Behavior and discipline
Q: I have three children, and my middle child seems to get into all sorts of trouble. What should I do to discourage this behavior, to tell him this isn't the sort of attention he should seek? - Seattle
A: In general, the more attention paid to inappropriate behavior, the more it will continue. Ignoring acting-out behavior (so that it doesn't achieve its goal) should gradually decrease the frequency. Walking out of the room and briefly stating the reason should work eventually.
Q: My 8-year-old has very big tantrums always revolving around her 3-year-old sister. We just had a big fight and everyone went to their rooms, but my daughter bit me and hit me. Help me! - Seattle
A: Certainly sibling fighting is a common problem, and sometimes a difficult one, especially since it is often difficult to know who got the fight going. I've certainly seen many younger siblings who know exactly how to push the older child's buttons and get them going. However, I am concerned that an 8-year-old would bite and hit you. That should not be allowed at any time. I have a feeling if it has come to this intensity there is not a quick fix because you need help in setting limits with your daughter and commanding her respect. There are good books about discipline that may give you some guidance, such as "1-2-3 Magic" (by Thomas W. Phelan) and "Siblings Without Rivalry" (by Adele Faber and Elaine Mazlish), but I think you should ask your pediatrician or family doctor to refer you to a child psychologist who could help you with the problem in a more hands-on way.
Q: I have a 3-1/2-year-old and a 1-year-old, and I have questions about both. My 3-1/2-year-old is afraid of everything. He's afraid to go to the bathroom by himself (I have to stand in the bathroom with him). He's afraid to go in his room, go upstairs by himself, etc. I have to go with him everywhere. He seems paralyzed by fear, and I don't know what he is afraid of. It is starting to wear on me because he can't do anything on his own. This behavior has been going on for about a month. What can I do? My 12-month-old is experiencing separation anxiety, I think, and she constantly wants me to hold her. I can't leave the room without her having a fit. It's hard to get anything done because she is always following me and crying for me to pick her up. Should I pick her up all the time or let her cry? - Seattle
A: The separation problems are actually pretty common at these ages, although usually not quite so intense. For the older child, I'd wonder about what he's been exposed to in terms of movies, movie previews, stories, videos, etc. Reassurance is helpful, but won't solve the problem quickly. Being available when he needs you, but maybe standing farther away gradually - outside the door, a little way down the hall, etc. may be helpful. Be patient, it usually gets better.
One-year-olds sometimes will be able to be distracted with interesting toys, her sibling to keep her occupied while you are doing something else. When she wants to be picked up, try offering her something else while you're in the same room.
Q: How can you tell between a child having a hearing problem, and one who is just not listening? I have a 3-year-old, and I know he gets distracted easily, but after repeating myself numerous times to get him to acknowledge that I've said something, I'm beginning to wonder if he really can't hear me. Should this be something I have checked out? - Kent
A: I'd consider having the hearing checked. At this age, it's usually something a hearing specialist would do, rather than a pediatrician. If it's checked and normal, you don't have to worry about it anymore.
Q: I have a teenager (16) who has been on Lexapro 20mg for awhile. Recently he has been sleeping a lot and not eating. Should I be concerned? - Bellevue
A: Some teenagers do sleep a lot. The real question is whether it is interfering with his daily life, school, friends, social etc. It could be a sign of worsening depression, which is probably why he is on the Lexapro in the first place. Appetite changes can also reflect that. You don't mention his weight or height. Maybe he wants to be in "better shape" - just a guess. I think he should have a visit to his regular physician for an evaluation.
Q: We have an adopted 16-year-old boy who has been diagnosed as having oppositional defiant disorder (ODD). Within the past two years his behavior has significantly turned hostile and negative (beginning at approximately age 14). He has been stealing, lying, refusing to go to school and obey home and school rules. Because of this out-of-control behavior, he is now in a boarding school. The question is, what are the symptoms of fetal alcohol syndrome (FAS)? This possibility has been suggested by his school counselor. Another teacher suggested that he be placed on medication for ADD (attention-deficit disorder). Neither of these conditions have previously been suggested by his doctor or psychologist, but the teachers and school saw him in action. We've tried everything but medication - new schools, psychological counseling, family therapy, and nothing worked. He is filled with anger and we are wondering what more we could have done. - Seattle
A: First, your question seems to have a "guilt" piece - NOT FAIR! I am confident you have done as much as anyone could have. This is very complex. FAS definitely can present this way. There is a great FAS clinic at Children's Hospital, and you might want to call them. There is no "medication" for FAS, but there is much "overlap" with ADD, ODD, and other psychiatric disorders - including depression, which can also be a part of his frustration and behavior A very experienced psychiatrist (not a psychologist) would be a good resource. A trial on medication (Adderall or Ritalin etc.) would also be a possibility for partial treatment. They work quickly, so you would know in less than a week.
Try to find an experienced adolescent psychiatrist with expertise in this area. If you need a referral, call Children's Hospital and ask for the Psychiatry Department (Division of Behavioral Sciences).
Q: My child, who is an 8th-grader, has a problem of anxiety. Where would you recommend we go for testing and treatment for the anxiety? - Bellevue
A: I would start with your pediatrician. If your pediatrician feels this is an excessive problem, then he will recommend a psychiatrist or psychologist.
Q: My son just turned 8 months old and he's starting his phase of separation anxiety. During the day, when he's playing, how can I leave him so I can get a few chores done? Also, at night, he's waking crying almost screaming. Do you have any suggestions on ways to cope with this issue? And how long does it last? - Edmonds
A: If possible, try to do some of your chores in the presence of your child. Also try to keep your child interested in something when you try to leave him. Unfortunately, he is still likely to cry, and you will have to just accept the crying. Separation anxiety usually starts around your son's age and can last until 1.5 years old.
Q: My 3-/2-year-old is exhausting me as she kicks, screams and cries every morning when I drop her off at school. As a working parent, this is terrible way to start the day (for both of us). I should mention that in the last six months she has become a big sister to a 1-1/2-year-old girl from China. While I know a lot of the morning "trauma" is about adjustment to her new sister, what steps can I take to help her get through this challenging time? - Seattle
A: She is likely having difficulty adjusting to two new events: school and the new sister. Remember to continue spending quality time with her so she doesn't feel left out. Sometimes having her "help" you with the little sister can also be rewarding for her. Her reactions are normal and some patience will be required as she slowly adjusts to these big changes.
Answers provided by pediatricians affiliated with the Washington state chapter of the American Academy of Pediatrics during the Feb. 2, 2005, pediatric hotline. Answers are for information purposes only and aren't intended to supplant the physician-patient relationship or a professional medical examination. You should talk with your doctor if you have questions or concerns about your health or the health of a child.