Grandmothers Raising Grandkids

Grandmothers are an important resource for both parents and kids. They routinely provide child care, financial assistance and emotional support. Occasionally they are called upon to provide much more including temporary or full time care and responsibility for their grandkids.

An increasing number of kids in the United States live in households headed by a grandparent. This trend is due to:

• AIDS
• death or disability of parents
• incarcerations of parents
• increasing numbers of single parent families
• parental abuse and neglect
• substance abuse by parents
• teenage pregnancies
• the high rate of divorce

In many of these homes, neither of the youngster's biological parents is present. In most cases, kids taken care of by grandmothers move in with them as infants or preschoolers and remain with them for five years or more. These grandmothers are a diverse group ranging in ages from the thirties to the seventies. Many grandmothers are ready to simplify their lives and slow down. Giving that up and taking over the responsibilities of being a primary parent again can stir up many feelings including grief, anger, loss, resentment and possibly guilt. This transition can be very stressful and the emotional and financial burdens can be significant. Culture shock at having to deal with kids and adolescents of a different generation can be great. Grandparent headed households have a significantly higher poverty rate than other kinds of family units.

Many grandmothers in this care taking role underestimate or are unaware of the added burdens their new role as "parents" will place upon them. Grandmothers often assume their role will be to nurture and reward kids without having to set limits. When grandmothers serve as parents, however, they must learn to set limits and establish controls as they did with their own kids.

Many kids living with grandmothers arrive with preexisting problems or risk factors including abuse, neglect, prenatal exposure to drugs and alcohol, and loss of parents (death, abandonment and incarceration). This situation can create risks for both kids and grandmothers. Caring for your grandkid can also be very positive and rewarding. Grandmothers bring the benefit of experience and perspective. They can also provide important stability, predictability, and be a healthy role model for their grandkids.

It is very important for grandmothers to receive support and assistance. Seeking out other family members, clergy, support groups and social agencies can be helpful. The Grandparents Information Center (sponsored by the American Association of Retired Persons) is a good place to get information, referrals and support. The American Association of Retired Persons website address is www.aarp.org. Financial aid may be available especially if the youngster was abandoned, neglected or abused. Mental health professionals including child and adolescent psychiatrists, community mental health and child welfare agencies and parent-teacher associations are other important resources for the grandmothers and grandfathers.

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Violent Behavior in Children and Teens: The Influence of TV, Video Games and Music

There is a great concern about the incidence of violent behavior among kids and adolescents. This complex and troubling issue needs to be carefully understood by moms and dads, teachers, and other adults.

Kids as young as preschoolers can show violent behavior. Moms and dads and other adults who witness the behavior may be concerned, however, they often hope that the young youngster will "grow out of it." Violent behavior in a youngster at any age always needs to be taken seriously. It should not be quickly dismissed as "just a phase they're going through!"

Range of Violent Behavior—

Violent behavior in kids and adolescents can include a wide range of behaviors: explosive temper tantrums, physical aggression, fighting, threats or attempts to hurt others (including homicidal thoughts), use of weapons, cruelty toward animals, fire setting, intentional destruction of property and vandalism.

Factors Which Increase Risk of Violent Behavior—

Numerous research studies have concluded that a complex interaction or combination of factors leads to an increased risk of violent behavior in kids and adolescents. These factors include:

• Being the victim of physical abuse and/or sexual abuse
• Brain damage from head injury
• Combination of stressful family socioeconomic factors (poverty, severe deprivation, marital breakup, single parenting, unemployment, loss of support from extended family)
• Exposure to violence in media (TV, movies, etc.)
• Exposure to violence in the home and/or community
• Genetic (family heredity) factors
• Presence of firearms in home
• Previous aggressive or violent behavior
• Use of drugs and/or alcohol

What are the "warning signs" for violent behavior in kids?

Kids who have several risk factors and show the following behaviors should be carefully evaluated:

• Becoming easily frustrated
• Extreme impulsiveness
• Extreme irritability
• Frequent loss of temper or blow-ups
• Intense anger

Moms and dads and teachers should be careful not to minimize these behaviors in kids.

What can be done if a youngster shows violent behavior?

Whenever a parent or other adult is concerned, they should immediately arrange for a comprehensive evaluation by a qualified mental health professional. Early treatment by a professional can often help. The goals of treatment typically focus on helping the youngster to: learn how to control his/her anger; express anger and frustrations in appropriate ways; be responsible for his/her actions; and accept consequences. In addition, family conflicts, school problems, and community issues must be addressed.

Can anything prevent violent behavior in kids?

