start a conversation.
- 20:23It depends on what. Oh OK.
- 20:25Well what if my child is more extroverted?
- 20:28What if my child is more irritable?
- 20:30If you can actually start moving
- 20:32beyond that and the
- 20:33literature sometimes provide
- 20:34some guidance for that.
- 20:36Then we you know can move into a
- 20:38really productive place and and
- 20:40then I think where we want to go.
- 20:42Or in many cases,
- 20:44is to encourage parents actually under,
- 20:46you know, learn a little bit
- 20:49of the science and move from
- 20:51kind of a more knee jerk,
- 20:52reactive style of parenting to
- 20:54one that's a little bit more
- 20:56thoughtful and a little bit more
- 20:59deliberate and a little more plan.
- 21:04So let me get into sort of a few.
- 21:06I just selected, you know,
- 21:07three different topics out of many
- 21:09different controversies out there.
- 21:11Just to give you a flavor of kind
- 21:13of where the science is and how we
- 21:15can kind of adapt this more sort
- 21:18of it depends kind of thinking
- 21:20when it comes to specific topics,
- 21:22so we're going to talk first about
- 21:24sort of global parenting styles.
- 21:26Praise and then sleep training.
- 21:32Alright, so there are a
- 21:33lot of sort of general.
- 21:34A lot of the books that are out there
- 21:36on parenting summer very specific on,
- 21:38you know specific topics,
- 21:39but many of them advocate for
- 21:42a specific type of approach
- 21:44and there are a lot out there.
- 21:46I would say you know five of them
- 21:48kind of the the ones that the
- 21:50public at least hear about the most.
- 21:52One of course is helicopter parenting.
- 21:54That nobody likes to say that
- 21:55they're in a helicopter parent.
- 21:56That's a term that is more
- 21:58derogatory and used by people who
- 22:00take other approaches to describe.
- 22:02Kind of this more intensive type work
- 22:07where parents are very involved with
- 22:09kids there sometimes running interference.
- 22:12There kind of restricting some of their
- 22:16their freedom but also wanting kids
- 22:18to be kids and not have to not have
- 22:21them being burdened with adult things.
- 22:23It's a very you know.
- 22:24I think you've all you're all familiar with
- 22:27this and and it's it is certainly you know,
- 22:30maybe the dominant sort of approach.
- 22:32Especially,
- 22:33I would say among sort of middle upper class,
- 22:36you know white families, but you know
- 22:39very common you know across the country,
- 22:41but you know there are others,
- 22:43probably the opposite of this is you know
- 22:46what's been termed free range parenting,
- 22:48which is a much sort of back off.
- 22:50Encourage independence,
- 22:51let kids do what they're gonna do.
- 22:54Let them take some risks.
- 22:56Understand that the world isn't quite
- 22:57as dangerous as you may think it is.
- 22:59You know it.
- 23:00It's, uh, you know.
- 23:01Clearly a different step.
- 23:03And then there's, UM.
- 23:06There's a, you know what's been
- 23:07called tiger parenting or what.
- 23:09I sometimes called old school parenting.
- 23:12Tiger parenting is more, you know,
- 23:16heavily, more supervising,
- 23:17more achievement oriented scheduling.
- 23:19Lots of you know, music lessons,
- 23:22art lessons, extra academic prep.
- 23:26Whereas old school is more
- 23:27sort of the parents.
- 23:29Often the dad is in charge and the
- 23:33disciplinarian and and then the another
- 23:36one is is is what's called attachment
- 23:39parenting and that that one comes up,
- 23:41especially among very young kids.
- 23:44It's kind of quite different from the one you
- 23:46know you might call the old school parenting.
- 23:49It's it's more about attunement,
- 23:51sensitivity, responsiveness, less about.
- 23:56Punishments and uhm?
- 23:59Uhm, you know and and and and then.
- 24:01For infants it gets into things like.
- 24:04Uh, the you know,
- 24:05sharing a bed and sleep training issues,
- 24:08but we'll talk about it in a bit,
- 24:10but this is the language
- 24:12that the public hears.
- 24:14And you know these,
- 24:15have you know very different implications.
- 24:18I mean, and this is a just example.
- 24:19Very typical, say,
- 24:21scenario that might play out,
- 24:24right?
- 24:24So let's say we had that a 6 year
- 24:26old boy who's playing in the four
- 24:28year old sister comes in and starts
- 24:30to mess with the Lego structure
- 24:32that the the boy has made and
- 24:35this gets into an argument.
- 24:36And then it ends up into a fight and finally
- 24:39the brother hits the sister,
- 24:40knocks her to the ground.
- 24:41Now both kids are crying and the.
- 24:45The son is saying his Legos are ruined
- 24:47and the and the daughter is upset and
- 24:50then the say the mother comes in.
- 24:52You know what would you do in that situation
- 24:54and and how do the different approaches
- 24:57sort of suggest different courses of action?
- 25:01So if you are a free range mom,
- 25:04you might say I'm I'm not a,
- 25:06you know police officer,
- 25:07I'm staying out of this.
- 25:08You two need to work this out.
- 25:10Uhm, you know,
- 25:11figure this out for yourself.
- 25:14Uh, if you were more of an old school,
- 25:16or maybe a tiger parent,
- 25:17you might give the sun a time out.
- 25:20You might even spank the
- 25:22sun or striking his sister.
- 25:25You wouldn't worry too much about expressing
- 25:28you know some outward levels of anger.
- 25:31Come if you are more coming
- 25:33from the attachment school,
- 25:34I think rather than to give a time out,
- 25:37you would try to give the son of time
- 25:40in try to sort of get down on his level
- 25:43kind of Co regulate helping him calm down.
