Tonight We Will Explore:
Basic principles of limit setting with MS and HS children, How to
set limits to help children behave better, feel better and be
better people (morally) when they are grown
 How Limits are “love” and children with special needs require
them as much, or more than “normies”
 The basics of the vulnerable and amazing adolescent brain
 The main “culprits” of potential compulsive/ addictive behaviors
 The Fear/ Control Parenting trap
 Data on the specific impact of technology on teens brains
 Data about WEED, Vaping and alcohol abuse
 And specific questions that you have
Children with Special Needs Require
Some Unique Limit Setting challenges
 Attentional issues, ADHD
 Learning challenges, Dyslexia, dysgraphia, dyscalculia
 Processing issues, auditory, visual, language
 Sensory integration issues
 Anxiety and depression are closely correlated with LD and
other special needs, especially if they are not having their
needs supported at school and/or other environment
As parents we have to robustly avoid seeing our special needs child
as less capable than they can be while being sensitive to their
actual limitations
Limit setting with Special Needs
Children
 There is the dialectic of “Its harder for you to do
some things and easier to do others. Even when its
hard you need to keep trying to feel the thrill of
‘getting it’.”
 We expect you to show your strongest effort, we are
not worried about the grades
 All children tend to follow their parents clearly
expressed and enforced limits. We are usually “the
problem” when it comes to limits
“Children need two things to be
healthy and happy as they grow;
to know that they are loved for
who they are and that there are
limits to their behavior.”
— Marie Fakkel, M.D.
(as quoted to a nervous, first time mother, circa
1986)
Are Things Really That Different Today?
 The culture has shifted from parenting being concerned with
raising functioning, responsible adults, to raising ’happy’
children and teen. Parents are ‘failure’ aversive- more on this
later
 Children can be exposed to many intense sexual and violent
images in media, music, video games, even when we carefully
supervise them
 Parents are often unaware of how important setting firm and
consistent limits is and instead worry about “results”
 Many parents are stressed and overwhelmed and fail to
properly supervise their children
 In our area we have to be aware that affluence is a unique risk
factor
Affluence is a Risk Factor?
Suniya S. Luthar and colleagues of Colombia
University have studied affluent youth both
prospectively and retrospectively and found
that affluence is positively correlated with
higher rates of depression, anxiety and
substance abuse than teenagers from middle
class and disadvantaged youth
WHY?
 The confluence of actual separation from parents
(due to extended work hours, travel, etc.), more
emotionally “distant” relationships with parents and
high pressures to succeed in academics and a variety
of extra curricular areas create a state of
psychological distress in many affluent youth
 Children need and want time with their parents
 Market functions are also in play. More access to
liquid income translates into more access to alcohol
and other drugs
PET , MRI and fMRI scans have demonstrated
what parents have known for millennium:
Teenagers are unpredictable and can be “crazy”
 It appears the limbic system and drive for new
experiences crucial for brain development dominate
the PFC
 Teenagers are ruled by emotion and instinct
 Activity in the PFC increases with age as limbic
activity appears to diminish
 Activity in the PFC appears to increase when teens
“stay frustrated” and are forced to use reason: it
appears as if this helps speed the development of the
PFC
Adventures with Neuroscience
OR “It’s not Rocket Surgery”
This state of intense “plasticity” of the
adolescent brain makes for a ‘Perfect storm” of
compulsive/addictive behaviors
 Data has consistently shown if you can get a child out
of adolescence not ‘addicted’ to anything, they will
most likely never be addicted
 Teens are both biologically and socially vulnerable to
factors leading to addictive behaviors
Current Top Contenders for
“Compulsive” teen Behaviors
 SCREENS in general
 JUUL/ Vaping
 “Weed”
 Binge drinking
 Multi player video games, single player games
 Social Media
Technology: A Privilege, Not A Right!
