"Sex, Drugs, and Rock 'n Roll"

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 cigarettes.  They are similar to the reasons why kids start other unhealthy activities.  There are some that are not preventable, like poverty. Kids grow up in the families they grow up in.  Don't be re-assured by high and moderate socio-economic status  (SES). While low SES is associated with smoking, high SES is associated with alcohol and marijuana* use.

"Young adults with the highest family background SES were most prone to alcohol and marijuana use."

Hold on, wait right there.  The literature on marijuana use during adolescence indicates that it is not benign. 

"The literature ... provide strong evidence that chronic cannabis abuse causes cognitive impairment and damages the brain, particularly white matter, where cannabinoid 1 receptors abound."   

Ages 12 to 25 are the important years. Young people are most likely to start using destructive substances during these years.   

" ... by 26 years of age, nearly all people who are going to use tobacco have already begun, so the focus of primary prevention with young people really spans the ages of 12 to 25 years."

• Relatively low SES,
• Relatively high accessibility and availability of tobacco products,
• Perceptions by adolescents that tobacco use is normative, that is, usual or acceptable behavior,
• Use of tobacco by significant others and approval of tobacco use among those persons,
• Lack of parental support,
• Low levels of academic achievement and school involvement,
• Lack of skills required to resist influences to use tobacco,
• Relatively low self-efficacy for refusal,
• Previous tobacco use and intention to use tobacco in the future,
• Relatively low self-image, and
• Belief that tobacco use is functional or serves a purpose.

You can see that the age range of concern is between 12 and 25, but most parents do not activate to address adolescent concerns until it's too late, often not until after-the-fact.  The point at which parents will need to begin preparing their children to reduce the risk -- at the very latest --  is prior to age 12.  

A well-designed, proactive parenting plan will begin work on preparing children for adolescents beginning at birth, but if you start late, age 8 is good.  A pro-active parenting plans lays out the pathway toward the desired outcome for each child.

To get a sense of what this plan might look like, flip each of the risk factors listed above into its positive opposite whenever possible.

• High or Low SES is hard to alter.
• Accessibility and availability? Reduce.
• Perceptions by adolescents?  Teach facts: only about 8% of high school students smoke, etc.
• Parents, aunts, uncles, grand parents, etc., stop using and disapprove.  
• Increase parental support.
• Support and facilitate academic achievement and school involvement.
• Increase peer-pressure resistance skills ("Go along to get along", compliance and conformity, is not a constructive lesson for children).
• Increase child's belief in their effectiveness in refusing.
• Address faulty ideas supporting intention to use.
• Enhance self-esteem, self-image, self-worth constructively.
• Nurture belief that substance use serves no constructive purpose.

There are critical skills children need to be taught and parents will need to have developed a relationship with their children that supports open discussion. Any parenting practices that impinge on open discussion are counter-productive.

Additional Reading

• Socioeconomic Status and Substance Use Among Young Adults: A Comparison Across Constructs and Drugs

• Social, Environmental, Cognitive, and Genetic Influences on the Use of Tobacco Among Youth

• The effect of alcohol use on human adolescent brain structures and systems

• Adverse Structural and Functional Effects of Marijuana on the Brain: Evidence Reviewed

*Traumatic brain injury

Kenneth H. Little, MA 
Achieve Educational Success
603-726-1006

© 2019 Kenneth H. Little. All rights reserved.  

Behavioral Process: Step by Step

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-range, and long-term objectives?
• Flip negative behaviors into their positive opposites.

Move Toward Success Slowly, Progressively, Patiently, Persistently.

• Practice patience.
• Be persistent in your effort to achieve success. 
• Gradually, thoughtfully shape behavior through successive approximations.  
• Expect set-back, ups and down; regressions happen. Behavior is not linear.  When the going gets tough, people regress.  
• Be practical -- close enough really does count. It never needs to be perfect.  We are working a practice to mastery activity.     

Analyze the Task / Situational Demands.

• What are the required steps
• Environmental factors
• Time of day factors
• Competing  factors
• Where is the breakdown?

Evaluate Skill Level.  

• What skills are fully developed
• What skills are partially developed
• What skills are not developed

Assess Developmental Stage: challenges should be matched to developmental capacities.

• Cognitive
• Emotional
• Biological
• Chronological.  Age is the least relevant in terms of developmental capacities, especially in school.  Each child follows a unique developmental trajectory moving at it's own pace.  Age does not tell us anything about ability.    

Develop Behavioral Plan Collaboratively (parents and children)

• Identify problem
• Generate potential solutions
• Choose the best solution
• Implement plan collaboratively (parents and children).
• Launch plan
• Monitor progress
• Evaluate Outcome

Reward & Celebrate Successes. 

• Partial success
• Proportional success (e.g.: minutes success v. minutes of failure, etc.)
• Tangible rewards
• Intangible rewards

Analyze & Celebrate Failure. 