- 25:46Have a conversation about what
- 25:48happened and try to talk about
- 25:49how to do things differently.
- 25:51Try to empathize with you,
- 25:54know the feelings that the son and
- 25:56daughter had encouraged to use,
- 25:57the words you probably wouldn't
- 25:59use any kind of a punishment.
- 26:01And then more sort of the
- 26:02modern style or the helicopter.
- 26:03Or maybe you you know you saw
- 26:05something online and you said oh what
- 26:07I need to do is shower attention
- 26:09on the daughter and that will.
- 26:11You know that will be the the path out
- 26:13and that will help the sun realize you
- 26:16don't get attention for misbehaving.
- 26:18Or maybe you'd give the toy at time out.
- 26:20That's another new technique, right?
- 26:22You put the toy away.
- 26:24But it,
- 26:24whatever you would still probably
- 26:26stay in the room,
- 26:28and you might even like use
- 26:30yourself as a physical barrier
- 26:32to make sure that the kids don't.
- 26:34Uhm, kind of repeat the same thing.
- 26:38So you know these these different
- 26:40approaches really do end up sort of
- 26:43leading to different techniques and
- 26:45strategies, and parents often want to know,
- 26:47well, you know what?
- 26:48What would you do?
- 26:49Or you know what is?
- 26:50What is the right answer and all of
- 26:52these different approaches I think,
- 26:54have you know,
- 26:56are logical in some ways they
- 26:57can be useful in some ways.
- 26:59The question is,
- 27:00you know there's one shows superiority
- 27:02over the other or or is it more that
- 27:06some kids respond to different types?
- 27:08And what can be confusing when you try
- 27:11to mix sort of what the public here is
- 27:13about the different styles of parenting.
- 27:14Is that the academic world
- 27:17doesn't use any of these terms,
- 27:19and they you know you don't
- 27:20read studies about tiger,
- 27:21parenting or or helicopter parenting.
- 27:25You know what you have is
- 27:27this structure that's existed
- 27:28for decades where you have kind of this
- 27:31two by two table and there are four
- 27:34parenting types based on whether parents
- 27:37are high or low in a dimension of.
- 27:39Affection and warped and the other
- 27:41dimension of supervision and control.
- 27:43And, uh, you know there,
- 27:46there's the and unfortunately,
- 27:47the two of these words are almost
- 27:49identical and fouls everybody out,
- 27:51but that's what we have right now.
- 27:53So if you're high in both warmth
- 27:55and high in supervision and control,
- 27:57that's authoritative.
- 27:59Hi and supervision and control but
- 28:01low and work that's authoritarian.
- 28:04Uhm and then high in a warmth below and
- 28:07control is more of the permissive style.
- 28:11But this is the academic language.
- 28:12How do you map those two things
- 28:14on so you know?
- 28:15I think if you ask the the sort of
- 28:18major advocates of the of the more
- 28:20popular types that all say that
- 28:22they're they're advocating for an
- 28:25authority and authoritative approach.
- 28:27But this was my attempt to sort of map,
- 28:31you know how the more popular approaches
- 28:34sort of map on to the more academic
- 28:37structure with the modern parenting.
- 28:40You know most of them.
- 28:41Sure.
- 28:43You know clustering around the authoritative.
- 28:48But you know some some movement with
- 28:50the tiger and old school being a little
- 28:53more authoritarian and free range.
- 28:54Being a little bit more on the Commission.
- 28:58But how about it? It depends, right?
- 29:01I think most of us, you know,
- 29:02hearing those scenarios might say, well, uhm.
- 29:04It might be different depending
- 29:06on the child's temperament or the
- 29:08culture or other things, so you know,
- 29:11I think when you look at the.
- 29:14The literature you find that often
- 29:16there isn't a cut and dry answer that
- 29:19that works best, I think certainly.
- 29:21The bulk of the research tensive
- 29:24suggests that the authoritative
- 29:27approach tends to be related to.
- 29:30Better outcomes in a lot of different ways,
- 29:32but there are some exceptions to that,
- 29:34and one of them is culture.
- 29:36UM, a lot of the research on authoritative
- 29:39parenting comes from a kind of middle
- 29:42class white non Hispanic families
- 29:44and some studies show that the.
- 29:47Sort of.
- 29:48The superiority of the authoritative
- 29:50approach doesn't hold up quite
- 29:52so much in in some other groups.
- 29:55Come and temperament maybe a little
- 29:57bit different so you know there was
- 29:59another study that shows that the
- 30:00more permissive style was actually
- 30:02related to to more problems for kids
- 30:05who are higher on anxiety, you know.
- 30:07So there are these.
- 30:08It depends factors that really come
- 30:11into play and and people would say,
- 30:12like you know what I should do is what works.
- 30:15You know instead of sort of blindly
- 30:17and rigidly following one line,
- 30:19you try something and and observe.
- 30:21And if it's working great, just go with it.
- 30:24And if it's not. You sometimes need to shift.
- 30:29And one thing that I will sometimes
- 30:32advocate for and talk to parents about it.
- 30:34And I know this sounds almost.
- 30:37In complete contradiction to
- 30:38what Doctor Spock says and and I
- 30:41don't mean it to be because I,
- 30:42I think actually we have to parent
- 30:44instinctually and we have to do things
- 30:46we have to parent in a way that.
- 30:48Comes naturally to us, but.
- 30:50I often encourage families to sort of
- 30:53think about their own temperament,
- 30:55and I sometimes think that sometimes.
- 30:57What parents need to do is take a
- 31:00couple steps in the opposite direction
- 31:02of what comes most naturally to them.
