It seems like every few months there’s a news story that looks at the way we as a nation medicate our kids—the increasing rates, the negative side effects that can come with medication, the off-label usage. All of it raises questions about the ways meds affect our children’s health and development. These stories are thought provoking at the least, utterly disturbing at the worst.

But who doesn’t know someone—perhaps it’s even in our own family—who has lived through the havoc that a serious mental or behavioral health problem can bring? Many families manage to reclaim a sense of healthy functioning after their child receives medication.

While there are some who argue against the use of any mind-altering medication in treating a child for mental or behavioral disorders, research backs what many children and their families witness firsthand—these medications often work. They can be effective in alleviating symptoms and treating problems that previously represented huge obstacles in a child’s ability to function at home, learn at school, or even live safely with family.

Still, there are those disturbing things, too. Some of the drugs are prescribed off label. Many have side effects. Parents need to weigh the benefits the drug provides with any side effects or risks that may come with it.

Like the rest of the nation, Texas has a severe shortage of child psychiatrists, and many parents turn to their pediatrician or family doctor for help in navigating these decisions. In fact, most prescriptions for psychotropic medication for children are written by pediatricians and family physicians, and not by child and adolescent psychiatrists, who have the most training in the appropriate use of these kinds of medications.  While primary care doctors play a critical role in addressing children’s mental health, many may find themselves ill-equipped to help families address the complex issues and needs that often come with serious children’s mental health concerns.

So while medication is a valuable tool that, when used appropriately, has its place in many children’s treatment plans, there are real concerns that children are being inappropriately prescribed medications when other treatment options could—and perhaps should—be used.  Several things may be playing into this. Doctors may be using the tool they are most familiar and comfortable with (you know, just like how carpenters like hammers, surgeons like scalpels…). Pharmaceutical companies are very adept at marketing to both doctors and parents, so not only are doctors are being to encouraged to prescribe the “latest and greatest” medication on the market, but parents desperate for solutions are now coming to their child’s doctor’s office asking for specific meds. And sometimes, well, a pill may just be a more convenient and cheaper way to fix a problem than using other, more appropriate, and less intrusive interventions, such as talk therapy or giving parents and teachers training and tools that help children manage their symptoms.

Perhaps most troubling are reports suggesting some kids are at particular risk of being overmedicated.  A recent federal report found that kids in the Texas foster care system are prescribed psychotropic meds at higher rates than kids in the foster care systems of other states.  This is even after Texas put in place some good policies to bring down its foster care prescribing rates (Texas’ rates have gone down, but we’re still higher than the other states). A couple of years ago, the New York Times reported low-income children covered by Medicaid were prescribed antipsychotic drugs four times as often as their peers covered by private insurance, and that these low-income children were more likely to be handed a prescription for smaller concerns.

As if having a child with mental health or behavioral concerns isn’t hard enough, parents find themselves having to make some tough calls on treatment decisions on what’s best for their child.  What can they do?  Well, I’m not expert, but I say:  Ask questions and research options.  Become educated, and be informed on both your child’s diagnosis and the different treatment options available to your family.  Medication may be the right choice, either alone or in combination with other strategies, or it may not be.  But always, ALWAYS advocate for what your mama-instinct is telling you your child needs—at their doctor’s office, with their therapist, and at their school.

Here are a few resources that might be of some help:

• Choosing the Right Treatment : What Families Need to Know
• Resources from the American Academic of Child and Adolescent Psychiatry
• Guide to Psychiatric Medications for Children and Adolescents
• Advocating for Your Child: 25 Tips for Parents

It’s also important for parents to advocate for their children at the Capitol, because decisions made at the Legislature affect the type of care that’s available in our communities.  There are real actions our state lawmakers can take to attract and keep good doctors and child psychiatrists in our state. They can help make sure other people who work with our children—like child care providers and teachers—have information and resources they need to help children with concerns.

Our lawmakers can also take action to increase the availability of effective mental health services and supports available in our communities, so that parents have real options when deciding what’s best for their children—and don’t have to settle for the first treatment that’s offered to them.

Written by: Josette Saxton

Of all the unsettling things about 2011, few felt like a punch in the gut the way the scandals at Penn State and Syracuse University involving sexual abuse of kid did. The year also brought a series of CNN reports on a stomach-churning parenting book that advises using “a rod” to discipline children . . . and the child deaths that followed.

Thinking of out-of-control adults targeting helpless kids leaves most of us feeling pretty powerless. So, if I’m not supposed to hide or scream, what can I do?