→ Return to step 1, as needed.

Critical Components

• Be Optimistic
• Be Supportive and encouraging.
• Do not criticize.  
• Emphasize mastery: Practice to improve / practice to mastery / practice never makes perfect

Anger:

• Anger is normal / natural / helpful.  Anger tells us when something is wrong, when there is a problem we need to attend to.  
• Anger can inspire action. 
• Anger can lead to determined effort.
• Everyone gets angry
• Too much anger is bad - build an anger management plan

Anger management activities must be implemented prior to reaching the threshold of anger.  As anger increases people become increasingly irrational.  To intervene with anger plan, the intervention must happen before the brain dissolves into an irrational mass of goo. 

• Adult initiated 
• Child initiated

Kenneth H. Little, MA / 603-726-1006 / KenLittle-NH.com

The Tragedy of 'No' (Draft)

Draft

The “No” Word 

As many parents have pointed out, the word "no" can create an avalanche of horribly cascading dysregulation, and not just among toddlers.  A toddler's tantrum can be taxing, although sometimes cute, but a toddler's tantrum is never as difficult or as dangerous as the tantrum 'tweens and teens can throw. 

A 'tween's tantrum can become a property destroying rampage; and anything a tween can do, a teen can double-down on.    

Note: All of these blog posts are based on case compilations involving 100s of children and families that I've worked with over the years.   

Mom of an 11 year old: My son can go from zero to tantrum in the blink of an eye.  

me: What's the trigger?   

Mom: When he hears the word "no".  

me: What's the tantrum look like?  

Mom: Oh, it's hell on wheels.  He swears, tips over furniture, breaks things, threatens me, slams doors, punches holes in his bed room walls."

me: What did you say "no" to?

Mom: He wanted more juice .... 

Special note:  No, a "whooping" won't help.  I'll explain another time.

There are three basic rules for the "no" word.

~ Rule #1) If you say it, you have to mean it and make it stick.

~ Rule #2) Don't say it if you don't mean it.

~ Rule #3) If you say it but don't really mean it, ignore rule #1. 

Wait, what? Why ditch rule #1?  Doesn't my kid just have to learn to accept a simple "no"?  Yes, she does.  How many years have you been trying?  How's it going so far? 

If you are happy with the way things are and want to persist along your current path, carry on.  

If you want to try something different, read on.

The reasons we ditch #1.

First, if we said "no" when we did not mean it, saying it was our mistake, not the child's.  We can own the mistake, take responsibility, and work to fix the problem.   

Second, it's just pragmatic. The tantrum is not worth living through.  There is no truly important issue on the table worth tipping the entire family and household over.    

Most importantly, teens, tweens, and younger children who still tantrum tend to be (no, not brats) ... cognitively inflexible. It's a neurological thing.   

Their brains gets stuck.   They need to learn new skills.  

They can have tremendous difficulty shifting mental sets: transitioning from one activity to another; transitioning from a preferred to non-preferred activity; adapting to changing plans, circumstances; etc.  

Stress can make people even more inflexible and life, if nothing else, is highly stressful to kids who are cognitively inflexible.    

Adult inflexibility is not a helpful response in the moment.  It does not role model flexibility. In other words, adult stubbornness teaches and reinforces child stubbornness.  Adult inflexibility supports and encourages child inflexibility.

The adults are responsible for leading by example; to model flexibility. 

Try to meet inflexibility with flexibility, a maladaptive response with an adaptive response.  Role model the adaptive opposite. The opposite of inflexibility is flexibility.

So, what happened to rule #1 above? 

Reserve the word "no" for situations that matter.  

If your 8 year old wants to camp-out in the living room, say yes.  If he asks if he can build a fire pit in the middle of the floor, "no" makes perfect sense.  Or, if your 12 year old asks if she can drive the car down to the store, "no" makes sense. 

These are logical, hard "no" situations.  Safety is at stake.  You say "no" and make it stick.  It's hard to argue with and it really matters.  

There is always room for some skilled finesse in how you say "no", but "no" is the only possible answer in these situations.

You might say, "camping out in the living room is so much fun, but, hmmm, having a fire in the living room might turn out badly.  How about if we make the fire in the back yard?"

This is saying "no", then suggesting (redirecting the child's brain to) a better idea. 

You can say "no" firmly, but empathically.  

Example, "sorry, Buddy, absolutely no to the fire in the living room.  It's not safe.  Our house will burn down." 

Logical "no"s make sense. Kids can understand them even if they do not like them.  

On the other hand,

• Casual "no"s
• Kneejerk "no"s
• Habitual "no"s
• Convenience "no"s

... all tend to be fairly arbitrary.  They don't make sense and can be infuriating. Kids know they don't make sense.  Parents know they don't make sense. It's a no-win situation.  

Tween arriving home from school: "Mom, can I have juice?"

Mom: "no, it's too close to dinner."

