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It's no leap of brilliance to state that kids require consistent limit setting. And yet, we all struggle in different ways as to how to go about implementing it. Our kids resist, often quite resourcefully. We want them to be happy, and we want to be happy ourselves, so we relent, perhaps because just at that moment we're too tired and rundown to rally. Maybe sometimes our neighbors set different standards and we worry they'll judge us, or that our kids will.
Further confusing the picture, some books and websites advocate for fewer limits. They encourage us to anticipate each need of our kids ahead of time, or to treat a two year old how we would another adult. Not only does this burn out parents, it flies in the face of what we know about cognitive development.
We absolutely want to minimize our children's distress and maximize their well-being, treating them with loving-kindness and respect. The overriding goal is a warm and supportive environment that balances clear rules with openness to discussion as children get older. Yet the bottom line is that kids require clear limits to grow, to develop resilience and frustration tolerance, to understand that boundaries are a part of life, and to learn how to interact with the world. From our position as well-meaning adults with the benefit of some life experience, we must strive to keep track of what's best for our children over the long haul.
Limits Shape the Brain
Limits are a large part of why kids need parents. If children knew how to behave in public, eat a balanced diet, pick clothes that make sense for the weather, treat their friends well, manage their time, handle responsibilities, and make healthy lifestyle choices from the start, we could get them an apartment when they go to kindergarten and leave them to it.
In reality our kids rely on us to help mediate between them and the world, to protect and teach them as they grow. During this phase in life we do everything we can to care for them, knowing that whenever they leave our home, life will present challenges. In anticipating those times our role is to cultivate skills that help in managing the ups and downs of life with autonomy such as emotional resilience, cognitive flexibility and patience.
We know from decades of research that experience shapes brain development. Parenting techniques, lifestyles, and preschool programs that emphasize core social-emotional skills increase the likelihood children thrive both socially and academically. Moving down this path to greater independence depends on our ability to teach boundaries now and to allow kids to encounter, and manage, occasional frustration along the way. Common-sense, old-fashioned parenting sayings - life isn't always fair, you can't have one just because your friend Joseph has one - may appear to be going out of vogue but are often what science suggests children need to thrive.
Mindfulness and Parenting
Would we deprive a child who stepped on a nail a required tetanus shot because they are screaming a blue streak? Of course not. A short-run battle, but long-term prevention. Reality is, children can get incredibly upset over almost anything. And one common flash point is when they encounter a limit: It's bedtime now. You can go out to play when your homework is done. You can't push your sister, go take a time out. These standards sometimes lead to an upset child or a tantrum, yet that reaction does not mean our choice was not healthy or valuable, or that we've let our child down.
It also doesn't suggest we are being 'mean' to our kids. They may feel, and they won't hesitate to let us know, we are 'depriving' them of the newest video game or funkiest shoes and wrecking their lives. It's not fair that the kid next door has a later bedtime. Still, the most skillful option we have is maintaining our open-minded objectivity, taking stock of the situation, making a choice, and then standing by our judgment of what is appropriate. We're rarely doing a child a favor by overindulging them or failing to guide their behavior.
Clear limit setting is therefore inherent to mindful parenting, paying full attention to our family with compassion for everyone. When we truly pay attention to our children - recognizing their temperament and abilities, knowing their likes and dislikes, and responding to their development through the years - we discover an evolving necessity for rules and guidance. At two years, at ten and into their teens the details will change, yet consistently upheld limits remain one of the most essential, loving parenting skills kids require from us.
So what gets in the way of our limit setting? Our own exhaustion, for one. Parents who immerse themselves in rearing children without any acknowledgement of their own needs are at risk for burn out - which often leads to inconsistently managed limits, and potentially a general state of over-indulgence. Yes, you can have the whole box of cookies for all I care as long as you let me finish this phone call and go play.