Pre teens and Teens Can survive with limited access
 Data, 2013 From the American Academy of Pediatrics: The
average child 8-10 spends 8 hours a day on screens, 12 to 18
year old's spend 11 hours a day on screens
 18% of college students are screen addicted (Young 2015)
 Approximately 10% of teens are predisposed biologically to
screen addiction, most likely due to pre- existing anxiety,
social isolation, depression. Also there is an interactive effect
of excessive screen use causing and exacerbating anxiety,
depression and even mimicking psychosis (more on this later)
 Dr. Peter Whybrow, Director of Neuro science at UCLA calls
screens for children and teens, “Electronic Cocaine”
Children and Teens Brains DO Get addicted to
screens and games in the same way that brains
get addicted to drugs
 The brain’s “Dopaminergic Reward System” The brain uses
floods of Dopamine (and other neurotransmitters) to reward
behaviors She feels are crucial to survival. This system gets
“tricked” by the screen world of stimulation and rewards
 This is also called “Pathological over learning”
 Homeostasis in the brain and addiction
 It takes 4 – 6 weeks of screen “abstinence’ to break this cycle
and return the brain to pre-addicted balance
 Its almost impossible to keep a child away from screens in
school/ society, however “Wilderness therapy” is NOT THE
ANSWER
Is what happens on ‘screens’
“REAL” to children and teens?
 I believe children and adults see this question very differently
 Research is emerging to show an “other” perception of screen
activity and ‘persona’ that is neither real or not real
 Many tweens/teens engage in online communication (and sending
risqué pictures etc.) as if they are an ‘avatar’ of themselves
 They feel ‘removed’ from the actions and possible consequences
of this “avatar” self
 This helps answer the question of how teens can more easily
engage in sending nude pictures, saying cruel and awful things
electronically they would never say in person etc.
TECHNOLOGY 24/7
We are in the middle of a massive
experiment with no ethics board and no
control group
We as parents and educators should be aware and
concerned but not panicked about keeping media in
balance- we can do this with some simple guidelines
and a little persistence
“Old school” love and limits are the way to go
We can not even attempt to stay “on top of” all the
media trends as they emerge: That would be a full
time job!
Is my Child “addicted” to Media/
Screens? What are the signs? (American
Academy of Pediatrics 2015)
 Your child exhibits some these symptoms:
 Irritable
 Depressed
 Excessive tantrums, mood swings (often related to lack of
access to screens)
 Low frustration tolerance
 Defiant
 Trouble sleeping
 Disorganized behavior
 Learning difficulties
 Poor short-term memory
Symptoms continued:
 Your child’s symptoms are causing major problems in
school, at home or with peers.
 Your child’s symptoms improve after 3-4 weeks of
strict removal of electronics.
 Symptoms return with the re-introduction of the
electronics.
 Some children are so vulnerable to “screen” addiction
they may need little or no exposure or only
supervised exposure and outside therapy with
professionals expert in this problem.
Gaming Can be Highly Addictive
 Limits on time spent gaming must be set
 Gaming systems must be monitored
 Games are designed SPECIFICALLY to “hook” the
reward system of the brain
 Many newer games are also designed to have kids
purchase levels and rewards within the game using
Itunes etc.
Firm rules should be set for any new technology or device
that enters your home, Many families have no technology
rules, this leads to over use in almost all kids
 Children will object less if the rules are set up front, but new
rules can be made and enforced at any time
 Technology devices and phones out of rooms over night.
 Parents know device passwords and change them when needed to
“ground” kids from tech
 Children need to hear from parents that they will have some
freedom to use and access media as long as they are taking care
of all other responsibilities and behaving well. This needs to be
supervised, parents need to stick to the time limits imposed
 The Golden Rule (character) First, then School work, then
physical activities and creativity, THEN media
Cortisol Flooding and Stress: How Anxiety and
Depression can arise from chronic stress
 Our nervous system releases cortisol, the stress hormone to
prepare us to respond to threats in the environment
 If we can use resources in ourselves/ immediate support system
to resolve the problem, cortisol lowers and the brain is flooded
with rewarding chemicals
 If the stress is chronic (LD without sufficient support, waring
parents, bullying) the child’s brain will not recover from the
stress
 Children’s brains are plastic and easily impacted by cortisol
“flooding”, leading to symptoms of depression and/or anxiety
 As parents we must help protect their sensitive brains
WITHOUT over protecting them
“I HATE VAPING” Liz Jorgensen
Vaping is epidemic among teens,
However Not every teen gets addicted
Vaping Continued:
 2015 Data from the CDC: One in Four teens use E-cigarettes
 44 Percent of HS students have vaped
 About 10% of MS students Vape
 More boys than girls
 Teens are heavily swayed by the “marketing” and ‘toy like’
packaging of the JUUL.
