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4/12/2010
The "DSM" (Diagnostic and Statistical Manual of Mental Disorders) is the main reference that mental health providers use to diagnose and research mental disorders. The fourth edition, which came out in 1994 and was revised slightly in 2000, is now under major revision for DSM-V, which is due out in mid-2013. Unfortunately, science gets mixed in with politics whenever these revisions are made, and there has been a lot of infighting and disagreements by the large committees that are drafting the guidelines for DSM-V. At the crux of the concerns is maintaining a balance between correct identification and treatment of people with serious mental disorders, versus overpathologizing normal human behaviors. The latter concern has major implications for health care costs, medication utilization, not to mention potential stigma that someone might experience for being "labeled" inappropriately with a mental disorder.
Among some the highlights of the proposed changes:
- Subsuming Asperger's Disorder as part of a "continuum" of autism spectrum disorders, rather than its own distinct diagnosis
- Attempting to rectify the explosion of (in many cases, inappropriate) diagnosis of Bipolar Disorder in children, by introducing a new condition called "Temper Dysregulation Disorder with Dysphoria"
- Inclusion of Binge Eating Disorder under the eating disorders section
- Inclusion of non-suicidal self-injurious behavior (e.g., cutting) as a distinct mental disorder
- Eliminating the distinction of "Substance Abuse" versus "Substance Dependence"; misuse of alcohol and illicit drugs would be classified as various "Substance Use Disorders"
- Inclusion of pathological gambling as an "Addiction and Related Disorder" (NOTE: sexual addiction and internet addiction were not also included in this category, but will be researched further.)
- Better (but still not great, in my opinion) definitions of learning disabilities; at least they are de-emphasizing the achievement-ability discrepancy model, which is psychometrically not a good way to diagnose learning disabilities (see rule #7 from one of my previous blog posts).
What are your thoughts about the new DSM-V? If there are some things that you do or don't like about the proposed draft, you can write your comments for the authors here. 3/3/2010
I just attended the National Association of Independent Schools (NAIS) annual convention. Great conference! I attended several programs regarding leadership, in particular what makes an effective leader versus an ineffective one. I thought about how we have such a great opportunity to teach leadership skills to children now, so that they can be better prepared to assume such roles in the future.
I learned some interesting things regarding leadership, based on a session I attended with Triangle Associates. A lot of the characteristics that we think are important in leadership really are not so important, researchers have found. Qualities such as charisma, intellect, strategic thinking, and being "action oriented" are important, but not as important as one might think in leadership. Rather, the more important qualities for effective leadership include:
- Self-Control: the ability to pause, reflect, and to consider all aspects of a situation fully before making a decision; the ability to control one's emotions effectively when faced with a difficult situation.
- Empathy: Many will argue that this is a key factor that has led to some of the economic problems we face in America today: decisions are often being made without considering how actions affect other people who might be harmed. Effective leaders are able to show others that they can empathize with their concerns. The ability to be empathic is so important, and I am pleased with how we emphasize empathy building in our service learning programming and our curricula here at Park Tudor.
- Teamwork: The ability to work effectively with a team is vitally important for successful leadership. Having great vision for an organization and problem solving skills does not help much if a leader has difficulty working with others.
- Self-Confidence: We've heard the phrase "never let 'em see you sweat." There is a kernel of truth to this dictum in leadership: we respond to others who exude self-confidence. Of course, we all have times when we are plagued with insecurity and self-doubt. However, effective leaders are able to keep these feelings in check and not let them interfere with leading others. People respond to leaders who have an air of confidence about them on the outside, even when they are not feeling confident on the inside.
- Achievement Orientation: Good leaders are driven, goal-oriented people. They see themselves as lifelong learners. They challenge themselves to strive for improvement, and they hold others to a similar standard of looking for ways to get better.
- Integrity: Integrity is doing the right thing, even when the decision may not be popular. Effective leaders are consistent, stand by principles, and they do what they believe is the best interest for the greatest number of people whom they lead. They are transparent with their reasoning for making decisions.