An important aspect of setting limits for kids is therefore understanding our own. Good parenting recognizes the necessity for time to take care of ourselves. Setting aside a few minutes a day to meditate or hang out with a friend or schedule a date night with our spouse can go a long way towards establishing consistency with our kids. It can be the refresher you need to hold your ground in the face of resistance.
Attachment Isn't Limitless
Children are more likely to grow to be settled, happy adults if they develop 'secure attachment' to others. From a psychological perspective, attachment refers to a strong, unwavering emotional bond between a caretaker and a child; it should not imply a child who never experiences frustration or disappointment. Secure attachment does not demand that every momentary desire be met and every problem solved for a child by an adult. Unconditional love, confidence your parents care for you and will protect you, is in no way antithetical to setting limits. Limit setting teaches self-regulation and builds resilience; secure attachment alone isn't enough.
Maintaining clear rules and guidelines also does not mean becoming rigidly strict or draconian. Guide behavior through reward and praise whenever possible. Have fun, make jokes. Offer reasonable options - you can do your homework now or in half an hour (but not at ten o'clock tonight). Pay attention to your choices, and stick to only as many limits as required. Recognize your role in the equation, and remember to take care of yourself. And then, remaining open to discussion and flexible about change when appropriate, establish clear boundaries you adhere to the remainder of the time. This is mindful, caring parenting.
Up Next: Part Two: Exploring Your Own Limit (setting): Mindfully Balancing Attachment and Limits At Home
Published on June 28, 2011 by Mark Bertin, M.D. in The Family ADHD Solution
The statement "he's fifteen and should take responsibility for his school work" doesn't always hold water. It doesn't have anything to do with "should." Either he can or he can't keep track of it. You can "should" him and yourself and his school all you want, but the only real solution creates an appropriate support system in the short term, and teaches required skills over time. 
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James is a fourteen year old who looks like any other kid his age, slouched in his chair and mumbling one word answers to questions about his life. The only difference is James has ADHD. Despite all the help he is getting from his teachers and elsewhere, James continues to do poorly in school. His parents aren't happy with his performance, and he doesn't appear to care about academics at all.
James takes medication daily and everyone agrees he now has little difficulty focusing. He's stopped talking out of turn and his grades have improved, but not enough. His test scores are all over the place, from 55 to 95 and then back down to 75, reflecting what he actually knows only inconsistently. He rarely gets his homework in on time, if at all. All his teachers have offered to stay after school to help him keep up, but he just leaves at the end of the day. There are complaints that he seems unmotivated, disengaged, or lazy. What's gone wrong?
High schools approach academic support for children differently than primary and middle schools do at lower grade levels. Kids, both with and without ADHD, are expected to take responsibility for their education. They are supposed to manage their schedules on their own, handle intense homework loads (and hand everything in on time), and coordinate time around all their after-school activities. The pressure can be intense, but most kids without ADHD sort it out, make a plan, and thrive.
Yet even without ADHD, teens don't have the brain of an adult. The average teen is still developing their executive function abilities - the mental capacity to regulate emotions and behaviors, organize, plan, manage time, and a host of other related tasks. A burst of neurological growth starts in adolescence and progresses through the mid to late twenties. In one way, adolescence is about surviving impulsive decisions and scattered thinking and then to become an older, wiser grown up - as reflected by these changes within the brain.
As parents we allow teens to grow and become individuals, hand them responsibilities and let them fail at times, but we also must keep an eye on the bigger picture. Executive function relates to concepts such as 'wisdom' and 'maturity,' and does not plateau in its development until near age thirty. This cognitive progression leads to a decrease in risky behaviors and a better ability to monitor our behavior and to plan for the future. Any individual may have more or fewer of these skills, but from a neurological perspective the expectation that most teens will make rational, long-sighted choices does not make sense. (It's one reason to insist kids wait until they are older to consider something like a tattoo.)