- 31:05And by that I mean that if you're a
- 31:08parent who you know instinctually.
- 31:12Wants to be your child's best friend.
- 31:14You really don't like having to do
- 31:16anything in terms of supervision or
- 31:18setting limits, and that is hard for you.
- 31:21Well, maybe you know that's a place where
- 31:24you need to to work on it and take a step.
- 31:26Being a little bit more in
- 31:29the authoritarian direction.
- 31:30And conversely,
- 31:31if you're the kind of parent who.
- 31:34You know,
- 31:35has trouble showing affection has
- 31:38trouble showing warmth and you
- 31:39may sort of say,
- 31:40well I I'm I'm an old school parent
- 31:42that's that's what fits me well,
- 31:44you know,
- 31:45maybe you know that's the kind of
- 31:47parents that actually could move a
- 31:49step and try to be a little bit more
- 31:51playful and and and warm and so.
- 31:55You know,
- 31:55in some cases I think you know you have to.
- 31:58You have to parent in a way that
- 32:00that that you can do,
- 32:01but I think sometimes taking a
- 32:03step away from your temperament,
- 32:05you know swimming against your
- 32:06temperamental tide a little bit
- 32:08can be very useful for kids.
- 32:13Any new move now to praise.
- 32:15Uhm, another topic in here.
- 32:18Uh, so let me just start with this.
- 32:20So again, like what our options here
- 32:22are six year old Dr draws a picture
- 32:25and brings it to their parents.
- 32:27And says look, look what I did.
- 32:31What's the best way to respond to that?
- 32:33Should you say what a beautiful picture?
- 32:36You're a terrific artist.
- 32:39You're the best artist in your class.
- 32:43You really worked hard to get your
- 32:45drawing just right. Or I probably
- 32:47would have used orange in that spot.
- 32:50So let's think through a little bit about
- 32:53the the literature about praise and,
- 32:55and this is also an area that it has become,
- 32:58you know, very controversial praise.
- 33:01On the one hand is something that is sort of
- 33:04built into the authoritative parenting style.
- 33:08Most evidence based approaches to kids
- 33:11who struggle with oppositional defiant
- 33:13behavior talks a lot about praise,
- 33:15encourages a lot about praise.
- 33:17But as you all know,
- 33:18there also is this kind of.
- 33:20Backlash out there that's saying, well,
- 33:22we've gone too far for for praising kids
- 33:25for breathing it's getting too much.
- 33:28Everyone is getting a trophy.
- 33:30You know you know we're turning
- 33:32everyone into narcissists so you
- 33:33know what do we actually know
- 33:35about this and and are there some?
- 33:37It depends factors that we
- 33:39want to be thinking about.
- 33:41The praise you know, why do we use praise?
- 33:43We really use praise for two reasons.
- 33:45One as a as sort of a cold steely
- 33:48reinforce are just like those pellets
- 33:50that the pigeon spec for food.
- 33:53We use it because we want if we
- 33:55see something a child is doing,
- 33:57we use praise to try to make the
- 34:00probability of that happening again go up.
- 34:03But we also use praise as a self esteem
- 34:06builder to help children sort of build
- 34:09that inner sense of value and efficacy.
- 34:12Uhm?
- 34:13But this is where you know and and and
- 34:15certainly you know praise has been,
- 34:18you know, highly endorsed by,
- 34:21you know, all of you know a lot of
- 34:22our major professional organizations.
- 34:24I think I mentioned all this.
- 34:26But there is, you know.
- 34:27Again, there is this, UM.
- 34:30Their counter argument that,
- 34:33UM,
- 34:34that you know if you use praise
- 34:37too much that.
- 34:39That either children will become
- 34:40sort of impervious to it,
- 34:42it just loses its value just like any
- 34:44any currency that gets over that there's
- 34:47too much of it kind of loses its value,
- 34:50whereas some kids might sort of get
- 34:52addicted to the praise and and and
- 34:54they start doing things not because of
- 34:56the intrinsic motivation or you know,
- 34:58not because they want to do it,
- 35:00or because they find something
- 35:02intrinsically valuable.
- 35:03But because of the praise and you know,
- 35:05there is some some research to that that
- 35:07that you know if you put in a lot of.
- 35:09External motivators that sometimes
- 35:11kids will lose their interest,
- 35:13their intrinsic motivation.
- 35:14So you know what do we know
- 35:16about this? So here. Uhm, you know what?
- 35:19Probably is one of the biggest. It depends.
- 35:21Factors is not so much on the type of child,
- 35:25but actually the type of praise.
- 35:27And there is an interesting research about.
- 35:31The different types of praise.
- 35:33So in in in some of the letter chair they
- 35:35divide up phrase into what's called person,
- 35:38praise and process praise.
- 35:40So person. Praise is a statement
- 35:43that's directed as as at traits.
- 35:46So that would be something like you
- 35:47are a fast runner or you or smart,
- 35:49or you're so pretty.
- 35:51You know you're describing a trait,
- 35:54whereas process praise is describing a
- 35:57specific behavior or an effort or method.
- 36:00You know you train.
- 36:02So hard for that that race so.
- 36:04There is a.
- 36:06You know, and I'm sure some of you are
- 36:09familiar with some of this work, but.
- 36:12You know there is some evidence
- 36:14to suggest that that person prays
- 36:15contributes to something which
- 36:17that's called a fixed mindset.
- 36:19Which is the idea that.
- 36:22That achievements or that
- 36:24success is sort of built in,
- 36:28and that you're sort of born with it,
- 36:30or you're not.