 Data is 2 years behind, the clinical trend in CT appears higher
 The teens who will become addicted appear to have pre-existing
anxiety and/ or depression
WEED: What’s the Big Deal?
 The current adolescent culture is not only completely accepting
of weed, it is a essential part of the “commerce” of their
culture.
 Even kids who don’t smoke at all think its ‘not a big deal’ so there
is no social stigma to use. Social stigma protects teens
 Kids can become instantly “popular” by selling weed, sharing weed
etc.
 Teens believe myths that weed is not only harmless, but that it
can be “good” for you.
 “Liz, it cures Cancer”
The Hard Data on Teenage Brains on Weed
“Persistent Cannabis users show neuropsychological decline from
childhood to midlife.” Meler, Caspiand Ambler et. Al., PNAS, 2013
Longitudinal study, 42 years in the making, followed a large cohort of subjects from
birth to age 38
The study has proven that early use of cannabis in adolescents has a dose and age
related impact on cognition, memory that can be permanent AND can translate to a 8 –
10 point DECREASE in IQ at adulthood.
If subjects stared using cannabis AFTER adolescence they DID NOT show the same
cognitive declines, and cognitive declines IMPROVED if they ceased use.
NIMH study, Northwestern University, 2013:
 Abnormal brain structure in cannabis smokers AFTER heavy use pre dates
schizophrenia and Abnormal brain structures deep in the brain correlated with
poor memory and are a CONSEQUENCE of frequent weed use in adolescents
and were observed in the subjects brains in their 20s even after TWO YEARS
of abstinence from weed
 All previous long term studies focused on the out layer of the brain, the neo
cortex, this study scanned the deep regions of the brain
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Dude, Weed is Not Addictive!
 Is Marijuana Addictive?
Contrary to common belief, marijuana is addictive. Estimates
from research suggest that about 9 percent of users
 become addicted to marijuana; this number increases among
those who start young (to about 17 percent, or 1 in 6) and among
people who use marijuana daily (to 25-50 percent).
NIDA, 2013, AMA, 2012, 2013
More clients seek treatment for Marijuana (more than one million
per year) then for heroin and cocaine combined making it the
number one drug in terms of clients self selecting treatment as
adults. In other words, debate over- People ASK FOR
TREATMENT due to Cannabis dependence
27
Are we giving passive or active
permission to young people
to smoke weed?
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Ritual Use of Alcohol is the ONLY
acceptable level for teens
Binge drinking (3 or more drinks for females, 4 or more
for males) in teens has been PROVEN to have a
damaging effect on the gray matter of the brain. This
damage appears to be permanent
Teens drink to get drunk in groups, they don’t sip wine
and chat
The same kids at risk for other addictive behaviors
absolutely can use alcohol abusively or even become
dependent
“But it is a rite of passage- Liz we have to
learn how to drink before college!”
How do we set effective safety and
behavioral limits and maintain a close
connection to our children?
 Is this possible?
 Yes, Limits are LOVE! Children know this, and they
WANT limits!
 Children will not say “thank you” for limits until they
are 25 years old
 Can I set effective limits and enjoy my time with my
kids ? ”Yes if you adjust your expectations just a
bit… and work hard on your sense of the
ridiculous…”
 Its all about being clear, consistent and not taking
their insane antics personally!
Authoritarian, Authoritative and
Disengaged parenting styles
 Many of us were raised with authoritarian parents
and we have strived to reason with our children
rather than dictate
 Unfortunately TOO MUCH reasoning can leave a child
confused and in a position of TOO MUCH POWER
within the family
 Authoritative parents present rules with some
explanation for “why” but there is no negotiating on
safety rules, health rules and character rules. Other
things can be negotiated
The failure of the “Self esteem” movement:
Children need excellent frustration tolerance
not over- abundant praise!