While most teens struggle with executive function, those with ADHD fall even further behind. Their capacity to organize and plan lags by several years. Because of their neurology they struggle with staying on task, transitioning from activities, keeping track of lists, handing things in, and managing their time. The ability to connect immediate behaviors (I don't feel like going for extra help today) to future consequences may not exist yet.
This attribution to 'effort' or 'motivation' is the fundamental flaw undermining many academic plans for teens with ADHD. These issues have little, if anything, to do with motivation. Even with lots of effort if a teen does not possess age-appropriate executive functioning the essentials for school success are not going to be found without the involvement of responsible, caring adults.
Visiting a teacher for after-school support requires the ability to remember the possibility exists, to keep track of time, to put aside the current activity, and to maintain attention from point A to point B. It requires recognizing a need for help, making a plan, and then sticking with the plan over the long haul. As teens fall further behind the stress increases and at the same time more and more school work accumulates, further taxing their limited executive function skills. For someone with ADHD, it may be too much to ask.
Someone who looks and acts like a teen-ager may have the executive function and self-monitoring skills of a child years younger. A fifteen year old with frontal lobes going on ten has the capacity of a ten year old to manage his workload and responsibilities. Establishing a school plan for a ninth grader with ADHD is a set up for failure when relying entirely on that teenager for planning and communication. Superficially, it might not seem to make any sense that high school teachers must communicate with parents about school work, but for certain students that intervention is a vital part of short-term planning. Parents stay in the loop, aware within days if work falls behind.
The statement "he's fifteen and should take responsibility for his school work" doesn't always hold water. It doesn't have anything to do with "should." Either he can or he can't keep track of it. You can "should" him and yourself and his school all you want, but the only real solution creates an appropriate support system in the short term, and teaches required skills over time.
Teens require an opportunity to collaborate, to feel like they are individuals and are being heard, and they may rebel when too much is dictated about their lives. If a particular teen can handle their schoolwork, you can run with it, let him take responsibility and prosper. If he can't stay on top of things because of ADHD and executive function, then he can't.
What helped James get back on track? Offering controlled options, such as posing the question, "Which teacher would you like to work with?" instead of "Would you like to work with a teacher?" Moving some organizational help outside of regular school hours, with a tutor, because he didn't want to feel different during the school day. Making an end-of-day resource room part of his schedule, instead of voluntary. Giving direct instruction in organizational skills, instead of an open-ended study hall. His parents and teachers established a safety net that kept James on target, with a goal of handing him back responsibilities at a rate he could manage on his own.
Some children do lose motivation because they have been struggling for so many years. However, as motivation typically builds from success and a sense of mastery, the initial step to improved motivation is putting the right plan in place. The long term goal of independence doesn't change, but without the support network kids become overwhelmed.
As always, the bottom line is a compassionate and objective view of someone's real skills. We must seek a clear understanding of our teens' capacity to manage their lives, instead of leaving them to flail when they fall behind. We may have an entirely different picture of what a teenager 'should' or 'shouldn't' be doing in life, but reality may be different. Just because a student has entered high school doesn't mean they are ready to thrive on their own.
Published on June 1, 2011 by Mark Bertin, M.D. in The Family ADHD Solution
In the 1950s smoking was everywhere.There was a cultural assumption that it was cool to smoke and everyone had the right. People smoked sitting next to you on planes or restaurants, and in the office. Advertisements were plastered on billboards around the world, and actors smoked throughout both television shows and movies. Even doctors touted their favorite cigarette brand in magazines. And then, slowly, we realized that smoking has significant health risks. It became a well-defined public health concern and steps were taken to protect our children from the hazards of cigarettes and second-hand smoke.
Today our society seems more attuned to potential risks in our environment. A few years ago, preliminary evidence uncovered a possible danger from a certain plastic found in bottles. Parents leapt into action and because of that pressure companies stopped using it. Studies about potential risks of pesticides and food dyes make headlines for weeks and weeks after their release.