- 36:31Versus sort of a growth mindset.
- 36:33Which is that success is something
- 36:35that you can earn that takes practice
- 36:37and that you have to sort of keep
- 36:40at it over and over again and fail
- 36:42a lot and keep working better.
- 36:45Uhm,
- 36:45and there is some evidence that the
- 36:47that the person prays contributes
- 36:49to this idea of a wall laugh.
- 36:51I'm this person saying I'm smart.
- 36:54You know,
- 36:54I don't wanna I don't want them
- 36:56to find out otherwise and so you
- 36:57get into a more sort of defensive,
- 36:59protective mindset where you
- 37:01don't want to challenge yourself.
- 37:04You don't want to reveal to anyone
- 37:06that you may not be as brilliant
- 37:09as everybody thinks you are.
- 37:11Uhm, whereas of the North growth mindset,
- 37:16you know you actually want to
- 37:18just sort of jump in there and
- 37:20be challenged and succeed.
- 37:21And there was this, I think a great study.
- 37:26That was done a few years ago that
- 37:28cut that really looked at this and
- 37:30they they were little deceitful.
- 37:31So they went into these homes
- 37:32and they said that we were doing
- 37:34a quote language study.
- 37:35But what they're actually doing
- 37:37is just sort of categorizing
- 37:39everything that parents and kids
- 37:41said to each other and we're really
- 37:44looking at praise and looking at
- 37:46this how the different types of
- 37:48praise might be related to.
- 37:50Uhm?
- 37:51You know motivation,
- 37:53structure,
- 37:54and academic academic achievement later on,
- 37:57and II.
- 37:58You know it's just an interesting
- 37:59study on some of the basic statistics,
- 38:01so it turns out that across the board
- 38:04phrase was about 3% of what parents say,
- 38:06but that there was actually huge differences
- 38:09in families on how much praise they utter.
- 38:12So you know the high praise families might
- 38:15save 16 times as much praise as as the low.
- 38:19The note,
- 38:20the low praise families.
- 38:22Parents tended to have a style of
- 38:24praise so that there were, you know,
- 38:26parents tended to use more person,
- 38:27praise, or process praise.
- 38:29But really, you know what we
- 38:31were really interested in.
- 38:32What they found was that more
- 38:35process praise was associated to.
- 38:37To like challenging tasks
- 38:39so like being pushed,
- 38:41and to have more of a growth mindset
- 38:43to see success as something that
- 38:45was real result of effort whereas.
- 38:49Uhm? Kids who had more person
- 38:52praise was the opposite,
- 38:54and then when they followed these kids out,
- 38:55even into kindergarten,
- 38:56they're actually tended to
- 38:58be differences in terms of
- 39:00academic achievement as well.
- 39:03Another study up and they used to a
- 39:07design called across leg panel modeling.
- 39:09That's that's pretty good
- 39:11at at at cause and effect.
- 39:13Also found that sort of
- 39:16overpraise sort of overvaluing.
- 39:18Empty inflated praise was related to
- 39:21kind of more child narcissistic traits,
- 39:24while self-esteem was really
- 39:27predicted by parental warmth.
- 39:30Another interesting component that I
- 39:32I think is worth talking about is they
- 39:35looked at sex differences and they
- 39:37found that boys tended to hear more,
- 39:39proportionately more processed
- 39:41praise than girls.
- 39:43And that also kids who tended to
- 39:46have lower and lower self esteem also
- 39:48tended to hear more person praise
- 39:51which then ended up sometimes sort of
- 39:54undermining and and leading to more
- 39:56feelings of shame after a failure.
- 39:58So these kids that we would love
- 40:00to be able to just sort of help
- 40:02them by saying the right thing.
- 40:04It turns out that you know if you if
- 40:07you offer praise that tends to be
- 40:10unearned or inflated even with the best.
- 40:13With intentions it can.
- 40:14It can sometimes backfire.
- 40:18And then another part about praise
- 40:19that I think is really important,
- 40:21is that sometimes you know we have to
- 40:24be focusing not just on the praise,
- 40:26but on the opposite.
- 40:28And there is. You know,
- 40:30some good evidence that you can really
- 40:34undo the positive effects of praise with,
- 40:37you, know, just a few really harsh
- 40:41negative kind comments.
- 40:42So you know you could utter 10 good jobs,
- 40:47but if you then say you know
- 40:49what's wrong with you when you're.
- 40:51When you're really upset that that
- 40:52can really undo a lot of that,
- 40:54and so for a lot of families,
- 40:57what we need to be doing is not
- 40:58only just talking about you know
- 41:00what types of praise can be useful,
- 41:02but also trying to help families.
- 41:04Do you know,
- 41:05avoid some of these really negative
- 41:08comments that that overtime can
- 41:10really have a negative effect?
- 41:14So overall,
- 41:15I mean I think praise is a good thing.
- 41:18I do worry that I do worry a
- 41:20little bit about the sort of the
- 41:23public idea that that overall,
- 41:25we're running a appraise surplus with kids I,
- 41:29but sometimes I wish we could just
- 41:31kind of re distribute it a little bit.
- 41:33There's still,
- 41:34I think there's a lot of kids who probably
- 41:37could hear a lot more praise in their lives,
- 41:39and there may be some that are hearing
- 41:42too much and it's much more of sort of.
- 41:44And it depends.
- 41:45And again,
- 41:45it may be that the reason that
- 41:47there's a picture Will Smith.
- 41:48There is, you know again for the,
- 41:51for the parents who really struggled.
- 41:53So if you know the movie he was
- 41:55kind of a narcissistic guy and he
- 41:56could never tell but tell people.
