Dr. Mike, My friend refuses to allow her 17 month old to watch TV. She believes that early TV exposure can cause cognitive problems in development, and she even cited an article to make her point to me. Is this true? I hope not because my toddler loves Sesame Street. He watches a little in the morning and then a little at night. I watched tons of TV growing up, and I turned out okay. What are your thoughts? Am I a bad mom? – B. in Loudoun County
B., I do not think you’re a bad mom for allowing your toddler to spend a little time with Elmo and the gang. However, between watching television and videos, Twittering, surfing the Internet, texting and playing computer or video games, it seems that we are all spending more time than ever looking at some sort of screen, which does beg the question — How much screen time is too much for our little ones? As a psychologist, of course I am been witness to the extreme cases. However, over the past few years, screen time concerns rank up there for why kids and teens are coming to therapy. Presently, I work with several teenager boys who were spending the majority of their free time gaming in isolation with limited, and for some, no peer related social contact. I also see several teenagers who have great difficulty managing their texting time. More and more elementary aged children I work with can’t seem to get enough of their handheld gaming devices – DS, Gameboy, PSP, etc. Early intervention and planning is the key to successfully managing your child’s screen time. As the parent of a toddler, you are in a position to set the stage for healthy screen time for him for years to come.
I don’t know exactly which article your friend cited, but The American Academy of Pediatrics currently holds the position that children two years and younger should watch NO television and should have NO screen time. Children three years and older, according to the American Academy or Pediatrics, should have very limited screen exposure. Interestingly, some of the research on the Baby Einstein series has actually revealed a delay in language development for toddlers who watch that show. At the same time, complete abstinence from TV for our little ones may not be realistic for all parents. I think it comes down to time management and the mere fact that most of us are living very busy lives. Screens are wonderful distractions for our toddlers, especially at those times when we as parents have only two hands and way too much to manage.
I hold the position that abstinence is best but moderation in TV viewing is fine for our toddlers. The idea being that TV should not be used as a babysitter but rather as a complimentary activity to your child’s day. If you are going to allow your toddler to watch a little TV, then make the most out of each and every viewing experience. Be present when he watches and interact with him during the show. For example, if the Count is counting to the magic number of the day, then count along, or if Elmo is dancing, then dance along. Perhaps you could even schedule TV time as an educational activity each day, reviewing what was watched for greater retention. I advise against allowing your child to watch TV whenever he wishes or alone or for him to watch TV during meals or during other social activities.
Dr. Mike, My husband and I are in a serious disagreement and need your input. I’d like to seek treatment for our teenage daughter who is depressed and acting out in a number of concerning ways. My husband is opposed to treatment because he feels that our daughter will be “labeled for life with a mental disorder” by the insurance company. He also feels we can solve our daughter’s problems at home as a family by increasing structure. While I agree that we can and should be doing more as parents, I also feel we need professional help. What do you think about his point on labeling? – S. in Loudoun County
S., Typically a client’s private mental health record remains private under the Health Insurance Portability and Availability Act of 1996 (HIPAA). It is true, however, that third party insurers (managed care companies and insurance companies) often require a diagnosis in order for treatment to be approved and covered. Thus, there will be a history, a paper trail and a label for your daughter once she is in the system. While a client’s information is generally considered to be private, many of our clients elect not to use their mental health benefits to avoid a mental health diagnostic label on their record (or their child’s) or the risk of that information ever being discovered later in life.
I agree with both you and your husband in regard to what you should do. If you believe your daughter is depressed, she should be assessed by a mental health professional immediately. It is better to be safe than sorry with your daughter’s wellbeing, and if that means receiving a diagnostic label, so be it. At the same time, as parents you will likely need to improve communication and increase structure to help her through this difficult time.
For more information on your privacy rights and protecting your mental health treatment, contact SAMHSA’s National Mental Health Information Center at: SAMHSA, P.O. Box 42557, Washington, DC 20015. Telephone: 800-789-2647. E-mail: firstname.lastname@example.org and Webpage: http://mentalhealth.samhsa.gov
Dr. Mike, We recently found out that my husband, who is in the Army, is being deployed to Afghanistan for several months, and he is leaving at the end of Summer. We would like some advice on how and when we should tell our sensitive 4 year old daughter. – M. in Loudoun County
M., Your husband’s deployment is going to be an adjustment for you all, but there are a few things you can do to make things a little more manageable for your daughter. I would not share the news of the deployment with your daughter too early, as you don’t want her to become sad and/or anxious over the next several months. Instead, enjoy your Summer as a family. I would let your daughter know of her daddy’s deployment about two weeks before his departure date. This will give her plenty of time, at four years of age, to process the hard news and prepare for his leaving.
