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“Child Psychopaths”: What Does Research Tell Us?

May 16, 2012 at 7:08 am , by

Can you label a child a psychopath? The recent provocative story in the New York Times has stimulated lots of interesting discussion on the internet. But what does research tell us? 

Rather than identify “child psychopaths,” researchers have studied specific traits in childhood and adolescence that are considered to be early signs of risk of later psychopathy in adulthood. Primary amongst them are “callous-unemotional” traits. Here are some examples:

  • glibness
  • lack of guilt
  • manipulation
  • untruthfulness
  • callousness
  • failure to accept responsibility

Studying these characteristics as a trait means that it’s not just a “yes or no” approach. Any kid could show some of these traits at any point in time. The idea is to get a bigger picture (a total score) when you add up the levels of each of these traits. When this is done, the vast majority of kids show very low levels of callous-unemotional traits. An especially informative study tracked the trajectory of these traits in nearly 10,000 kids from age 7 to age 12. They found that about 4% could be considered to have very high levels of callous-unemotional traits along with documented conduct problems. This is a small subgroup of kids that would warrant intensive intervention.

What happens to kids with high levels of these traits? Do they go on to be psychopaths in adulthood? Most do not. One report found that the majority of teens with high levels of callous-unemotional traits at age 13 would not be diagnosed with psychopathy at age 24. That said, there was some prediction available, particularly in the sense that those diagnosed with psychopathy at 24 were also likely to have had high levels of callous-unemotional traits at 13. So kids with this profile are at high risk for psychopathy – but clearly there is some malleability and other factors influence the extent to which they develop maladaptive behavior as adults.

Lots of studies have tried to examine the causes of callous-emotional traits. There is strong evidence that genetics plays a role, as indicated by informative twin studies. Some projects also suggest that genetic factors may underlie the linkage between callous-unemotional traits and aggressive behavior. But the role of the environment is not trivial, and a disruptive family environment is often involved as well. Bear in mind that this work is far from complete, and no genetic markers – or associations with brain architecture or functioning – have been established with certainty.

This brief sketch of the research provides something of a big picture on the development of psychopathy. Individual case studies always have their own nuance. The bottom line is that kids who show a troubled picture characterized by callous-emotional traits – especially when combined with early emerging problematic behavior – should receive intensive clinical evaluation and care. As pointed out in a thoughtful piece in the Huffington Post, though, specific tailored treatments have yet to be developed – suggesting the need for more clinically-based research.

Child brain via Shutterstock.com

 

Making Screen Time QUALITY Time

May 8, 2012 at 9:03 am , by

As screen time increases for both parents and kids, we often talk about how to reduce it. But is this focus misplaced and unrealistic in today’s society? Today Golnar Khosrowshahi of GoGoNews offers her perspective on how the quality of screen time may be a more forward looking way of approaching the issue. 

The Louvre Museum in Paris recently unveiled Nintendo hand held consoles as their interactive device of choice for visitors to navigate the museum and learn more about selected works of art. While the innovation is fantastic and it delivers substantive nuggets of information to the museum goer, it also partially transforms what was previously an interactive experience with the art and other visitors into an interactive experience between man and machine. In support of the device however, I would argue that providing easier access to better information results in an enlightened individual and altogether, more productive time spent under Pei’s pyramid.

When I was growing up, the popular trend in helicopter parenting was to limit children’s exposure to television. Today’s generation has a more generic limitation in that many parents want to limit ‘screen time’. It is undeniable that children are consuming a variety of content be it video games, television shows or music videos through a variety of screens be it television, smartphones, tablets or computers. However, it cannot all be that bad with the wealth of educational content that is distributed through these very same screens. Should parents be counting and thus limiting those ‘good’ screen hours together with the ‘bad’ screen hours? Many parents’ aversion to long hours spent in front of the screen is prompted by the misconception that these have to be solitary hours. Why not turn this time spent together looking at interesting websites and using the content as a platform for further discussion?

I often question my personal indifference to my children’s time spent between their desktop and tablet computers. Instead of encouraging them to power down, I am exchanging notes with them on the latest and greatest Apps, getting into drawing competitions with them with interactive games such as Draw Something and when not in their company, gifting them books I think they would enjoy to their e-reader accounts. I know, however, that I would start limiting their screen time if all they were doing was watching mindless teeny bopper comedies. But because they are either reading, drawing, or even playing games that hone their fine motor skills, I not only have absolutely no problem with the screen time, in fact I actually encourage it.