- 41:58Good job and with some help he finally
- 42:01you know was able to start saying good
- 42:04things about other people and you know,
- 42:07I think that maybe you know
- 42:09the way that we sometimes want
- 42:10offer our guidance for parents.
- 42:12You just.
- 42:12You know, they really gravitate to this.
- 42:14Oh no participation, trophies,
- 42:16praise needs to be earned,
- 42:17while those maybe the the families were.
- 42:20They could use, you know,
- 42:21a little bit more praise in their life.
- 42:26So let me go to the third
- 42:28area sleep training.
- 42:28This has been a controversy forever and
- 42:32by sleep training you know what we're
- 42:35talking about are specific techniques
- 42:37that people use to help infants.
- 42:40Well, they say get sleep through the night.
- 42:42Nobody actually sleeps through the night,
- 42:44yeah, but what we're really talking
- 42:46about is children being able that
- 42:48when they do have these little slight
- 42:50awakenings that we all have during the
- 42:52night that they can get themselves
- 42:53back to sleep rather than crying or
- 42:56needing to have a parent sued them.
- 42:59And this is a as as many of you know,
- 43:02it's very very common.
- 43:03Probably about half of intense struggle
- 43:06with staying asleep on their own and it's
- 43:08become an incredibly controversial area.
- 43:11For a long time, a lot of the advocacy
- 43:14was really against sleep training.
- 43:17You didn't see a lot of advocacy for it,
- 43:19but as some of the data regarding
- 43:22bed sharing and and SIDS,
- 43:24which is a complicated literature
- 43:26in and of itself.
- 43:28Started coming out.
- 43:29You've actually started to see
- 43:31pushback where advocates of of
- 43:34of not having infants share beds,
- 43:37and this was a very provocative
- 43:39public safety message from Wisconsin,
- 43:41where they are basically arguing that
- 43:44sleeping with your young infant is
- 43:46just like having them sleep next to
- 43:49a meat cleaver. But you know this is.
- 43:51You know why this has become
- 43:54a very contentious topic.
- 43:55Uhm, parents.
- 43:56Expect that when you have a baby,
- 43:58you're not going to sleep well.
- 44:00It's kind of a badge of honor.
- 44:02It's often sort of the first question
- 44:04that a lot of new parents get.
- 44:06Uhm, and people put up with it,
- 44:08but the literature really shows that
- 44:11that that fatigue is really no joke.
- 44:14That parental fatigue, you know,
- 44:17is related to depression.
- 44:19Feelings of burnouts,
- 44:21higher rates of accidents, and even you know.
- 44:25Parents feeling,
- 44:26you know,
- 44:26having a shorter fuse and and having
- 44:29more sort of punitive parenting.
- 44:32So a lot of people when they think
- 44:33of sleep training, they think of
- 44:35this guy which is Richard Ferber,
- 44:36who was the former director of the Boston
- 44:39Children Sleep Clinic and published
- 44:41in 1985 a a book called, You Know,
- 44:45Solve Your Child's Sleep Problems.
- 44:46And here he basically advocated for using
- 44:50a particular sleep training technique,
- 44:53which many of you I'm sure know about
- 44:56where where parents are encouraged
- 44:59to wait progressively longer periods
- 45:01of time before going in to comfort
- 45:04their infants with the idea that
- 45:06you know you do this technique
- 45:08for a matter of days and children
- 45:10will learn to sleep on their own.
- 45:13This is he's become synonymous was
- 45:15with what's called the crying it out.
- 45:18This technique, which way?
- 45:20And it's a bit ironic because.
- 45:23Forever, never.
- 45:24Actually he doesn't advocate kids,
- 45:26just be you know parents ignoring
- 45:28kids until until infants sort of
- 45:31fall asleep out of exhaustion.
- 45:33He this this sort of progressive
- 45:36comforting at longer intervals was
- 45:38his way of sort of the kinder and
- 45:41gentler approach to the true crying
- 45:43it out which which was you know,
- 45:46often advocated before him.
- 45:48But nevertheless,
- 45:49you know that's how politics works,
- 45:50and he's been sort of.
- 45:53You know, associated with this,
- 45:54crying it out? There are some.
- 45:58Other techniques though,
- 45:59that I think a lot of people
- 46:01are not aware of that are also
- 46:03sleep training techniques.
- 46:04There's one that's called camping out,
- 46:06where instead of adjusting the time
- 46:08intervals of when you go comfort your child,
- 46:11you adjust your physical proximity.
- 46:14So for a few days you help your child.
- 46:16You're standing right by the crib,
- 46:18then a few days you move
- 46:19to the middle of the room,
- 46:21then for a few days you moved
- 46:22halfway out the hallway.
- 46:24You know you slowly move away.
- 46:27There are other techniques.
- 46:29Out there,
- 46:30that and many of them don't involve
- 46:32any actual sort of prying it out that
- 46:34that people are less aware of it,
- 46:36but the the the Ferber isation technique
- 46:39is probably the most widely known,
- 46:41and it gets very heavily criticized.
- 46:44This is someone who also is one of my
- 46:46Co bloggers on Psychology Today and and,
- 46:49and she writes blogs that this
- 46:52is probably been viewed a million
- 46:54times and she makes claims that.
- 46:56That sleep training techniques
- 46:57makes kids less telligent,
- 46:59less healthy, more anxious.
- 47:02Come and then she has.
- 47:05Is citation so it looks very scientific,
- 47:08but when you actually go to the citations,
- 47:10none of them are actually
- 47:11about sleep training.
- 47:12In infants.
- 47:12They're actually about like giving
- 47:14monkeys cortisol to drink for a month,
- 47:16or about the effects of of abuse.
