Mad River Behavioral Health

Only through the full and unconditional love and acceptance of each of our children, exactly as they are at any given time, complete with their full array of human flaws, can we even begin to lovingly and gently guide and support them in developing the skills and abilities they will require to become the successful adults we all hope they will become.  Kenneth H. Little, MA  603-726-1006 KenLittle-NH.org

The very best response to the vast majority of children’s misbehavior is a simple, quiet conversation moderated by reason, wisdom, and compassion; a conversation that guides the child quietly and gently to a better, more helpful place in life. Raising children is a long, gradual process. It takes years and years of patient and persistent effort. Gentle guidance is the primary choice in parenting. Sometimes a planned system of positive and negative consequences makes sense. This is not a system of rewards and punishment, so to speak, but a well crafted system of inductive consequences; constructive and instructive consequences that gradually teach better behavior, better problem solving skills, better stress management skills, and better decision-making skills. Arbitrary and / or harsh consequences should be avoided. They are far more likely to inflame the situation and create resentment within the child which will obscure any learning benefit. It is far more likely that arbitrary a...

Our dedication is to the whole child.  Our interest extends to the child’s family, neighborhood, school, and community.  Each child’s well-being is contingent on the well-being of the extended network surrounding and supporting their growth. Our interest in the whole child includes their well-rounded and well-balanced development.  We must attend to each area of need and support carefully weighted, balanced, and multi-dimensional growth: music, art, sports, friendship, family, hobbies and interests, academic achievement, ethical and spiritual well-being.  No one area can be allowed to consume our attention at the expense of another area.  We must remain flexible and responsive to the child’s needs. We must nurture each child’s strengths and carefully attend to their weaknesses. Elements of Character, Development, and a Healthy Lifestyle:  Honesty Creative Well-being Cooperation / Teamwork Physical Well-being Work Emotional Well...

Raising children requires open and honest communication. The only way children will ever participate in an open and honest dialogue is if they feel safe to speak openly and honestly. If you as a parent create any sensation of fear, even the slightest amount, if you are angry, harsh, critical, or punitive, you are creating a sizable obstacle to effective communication with your children.  All problem solving and all skill development requires safety and trust. Children may forgive our transgressions, but they will not necessarily forget. Now, with that said, I have never met a parent who did not lose their sense of calm at least every now and then.  So, what do we as parents do when we make parenting mistakes? The first step is always to take a step back, take some time to consider what went wrong and to regain a sense of calm.  It may take a while to figure out what went wrong, but once we do regain our composure we will want to go back to our children and apol...

Parenting requires two key elements: trust and faith. It's very important that parents trust their children and have faith in their innate goodness and capacity, while continuously working to develop the required skills, ability, and character. With constructive proactive parenting the likelihood is very high that your children will turn out to be the good, capable, successful adults they were born to be.  Believe  this. Believe in your child’s natural goodness and innate ability from birth on. The probability of a good outcome declines as parents implement parenting plans and methods that are based in fear, anxiety, anger, and mistrust. For example, if you believe that children are inherently sneaky and dishonest, you are likely to parent them in a way that increases their sneakiness and dishonesty. Similarly, overly restrictive parenting designed to increase child obedience and safety often inspires increased rebellion and risky behaviors. Trust I often he...

When my wife and I brought our first son home from the hospital, all packed into the warm winter snugly fleece in his little car seat, I carried him into our apartment and placed him, still in the car seat, in the center of the kitchen floor ... very much like a bag of groceries.  We stood there looking down at him.  I looked at my wife.  "Now what?" Groceries, I know what to do with.  You unpack them and put them away.  An infant was a whole new and anxiety producing adventure for me.  My wife -- a pediatrician in training -- seemed a wee bit more confident, but not as much as I would have liked. Although I had been working with children as a mental health professional for over 5 years, I had no direct parenting experience at all, had never changed a diaper in my entire life. I began rummaging through his bag of things.  Where is the owner's manual?  How do you turn this thing on, off; change its settings? I had no idea ... none. I'm su...

Figuring out how and why you get stuck in a parenting ordeal can be a very difficult task. The answers are not always as obvious as one might think.  I have been meeting with a single Mother who has temporarily lost custody of her son.  We had developed a pretty tight plan of action, things that Mom really needs to work on to begin the process of getting her life in order so she might be able to regain custody of her son. Mom has accomplished none of these action items over the past few months. I queried Mom about this, what she thought might be preventing her from following through on the action steps we had designed. There could be many reasons, but I've had an inkling for some time that she's just exhausted, ashamed; that on some level she believes herself to be a bad parent. I have wondered if perhaps, she might not be relieved in some ways that she no longer has custody, that she is no longer responsible for parenting her son.  Could it be that she secretly b...