That’s what I’ve spent the first part of the new year trying to figure out: whether there’s some way I can protect not just my daughter, but kids in general from abuse. It turns out, there’s a lot I can do to put the power back where it belongs: not with the abusers but with children and those of us who want them safe. If all of us who hate child abuse made a new year’s resolution to do a few of these things, our kids would get a much safer 2012. Here are four things I found I can do:

• Get informed. The Children’s Advocacy Centers of Texas says 1 in 4 girls and 1 in 6 boys will be sexually abused before they reach adulthood. Children are also victims of other types of abuse and neglect—and few ever tell. It’s up to us as adults to be there for kids. You can learn the signs of child abuse here.

• Talk to your kids. Yes, even your little kids. There are age-appropriate ways to arm children with the ideas and words that could protect them in a dangerous situation. Stop It Now has some great suggestions for how to talk to your child or teen about abuse. Letting your child know you are there to listen, whatever he or she wants to talk about, is important. Another good idea from the experts: reinforce that your child’s body is his or her own. If something you don’t think is a big deal makes your child uncomfortable—whether it’s hugs hello for Auntie or tickle wars with brother—go ahead and honor your kid’s desire to put some boundaries around his or her body. Kids should get in the practice of making that call for themselves.

• Help child victims. We, the community, are responsible for the little ones who need protection most. It’s not just about reporting suspected abuse, though that’s important. (The Texas Abuse hotline takes calls 24 hours a day: 800-252-5400.) You can also volunteer your time or make a donation to an organization like Texas CASA, which matches each of its volunteers to a child in the foster care system in need of mentoring and support. To learn about other local groups working to address child abuse and neglect, try I Live Here, I Give Here’s “Connect with What You Care About” online tool.

• Pressure elected leaders to act. Imagine if there were services out there so effective that they cut in half the chance that a child will ever be abused.  It’s not a fantasy. These programs exist, and vulnerable kids need grown-ups to speak out for them. Let the people in elected office know that keeping kids safe is your priority. It takes only seconds to call the office of your representative or to jot a quick email of support. Sign up for action alerts from Texans Care for Children (where I work), and we’ll let you know when your action matters most and what you can say to have the greatest impact on decisions about child protection.

We as moms know we can’t live in fear all the time, and we don’t want to instill paranoia in our children. But we also need to be responsible. I’d love to hear fellow moms’ experiences with striking that balance. How did you broach talking about abuse with your child? What tips do you have about leveling with kids without scaring them unnecessarily?

photo credit: Edmund Garman: A display for child abuse awareness

Written by: Christine Sinatra

The title of the Statesman article was “Family Connections: the death of a nonprofit”, and for those of us who went there often, the feeling is accurate. Many of us registered our shock and sadness through our Facebook status updates. It all seemed so surreal. Some friends remembered the postpartum classes that got them through those difficult months after having a baby. Others fretted about the staff, many of whom continued to go to work for free in the days after the closure. One mama friend confessed that she felt awkward having items that were checked out from the library, comparing the situation to having personal effects of someone who has passed away. Yet another mom listed all the friends she and her son had made there and with whom they remain close.

The worst part was that it seemed so final — we were powerless to do anything to change the inevitable.

For those of you who never made it, Family Connections was a sanctuary for families. An agency which offered a bevy of classes for parents, childcare location services, storytimes, the annual Celebration of Families event (which I was going to cover for LiveMom), Family Connections was also a prime meeting spot. On rainy days, playgroups might gather around the pretend kitchen and make a meal or giggle upon donning bee and ladybug costumes. Moms could nurse their babies without feeling self-conscious. It was rare when I opened the door and didn’t see a familiar face.

Early emails from staff indicated that the only way Family Connections could be saved would be through another agency “adopting” them. Thus far, no news has surfaced and I would guess this would be a challenging funding climate for another nonprofit to take on the many pieces of the agency. A Facebook page, Friends of Family Connections, was created to “support the continuation the services Family Connections was providing”. Group members were encouraged to contact City officials to express support and attend a special meeting of the Early Childhood Council at 6:00pm TONIGHT (April 20th) at City Hall. To be added to the list of speakers, you can contact Ron Hubbard, Early Childhood Coordinator, at (512) 972-5028.

What is your reaction to the closure of Family Connections? What has surprised you the most about this story as it unfolds? What is the best way to keep Family Connections’ services in our community?

Written by: Nicole Basham

“Jamie Oliver is here to start a revolution. The impassioned chef, TV personality and best-selling author is determined to take on the high statistics of obesity, heart disease and diabetes in this country, where our nation’s children are the first generation not expected to live as long as their parents. Oliver is inviting viewers to take a stand and change the way America eats, in our home kitchens, schools and workplaces, with this thought-provoking new series.”