What are some ways you think we can instill these qualities in our youth? I'd be curious to hear your thoughts… 2/3/2010
The media and blogosphere are abuzz about a recent study published in the Journal of the American Medical Association (JAMA). This meta-analysis (i.e., a synthesis and statistical analysis of numerous research studies about a particular topic) suggested that antidepressant medication appears to be superior to placebo with more severe levels of depression, but with more mild cases, there may be little additive benefit of an antidepressant over placebo. In other words, antidepressants generally work better for more severe depression, but may have questionable need/benefit for milder forms of depression.
I've read several media accounts and blogs about this article. One thing that surprises me is how much emotion this study has stirred up. Many people insinuate that the media may have an anti-antidepressant bias and may keep people from getting effective treatment. Others may be relieved because they have a problem with the "pharmaceutical manifestation of the American pursuit of happiness," and they champion this recent meta-analysis as "proof" that their view is right, that we are a pill-happy society.
My thoughts? I often try to be the voice "in the middle" on clinical matters. In over-hyping the placebo effect, we run the risk of keeping people who really need antidepressant medication from getting the help they need, as well as continuing to stigmatize mental illness, along with promoting misinformation about antidepressants. However, we also have to safeguard against a knee-jerk reaction to take medication at the first sign of mood disturbance. The key lies in a good, thorough assessment by a qualified mental health professional. Such an evaluation can help provide sound information regarding whether someone is in fact showing signs of depression, and if so, what course of treatment would be best, given the severity level of depression symptoms and their impact on the person's functioning. Antidepressants have been shown to be effective (particularly in combination with therapy) for people suffering from major depression. That being said, they are one strategy to treat depression, but not the only. My advice to people who think they are depressed is to consult with a mental health professional for a thorough evaluation. Rule out if there are any other explanations for depression (e.g., grief; transient stressors; family problems; academic or occupation problems). Also, make sure a physician rules out any medical conditions that can mimic depression. 1/11/2010 This is the time of year when standardized testing is on the radar within our schools. For many teachers, parents, and students, a range of emotions are possible regarding testing, from excitement to fear to boredom to indifference. I get asked a lot about why students perform differently from one year to the next on standardized testing, or why sometimes there is a disconnect between students' grades and performances on standardized tests, or simply, why a student struggles on standardized testing. I find it interesting that sometimes students test better than how they perform in the classroom, and other times the opposite is true. Here are some reasons why there is often a disconnect between tests scores and grades:
- Motivation: Sometimes students simply don't care about the testing, and they make a haphazard or weak effort on the test. Answer blanks that have several omitted answers or the same response repeatedly given are good indicators of this careless response style. Students who finish the test well ahead of the allotted time limit should also be suspects for low test motivation.
- Anxiety: Children and teens can often be nervous during standardized tests. An excessive amount of anxiety is likely to affect a student's performance on a standardized test. Fortunately, research has shown that test anxiety is very treatable. One form of test anxiety treatment, called Cognitive Behavioral Therapy (or CBT) is particularly promising. This approach helps students reduce physical symptoms of test anxiety (e.g., racing heart; stomach upset; tension) through relaxation techniques, as well as to alter negative "self-talk" (i.e., "I'm stupid"; "I know I'm going to fail this test"; "Everyone is doing better than I am") that interferes with test taking.
- Test Day Variables: There are many "game time" factors that can affect performance on a standardized test. Environmental conditions (e.g., noise; lighting; temperature) can certainly be relevant factors. Also, fatigue, hunger, and illness can affect how well a person performs on a standardized test on a given day.
