Here is an article that appeared in yesterday's paper, outlining the results of a small study on SSRIs (modern antidepressants like Zoloft, Paxil, Prozac, etc), and their negligible and/or detrimental effects on the test subjects, who were children.

This is the quote that got me thinking:

quote:

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- Children who took a placebo showed strong improvement and those who took the real drugs didn't do significantly better. Two small studies found no advantage for the antidepressants over the placebo.

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I'm not here to discuss the merits vs contraindications of taking anti-depressants, and/or prescribing anti-depressants 'off-label' to kids. What I'm interested in (for this thread anyway) is the findings that the placebo subjects showed 'strong improvement', and I wondered to what degree that was due to the expecations of the adults in the kids' families, and the implications thereof.

A personal story: when I was a teen, I was a camp counsellor at a camp for kids with severe learning disabilities and behavioural problems. From the kids' files (and the often-insistent critical descriptions provided verbally by parents) we got images of kids who were liars, fire-starters, contrary to the extreme, self-harming, vulgar, etc etc etc.

Most of the kids showed none or very few of the behaviours we were expecting; they were often the exact opposite of how their parents, teachers, caregives, doctors and therapists found them.

It was amazing how often we counsellors stood to the sides of activities and said to each other 'Is that the same kid? The one the parents said was lazy/a chronic liar/rude/incapable of concentrating/etc etc etc?' The differences between what we had been expecting based upon descriptions and how the kids turned up to us was often like night and day.

But the most amazing thing was trying to convince the parents of our observations and experiences with their children. They were often stubborn to the point of rudeness in insisting their characterisations of their children were correct. We counsellors were accused of lying, misrepresentation, and many other things in parents' determination to stick to their unfavourable assessments of their own kids.

We counsellors all came away with a vivid lesson in the degree to which kids respond to expectations. Is that what was at work in the study? What does this mean to the child-mental-health community?

Or am I out to lunch?

[ 10 April 2004: Message edited by: Anchoress ]

The one response I will make is the "day care phenomena" response. Children will be "good" all day in day care (or when they're at someone else's house), and then when the parents show up to take them home, the toddlers or preschoolers will start acting up, misbehaving, throwing tantrums, etc.

The common wisdom in ECE circles is, I believe, not that it's because the parents expect that behaviour from the child, but that it's because the child sees the parent, and suddenly feels they can "let go" again. They don't feel as comfortable letting their hair down and expressing frustration, anger, or just plain bad behaviour with day care workers and other children (or possibly camp counsellors and fellow campers) as they do in front of parents and siblings, because while they know their parents' love and acceptance of them, warts and all, is unconditional, they do not have that same security with non-parents or non-family people.

Which is often a very reassuring thing to tell parents, because many parents are absolutely bewildered at why their child would act so well all day and then suddenly go on a tear as soon as they show up.

[ 10 April 2004: Message edited by: Michelle ]

Of course children are influenced by their parents' expectations. But where do parents get unrealistic/inaccurate expectations? Obviously, some of the parents' ideas come from experts - teachers, school counsellors, physicians - and let's not forget the media and their fruitcake recipe of the month. But at least some part, if not most, of what parents expect is a result of how the child actually behaves at home.

Every member has a definite role to play in the family drama. When a new kid enters, s/he fills a vacancy --- to the best of hir ability. Not every member of a family is perfectly cast. (I mean, of course, that hardly anybody is born into the family dynamic that best suits their talents and temperament.) The old members have existing relationships, histories, an on-going struggle with life, a load of emotional luggage: resentments, inadequacies and fears about themselves, as well as hopes and plans and anxieties about the new person. So everybody, old and new, has to make a whole lot of adjustments. They'll all do it at different rates and with different degrees of success. Meanwhile, outside the family unit, there is a whole big world and society, which keeps changing and demanding more adjustments.