Most of what I saw I expected: further confirmation that kids are becoming more removed from where their food comes from, further sadness that some children can’t recognize vegetables LIKE A TOMATO (c’mon kids, don’t you see the picture of the tomato on the ketchup bottle?) and increased angst about my son entering the public school system and being forever resigned to packing his lunch.

I think it’s great that the show highlights a growing number of advocates (like Kate Adamick) who have changed their career path to lobby for changes in the meals we serve our children and a switch back to made-from-scratch meals and away from processed fare. If school lunch reform is the basis for a reality show, you know a critical mass is concerned about the issue and more will be made aware of the obvious link between raising childhood obesity rates and what is being served in our lunchrooms.

On one hand, I do feel lucky to live here in Austin and be surrounded by people who care about locally grown food. On the other hand, I cringe when I remember mentoring a Fulmore middle schooler and seeing that her lunch consisted of hot Cheetos, Powerade and fries (I felt like I was seriously helping her by taking her to Pizza Hut!)

For those of you with school-aged children, how do you feel about what’s served in Austin’s schools? How do you feel it compares to what was being served in Huntington, West Virginia? What efforts are you aware about locally to improve what’s served to Central Texas students?

Written by: Nicole Basham

Pregnancy, however, is just the tip of the iceberg. Once you give birth, as you cradle this innocent, helpless little being that relies COMPLETELY ON YOU, it’s hard not to feel a huge responsibility as a new parent. You want to protect this amazing bundle and do everything in your power to raise a happy, healthy child.

You have purchased The Ecologically Correct organic bedding, you have stocked up on The Obligatory Outlet Covers. You prepared the nursery with a coat of The Nontoxic Paint. You even have a full array of The Natural Skin Care Products.

Parentnoia. It is a strong force. Despite that nagging voice in the back of our heads that says “I did fine despite not having a sleep positioner”, we soldier on, purchasing products we may or may not need and agonizing over how we are doing as parents.

I’m not sure if this phenomenon is magnified for stay at home parents who have made a choice to put aside career to raise their little ones, or if it’s a function of all the information constantly coming at us from the news, friends, the Web or social media. Or, is it that we have more disposable income to put towards children, particularly as many of us have children when we are in our thirties?

Granted, as your child grows older and you see that she did survive despite watching more than the American Academy of Pediatrics-recommended allotment of TV a day, you learn to relax a little and adjust your expectations. But, there is always some worry lurking at every age.

As children start school, you want to discuss stranger danger with them. As Catherine’s post yesterday pointed out, you may worry about tweens and their internet use. Then of course, there will be dating as they get older.

How do you quiet the forces of parentnoia? Does it ever disappear?

* Kudos to LiveMom contributor Shannon for coining this term.

Written by: Nicole Basham

What is the difference between therapy and parent coaching?

Parent coaching is short-term, solution-focused consultation with parents who want to improve specific areas of their family’s life, their child’s behavior, or their confidence as a parent.

In my parent coaching role, I am more of a consultant—someone with extensive training and experience in psychology, behavior, child development, attachment theory, parenting, and more—with whom you consult about a specific problem. You describe the problem, I ask you to collect data, then we examine & explore what’s going on and come up with an individualized, intuitive, thoughtful, loving, and effective response! Parents LOVE parent coaching because it leaves them in control, gives them tons of useful information, improves their confidence, and offers so much support.

Parent coaching is actually quite different from therapy—therapy is more process-oriented (meaning, that it moves slower, you talk & I listen, we’re not trying to get to an ‘answer,’ etc.) So, if you compare me to a traditional individual therapist, the experience is about as different as apples and giraffes!

When might parents want a coach?

The reasons that bring families in to see me vary, but the most popular is discipline and family harmony, particularly with younger children. To be more specific, parents talk with me about improving their effectiveness in getting their kids to behave appropriately, understanding why behavior problems arise, and overall in feeling more confident in their parenting. Parents also often come to me with questions about healthy childhood sexual development, parenting through divorce, and school problems.

Is parent coaching ongoing or one time?

Both! It completely depends on what you want to get out of it. If you have a focused, specific item to address, one session can cover that. But, if what you’re working on is, say, discipline—well, that’s likely to fit best with a series of sessions.

How would parent coaching be different from talking to other moms about challenges I’m facing with my child/ren?

It’s great to do both. Parents NEED a village—nothing can replace a supportive community of moms! And, I have a Master’s degree in clinical social work, ten plus years of professionally working with families and tons of continuing education on child development, parenting, attachment theory, etc. In addition to the training, I also have these conversations with parents all day every day—you’d be surprised how much you learn through the experience of helping other parents.