I believe that we can all benefit from the ease and access that children have to information in today’s world. For my children, the additional exposure and cross platform access is making them read in great quantity across a variety of subjects. Experiences such as a visit to the museum are of a greater quality because children can learn and understand more than they would have otherwise – all from a screen. So perhaps, our job as parents is not so much to limit screen time, but to ensure screen quality time, and at the end of the day, channel all of these eye opening experiences into dinner table conversations.

Golnar Khosrowshahi is the founder of GoGoNews, a website that publishes up to the minute, age appropriate current events for children. She has also written for The Huffington Post and been featured in many technology and parenting related columns. You can read featured guest blog posts by her here at Red-Hot Parenting the 2nd and 4th Tuesdays of every month.

Type 2 Diabetes In Obese Youth Is Hard To Treat (Or Another Reason Why Prevention Is So Important)

May 1, 2012 at 8:17 am , by

We all know that obesity rates in youth are way too high and increasing. We all know that obesity in youth is associated with the onset of type 2 diabetes. And now new research – you can click here to read the report – is showing that the initial course of treatment for type 2 diabetes in obese youth only helps about half of the kids – suggesting many will go on to need insulin therapy before they reach adulthood. 

What’s especially sobering is that this study was very well conducted. It used the most highly supported medication regimen for the early stages of type 2 diabetes along with psychological intervention designed to change lifestyles. The research protocol attempted to secure adherence to the interventions. The youth were carefully studied and monitored over time. Yet despite all this, in only half of the cases did the medication regimen achieve “glycemic control” – and that the psychological component did not produce additional benefit. Again – it bears repeating – the net result is that half of these kids will likely need insulin therapy in just a few years.

While it’s clear that researchers will continue to try to come up with more effective treatments for the early stages of type 2 diabetes in obese youth, this study provides yet another reason for parents to take prevention seriously in childhood. There are no magic bullets here – we all need to struggle with a number of environmental trends and pressures that promote the development of obesity in youth. So here are the logical places to start:

None of this is easy. It’s really not. Especially given the day to day challenges we all face as parents. But trying to be vigilant about your child’s nutrition, exercise, and sleep is the best pathway to trying to prevent obesity and the onset of type 2 diabetes.

Definition of insulin via Shutterstock.com

 

Target Continues To Support Education Via Their School Library Makeover Program

April 30, 2012 at 10:33 pm , by

I receive periodic updates from Target on their continuing ways of supporting the development of literacy across the US. Given the critical importance of emphasizing the many ways in which literacy can be encouraged in communities, I am always pleased to be able to share their information with you all. As a parent or educator, it is a great idea to become familiar with the programs Target offers – so that you can potentially become an advocate for your child’s school to become an educational target of the good works being done by Target. Here’s some of the highlights of Target’s plans to give more than $12 million to local schools as part of the 2012 Target School Library Makeover program that will impact 150 in-need schools via three program components: 

  • New Libraries: Target will remodel 32 school libraries across the country in 2012. The remodeled libraries will feature 2,000 new books, furniture, carpet and shelves, and a complete technology upgrade including new iPads. Each school will also have the option to receive a Target Meals for Minds school based food pantry. Click here to view a video: http://shuttle.imre.com/a98899f1.wmv
  • $15,000 Reading Grants: Target will show its continued support of the program’s previous library makeover recipients by donating $15,000 reading grants to more than 100 schools for a total of $1.5 million.
  • Literacy Pilot Program: Target will partner with the Los Angeles Unified School District and D.C. School District to launch a literacy pilot in 12 schools. The goal of the pilot program in each school will be to improve third grade reading proficiency.

 

How Early Exposure To Trauma Affects Children’s Cognitive Development – And What Can Be Done About It

April 30, 2012 at 10:23 pm , by

Unfortunately some babies, toddlers, and children are exposed to maltreatment and trauma – they can be witnesses to physical and emotional abuse, sexual abuse, and partner violence, and also experience it directly. Prior research has shown that such exposure may have lasting negative effects on cognitive development. The lead author of a key new study – Dr. Michelle Bosquet Enlow of Children’s Hospital Boston – took the time to expand on her current findings and the implications for intervention. Below are her responses to specific questions I posed.