I see spirited children often. I love their natural energy.  Their parent(s) always look a bit tattered, ruffled, and strained.  Most parents would say, I think, that they want their children to have some "get-up-and-go", a bit of "fire in their belly", some internal tenacity.  These are admirable traits and characteristics that will serve children well as they learn how to refine, harness, and direct their energies as they move toward adulthood. They will very likely clash with the world during this process. It is better to guide these children gently forward rather than to try to break them of their natural tendencies.    Kenneth H. Little, MA / 135 Lee Brook Road / Thornton, NH 03285 / 603-726-1006 /   Achieve-ES.com © 2019 Kenneth H. Little. All rights reserved.  

When children first come whooshing out into the world they are fully reliant on their parent(s) for all of their needs and well-being.  As soon as the umbilical chord is cut, however, the very long and gradual process of separation and individuation begins.   Parenting from here on out, every minute of it, is fully about preparing -- incrementally --  the child to occupy a successful, healthy role in the adult world to the best of their abilities.  With each passing moment children grow, change, move inexorably toward adulthood.  Ready or not, adulthood will arrive. Children are not well prepared by overly involved, overly controlling parents.  Children are not well prepared by under involved, neglectful parents. Children are best prepared by collaborative parents who gently and gradually ween them off parental control and into self-management.    To be continued.    Kenneth H. Little, MA / 135 Lee Brook Road / Thornton, ...

In the medical community " nonmaleficence " is the ethical obligation not to inflict harm.  In medical ethics, the physician's guiding maxim is “First, do no harm.” The opposite is beneficence (do good); provide benefits to persons and contribute to their welfare. Refers to an action done for the benefit of others. " Nonmaleficence means non-harming or inflicting the least harm possible to reach a beneficial outcome. Harm and its effects are considerations and part of the ethical decision-making process ..." Clearly, parenting should come with the same sort of ethical guidance.  A parents first obligation to their children is to inflict no harm; or at least to inflict the least amount of harm possible to reach the beneficial outcome. 1) Nonmaleficence - do no harm 2) Beneficence - do good Evidence-Based Parenting The research on parenting provides a reasonably clear set of guidelines on what is harmful and what is helpful. Evidence-based parentin...

A brief talk with a colleague this morning prompted me to write this short essay. She was describing to me how frustrating it is to walk out into the living room and realize how much mess has accumulated while your children sit and giggle watching youtube videos, apparently oblivious to the carnage surrounding them. I know this feeling.  It can be infuriating. The urge to scream can be powerful. But First, Ask ... is this an emergency? Take a step back.  Evaluate.  Is this an emergency?  Is anyone gushing blood or on fire?  If yes, it's an emergency -- stay calm, think clearly, take action.  If no one is gushing blood or on fire, there is no emergency -- stay calm, think clearly, delay taking action.  Emergency or not, stay calm - think with a clear head. Own the Problem First, always own the problem.  If the family is not functioning as desired, responsibility falls to the leadership. The family leaders are responsible for creating ...

I think for most parents, myself included, figuring out how to be the best possible parent, figuring out how to help our children become the best possible version of themselves that they can be ... is central to our existence as parents. In my mind, this purpose is an all-consuming obligation.  The whole purpose of this blog is directed toward fulfilling this purpose.  In this essay I offer thoughts on developing a constructive family culture.  I use the word constructive to describe a family that adds value to their children.  Not all families do this.  In fact, many diminish their children either subtly or in crushing torrents.    Family culture describes the rules, norms, values, customs, traditions, and leadership style of a family that guides and informs the way people behave on an individual basis and interact with each other. This essay is not prescriptive, an instruction on how to make a specific family culture.  It is a thinking too...

Why Do Kids Start Smoking; and other unhealthy, self-destructive behaviors? What can parents do?  How to develop a constructive parenting plan that will reduce the risk? Why does it matter? "Isn't risky behavior during adolescence normal?"  "I did it and I'm fine, what's the big deal?" Ingesting, inhaling, injecting drugs and alcohol can impact brain development during the adolescent years, a time of rapid brain growth. Even small differences in neurological development can cause lasting problems well into adulthood.   "Altered brain development due to exposure of neurotoxins during adolescence, particularly alcohol, could set the stage for cognitive problems into adulthood, conferring functional consequences throughout life."(3) It is best if the brain is well protected from birth until age 25.  Drugs, alcohol, tobacco (other*) all pose significant risks to healthy brain development. Below is a list of risk factors for smoking cigare...