Research studies have shown that much violent behavior can be decreased or even prevented if the above risk factors are significantly reduced or eliminated. Most importantly, efforts should be directed at dramatically decreasing the exposure of kids and adolescents to violence in the home, community, and through the media. Clearly, violence leads to violence.

In addition, the following strategies can lessen or prevent violent behavior:

• Early intervention programs for violent youngsters
• Monitoring youngster's viewing of violence on TV/videos/movies
• Prevention of youngster abuse (use of programs such as parent training, family support programs, etc.)
• Sex education and parenting programs for adolescents

***Kids and TV Violence***

American kids watch an average of three to four hours of television daily. Television can be a powerful influence in developing value systems and shaping behavior. Unfortunately, much of today's television programming is violent. Hundreds of studies of the effects of TV violence on kids and teenagers have found that kids may:

• become "immune" or numb to the horror of violence
• gradually accept violence as a way to solve problems
• identify with certain characters, victims and/or victimizers
• imitate the violence they observe on television

Extensive viewing of television violence by kids causes greater aggressiveness. Sometimes, watching a single violent program can increase aggressiveness. Kids who view shows in which violence is very realistic, frequently repeated or unpunished, are more likely to imitate what they see. Kids with emotional, behavioral, learning or impulse control problems may be more easily influenced by TV violence. The impact of TV violence may be immediately evident in the youngster's behavior or may surface years later. Young people can even be affected when the family atmosphere shows no tendency toward violence.

While TV violence is not the only cause of aggressive or violent behavior, it is clearly a significant factor. Moms and dads can protect kids from excessive TV violence in the following ways:

• disapprove of the violent episodes in front of the kids, stressing the belief that such behavior is not the best way to resolve a problem
• pay attention to the programs their kids are watching and watch some with them
• point out that although the actor has not actually been hurt or killed, such violence in real life results in pain or death
• refuse to let the kids see shows known to be violent, and change the channel or turn off the TV set when offensive material comes on, with an explanation of what is wrong with the program
• set limits on the amount of time they spend with the television; consider removing the TV set from the youngster's bedroom
• to offset peer pressure among friends and classmates, contact other moms and dads and agree to enforce similar rules about the length of time and type of program the kids may watch

Moms and dads can also use these measures to prevent harmful effects from television in other areas such as racial or sexual stereotyping. The amount of time kids watch TV, regardless of content, should be moderated because it decreases time spent on more beneficial activities such as reading, playing with friends, and developing hobbies. If moms and dads have serious difficulties setting limits, or have ongoing concerns about their youngster's behavior, they should contact a youngster and adolescent psychiatrist for consultation and assistance.

***Kids and Video Games: Playing with Violence***

Video gaming (playing video games) has become a popular activity for people of all ages. Many kids and adolescents spend large amounts of time playing them. Video gaming is a multibillion-dollar industry – bringing in more money than movies and DVDs. Video games have become very sophisticated and realistic. Some games connect to the Internet, which can allow kids and adolescents to play online with unknown adults and peers.

While some games have educational content, many of the most popular games emphasize negative themes and promote:

• criminal behavior, disrespect for authority and the law
• foul language, obscenities, and obscene gestures
• racial, sexual, and gender stereotypes
• sexual exploitation and violence toward women
• the killing of people or animals
• the use and abuse of drugs and alcohol

There is growing research on the effects of videogames on kids. Some video games may promote learning, problem solving and help with the development of fine motor skills and coordination. However, there are concerns about the effect of violent video games on young people who play videogames excessively.

Studies of kids exposed to violence have shown that they can become: “immune” or numb to the horror of violence, imitate the violence they see, and show more aggressive behavior with greater exposure to violence. Some kids accept violence as a way to handle problems. Studies have also shown that the more realistic and repeated the exposure to violence, the greater the impact on kids. In addition, kids with emotional, behavioral and learning problems may be more influenced by violent images.

Kids and adolescents can become overly involved and even obsessed with videogames. Spending large amounts of time playing these games can create problems and lead to:

• aggressive thoughts and behaviors
• exercising less, and becoming overweight
• lower grades and reading less
• poor social skills
• time away from family time, school-work, and other hobbies

Tips for Moms and dads—

Moms and dads can help their kids enjoy these games and avoid problems by:

• checking the Entertainment Software Rating Board (ESRB) ratings to learn about the game’s content.
• playing videogames with their kids to experience the game’s content.
• remembering that you are a role model for your kids – including video games you play as an adult.
• selecting appropriate games—both in content and level of development.
• setting clear rules about game content and playing time, both in and outside of your home.
• strongly warning kids about potential serious dangers of Internet contacts and relationships while playing games online.
• talking with other moms and dads about your family’s video game rules.