Imagine what would happen if a substance in our water supply was linked to obesity, poor academic performance, aggressive behavior, and early sexuality in teens. It sounds horrifying, impossible we would expose our children to such risk. There would be a public outcry. Yet in reality, that 'substance' already exists. Unregulated media time for children and teens has been linked to all these problems and more. A generation from now, what are we going to think about the excesses we are now allowing?
It's the Message and the Messenger
In the same way as smoking once was, video screens today are inescapable. Televisions and computers sit throughout the house, in living rooms and kitchens and bedrooms - even in those of young children. They are in our cars, and media is accessible on our laptops and phones. We encounter more screens at the gas pump, barber, in airports, doctor waiting rooms, in line at the supermarket, and everywhere we turn. They continue to multiply, seemingly exponentially, without any real attention paid to possible implications. We are living on autopilot, individually and as a society, allowing it to happen to us instead of giving fair consideration to what is beneficial, what is harmful, and what could be simply inappropriate for many younger viewers.
Children don't fully understand the difference between reality and the pretend situations they see on TV and the computer screen. Younger children don't see the difference at all. Older children may be able to label something 'pretend' and still not fully grasp the subtle (and not so subtle) implications of anything from a violent police show or video game to reality television in general. Many teens lack the judgment to separate fact from fiction, recklessly mimicking inappropriate behaviors they watch on screen without recognizing the potential implications in their own, very real, lives.
This inability to understand media fully has always been true for kids, but the medium has changed immensely. The level and type of violence seen in cartoons and shows, the sexual content, and the direct sales pitches aimed at kids are nothing like a generation ago. The images are far more graphic and realistic, the marketing more targeted and inappropriate.
Studies have shown that as media hours increase, so does the risk of everything noted above - from obesity to sexuality and experimentation with alcohol to behavioral issues. They have shown that exposure to violence and aggression numbs children to them. They have suggested that increased media hours may even correlate with academic and attention problems.
Who do you want to sway your child's choices, your family and friends or a corporation? Marketing influences behavior or it wouldn't exist, and billions of dollars are spent on it. Children are particularly susceptible to media influences and companies take advantage. Advertisers have known for years a basic fact - seeing a product promoted multiple times makes it more likely a child will prefer it to another (perhaps healthier) option.  Businesses today have become as skilled at defining what motivates young children as child psychologists, if not more so.  (We may be starting to catch up - just this week regulations on marketing to kids were recommended by the government.)
I don't mean to say that we should get rid of our televisions, smart phones, or computers. Technology is part of the fabric of society and provides many benefits and plenty of healthy entertainment. But for some parents, there seems to be an assumption that media trends are either untamable or completely benign. Instead of waiting a generation to regret the effects of unfiltered media, we can start by making long-sighted, rational choices that fit our individual families' needs.
Smoking and media is not a perfect analogy. Smoking is absolutely bad for anyone in any quantity and media is not. Media is entertaining and at times informative, and helps us organize and find information. So perhaps it would be more precise to say this: Media is to healthy child development what dessert is to healthy eating.
We don't expect children to regulate their own dessert intake. Most kids, if allowed to make their own choices, would elect to eat more junk food than is best for their health. Instead of letting that happen, we guide them and set boundaries that over time teach self-care. Some children need more supervision, some children need less - but all of them need guidance. In the same way, it is imperative that instead of letting anything just happen to us, parents make intentional choices about the role of media in our lives.
Action Steps for Media Control
Here are some starting points for any parent to consider.
Decide how much media time makes sense for your household. Choose an amount, set a timer if needed, and establish clear limits. Consider scheduling weekly media-free days for everyone in your family. Establish healthy family habits early by keeping the television off during meals, and turning it off when no one is directly watching. The American Academy of Pediatrics recommends no more than one to two hours of screen time a day total; younger kids need far less. Other healthy alternatives, especially as homework loads increase, are to allow none at all during the week or none until homework is completed.