- Immediate Problem Solving Skills: There are students who do well in school because they rely on strong organizational and memory skills. That is, they are able to take a set of information, organize it into meaningful "chunks," and recall this information on a test. Success on standardized tests is more dependent on immediate problem solving skills (psychologists sometimes refer to this ability as fluid reasoning), which is the person's capacity to apply their knowledge to solve problems in novel situations. In other words, standardized testing is more difficult to "study for" than are classroom tests. Students who are stronger in factual knowledge/memorization tend to perform better on classroom tests than they do standardized tests.
- Divergence from Curriculum: Standardized tests have varying degrees of "match" with a particular school's scope and sequence of its curriculum. Particularly with younger children, standardized tests can sometimes present content areas in which the student has not yet been instructed or mastered the skills needed to solve the problem. Unfortunately, the pressure that some schools have to raise tests scores has led to a phenomenon of teachers' "teaching to the test," that is, teaching children content mastery designed to improve scores on a specific test, rather than helping them to develop critical thinking and reasoning skills.
- Pacing: Some children cannot finish standardized tests in the allotted times. A variety of reasons can contribute to this difficulty, including a reading or writing fluency weakness; general processing speed weakness; or distractibility/poor concentration due to an attentional disorder such as ADHD. Alternately, students who tend to be obsessive-compulsive in their approach to academic tasks sometimes have difficulty maintaining a sufficient pace on tests due to frequent erasing and re-writing, or for being overly inclusive/elaborate in responding to open-ended questions.
- Poor Test Taking Skills: Being able to succeed on standardized tests requires several "executive" skills to work in synchrony, such as task initiation; planning problem solving approaches; reading and following directions; problem solving and strategy use; and self-monitoring (i.e., noticing and correcting careless errors). Some students have notable deficits in strategies they employ to answer specific types of questions (e.g., multiple choice; essay), or how they plan their approach to the entire test.
- Standardized Testing is Just a "Slice of the Pie": Standardized testing measures a narrow range of abilities in the realm of "analytic" skills. Ideally, evaluation of classroom performance is based on a wider range of factors, such as creativity; social skills (e.g., working cooperatively with peers in groups); class participation; practical reasoning and problem solving skills; work ethic; and organization and time management. Students who are stronger in these abilities but weaker in "analytic" intelligence skills may be at a disadvantage on standardized tests but otherwise function well in the classroom.
- Language Barriers: Students who are English-language learners are often at a disadvantage compared to native English speakers on standardized tests, not due to true abilities, but rather due to depth of exposure to the English language.
- Learning Disorders: Students with disorders in reading, math, or written language often struggle on standardized tests which measure the very area(s) in which a student has struggles.
As you can see, any one or combination of these factors can contribute to difficulty on standardized testing. Before parents push the panic button about their child's standardized test scores, I encourage them to meet with teachers to hypothesize about what factors may be contributing to their difficulties on the test. I also remind them that standardized test scores ideally are part of the education process, but they should never be seen as the total sum of the student's abilities. Psychologist Dr. Robert Sternberg is a living example of a highly successful adult who performed poorly on standardized testing. 12/15/2009
As a psychologist, I am committed to understanding of learning, the brain and human behavior that is grounded in good science. Unfortunately, there is a lot of misinformation out there that has become "factual" based on popular mythology. A good example of this is the belief that the holiday season leads to an increase in suicides. According to a recently published report by the Center for Disease Control (CDC), the number of suicides by month remains fairly consistent across the calendar year. In fact, some studies have revealed that suicides are more likely to peak in the spring and early summer, not the holidays.
So where does this myth come from? The media may be a primary source of this persistent myth. The Annenberg Public Policy Center at the University of Pennsylvania has been studying how the media reports the suicide-holiday connection. Their data suggest that with the exception of 2006-07, the media are just as likely to report stories that support the myth as they are to debunk the myth. However, progress has still been made in debunking the myth since 1999, when about 80% of media stories supported the holiday-suicide connection.
I think the recent return to conveying the myth may reflect the general stress that people are feeling about the economy. The holidays are a time of year when people's budgets are often stretched thin. With our struggling economy, it is easy to see why some media reports make the illogical leap that more economic stress and high unemployment at the holidays might lead to more suicides.