If moms and dads are concerned that their youngster is spending too much time playing video games or appears preoccupied or obsessed with aggressive or violent video games, they should first set some limits (for example – playing the games for one hour after all homework is done) and try to encourage the youngster to participate in other activities. If there is continued concern about their youngster’s behavior or the effects of videogames, a consultation with a qualified mental health professional may be helpful.

***The Influence of Music and Music Videos***

Singing and music have always played an important role in learning and the communication of culture. Kids learn from what their role models do and say. For many years, some kids's television very effectively used the combination of words, music and fast-paced animation to achieve learning.

Most moms and dads are concerned about what their young kids see and hear, but as kids grow older, moms and dads pay less attention to the music and videos that capture and hold their kids's interest.

Sharing music between generations in a family can be a pleasurable experience. Music also is often a major part of an adolescent's separate world. It is quite common for teenagers to get pleasure from keeping adults out, which causes adults some distress.

A concern to many interested in the development and growth of teenagers is the negative and destructive themes of some kinds of music (rock, heavy metal, hip-hop, etc.), including best-selling albums promoted by major recording companies. The following themes, which are featured prominently in some lyrics, can be particularly troublesome:

• Drugs and alcohol abuse that is glamorized
• Graphic violence
• Sex which focuses on control, sadism, masochism, incest, kids devaluing women, and violence toward women
• Suicide as an "alternative" or "solution"

Moms and dads can help their teenagers by paying attention to their teenager's purchasing, downloading, listening and viewing patterns, and by helping them identify music that may be destructive. An open discussion without criticism may be helpful.

Music is not usually a danger for an adolescent whose life is balanced and healthy. But if an adolescent is persistently preoccupied with music that has seriously destructive themes, and there are changes in behavior such as isolation, depression, alcohol or other drug abuse, evaluation by a qualified mental health professional should be considered.

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Discipline for Difficult Children

Kids do not always do what moms and dads want. When a youngster misbehaves, the parent must decide how to respond. All kids need rules and expectations to help them learn appropriate behavior. How does a parent teach a youngster the rules and, when those rules are broken, what should moms and dads do?

Moms and dads should begin by talking to each other about how they want to handle discipline and establish the rules. It is important to view discipline as teaching not punishment. Learning to follow rules keeps a youngster safe and helps him or her learn the difference between right and wrong.

Once rules have been established, moms and dads should explain to the youngster that broken rules carry consequences. For example, “Here are the rules. When you follow the rules, this will happen and if you break a rule, this is what will happen.” Moms and dads and the youngster should decide together what the rewards and consequences will be. Moms and dads should always acknowledge and offer positive reinforcement and support when their youngster follows the rules. Moms and dads must also follow through with an appropriate consequence when the youngster breaks a rule. Consistency and predictability are the cornerstones of discipline and praise is the most powerful reinforcer of learning.

Kids learn from experience. Having logical consequences for misbehavior helps them learn that they are accountable for their actions, without damaging their self-esteem. For example, if kids are fighting over the television, computer or a video game, turn it off. If a youngster spills milk at the dinner table while fooling around, have the youngster clean it up. Some behaviors have natural consequences. For example, a teenager who stays up too late may suffer the natural consequences of being tired the next day. Another type of consequence that can be effective is the suspension or delay of a privilege. For example, if a youngster breaks the rule about where they can go on their bike, take away the bike for a few days. When a youngster does not do chores, he or she cannot do something special like spend the night with a friend or rent a movie.

There are different styles and approaches to parenting. Research shows that effective moms and dads raise well-adjusted kids who are more self-reliant, self-controlled, and positively curious than kids raised by moms and dads who are punitive, overly strict (authoritarian), or permissive. Effective moms and dads operate on the belief that both the youngster and the parent have certain rights and that the needs of both are important. Effective moms and dads don't need to use physical force to discipline the youngster, but are more likely to set clear rules and explain why these rules are important. Effective moms and dads reason with their kids and consider the youngsters' points of views even though they may not agree with them.

The following are tips for effective discipline:

• Allow for negotiation and flexibility, which can help build your youngster's social skills.
• Be clear about what you mean. Be firm and specific.
• Consequences should be fair and appropriate to the situation and the youngster's age.
• Let your youngster experience the consequences of his behavior.
• Make sure what you ask for is reasonable.
• Model positive behavior. "Do as I say, not as I do" seldom works.
• Speak to your youngster as you would want to be spoken to if someone were reprimanding you. Don't resort to name-calling, yelling, or disrespect.
• Trust your youngster to do the right thing within the limits of your youngster's age and stage of development.
• Whenever possible, consequences should be delivered immediately, should relate to the rule broken, and be short enough in duration that you can move on again to emphasize the positives.