- 47:19You know, physical abuse and abandonment.
- 47:23So you know it's a little,
- 47:25I think a little sneaky in terms of
- 47:28you know how the literature gets used.
- 47:31But when you actually look at people
- 47:33who have really tried to study this,
- 47:35so this is a meta analysis that was
- 47:38done about sleep training techniques.
- 47:41It was found out that they
- 47:43were overall quite effective.
- 47:44Uhm, but that one technique
- 47:47is not superior to others.
- 47:49Uhm, but there's very little influence.
- 47:52We're very little literature on the different
- 47:55types for different subpopulations, so.
- 47:57You know what do you do
- 47:59if your kids more anxious?
- 48:00What if you do with a kid
- 48:01who has a trauma history?
- 48:02What do you do if a kid
- 48:04is like super energetic?
- 48:06And there's also really no evidence this
- 48:08was something Ferber said in his first book,
- 48:10and then backed away from this claim that
- 48:12if you don't use sleep training techniques,
- 48:15your kids will never learn how to self
- 48:17regulate or be able to self soothe.
- 48:19They're actually really isn't
- 48:21evidence for that.
- 48:23And and and Ferber axe himself
- 48:25actually backed away from this.
- 48:28But what people really are
- 48:29interested in also is well.
- 48:31Or are there any long term negative
- 48:33effects and many of the studies
- 48:35that have looked at that and
- 48:37there's just a handful really.
- 48:39Have come from Australia and
- 48:41one study sort of had followed
- 48:43people at different intervals.
- 48:46They found that you know in the short term,
- 48:49so I think this was maybe around
- 48:51one year that the sleep training
- 48:54techniques were effective.
- 48:55And that both the child and the
- 48:58and the parents got better sleep.
- 49:00And moms had less depressive symptoms.
- 49:03And then when they followed
- 49:05these kids at six years.
- 49:07And looked at the kids
- 49:08who had been randomized.
- 49:09Half of this group were
- 49:11randomized to learn sleep.
- 49:13Sleep training techniques
- 49:15and half weren't basically,
- 49:16and then they followed these kids at age 6.
- 49:19And they looked at everything you
- 49:21could imagine. They did attachment.
- 49:23Strange situation, cortisol levels,
- 49:25locking box.
- 49:27You know everything you could look
- 49:28at and they could not find any
- 49:30difference actually between the group
- 49:32that received the sleep training
- 49:34techniques and and things that didn't.
- 49:38So you know, putting it all together,
- 49:40uhm, you know what I will recommend to
- 49:43families is that I I it's really hard to
- 49:46argue that sleep training techniques,
- 49:49especially the ones that don't
- 49:51involve any crying it out,
- 49:53are linked to any kind of long term harms.
- 49:55But that being said,
- 49:56for kids who are particularly
- 49:57anxious or have trauma histories,
- 49:59I often will recommend that that that
- 50:02that parents try one of the other kinds
- 50:05of non crying it out techniques first.
- 50:08Uhm, and also considering, you know,
- 50:11consider the parents temperament to.
- 50:12I think there are some parents who feel
- 50:15like they're doing something wrong if
- 50:16they don't apply these techniques and.
- 50:18Uhm, you know we don't really
- 50:20have evidence of that either.
- 50:21So certainly you have to be careful.
- 50:23I think of the young infants and
- 50:25and kids and and that literature,
- 50:27but if you're talking about toddlers,
- 50:30you know.
- 50:30And I think we can give permission
- 50:31to families to.
- 50:32Do you know what they want if
- 50:35they're comfortable with it and.
- 50:36They're comfortable either letting
- 50:37them keep their going into the room,
- 50:39or having the kids come into the bed,
- 50:41which happens quite a bit,
- 50:43you know, I I,
- 50:44I think sometimes we have bigger fish to fry.
- 50:48For the last couple things,
- 50:49I'll just sort of say is just that was
- 50:52just to hopefully give you a little bit
- 50:54of a flavor of of of the science behind
- 50:56some of these parenting controversies.
- 50:58You know,
- 50:58how do we?
- 50:59How do we talk about this?
- 51:00How do we engage 'cause I?
- 51:01I think one of my take home messages
- 51:03that I I I think we as clinicians,
- 51:05because parents are so confused
- 51:07because there's so much disinformation,
- 51:09misinformation out there.
- 51:11I think it's really important
- 51:13to engage families about about
- 51:16parenting techniques and.
- 51:17In a way that helps them feel supported and
- 51:21not blamed and so some techniques that are,
- 51:25you know,
- 51:26things that I often talk
- 51:27about is change is slow.
- 51:29I sometimes use the analogy of an
- 51:31ocean liner turning very slowly and
- 51:33you know a lot of forces apply,
- 51:36but it doesn't seem like the boats
- 51:38moving anywhere but but slowly over
- 51:41time it does about choosing your
- 51:43battles and picking,
- 51:44picking things that are higher priority.
- 51:49Uhm, you know setting realistic goals.
- 51:52And just you know,
- 51:53and and and the importance of of warmth.
- 51:56Uhm, I could.
- 51:57I could do a whole talk on this,
- 51:59but you know,
- 52:00you read the literature.
- 52:02You know the importance of parental warmth,
- 52:05that positive energy that support.
- 52:09It's just kind of not going to
- 52:11the dark side and getting that
- 52:14negative irritable reactive mode.
- 52:16It just seems so important and
- 52:17I was just so many studies.
- 52:19It's just they just keep coming up
- 52:21showing how important warmth is
- 52:22and I used to kind of dismiss that.