The danger in the persistent myth is that individuals who need help might instead see suicide as an acceptable, if not normal, response to stressors. There is also the possibility of a "contagion" effect, where a highly publicized and sensationalized suicide around the holidays leads others to engage in the same behavior. As such, we need to encourage the media and our elected officials to engage in accurate reporting of data regarding suicide and the holidays. The American Foundation for Suicide Prevention has some excellent recommendations for media with regards to reporting about suicides. 12/1/2009I've been doing a lot of reading recently about what many in the world of education refer to as "21st Century Skills." Authors such as Daniel Pink and Alan November have written extensively about the kind of skills that our youth will need to develop today, in order to survive in the job market of tomorrow. There is a group called "Partnership for 21st Century Skills" that outlines some specific curricular recommendations for schools to adapt to changes in the 21st century job market. Even the corporate world is on board with "21st Century Skills." However, not everyone has jumped on the "21st Century Skills" bandwagon; Jay Matthews earlier this year wrote a much-blogged-about editorial in the Washington Post condemning the "21st Century Skills" movement as "the latest doomed pedagological fad."
Regardless of whether you agree with Pink, November, et al. regarding the 21st century job market, there are some interesting themes that emerge from these authors. The "21st Century Skills" seem to me to emphasize utilizing (and not fearing) technology in the classroom, critical thinking, creativity, collaboration, empathy, a global/multicultural perspective, problem solving, and innovative assessments (i.e., not just tests and papers). I think these are worthwhile educational tools in and of themselves, regardless of what the 21st century job market looks like.
I see part of the problem in critics embracing the "21st Century Skills" approach is a fear that we will somehow forget the basics (e.g., math facts; content mastery). However, I don't see it as an "either-or"; I see it as a "both." In other words, "21st century skills" is a means, not an end. I think the best teaching occurs when teacher can integrate creativity, critical thinking, collaboration, empathy, innovative assessment, and technology into the "traditional" pedagogy. Simply put, it's good teaching. We don't have to forget the basics if we integrate "21st Century Skills." I am thrilled that the school for which I work-Park Tudor School in Indianapolis, IN- seems to be doing an excellent job across the different grade levels with blending "21st Century Skills" without sacrificing the 19th and 20th Century skills in the process. 11/17/2009
In the final post of this three-part series, Ms. Lisa Mercurio, Upper School Psychologist at Park Tudor School, addresses the question, “How much should I support my student at home?” as it relates to high school students and parents.
High school yearsBy Lisa MercurioPark Tudor Upper School Psychologist
Each student is working toward becoming as much of an independent learner as possible before transitioning to college. Parents may notice their adolescent resisting assistance more and more. This is a natural occurrence and a way of testing their wings. Despite this natural development, the family continues to be a crucial part of a student’s life, and family members’ support factors heavily in a student’s success in school. Parents can support their students in high school by staying connected and avoiding controlling. The goal is not to help them avoid all mistakes. Persevering through difficulty, reflecting on a bad decision, and knowing what it feels like to make a mistake are a vital part of growing up. The connections between adolescents and the adults that care about them increase the likelihood of them entering the adult world prepared for whatever they may face.
Concluding thoughts on this series from Dr. Scott Hamilton
One commonality across all ages is the importance of teaching children how to handle failure and learn to cope with disappointment. By protecting children from things like disappointment, adversity and hurt, we deprive them of the opportunity to learn important coping skills, as well as a realistic sense of their own strengths and limitations. It is also important to remember that the ultimate goal is to help children along the path to becoming independent learners and adults. While it is important to provide the appropriate support for all types of learning styles, it is also important to keep in mind that too much support can be detrimental to development. The level of support given to a student should be developmentally appropriate, while keeping in mind individual learning strengths and needs. When children are robbed of the opportunity to learn to handle or face academic and social obstacles, failures, disappointments, frustrations, or feelings, then as they are growing up, it may mean that as young adults, they do not have the skills necessary to cope with these situations on their own. I hope that this series has helped you to better understand how you as a parent can provide adequate support to your children at any age.