The other big difference is a bit of magic—when a parent commits to working with a professional, they take some major steps: they acknowledge that there’s an area they’d like to change, they open themselves up to hearing another point of view, they look at the ‘problem’ with new eyes, they pay more attention to their own thoughts/feelings/actions, they spend time and money, they agree to experiment with slightly new ways of parenting, and then come back and talk about how those changes worked. The time, focus, and energy commitment in working with a professional is so much greater than in talking with a friend—it can’t help but make a big difference!

Do you have any workshops happening in the next few months?

Yes. My Beyond Birds & Bees workshop for parents covers healthy childhood sexual development, sexual abuse and how to talk to your kids about sex. In the Mother-Daughter Puberty & More workshop, mothers and daughters participate together. That workshop covers the nuts and bolts of puberty, communication, and creating your own ‘coming of age’ ritual. Lastly, I am hosting a joint event with Well Styled, Looking Good, Feeling Good: Mother-Daughter Shopping Trip. Daughters work with Well Styled to find a stylish, flattering, age appropriate outfit, while Moms talk about parenting a pre-teen, clothes, body image and more. You can learn more about these workshops on my website.

What led you to develop a workshop focused on the “birds and the bees”?

Many, many conversations with parents.  Parents kept telling me that they wished there was help out there in figuring out how, what, and when to talk to their children about sex. Practically no one in our generation had parents who talked easily with us about sex—but ALL of us want our children to be able to make good decisions about their sexuality. But, how to get there?! I realized that all parents needed to get started was a little basic information about what is important & appropriate, and support in believing that they COULD do it!

What do you like about being a therapist and parent coach?

You know, I really, really love my job, for many reasons. I love talking with parents about the really tough experiences—the big ugly moments, if you will—and helping them understand that we all feel that way, make big mistakes, feel hopeless sometimes. Parenting is so hard, and there just isn’t enough support, validation, and understanding out there for those of us doing it! I love getting to provide it.

My other favorite thing is watching my clients grow out of needing my services. No, really! It feels so good to see clients putting pieces together, realizing things on their own that we once had to work to see, feeling so much more confident and effective. Seeing a parent feel proud, effective, and confident in their parenting feels great! I absolutely LOVE that that’s my job.

What do you think parents can lose sight of?

The role that they play in their child’s behaviors. We are so much more powerful and influential than we realize. This is actually a GOOD thing, but when we forget it, we feel powerless and frustrated. I like helping parents reclaim that power in ways that help the whole family.

How did starting a family change the way you related to your clients?

I was a family therapist before I was a parent, and a lot of what I say now is what I said then. Two big things have changed, though:  (a) I focus more on how much parents affect their children—and therefore how a parent can change what THEY do in order to bring about change in their child; and  (b) on a non-verbal, gut level: I GET IT—parenting is so, so, so hard. I really, really understand why parents do the things they do-even the ugly stuff. I think it’s hard to GET that until you’ve made a few dozen of your own ugly parenting mistakes.

What do you like most about Austin?

Intelligent, thoughtful, unique people live here, of course! I also love that weird is a good thing here. Coming from rural Louisiana, *I* was weird there. Here I’m practically vanilla—I love it!

What do you like to do outside of work?

Go on adventures with my daughter. We love to take the bus downtown—kids make the bus fun. Our family loves to ride bikes, swim, take day trips around central Texas, work in our backyard—anything outdoors. Board games and talking with girlfriends. Reading really great fiction when I’m alone—yum. But lately, a lot of my time currently is spent at my daughter’s school—I’m on the PTA, and it’s like a part-time job!

What’s the best way to keep up with what you are doing?

You can find me on Facebook, sign up for my monthly parenting e-newsletter, read my blog or follow me on Twitter.

Written by: Nicole Basham

I (perhaps unwisely) stubbornly refuse to think about shopping until after Thanksgiving. And although I had no intention of participating in any Black Friday sales, I couldn’t resist at least thumbing through the advertisements that came in the Austin newspaper, where inserts outnumbered news probably 3 to 1.