Could you briefly give a description of what you examined in your research?

Our research specifically studied child exposure to maltreatment (the large majority, though not all, at the hands of the mother) and domestic violence against the mother. These kinds of trauma exposures may require additional considerations compared to other types of traumas that do not involve the parent (for example, being involved in a serious car accident, death of a non-parental family member). For example, when the caregiver is the perpetrator of the trauma, the child may need to be removed from the caregiver’s custody and some of the answers below may not be as applicable.

Do we know yet what the mechanism might be that affects cognitive/brain development? How does trauma affect the developing brain especially early in life?

There are many ways that trauma may affect the developing brain. Certain types of trauma, such as physical abuse or neglect, may cause direct injury to the brain, for example through injury to the head or malnutrition. We also know that when humans face a stressor, especially an extreme stressor like a trauma, the body prepares to react to the stressor. Chronic or severe stressors can cause changes in how the body secretes and processes a number of hormones that affect how the brain functions. These effects may be particularly strong in early life when the brain is developing so rapidly. Any changes to the brain during this critical time may affect how the brain is organized, and therefore have lifelong consequences. Also, infants and young children have fewer coping resources to manage stress, given their immaturity and dependence on their caregivers. We know that caregivers have a critical role in fostering children’s cognitive development. Sensitive, warm, consistent, empathic caregiving is key. Finally, for many children, trauma exposure can lead to emotional difficulties, like depression and posttraumatic stress disorder (PTSD). This is true even for very young children. These difficulties can interfere with learning new skills. For example, a child with PTSD may be preoccupied by disturbing memories of the trauma and have difficulty sitting still and paying attention. This can make it difficult to pick up new cognitive skills.

If a baby/toddler is exposed, what can be done with respect to intervention? What could a parent or caretaker do to minimize the effects?

Caregivers are absolutely essential to children’s recovery after a trauma. First, caregivers need to make sure that they are taking proper care of themselves so that they can be most helpful to their child. Sometimes, a caregiver and child suffer the same trauma (for example, being in a car accident together). Just knowing that your child has suffered a trauma can be very upsetting to the caregiver. This may cause feelings of guilt, helplessness, depression, and anxiety and difficulties with sleep, appetite, and concentration. Caregivers should seek out help for themselves if they feel that they are having symptoms that are getting in the way of their ability to function or care for their child. They may talk to their primary care physician or seek out a counselor.  They should make sure to get enough sleep and eat right and exercise if possible.

The other really important step caregivers can take is to help the child to feel safe again. Maintaining routines, such as the same bedtime rituals every night, is very important. Keep in mind that the child’s behaviors may change—for example, the child may become more clingy, have difficulty separating from the caregiver, have nightmares or resist going to bed, or not want to eat or want to eat a lot. The caregiver should do her best to be patient and remember that these are normal reactions. The child is not trying to manipulate anyone.  If possible, the caregiver should try to minimize separations, at least temporarily. If a separation is necessary, the child should be left with someone she knows and trusts. A familiar object to keep while the caregiver is gone, like a photograph of the caregiver, may help. The child may need extra hugs and lap time to feel reassured. If the caregiver feels the need to talk about the trauma with someone, she should make sure that the child cannot overhear the conversation. However, if the child wants to talk about the trauma, she should be allowed to do so. She may need to talk through what happened and get reassurances that she is now safe. If the caregiver has concerns about the child, she should talk with the child’s pediatrician. There are counselors who treat traumatized children, even very young children. These counselors can be very helpful in giving caregivers advice about ways to help their child. For example, we treat traumatized children and their families in the Psychosocial Treatment Clinic in the Outpatient Psychiatry Service at Children’s Hospital Boston.

Any suggestions to help parents in a compromising situation seek out help to prevent exposing their baby to trauma?

If parents are feeling stressed, they should seek out help for themselves, for example by calling a parenting helpline or by talking with their primary care physician or a counselor or friends and family. Physicians and counselors should be able to help parents find resources if needed to get out of a domestic violence situation or to get help if there is child abuse or neglect. The National Child Traumatic Stress Network has helpful information regarding child trauma, including information for parents and caregivers. Their website is www.nctsnet.org<http://www.nctsnet.org>.

Image depicting overcoming trauma via therapy courtesy of Shutterstock.com