- 52:23Like Oh yeah, yeah yeah.
- 52:25Workflow 4th, I don't dismiss that
- 52:27anymore and I and I think that that's really.
- 52:30One of the reasons why it's important
- 52:31for for parents to be able to pay
- 52:33attention to their own well being
- 52:35their own mental health just so
- 52:36they have enough gas in the tank.
- 52:39You know, when they're you know when
- 52:43they're parenting their kids so.
- 52:45Parenting discussions are hard.
- 52:46I think a lot of parents already
- 52:49come to us feeling blamed and guilty
- 52:51and can quickly get defensive and.
- 52:56You know the way that I've I've kind of
- 53:00learned to try to to help with this is.
- 53:02Is to not have this sort of old.
- 53:04You know your child is messed up
- 53:06because you screwed up and you know
- 53:08that's just gonna turn people off.
- 53:10It's probably not true.
- 53:11It's and instead really talk about fit.
- 53:14And and talk about what is your,
- 53:16what is the child pull out in you
- 53:18and how are you responding to that?
- 53:20I have a picture.
- 53:21This used to be a picture of Vermont mount.
- 53:23Now it's an Oregon mountain but I
- 53:26II sometimes say that kids just
- 53:28like like big mountains are capable
- 53:31of generating their own weather.
- 53:32And So what we really have to be able to do,
- 53:35is it?
- 53:35It might be very natural for a parent
- 53:38to respond in a more irritable way.
- 53:41But that that may not be the best
- 53:43response and we have to help families
- 53:46kind of override this order often use
- 53:49overrides kind of the natural tendency.
- 53:52I often like in my opening sessions,
- 53:55I asked parents, you know, I said,
- 53:57what are you most proud of?
- 53:58Talk about parenting for a minute.
- 54:00What are you most proud of as a parent
- 54:02and what are your bigger challenges?
- 54:04And when you ask the question that way,
- 54:06a lot of questions have an assumption
- 54:08built into them and the assumption
- 54:09built into that question is that
- 54:11everybody is doing some things well and
- 54:13everybody is struggling in some areas.
- 54:14And let's talk about it.
- 54:16Let's get that out of there.
- 54:18And let's and let's just talk about it
- 54:19a lot and and and I found that question
- 54:21would be very helpful and parents will say,
- 54:23well,
- 54:23I'm really good at it,
- 54:25but I struggle here and and it
- 54:27it just it opens things up for
- 54:30like or discussion from there.
- 54:32For finishing up,
- 54:33I know we're out of time here.
- 54:35And I know I covered a lot of ground,
- 54:37but I think the summary points
- 54:39are that as much as we would
- 54:41like them to be the the quick,
- 54:43you know,
- 54:44do this for every kid kind of parenting
- 54:47approach really is not going to be
- 54:49productive for a lot of people.
- 54:51You know we do best when we
- 54:53try to encourage parents to be
- 54:55thoughtful and deliberate,
- 54:56to be kind of like little
- 54:57scientists in some ways.
- 54:59But we have to appreciate the
- 55:01variability in that the one size
- 55:03fits all doesn't really work.
- 55:05I also just like to mention that there is a
- 55:07lot of science out there about parenting.
- 55:09It's worth understanding.
- 55:12But it's it's difficult.
- 55:14It's often inconclusive and
- 55:16sometimes outright contradictory,
- 55:17so it's not the easiest literature
- 55:20to work with.
- 55:21Uhm, but you know,
- 55:23just like a,
- 55:24just like with parents you
- 55:26know understanding it all.
- 55:27Being perfect is route is is
- 55:29neither an achievable goal.
- 55:31It's probably not even a desirable goal.
- 55:33And that a lot of parents can really do well
- 55:37when they admit their mistakes.
- 55:39Try something different.
- 55:40Acknowledge that.
- 55:41Show flexibility and model
- 55:43that for their kids so you
- 55:47know perfection is is is not,
- 55:49is not what we're going for here,
- 55:51but just you know,
- 55:52a less reactive kind of
- 55:54more deliberate style.
- 55:58So I will stop there and happy to
- 56:00entertain any questions or comments.
- 56:03Thank you so much Dave.
- 56:04Would you mind just stopping
- 56:06your share so that we can see
- 56:09the friendly faces of the crowd?
- 56:11Yep. OK, uhm any questions.
- 56:17I just saw Carla Horowitz,
- 56:21who knows a lot about parenting.
- 56:24Carla can I put you on the spot?
- 56:27Carla taught me everything I know
- 56:30about parenting, so you know,
- 56:31this is like two Titans of parenting here.
- 56:35Uhm, what? What I heard was nuanced
- 56:41and complex and really did bring in
- 56:44a lot of what we think about when we
- 56:48try and help parents or be parents.
- 56:51So I you know I I.
- 56:55You didn't hit anybody over the
- 56:56head with anything you you actually
- 56:58really had a broad expanse,
- 57:00and I think all of that information is
- 57:03really helpful, said in a non judgmental way.
- 57:07But everybody has their own taken
- 57:10their own vulnerabilities when
- 57:12it comes to their own kids,
- 57:14including those of us who are
- 57:16supposed to be parenting experience.
- 57:19Yes, I say all the time that being a child
- 57:22psychiatrist that doesn't make me immune.
- 57:25I make all the mistakes in the book.
- 57:27I'm just more aware of those mistakes.
- 57:34We have time for a couple more questions.
- 57:36I know Amanda, I don't see you,
- 57:38but I see you're right and go for diamond.
- 57:40I am I'm Amanda Detmer, thanks so much
- 57:44for really fascinating presentation.