Parenting classes and coaching can be helpful in learning to be an effective parent. If moms and dads have serious concerns about continuing problems with their youngster's behavior, consultation with a youngster and adolescent psychiatrist or other qualified mental health professional may be helpful.

Important Reminders about Discipline:

• After an older youngster completes his time out, then he is to agree to do what you had told him to do or if he had been misbehaving, and agrees to not to it again, otherwise he is to go into time out again. Again this doesn't usually apply to toddlers or younger preschool age kids.

• After disciplining your youngster, briefly explain the rule and what your expectations are when he misbehaves and explain what the proper behavior would have been.

• And always remember that it is better to support and encourage good behavior instead of trying to eliminate bad behaviors.

• Avoid physical punishment. Spanking has never been shown to be more effective than other forms of punishment and will make your youngster more aggressive and angry.

• Avoid repeating commands. You should give a command and if not followed, then you can repeat it once with a warning of what the consequences for noncompliance will be. If not followed, then apply the consequences. Do not continue to repeat the command.

• Avoid too much criticism. Make sure your youngster understands that it is the misbehavior that you are unhappy with and that you will always love him.

• Avoid too much praise. You don't need to be continuously praising your youngster, especially for routine activities, because it will make your comments less effective.

• Be a good role model.

• Be consistent in your methods of discipline and how you punish your youngster. This applies to all caregivers. Your youngster should learn to understand that there are predictable consequences for his actions.

• Be flexible, especially with older kids and adolescents. Listen and get your youngster's input on some rules and punishment.

• Do not offer choices in situations where you youngster has to cooperate with your rules. For example, instead of saying ‘do you want to take a bath?' you should instead say ‘it is time for your bath.'

• Don't argue with your youngster about the punishment. Ignore any protests. You can talk about it later.

• Don't focus on negatives all of the time, especially when offering positive reinforcement. It is much better to say ‘I like that you put all of your clothes away,' instead of saying ‘I like that, for once, you finally got around to putting your clothes away without my asking.'

• Don't give in to your youngster when he is whining, crying or having a temper tantrum. If you do, it will only teach him that this kind of behavior is an appropriate way to get what he wants.

• If your youngster leaves the time out chair, put him back in the chair and warn him "If you get out of the chair again, I am going to discipline you (by removing some desired activity/possession, etc.)". If he gets up again, just put him back in the chair without warning him again and apply the discipline technique. If he continues to get out of the chair, you can consider sending him to his room, or another room in your home, for the time out period (remove all toys, TV, video games, etc…).

• Learn to ignore minor, harmless or unimportant misbehaviors, such as fidgeting.

• Make punishments and rewards immediate. Avoid waiting more than a few minutes to provide the consequences of a behavior.

• Most importantly, provide your youngster with a safe environment in which he feels secure and loved.

• Now calmly take him to his time out chair, ignoring any protests or promises he may make, and say "You stay in your time out chair until I tell you to get up." He must now stay in time out until he has been quiet for the punishment time you have set for him (usually one minute per year of age). Remember that, for older kids who are being defiant, time out does not begin until your youngster has been quiet, even if takes several minutes or an hour. That doesn't apply to younger toddlers and preschool age kids though.

• Physically move your youngster when he is misbehaving, especially if he didn't respond to your firm ‘no.'

• Plan ahead. If you always have difficulty in certain situations, such as shopping or having visitors, go over a plan of action beforehand, which includes what your expectations are and what the consequences of misbehavior will be?

• Provide a safe environment that encourages exploration, but protects your youngster. For example, you can prevent your toddler from getting in trouble for opening drawers and cabinets if you have safety locks preventing them from opening.

• Remember that this is just one method of using time out and you will likely have to modify it to fit your own parenting style and your youngster's temperament. If it isn't working for you, especially if you have to use time out several times a day, or your youngster doesn't quickly go to time out, then you should likely look for a different discipline technique or a different way of using this one.

• Remember to give rewards and praise for good behavior.

• Set limits that are appropriate for your youngster's age and developmental level. Remember that you are in charge and that you will have to say ‘no' to your youngster sometimes. You should expect your youngster to cry when he does not get his way. This is a normal way of dealing with frustration in younger kids and should be ignored. You should also ignore temper tantrums.