11/5/2009
In a continuation of this three-part series, Dr. Mary Ann Scott, Middle School Psychologist at Park Tudor School, addresses the question, “How much should I support my student at home?” as it relates to middle school families.
I primarily work with students in grades 6 through 8. The amount of growth children make in these three years is extraordinary. As students begin middle school, they find that the school schedule increases in complexity. They not only have to adapt to changing teachers, but also changing schedules. Students quickly learn that they not only have multiple teachers, but also that each has his or her set of expectations in how work is to be formatted, notebooks are to be organized, and assignments are to be handed in. There are increasing demands on memory, planning, organization, problem solving, abstract reasoning and time management in the middle school years.
Middle school students are expected to:
Write down assignments consistently
Keep track of materials
Know which materials are to be brought home and taken to school daily
Plan and monitor long-term assignments including breaking them down into subtasks and creating timelines
Keep track of other responsibilities
Learn the material being taught in each of their academic classes
Navigate their social world
Parents can typically help their middle schoolers best by observing and providing structure and opportunity for them to practice needed skills and complete assignments. It is still very helpful for parents of middle school students to provide after-school routines. Most students need a break after coming home from school, some down time. However, there should also be daily scheduled study/homework time. I would recommend some time before and after dinner, depending on the amount of homework they have.
Especially when the student is new to middle school, it is important to check in with your children daily about homework, helping them keep in mind long-term assignments, and asking them how they plan to study for tests. This type of assistance can be faded as you see it is less and less needed.
While your children may require your assistance and guidance in planning and structuring time for work completion, it is very important that parents not complete academic tasks that their children should be doing for themselves. A child's brain will prune, or lose, mental connections that it does not use. Therefore, it is important for pre-adolescents and adolescents to solve academic problems themselves. Problem-solving skills will increase in complexity with practice, and practice will strengthen neural connections. Providing structure and support for students to practice increasingly complex thinking and problem-solving skills should be considered an essential parental responsibility.
Certainly when children come to parents for help, the parent should help, not by giving the student answers, but by providing them with support so the students may come up with the answer themselves. Middle schoolers, like adults, tend to want to avoid or seek assistance in areas in which they do not feel competent, but it is through opportunities to meet these challenges that they develop coping skills, a realistic sense of their own strengths and limitations, and a sense of competency.
10/30/2009
As Learning Project school psychologists, one of the most common questions we (myself, Dr. Mary Ann Scott and Ms. Lisa Mercurio) get asked by parents is, “How much should I support my student at home?” In other words, parents across different grade levels often wrestle with finding a balance between being too “hands off” on one extreme, or too “micromanaging” on the other. In this series, the three of us offer our thoughts on levels of parental academic support in pre-elementary and elementary years (Dr. Hamilton), middle school (Dr. Scott), and high school (Ms. Mercurio).
Pre-elementary and elementary years
Dr. Hamilton: Preschool and kindergarten is a time for exploration. Children of this age learn by exploring their worlds, often in a tactile manner (i.e., learning by doing and touching). It is important for parents to provide safe opportunities for children to try as many different activities in which they show an interest. By helping them discover their affinities, a healthy sense of self-esteem and a realistic self-concept can develop. Also, it is important for children to develop self-help skills with their daily routines at this age (e.g., transitioning into the classroom in the morning; hanging up coats; being able to start tasks independently). It is important for parents to encourage their children to exhibit these life skills by themselves, and to resist the temptation to do these things for them even though it may be easier and quicker to do so.