- 57:45Uhm, so I'm a comparative psychologist
- 57:48and behavioral neuro scientist, and I
- 57:50actually study monkey models of parenting,
- 57:52and I always interested in what we can
- 57:57learn from evolutionary forces, right?
- 58:01And so, and I'm also a parent of two kids,
- 58:05and especially I know how
- 58:07controversial the sleep training is.
- 58:08And, you know, I really like just on the.
- 58:11Other side of coming out
- 58:12of that with young kids,
- 58:13but I I guess my question is like how
- 58:16often are a comparative comparative
- 58:19science discussed with parents?
- 58:21You know, for example?
- 58:24Do parents ever hear like it's really?
- 58:26I'm really hard pressed to think of a mammal.
- 58:29Any mammal that parks its infant in
- 58:31another room to sleep alone at night and
- 58:33so that it's actually an adaptive thing
- 58:36that infants are disrupted at night.
- 58:38Or, you know, waking up at night and
- 58:41and then I kind of related to that.
- 58:43I'm curious what you think of
- 58:45the science of breast sleeping?
- 58:47You know James Mckenna's work
- 58:48out of Notre Dame?
- 58:49It's really systematic,
- 58:51really thoughtful work on the physiological.
- 58:54And psychological benefits of of
- 58:56what he terms breast sleeping.
- 59:01Yeah, I I have to say I don't.
- 59:02I don't know. I know that literature 10.
- 59:04I mean one of the chapters in my
- 59:06book was about breastfeeding in
- 59:08general and its links to behavior and
- 59:11intelligence and that controversial area.
- 59:13Breast sleeping sounds like a little
- 59:15a subdivision of that, so I can't say.
- 59:17I know and I I'd love.
- 59:20I'm gonna have to.
- 59:21I'd love to read more about this.
- 59:22The animal literature.
- 59:23I've seen some things about dogs
- 59:26and parenting styles about dogs
- 59:27that I think would be interesting.
- 59:30And uh, but I'd be fascinated
- 59:31to learn more how it works with
- 59:34the primates and monkeys.
- 59:40We have time for maybe one final question.
- 59:43I know we have a young parents
- 59:44in the crowd and we have some
- 59:46not so young parents and anyone
- 59:48we do have one question here in the room.
- 59:50Oh go for it. Hello, I'm Lily Bernard.
- 59:53Thank you very much for the talk.
- 59:55Just a question do you,
- 59:59could you say something about the
- 01:00:01interaction between the duration
- 01:00:03of paternity and the increase?
- 01:00:05Increasing concern about child
- 01:00:07sleep training like maternity
- 01:00:09leave and parental leave.
- 01:00:11Also that forces parents to go
- 01:00:12back to work and not have to
- 01:00:15improve the schedule of the kids
- 01:00:16so that work is again possible.
- 01:00:21Yeah, I'm sorry I didn't
- 01:00:22quite catch all of that.
- 01:00:23The the link between what
- 01:00:24were the two things? Again
- 01:00:27my question my as Sumption I would say
- 01:00:30is that the more we ask parents to go
- 01:00:33back to work soon after giving birth.
- 01:00:38The more you have to train the
- 01:00:41child to sleep at night, yeah,
- 01:00:43and so questions about maybe
- 01:00:45comparisons with other countries.
- 01:00:47For instance, no way where both parents
- 01:00:50gets one year of parental leave.
- 01:00:53Both the mother and the father.
- 01:00:55They can share it, just you know,
- 01:00:57if you know something about that.
- 01:01:00Yeah, thank you.
- 01:01:01Yeah I have. Yeah, one of the other
- 01:01:04chapters is all about the controversy
- 01:01:06between stay at home parents and.
- 01:01:08In early childcare and what we know
- 01:01:11about that, there was a huge study
- 01:01:14that was from the National Institute
- 01:01:16of Child Health and Human Development
- 01:01:19that actually was built to be the
- 01:01:22definitive study about about the effects
- 01:01:25of Nonparental early child care,
- 01:01:27and it it became a monster study
- 01:01:30that you know that had a lot of
- 01:01:32it depends in its own right,
- 01:01:34but it's worth sort of looking
- 01:01:37at that that literature.
- 01:01:38I think one way to make this less
- 01:01:40political is just as you said.
- 01:01:42I mean to talk about things like,
- 01:01:44you know, giving parents adequate
- 01:01:46time away when they haven't,
- 01:01:48and a newborn which you know,
- 01:01:51I think is is a a great thing.
- 01:01:54And I think we we are behind
- 01:01:56other countries like like Norway
- 01:01:57when it comes to that, but.
- 01:02:01Yeah,
- 01:02:01I'd encourage you to look at that that study.
- 01:02:05No, uh, David. I think that
- 01:02:08you know on this note,
- 01:02:10uh, you know, hoping that we're all in this
- 01:02:13country have parental leave for one year.
- 01:02:15You know a boy can dream up,
- 01:02:17but thank you so much David for for
- 01:02:21joining us from Vermont via Oregon
- 01:02:24and it's been wonderful to have you
- 01:02:26and we have your contact information.
- 01:02:28And Amanda, thank you for sharing that
- 01:02:30link and for wonderful questions.
- 01:02:32So we will see you all next week.
- 01:02:34And Dave, you need to come to a.
- 01:02:37You need to take the director
- 01:02:39Eugene Newhaven flight.
- 01:02:39I hear there's a new direct flight so.
- 01:02:42Awesome, I'm on it.
- 01:02:44Good. Thank you so much and
- 01:02:46we will see you all next week.
- 01:02:48Thanks again Dave. Alright
- 01:02:50thank you bye bye.