• Set up a daily routine for your younger kids and try and stick to it each day. This should include mealtimes, snacks, bath and bedtime.

• Stay calm and do not get carried away when your youngster misbehaves. Avoid yelling and screaming, since this can teach your youngster that it is all right to lose control if you don't get your way. If you feel like things are escalating too much, then take a break until you can regain your composure.

• Stop inappropriate behaviors with a firm ‘no' while looking your youngster in the eyes.

• Think ahead. Be prepared for what you are going to do and say to help your youngster understand the consequences of his actions. Don't just wing it, or do or say the first thing that pops into your head. You are more likely to react negatively if you haven't thought out your plan for discipline beforehand.

• Time out is a very effective discipline technique and will work with kids as young as 18-24 months old. By using this method of discipline you are giving your youngster time out from positive reinforcement (which includes any parental reaction such as yelling or hitting) after he misbehaves. Prepare a time out chair, which can be a chair in any room of the house, a space on the floor, the youngster's bed, etc… or any place where he is isolated from interaction with others. Use a kitchen timer to count down your youngster's punishment time, which is usually one minute per year of age. Time out can also be used outside of the home, such as in stores, restaurants, etc. If your youngster often misbehaves in a certain setting, such as the grocery store, you should stop before entering the store and go over the rules that you expect your youngster to follow. Also, give a warning about what will happen if he misbehaves inside the store. If he does break one of the rules inside the store, you should now place him in time out.

• Understand the difference between rewards and bribes. A reward is something your youngster receives after he has done something, while a bribe is given beforehand, to try and motivate your youngster to do what you want. Bribes should be avoided.

• Unlike the way it is used for older kids, time out for toddlers is more so that you can give your youngster time to regroup and calm down. A toddler will likely not sit still in a time out chair, even for a minute or two, and you shouldn't try to force him to or wait for time out to start until he has been quite.

• Use ‘I' messages, instead of ‘you' messages. For example, say ‘I am upset that you didn't clean up your room,' instead of ‘You made me upset for not cleaning up.' ‘You' statements can seem more accusatory and can lead to arguing.

• Use distraction to get your youngster's attention away from inappropriate behaviors.

• Use extinction to remove attention from undesirable actions. As long as your youngster can't hurt himself, you can walk away and not give him attention or an audience for acting inappropriately, especially if he is having a temper tantrum. Giving too much attention to your youngster when he misbehaves can reinforce bad behaviors.

• Use logical consequences (rewards), for example, if he doesn't put away his bike, then you will do it, but he won't be able to ride it for the rest of the day. For older kids, not filling the car with gas can have the consequence of not getting to use the car this week, etc.

• Use natural consequences (rewards) to let your youngster learn the results or consequences of his actions. For example, if he throws a toy out the window, then he can't play with it anymore.

• When you want your youngster to follow a command, ask him in a firm, but pleasant voice. Allow your youngster about five seconds to do what you have asked, and if he does not, then make direct eye contact with him and say "If you do not do what I asked, then you are going to sit in time-out" (and point to his time out chair). After this warning, if he still does not do what you have asked, then say something like "You have not done what I asked, so you have to go to your time out chair." Give these commands in a louder and firmer voice to get your youngster's attention, but do not yell or get angry.

• Withholding privileges is a very effective discipline technique, especially for older kids. Find things that he likes or especially enjoys (playing video games, renting movies, going to the mall, talking on the phone), and then take it away as a consequence for misbehaving.

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How To Discipline Children Through The Ages

Ages 0 to 2—

Babies and toddlers are naturally curious. So it's wise to eliminate temptations and no-nos — items such as TVs and video equipment, stereos, jewelry, and especially cleaning supplies and medications should be kept well out of reach.

When you’re crawling baby or roving toddler heads toward an unacceptable or dangerous play object, calmly say "No" and either remove your youngster from the area or distract him or her with an appropriate activity.

Timeouts can be effective discipline for toddlers. A youngster who has been hitting, biting, or throwing food, for example, should be told why the behavior is unacceptable and taken to a designated timeout area — a kitchen chair or bottom stair — for a minute or two to calm down (longer timeouts are not effective for toddlers).

It's important to not spank, hit, or slap a youngster of any age. Babies and toddlers are especially unlikely to be able to make any connection between their behavior and physical punishment. They will only feel the pain of the hit.

And don't forget that children learn by watching adults, particularly their moms and dads. Make sure your behavior is role-model material. You'll make a much stronger impression by putting your own belongings away rather than just issuing orders to your youngster to pick up toys while your stuff is left strewn around.