When you discuss the deployment all together, you and your husband should talk to your daughter openly and honestly. Your husband should certainly let her know that he will miss her, but he should also let her know that he is going away to do something very important and that many people are relying on him to do a great job. It’s also normal and okay for your daughter to hear that you are both sad and that you will miss one another and to see you both sad together as a couple. By experiencing you in these ways as parents, she will be more comfortable opening up about any negative feelings she is having. Your husband will also want to discuss where exactly he is going. Buy your daughter a globe or map, which she can keep in her room and pinpoint Afghanistan with her. You might even want to look up Afghanistan on-line and have age appropriate discussions on the country – the culture, the products that come from there and the weather your husband will be experiencing. The more your daughter knows about where daddy is going and what daddy will be doing the more secure she will be in accepting his deployment. Also, have your daughter help your husband pack. This should help to give her a sense of additional control over things with the departure.
Before your husband’s departure, video tape your husband reading several of your daughter’s favorite children’s books. Your daughter can comfort herself by playing and replaying the videos while your husband is away. Your husband might also want to make a photo calendar comprised of several family photos. This will give your daughter a visual aid to remind her of daddy and your connectedness as a family. She can also cross off the days on the calendar until her daddy returns. Your husband might even want to make two copies of the calendar – one for your daughter and one for him. This way your daughter and her daddy will have the shared, special task of crossing off the days while apart.
The Armed Services is doing an excellent job of supporting deployed service men and women with their children back home. Your husband will likely have frequent access to Skype, in which he can communicate via computer with you and your daughter face-to-face. There are also several good books now to assist your daughter in making sense of her daddy’s being away. I recommend you have a few of those on hand. “My Daddy’s a Hero,” by Rebecca Christiansen and Jewel Armstrong is a personal favorite of mine.
Once your husband is away, be sensitive to your daughter as she adjusts to her father being away and watch for signs of distress. At age four years, you will want to watch for: prolonged sadness, separation struggles, unexplained crying or tearfulness, clinging behavior, regression toward a favorite blanket or toy or younger behavior (e.g., thumb sucking), social avoidance, bad dreams, and fearfulness in new situations. Should your daughter struggle for several weeks across her home, school and social environments, I recommend you seek out the assistance of a child psychiatrist or psychologist for support and guidance.
Dr. Mike, My best friend’s child was diagnosed with Lyme Disease and their pediatrician feels that his behavioral and attention problems were caused by Lyme’s. My son was diagnosed with ADHD in the second grade. He is now ten and presently takes medication and is in behavior therapy for his ADHD. Should I get him tested for Lyme Disease? Is it possible that my son has been misdiagnosed all along and that he is not receiving the right treatment? – S. in Loudoun County
S., It is true that some individuals are misdiagnosed with psychiatric conditions when in fact they have Lyme Disease. That is because Lyme Disease, if left untreated, can negatively impact the nervous system. Most people think of Lyme’s involving circular rashes and swollen and painful joints. However, symptoms of advanced Lyme Disease can include memory impairments, disorientation, an inability to concentrate, migraines, difficulty falling asleep and profound fatigue. Since Lyme’s is a deer tick borne condition, many individuals with the condition may not even be aware that they were bit or why they are now experiencing problems. Those with Lyme’s may very well end up at psychiatrist or psychologist’s office confused over their symptoms of Panic Attacks, Obsessive Compulsive Disorder, Depression or ADHD.
Early detection and treatment is the key to addressing Lyme’s, otherwise the disease can become debilitating if left untreated. So should you test your son for Lyme Disease? I recommend you consult your pediatrician on this, but I think you should. Especially since you are now concerned about it and you live in Loudoun County where there are a fair amount of deer, and therefore, deer ticks.
Now, if your son is tested and Lyme’s is discovered, he will likely be on a course of antibiotics for a month or so. If his attentional symptoms are solely due to the Lyme’s disease, those problems should subside. Keep in mind though that your son may have ADHD regardless of whether or not he has Lyme Disease. I am not sure how accurately your son was diagnosed with ADHD, and so you may want to reconfirm that diagnosis as well with a qualified mental health professional. Neuropsychologists are the best trained to diagnosis ADHD. Dr. Amy Gordon in Loudoun County is an outstanding neuropsychologist.
Michael Oberschneider “Dr. Mike” is the Founder and Director of Ashburn Psychological Services (APS), a private mental health clinic comprised of 12 MD and PhD level mental health clinicians. He and his team are here to serve our Loudoun children, teens and adults. To learn more about Dr. Mike and the APS team, please visit: www.ashburnpsych.com or 703-723-2999.