Although this is the first year I think my son will really pay attention to the presents he opens, I want to be careful about the number of “things” we accumulate. My husband and I have always been mindful of the gifts we give him and ask our families to respect this desire, not only because we want to lessen our impact on the Earth, but also because we want him to value experiences over material goods. If you would like to do the same, or encourage your families to give different kinds of gifts, here are some ideas:

• A family membership to the Austin Children’s Museum is $10 off until the end of the year (including renewals). It’s a great place to go as a family, take out of town guests or take along friends (the Basic Membership allows 4 visitors). It’s worth it financially if you can make it once a month and gives you an excuse to go explore downtown and get out of the house.
• Speaking of downtown, take a carriage ride to spend a fun night together taking in the holiday decorations (or any time of year).
• The UT men’s and women’s basketball teams play at the Erwin Center and getting tickets to a game on a weekend is a fun family excursion (and it doesn’t matter if you are in the nosebleed section).
• Asking relatives to help pay for a class (we love Sportball, or you could try art or dance lessons). Some of these are drop off, but you can also find some that are Mommy and Me if you’d prefer to participate.
• Planning a family getaway — either something major, like Disney, or something simple, like camping at a state park.
• Buy tickets to a performance, be it The Nutcracker, A Christmas Carol, Holiday Heroes or even a movie at the IMAX.

What other ideas might I be forgetting?

There are so many fun events coming up, so be sure to check out the Weekenders to experience the holidays as a family. You can also check out my Taming Holiday Treats post for ideas on reducing your family’s sugar intake this holiday season. Happy shopping!

Written by: Nicole Basham

I never thought it was so horrible to be an only child. I liked it that my parents brought me to lots of “adult” places and that I got to talk about grown-up things. I would go to friends’ houses and play with their siblings, and when I was ready, I could go home. As the only grandkid on both sides and with no cousins, I never knew holidays with houses full of children of all ages to play with. Since I didn’t know any different, I didn’t secretly pine away for a different existence.

My husband and I talked about having two kids, but it didn’t work out that way. The newborn stage is hard on most people, but I really struggled. I didn’t think I could do it again, particularly having another child to care for. It works for many people, just not me. My husband and I talked about it, and decided to stop at one.

After a while, my mama friends started talking about having more children, and we adopted a black Lab. We told our son this was his dog brother, and he was completely on board. To this day, he has not asked about a brother or sister, and when we have asked him, he says he likes our family the way it is (well, perhaps he would prefer more pets, but that’s another post). Our families stopped asking, and we put all the baby things on Craigslist or passed them on to the new baby brothers and sisters of my son’s friends.

I wondered if seeing babies would make me want to have another. Turns out, it didn’t. I enjoyed the freedom of knowing I didn’t have to go through the hardships of those early months again, and was happy to be able to make meals or help out my friends who were battling through days with only a few hours of sleep and, in some cases, questioning their decisions.

I was surprised at how few other only children we came across. At first, it seemed like a secret club — people seem to just expect you’ll have more than one child, or if you don’t, that maybe there is a physical reason you can’t, so they don’t want to pry. I kept wondering if there was some handshake I was not privy to in order to gain entrance into this society. But slowly, I realized I wasn’t the only one.

I felt like I was coming out of the closet. There was nothing to be ashamed of, of course. I could tell some of my friends didn’t understand…”but you are so good with kids!?” I think to my son’s last tantrum and how I immediately felt that this was all I could handle.

As I am wont to do, I decided that I needed to read up on parenting an only child. I found the dad of my best friend in high school, Carl Pickhardt, wrote a book called The Future of Your Only Child: How to Guide Your Child to a Happy and Successful Life. The book certainly served as a mirror to illuminate some of my traits and foibles and gave me food for thought on how as a parent you can moderate some of the less positive characteristics of only children.

Now that my son is getting older, I daydream about the future, thinking about all of the amazing experiences we’ll have together as a family. Thinking about my future and all the possibilities that await as my son enters elementary school. Sure, there will be tough stretches. There will be cloudy days. But, I’m content knowing my family is complete and we’ll face it all together.

Written by: Nicole Basham

Which is one reason I found this article on The Nature Conservancy’s blog so compelling. The article speaks to another tough set of choices we face as parents: how to raise a child while attempting to reduce our impact on the planet. Specifically, how to stay green and stay on a schedule. The author discusses the trade-off between walking to school — the time for family togetherness, the ability to observe nature and the environmental benefit — versus the convenience of driving to school and getting up and ready a little later. As a night owl, I have a hard time thinking anything is worth getting up extra early for, although I admit that over time, mileage and gas emissions DO add up. It’s also hard with kids to embrace anything that adds MORE time to your morning routine.

I also like how the author points out ways to save time during other parts of the day to make up for the time spent walking, since that is certainly eating into some other priority. In particular, I like the idea of making sure you combine errands so you aren’t making one trip out for one thing (although I am occasionally guilty of that during the evenings, especially if I’m stuck at home all day).

Not having a school-aged child (yet), I also realize there is more to the equation. Is the route to school safe enough for a child to walk alone? Is the road well-lit throughout the year?

Has your family made any conscious choices to reduce your “footprint”? Do you have any ideas to share on making it easier to be green?

Written by: Nicole Basham