Set clear limits about how much time is appropriate each day, or each week. Few kids are going to be strong arbiters about what content makes sense, or when to stop. Children's brains are not wired to self-monitor; that skill doesn't fully develop until they are in their 20s. Some children prove themselves more capable of self-regulation around media than others, but letting children find their own way is rarely the best answer.
Know what is appropriate and what is not. Confirm that media content is appropriate for your child. The ratings systems are industry created, so check with a neutral source like Common Sense Media (n.b. I am on the editorial board for this organization). Watch a few minutes of the games your kids are playing and the shows they are watching. You may be shocked at how graphic they have become. Choose the shows your children will watch, never letting them channel surf. Many Internet service providers, computer companies, and cable companies offer software that filter media based on parental choices; install it early. 
Limit exposure to commercials and advertising. While marketing is now woven into plot lines and harder to skip, to minimize advertising influence emphasize DVDs and use digital recording to skip commercials. 
Tell your kids what you're doing and why. Since we can't avoid all marketing, take the time to discuss its influence with children while it is happening. Make a game of it, if you like. Make sure they understand at an early age that advertising aims to change how we think and behave. 
Keep screen time to the public parts of the house. Don't place computers or TVs in your kids' bedrooms. For portable media like laptops and phones, move it downstairs at bedtime. 
Monitor what media has been replacing in your child's life. We know of distinct benefits for cognitive development found through free play, sharing family meals and unstructured social time with adults and with peers. There is a large difference between 'active' entertainment, which involves creativity, imagination, and socializing, versus 'passive' entertainment, which (even when it is exciting) involves a computer leading and offering options. Educational software may prove to have benefits one day, but we are only in the beginning stages of figuring out what works and what doesn't for computer-based education
Observe your family lifestyle. Are your children learning about unstructured, creative play? Are they discovering ways to entertain themselves, and to honor down time? Do they have the ability to maintain linear thoughts, dig deeper into activities, and problem-solve rather than skim along the surface? However entrenched or inevitable some habits may seem, other choices are always possible. At any point in time, you have the ability to pause, reassess, and take a step onto a new path. 
Media Time and ADHD
When children have behavioral or developmental issues in particular, media time often allows adults to get things done. But while all children are susceptible to marketing tactics and influenced by inappropriate content, those with conditions like attention deficit/hyperactivity disorder (ADHD) are particularly vulnerable. The list of child development concerns related to media exposure roughly parallels the risks of having ADHD; both media and ADHD increase the risk of obesity, aggression, academic problems, early smoking, and early sexuality. The combination may increase the likelihood of issues developing down the road.
Excessive, unregulated media time is even more risky for kids with ADHD than the rest of thepopulation, and they will need even more parental guidance. ADHD is a delay in social judgment and self-regulation, and children with ADHD are therefore less able than others to govern their own choices around media. Some psychologists believe people with ADHD are at risk for an actual "internet addiction". That doesn't mean you should never use the television or computer to distract your kids while you make dinner or pay bills. It does mean staying aware and monitoring both the amount of time and content of media along the way.
Research Highlights
In the United States, children average between three and six hours a day of television and computer time. Research shows that increased television hours correlate with many adverse behaviors in children:
Children who watch more television are more likely to be obese. Television may replace healthier activities, and encourages the consumption of advertised foods and drinks. 
Children may learn to act aggressively through television viewing. They may become desensitized to the reality of violence, and may model situations where violence solves problems.
Teens (and preteens) who watch more television are more likely to be sexually active early. Even in shows geared to 2-11 year olds, in a recent study 29% of conversation was shown to involve sex and dating.
A 2008 study linked the risk of teen pregnancy with sexual content within shows they watched.
Attitudes about drinking are learned from television. Children report wanting to be happy and have fun like people shown in ads related to alcohol.
Studies have also shown a correlation between having short attention span and increased television viewing when young.
Published on April 29, 2011 by Mark Bertin, M.D. in The Family ADHD Solution
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