Infants and toddlers get frustrated by the large gap between the things they want to do and what they're able to do. They often respond with temper tantrums. Try to prevent outbursts by distracting your little one with toys or other activities. For children reaching the 2-year-old mark, try a brief timeout in a designated area — like a kitchen chair or bottom stair — to show the consequences for outbursts and teach that it's better to take some time alone instead of throwing a tantrum.

Ages 3 to 5—

As your youngster grows and begins to understand the connection between actions and consequences, make sure you start communicating the rules of your family's home.

Explain to children what you expect of them before you punish them for a certain behavior. For instance, the first time your 3-year-old uses crayons to decorate the living room wall, discuss why that's not allowed and what will happen if your youngster does it again (for instance, your youngster will have to help clean the wall and will not be able to use the crayons for the rest of the day). If the wall gets decorated again a few days later, issue a reminder that crayons are for paper only and then enforce the consequences.

The earlier that moms and dads establish this kind of "I set the rules and you're expected to listen or accept the consequences" standard, the better for everyone. Although it's sometimes easier for moms and dads to ignore occasional bad behavior or not follow through on some threatened punishment, this sets a bad precedent. Consistency is the key to effective discipline, and it's important for moms and dads to decide (together, if you are not a single parent) what the rules are and then uphold them.

While you become clear on what behaviors will be punished, don't forget to reward good behaviors. Don't underestimate the positive effect that your praise can have — discipline is not just about punishment but also about recognizing good behavior. For example, saying "I'm proud of you for sharing your toys at playgroup" is usually more effective than punishing a youngster for the opposite behavior — not sharing. And be specific when doling out praise; don't just say, "Good job!"

If your youngster continues an unacceptable behavior no matter what you do, try making a chart with a box for each day of the week. Decide how many times your youngster can misbehave before a punishment kicks in or how long the proper behavior must be displayed before it is rewarded. Post the chart on the refrigerator and then track the good and unacceptable behaviors every day. This will give your youngster (and you) a concrete look at how it's going. Once this begins to work, praise your youngster for learning to control misbehavior and, especially, for overcoming any stubborn problem.

Timeouts also can work well for children at this age. Establish a suitable timeout place that's free of distractions and will force your youngster to think about how he or she has behaved. Remember, getting sent to your room doesn't have an impact if a computer, TV, and video games are there. Don't forget to consider the length of time that will best suit your youngster. Experts say 1 minute for each year of age is a good rule of thumb; others recommend using the timeout until the youngster is calmed down (to teach self-regulation).

It's important to tell children what the right thing to do is, not just to say what the wrong thing is. For example, instead of saying "Don't jump on the couch," try "Please sit on the furniture and put your feet on the floor."

You can continue to use timeouts, but rather than enforcing a specific time limit, end timeouts once your youngster has calmed down. This helps children improve their sense of self-control. And praise your youngster for not losing control in frustrating or difficult situations.

Ages 6 to 8—

Timeouts and consequences are also effective discipline strategies for this age group.

Again, consistency is crucial, as is follow-through. Make good on any promises of discipline or else you risk undermining your authority. Children have to believe that you mean what you say. This is not to say you can't give second chances or allow a certain margin of error, but for the most part, you should act on what you say.

Be careful not to make unrealistic threats of punishment ("Slam that door and you'll never watch TV again!") in anger, since not following through could weaken all your threats. If you threaten to turn the car around and go home if the squabbling in the backseat doesn't stop, make sure you do exactly that. The credibility you'll gain with your children is much more valuable than a lost beach day.

Huge punishments may take away your power as a parent. If you ground your son or daughter for a month, your youngster may not feel motivated to change behaviors because everything has already been taken away.

As children enter school, they're better able to understand the idea of consequences and that they can choose good or bad behavior. It may help your youngster to imagine a stop sign that must be obeyed and think about a situation before responding. Encourage your youngster to walk away from a frustrating situation for a few minutes to cool off instead of having an outburst.

Ages 9 to 12—

Children in this age group — just as with all ages — can be disciplined with natural consequences. As they mature and request more independence and responsibility, teaching them to deal with the consequences of their behavior is an effective and appropriate method of discipline.

For example, if your fifth grader's homework isn't done before bedtime, should you make him or her stay up to do it or even lend a hand yourself? Probably not — you'll miss an opportunity to teach a key life lesson. If homework is incomplete, your youngster will go to school the next day without it and suffer the resulting bad grade.

It's natural for moms and dads to want to rescue children from mistakes, but in the long run they do children a favor by letting them fail sometimes. Children see what behaving improperly can mean and probably won't make those mistakes again. However, if your youngster does not seem to be learning from natural consequences, set up some of your own to help modify the behavior.