One caution is that children develop at different paces on different skills. Parents have to be careful not to panic if a child is showing more strengths in one aspect of development compared to others. Children at this age are largely “works in progress.” Sometimes children are slower to grasp a particular skill but then have a developmental “burst” where they show rapid growth in that area. Teachers have an excellent grasp of developmental milestones at this age – cognitive, social, behavioral and emotional – and they can provide you good feedback about your child’s development. I always encourage parents to have confidence in the teacher’s appraisal of the child’s developmental level on a particular skill.
Elementary school is when children typically start having homework and begin to use study skills (e.g., organization, time management, self-monitoring of task completion on long-term assignments, test preparation). Some children learn these skills naturally, almost as if it is through osmosis! However, other children need repeated, guided practice opportunities to master these skills. Children with learning disorders or ADHD are particularly vulnerable to having difficulty developing such study skills. My advice to parents of elementary school students is to provide “teachable moments” to practice these skills. In other words, talk with your youngster about how to set up a timeline for a long-term assignment, or how to prioritize tasks, or what to write in an assignment planner. But, be patient and realize you may have to repeat your message multiple times before it sinks in.
Bottom line: meet your child where he or she is at with regards to study and organizational skills. Provide modeling, instruction, and practice with these skills if they have not mastered them yet. But, once your child demonstrates these skills, resist the temptation to do things for them that they can already do by themselves. Another piece of advice… let your child turn in homework that is truly his/her own best effort; resist the temptation to correct his/her errors.
Teachers get better feedback from student homework when it has not been “copy edited” by parents. 9/25/2009
Director of The Learning Project
I get asked a lot about “giftedness” in students. Unfortunately, I think “giftedness” falls victim to the labeling-happy phenomenon in our country today. It is a label that gets slung around too easily and too readily. Many public schools have a special program called “gifted and talented,” which unfortunately leads to the conclusion that all students in the program show characteristics of giftedness. The reality is that some are in fact gifted, but some are bright, high achieving students that don’t quite show the level of abilities of a “gifted” student.
What does “gifted” really mean anyway? Traditionally, an IQ test has been used as a means of measurement, with a magic number of 130 possibly signifying “giftedness.” But, this definition is overly simplistic because not all gifted children have IQs this high, and not all children with this high IQ are gifted. Moreover, IQ tests measure only one aspect of intelligence (analysis, reasoning and problem solving), but they don’t do a very good job measuring other forms of intelligent behavior, such as creativity, practical reasoning and social intelligence.
Dr. Joe Renzulli has offered a widely cited conceptualization of giftedness, which includes high ability, along with two other critical factors: creativity and unusually high task persistence/motivation. Students who show strengths in all three areas are often seen as “gifted.” Depending on what research you look at, the percentage of children and adolescents meeting this definition would be in the 2 to 5% range.
As opposed to a “gifted” student, students who are “high achievers” in an area show above average performance in a particular domain, but do not quite have the passion, work ethic, creativity and exceptional talent in that area. Other characteristics that distinguish gifted from high achieving students (Heacox, 2002; Satler, 2002):
• Application/creativity, not just absorbing/copying information
• Self-initiation of work, not just “doing assignments”
• Tend to have higher IQ scores
• “Innovator” rather than a “technician” with concepts
• More connections/abstractions; less rote memorization
• Loves complexity rather than sequential processing
• Original thinking, unique perspectives
• Cognitive flexibility (can find multiple ways to solve problems)
• Accelerated pace of learning new concepts (don’t need a lot of repetition to “get it”)
• Insatiable intellectual curiosity and engagement
• Tendency to be more self-critical, perfectionistic
• Keen sense of justice/moral concern beyond one’s age
• Atypical self-awareness, empathy, insightfulness
• Tolerance for ambiguity
• Unusual task persistence/focus
• Asks a lot of questions, wants to know “why”
• Seeks out books/magazines meant for older children
• Asks a lot of “what if” types of questions
• Exhibits a well-developed sense of humor
• Can be overly sensitive (senses or emotions)
Do you agree or disagree with this list of distinguishing characteristics?
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