 Obviously we need to love our children and praise them when
appropriate (when they have actually done something
outstanding)
 Researchers have consistently demonstrated that children who
are excessively praised, and not given correction and
constructive advice on effort become ‘praise junkies’
 Since ‘process is 99.9% of life we must be careful not to over
praise “results”
 Even the most gifted people must learn to face frustrations and
put great effort into their actions in order to feel good about
achievements
 We as parents need to break our “addiction” to our kids being
“happy” in the short term and return to the focus of long term
goals
Just a quick word on Helicopter parenting
 “Zamboni” is my preferred term
Don’t do it!!! I don’t care if every other
parent is doing it, DON’T!
 Let your child have the precious natural consequences
of all their mistakes
 “Parents of this generation want the effect of their
child having natural consequences for their mistakes
without ever having to experience the
consequences.” EDJ in “Delay Your Gray”
 One major reason parents make the error of being too critical with
their children is that they get defensive They take children’s bad behaviors and developmental struggles
personally
 We are human and can’t help but get upset when our child erupts like
“the exorcist” we must stick to the limit and take “time out” from our
child
 We also make the mistake of “giving in” out of exhaustion, or
“bargaining” with a terrorist teen. Many parents feel guilty when they
have over reacted with anger and then STRONGLY reinforce the
terrible behaviors
Behavior is just behavior- it is not about
us, it is simply behavior
Teens admit to staff at Insight that they have
their parents “Trained” to get what they want
 The CURSE of Intermittent Reinforcement
 Decide what the limits are, be a team with your
partner (or ex-partner) and have the SAME rules
 Stick to them no matter what
 Breaking patterns of ‘Pathological over learning” in
your child will take professional help
AVOID Critical statements: Focus on
Behaviors with adjectives about them
 It is very important for us to distinguish “limits” from criticism.
This can be hard if we were raised with highly critical parents
 Research consistently demonstrates that parenting styles that
are highly critical, judgmental and/or detached create toxic and
harmful stress levels
 The ideal of “authoritative” parenting communicates “I love you
always, this behavior is not OK, here’s what I am asking you to
do to correct it.”
 Your child will then feel her own guilt and correct, eventually!
The Goal of Parenting Should be to Raise
a Child Who Doesn’t Need You Anymore
 A child’s moral development is very important. Most
children, although they have an innate sense of
fairness and caring, need strong moral guidance to
grow up to be good people.
 Children will need to be frustrated, angry at us and
maybe even “hate us” for the short term at times to
develop internal limits
 The logic of our limits is key as well as the style we
use to set them
The reason many well meaning and educated
parents “give in’ and become too permissive is
that they want their children to be ‘happy’ in the
moment. They also take the behavior personally
and give into inappropriate behavior to make it
stop.
The Fear and Control Trap
Either position, a critical response or a permissive
response has real, long term impact on behavior,
learning and ultimately character.
Children thrive and feel better when parents are
“authoritative”
Special Issues for Special Needs
 We need true expert assessments to understand our
child’s strengths and challenges and learn
communication styles that best work with our child
 We need to avoid the trap of too much anxiety and
even pity regarding our child’s challenges as this will
lead to insufficient limit setting
 Children with special needs do need to learn how to
live in the “real world” where no one will give them an
IEP. This needs to be done gradually, of course
Parents Need to be in Authority, But
Recognize They are Never
‘In Control’: Control is a DELUSION
Children will make mistakes and failure and consequences are
the best teachers on earth!
My brilliant son’s arrest story
As long as we are there to help our child experience the
consequences (and NOT RESCUE!) they will thrive!
In case you forget the fact that you can not be “in control” f
for even a moment your child will be more than happy to
remind you. Several times a day…..
Eating dinner together as a family as many
days per week as possible is one of the best
things you can do to help keep your child
from risk–
 Data consistently shows this is a key protective
factor for all “at risk” behaviors Premature sexuality
 Anxiety
 Depression
 Substance abuse
 Poor academic achievement
“Children need two things to be
healthy and happy as they grow;
to know that they are loved for
who they are and that there are
limits to their behavior.”
— Marie Fakkel, M.D.
(as quoted to a nervous, first time mother, circa
1986)