Older children usually better understand their feelings. Encourage them to think about what's causing them to lose control and then analyze it. Explain that sometimes the situations that are upsetting at first don't end up being so awful. Urge children to take time to think before responding to a situation.

Ages 13 and Up—

By now you've laid the groundwork. Your youngster knows what's expected and that you mean what you say about the penalties for bad behavior. Don't let down your guard now — discipline is just as important for teens as it is for younger children. Just as with the 4-year-old who needs you to set a bedtime and enforce it, your teen needs boundaries, too.

Set up rules regarding homework, visits by friends, curfews, and dating and discuss them beforehand with your teenager so there will be no misunderstandings. Your teen will probably complain from time to time, but also will realize that you're in control. Believe it or not, teens still want and need you to set limits and enforce order in their lives, even as you grant them greater freedom and responsibility.

When your teen does break a rule, taking away privileges may seem the best plan of action. While it's fine to take away the car for a week, for example, be sure to also discuss why coming home an hour past curfew is unacceptable and worrisome.

Remember to give a teenager some control over things. Not only will this limit the number of power struggles you have, it will help your teen respect the decisions that you do need to make. You could allow a younger teen to make decisions concerning school clothes, hair styles, or even the condition of his or her room. As your teen gets older, that realm of control might be extended to include an occasional relaxed curfew.

It's also important to focus on the positives. For example, have your teen earn a later curfew by demonstrating positive behavior instead of setting an earlier curfew as punishment for irresponsible behavior.

By now children should be able to control most of their actions. But remind teens to think about long-term consequences. Urge them to pause to evaluate upsetting situations before responding and talk through problems rather than losing control, slamming doors, or yelling. If necessary, discipline your teen by taking away certain privileges to reinforce the message that self-control is an important skill.

As difficult as it may be, resist the urge to yell when you're disciplining your children. Instead, be firm and matter of fact. During a youngster's meltdown, stay calm and explain that yelling, throwing a tantrum, and slamming doors are unacceptable behaviors that have consequences — and say what those consequences are.

Your actions will show that tantrums won't get children the upper hand. For example, if your youngster gets upset in the grocery store after you've explained why you won't buy candy, don't give in — thus demonstrating that the tantrum was both unacceptable and ineffective.

Also, consider speaking to your youngster's teachers about classroom settings and appropriate behavioral expectations. Ask if problem solving is taught or demonstrated in school.

And model good self-control yourself. If you're in an irritating situation and your children are present, tell them why you're frustrated and then discuss the potential solutions to the problem. For example, if you've misplaced your keys, instead of getting upset, tell your children the keys are missing and then search for them together. If they don't turn up, take the next constructive step (like retracing your steps when you last had the keys in-hand). Show that good emotional control and problem solving are the ways to deal with a difficult situation.

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Mental Illness in Kids

Mental Illness (MI) is a term used by mental health professionals that includes many disorders. Although MI usually does not occur until late adolescence or adulthood, it can and does occur in childhood as well. When MI occurs in childhood, it is considered childhood-onset mental illness (COMI). COMI can cause serious problems for the kids and adolescents who have it, including problems in their biological, social, and emotional development. Kids with COMI need the significant adults in their lives (moms and dads, grandmoms and dads, siblings, aunts/uncles, teachers, religious leaders, and others) to understand what COMI is, how it impacts kid's lives, and learn how to recognize its signs and symptoms. If untreated, kids with COMI can live their lives misunderstood and mistreated. Fortunately, COMI can be treated and kids with it can have meaningful lives. If you think a youngster may be experiencing symptoms of COMI, it is important to have the youngster evaluated by a mental health professional. Kids with COMI who receive treatment soon after symptoms appear have the opportunity to experience a quality childhood.

What is Mental Illness?

Kids, adolescents and adults of all ages can experience a MI. Mental illnesses are biologically based, meaning that chemicals or structures in the brain are not working as they are supposed to, resulting in symptoms that cannot be managed or overcome without treatment, often resulting in lives that are unstable and unfulfilled. Symptoms of MI include problems in thinking, behaving, and feeling (moods and emotions). When a person is experiencing the symptoms of a MI, relationships with family and peers, school or work performance, and basic daily activities (sleeping, eating, bathing, dressing) can be difficult. Kids who have MI sometimes need to be hospitalized to stabilize their symptoms or attend special programs, schools, or classrooms that specialize in treating COMI. These kids also can receive treatment in community based agencies or private practice settings.