Bam!  The tantrum hits in a great explosion.  Swears fly, the book bad soars across the room, smashing the lamp; tween stomps off, slamming doors and crashing around.    

Immediately, Mom knows her  mistake.  This is just not worth fighting about.  What to do, what to do?     

Arbitrary rules and enforcement can be infuriating, not just to children.  Adults get frustrated with arbitrary rules and enforcement.            

There are options. 

Think for a moment about what you really mean before speaking.  Instead of "no, not today", try "yes, we can do that tomorrow (or this weekend, etc)."

Think about how you frame your response.  If you are not sure, be honest.  For example, "hmmmm, I'm not sure.  Let me think about it for a few minutes."  Doing this models thinking things through. Ask a few clarifying questions: how much, how long, what's your plan?  

If you say "no" then try to make it stick but eventually give in to the tantrum, you have sabotaged your authority.  If you say "no" to a situation that does not matter, you come across as thoughtlessly arbitrary ... and sabotaged your authority.   

It’s better if you only say “no” when you really mean “no”. 

If you do say 'no" when you do not mean it, do be open to changing you mind, if possible, when your child uses positive verbal reasoning skills to explain her perspective.

Allowing yourself to being “persuaded” by your child when he uses positive verbal reasoning skills is a good way to help him develop a sense that verbal reasoning skills are valuable and can be used effectively.

Using verbal reasoning skills is the positive opposite adaptive behavior to tantrums and misbehavior.  This is what we want to help our children practice more of.  More verbal reasoning, fewer, less severe tantrums. 

Verbal reasoning is a primary life skill.

Bad Words! Bad!

No, not swear words.

There are certain words we use to describe children and their behavior that are counter-productive; one of the most destructive of which is the word "manipulative".

Bad words!  Bad!  Words matter.  To keep one's head straight, it's important to think about and describe behaviors in a constructive manner that makes success more likely.  

Using the wrong words makes success less likely.

Have you ever had a phone call from someone trying to sell you something, during which you felt like you were being manipulated?

If yes, what did you do?  

I hang up, cut the call off . Bam!  Discussion over. Problem solved.

As parents and mental health professionals, the last thing we ever want to do during our work with a child is to "hang up on them".  We can take breaks, this is sensible, but we never want to cut the conversation off.  

Try this.  Re-conceptualize "manipulative" behavior as a maladaptive behavior to get a need met.  

By changing the way we describe the behavior, we also change our relationship with the behavior. 

When we think of a behavior as a maladaptive effort to get a need met, we feel compelled to wonder -- what is the need and what would be an adaptive way to get that need met?

This is what parenting and treatment are all about, the process of teaching adaptive skills to children so that they can cope with and navigate the complexities of life in a better, healthier, more effective manner.

And, yes, we all want our needs met.  Let's not be 'judgy' about this. The challenge is to get needs met in an adaptive manner.      

When we think of behavior as manipulative, we feel a strong need to disengage, withdraw from the child (see Counter-Transference).  When we think of behaviors as maladaptive, it leads us to ask ... how can we help this child and what would be the adaptive opposite behavior?   

What we really want, is to keep the communication open, to figure out what the need is and how to teach, train, encourage more adaptive ways for the child to get his needs met.   

It's best to be very careful what terms we use to describe behavior.  

Always respond to maladaptive behaviors in an adaptive way.

Kenneth H. Little, MA / 135 Lee Brook Road / Thornton, NH 03285 / 603-726-1006 / Achieve-ES.com

Flipping, Positively Flipping

 All rights reserved by Alex-de-Haas

Flip negative behaviors into their positive opposites; maladaptive behaviors into their adaptive opposites.

Example: "tantrum" is flipped into "using words".  Children at times use tantrums to get needs met.  This is a negative, maladaptive skill. The positive, adaptive opposite skill is to use words to get needs met.

As we move forward we will begin to focus our attention on enhancing skills and abilities, the capacity to manage in and navigate a complex world.


Whenever we encounter a problem or concern we will begin the work of "flipping" the negative behavior into its positive opposite behavior or skill. From here, we will teach, coach, and encourage the use of the positive behavior or skill in the difficult situation.

Difficult situations require adaptive skills in order to navigate successfully. Skills require a lot of practice to master. 

Please keep in mind that all children ... will learn through experience an ever expanding set of behaviors and strategies for the dealing with difficulty.  Some of these may be adaptive and effective.  Some of these will be maladaptive.  

Important note: a maladaptive behavior in a current situation may have been an adaptive behavior in some previous difficult circumstance.  Try not to judge behaviors, but do provide constructive feedback that will enable the child to learn, practice, and develop more and more adaptive behaviors.

More on this soon.

* I'm using child, kids, children, teen interchangeably.

With much gratitude to Tufts University.

Kenneth H. Little, MA / New Hampshire / 603-726-1006 / https://kenlittle-nh.com/index.html