It's not the fault of the teachers. It's not the fault of the parents. It's not the students ...  ******************************************** You can always tell when a system is in trouble when blaming exceeds problem-solving. Let's stop blaming and get on with the work of solving. For many children, the public school system works just fine.  For some, the curriculum speed moves to slowly; for others, it moves too quickly. To solve this, how about if we match curriculum speed to each student's unique learning speed? Students should be able to gain 90%+ mastery on every single learning unit from kindergarten on before seeing the next learning unit. Children who move forward with less than 90% mastery have ever increasing learning gaps accumulating as they move through the grades. Can they get away with 80% mastery?  Yes, but it's not a preferred outcome.  Can students get away with 70% mastery?  Every now and then, but if kids are chronic B-C-D students, ...

Effective Discipline to Raise Healthy Children American Academy of Pediatrics Abstract Pediatricians are a source of advice for parents and guardians concerning the management of child behavior, including discipline strategies that are used to teach appropriate behavior and protect their children and others from the adverse effects of challenging behavior. Aversive disciplinary strategies, including all forms of corporal punishment and yelling at or shaming children, are minimally effective in the short-term and not effective in the long-term. With new evidence, researchers link corporal punishment to an increased risk of negative behavioral, cognitive, psychosocial, and emotional outcomes for children. In this Policy Statement, the American Academy of Pediatrics provides guidance for pediatricians and other child health care providers on educating parents about positive and effective parenting strategies of discipline for children at each stage of development as well as referen...

Never pay children for helping out at home. Being a cooperative and productive member of the family, making a contribution to the whole, is an expected part of life. Raising children according to a constructive value system is foundational to preparing children for a good, happy, healthy, successful life. Values: Clean up after your self Pitch in Be cooperative Be helpful Be respectful of self, others, property. All of these values are part of helping out at home. If kids want more money, they can help themselves and the family by earning it outside the family. Paying children to help out at home does not teach a valuable life lesson. Children come pre-wired to be good workers and you will teach them budgeting and purchasing skills as they are growing up.  The vast majority of young children want to help out at home; they want to load the dishwasher and washing machine, move laundry from washer to dryer, run the vacuum cleaner, etc. If they don't naturally want t...

Rule #1 Believe that “children do well if they can.”  If they aren’t doing well, wonder why that is - what is interfering.  Establish realistic expectations that the child is, in reality, capable of achieving.  Expecting something more than what the child can actually achieve is highly likely to result in failure, increased behavioral difficulties, and to foster a sense of ineffectiveness, helplessness, and worthlessness. Implementation Dip.  When you begin a new intervention .. expect things to get worse first.   It all works best if the process is entered into collaboratively -- with parent and child / teacher and child in agreement.  Let child know what is changing before beginning If you change your approach / style and they don't know why, it can make kids anxious and defensive.  Visualize Success.  What will success look like?   What are you trying to accomplish? What is your purpose? What are your short, mid-r...

A Guide to Behavioral Intervention Assess intellectual, instructional, learning, and situational factors and how they affect / contribute to the behavior problem. Develop and utilize a decision-making tree. Identify specific problem behaviors and their source / function. Conceptualize positive alternative behaviors. Progressively teach, coach, and support the student in developing and utilizing the positive alternatives: healthy, value-system-based behavioral and coping strategies in support of school / community / family success. Encourage the practice and progressive growth of positive alternative behaviors with coaching and positive, proactive behavioral planning. Scaffold: provide more support, encouragement, and behavioral skill instruction until the child begins to show some sense of competence, then wean and monitor.   Alter academic / instructional components as needed in accordance with assessment data and educational best practices. Establish realistic exp...

Coercive Transactions Imagine an argument you've had with either a child or significant other, one that spins out of control and get's pretty heated.  Keep this in mind while you are reading the interaction described below.  The interaction might be triggered by your child not doing something, not taking the trash out, or moving too slowly, like while getting ready for school.  The interaction can also be triggered by your child doing something undesirable. Do you recognize the  pattern?   “Coercion refers to a sequence of interactions between the child and parent. The sequence includes actions and reactions that increase the frequency and amplitude of angry, hostile, and aggressive behaviors. The sequence may begin with an argument over some action that has or has not been performed. It intensifies through verbal statements (e.g.: yelling, swearing) to more intensive actions (e.g., hitting, shoving). Ultimately, one person gives in or backs away from t...