There are many disorders that meet the criteria for COMI, including Major Depression, Bipolar Disorder, Schizophrenia, Schizoaffective Disorder, Attention Deficit Hyperactivity Disorder (ADHD), and certain Anxiety Disorders, including Obsessive Compulsive Disorder. Diagnosis can be difficult in kids, as symptoms in kids can look different than symptoms in adults. Additionally, some symptoms can suggest that the youngster may have more than one diagnosis, or an unusual presentation of a diagnosis. Organizations such as the NAMI and the National Institute of Mental Health (NIMH) have made gains in identifying and understanding how these symptoms specifically manifest themselves in kids. Information on COMI is readily accessible to the general public through consumer-based resources like NAMI and NIMH.

How is COMI Diagnosed and Treated?

Although a youngster with COMI may experience periods of instability even with treatment, when a youngster with COMI is correctly diagnosed and receives appropriate treatment, the likelihood of having a relatively normal childhood increases significantly. Often diagnosis begins when a parent, teacher, or other significant adult in a youngster's life notices subtle or significant changes in behavior, thinking or moods that signal the possible presence of a COMI and the need for a formal mental health evaluation. This evaluation can be the beginning of treatment or the beginning of a larger assessment process, depending on the severity of the problem and symptoms the youngster is experiencing. Mental health professionals who can evaluate for COMI include psychiatrists, psychologists, marriage and family therapists, clinical social workers, and professional counselors who specialize in the treatment of kids.

Will a Youngster with COMI Need Medication?

Due to the biological basis of COMI, psychiatric evaluation and treatment is generally necessary. The disorders associated with COMI usually require medications for symptom management. Youngster psychiatrists specialize in evaluating and treating the various disorders of COMI. Since some symptoms of COMI also can be symptoms of other medical conditions, a thorough medical evaluation is needed. Additionally, substance use or abuse can produce symptoms similar to those found in COMI. An accurate diagnosis of COMI can be made only after a general medical condition and substance use have been ruled out as the cause of the youngster's symptoms. However, even when substance use has been identified, it is not uncommon for kids with COMI disorders to use substances to cope with the symptoms associated with their disorders. Therefore, further assessment for COMI may be necessary.

Is Psychological Testing Necessary?

Some kids with COMI will need formal psychological assessment or testing. This assessment will inform those parenting, educating and treating the youngster how the youngster is functioning, direct the treatment and educational programs, and identify the youngster's strengths and vulnerabilities. Psychological testing should be done by a qualified mental health professional.

Who is Involved in Treating COMI?

COMI increases the need to create supportive and stable environments for kids. Consequently, a team of mental health professionals is needed to effectively intervene. The lives of kids are complex and can involve many significant adults. The youngster with COMI will experience the need for help in multiple settings, including home, school, and the community. The professionals involved with a youngster with COMI and his or her family may include 1) a family therapist, 2) a primary care physician, 3) a youngster psychiatrist, 4) a case manager, and 5) an occupational therapist or educational coordinator.

What Other Elements are Important for the Treatment of COMI?

In addition to medication, treatment for a youngster with COMI (regardless of the specific diagnosis) needs to include psychoeducation, behavior management, and psychotherapy. Psychoeducation teaches kids and families about COMI and the impact it has on the youngster's life and family. This includes information about the disorder, its symptoms, treatment, and future risks. Kids with COMI need age-appropriate psychoeducation regarding their illness, as well as an action plan to manage their symptoms and prevent the symptoms form reoccurring. Managing symptoms also includes behavior management techniques that help moms and dads, teachers, and others provide a structured environment where the youngster with COMI can be most successful.

Kids with COMI may also need individual and/or group psychotherapy to develop healthy coping skills. Therapy can focus on a variety of issues including positive peer interaction, self-esteem, and identity development. It is important for kids with COMI to be able to understand the role their illness plays in their lives, but also to recognize other parts of their selves that are separate from the disorder.

Is Family Treatment Necessary?

Family involvement in treatment for the youngster with COMI is very important. Among other things, families provide structure, support and the opportunity for the youngster to stay interpersonally connected to others. Families themselves also need help in accepting, understanding, and coping with a diagnosis of COMI when it is made. Treatment for families with COMI includes psychoeducation and support that is balanced by attention to other family issues or problems that may be affecting the stability of the home--for example, substance abuse or domestic violence. If other family problems are not addressed and treated, there can be significant negative consequences for the youngster with COMI. Likewise, there can be significant gains for both the youngster and family when the family receives treatment for COMI. A marriage and family therapist can provide the necessary psychoeducation, support and therapy necessary for kids and families dealing with COMI.

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