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Impulse Control and the lack thereof

Urbanmamas_monroe_logs
I was so angry when told, before my youngest's third birthday, that he'd be probably diagnosed with ADHD and Oppositional Defiant Disorder when he turned five (and those were "allowable" diagnoses). And here I am with a four-and-a-half-year-old, diagnosing him myself with some major attention problems.

Lots of the people who know him don't see it; his Multnomah County early intervention specialist only sees the sweet compliant Monroe (45 minutes a week) and always seems surprised when I tell her about his escapades. Even some other adults who see him in the community don't see it; he's active, yes, but what four-year-old isn't?

That's when I have to start telling stories. Like the time, a few weeks ago, when we went to the beach with my dad on a spectacularly stormy day. We just wanted to go feel the crazy wind and see the amazing waves and run around a little in the weather, and we drove from my dad's house to Oswald West, where the Short Sands creek comes into the ocean. We ran around for a while, and Everett and I were experimenting with overspeed running: watching the gusts of wind come at us, then turning around and sprinting and letting the wind push us fast fast fast. We'd gone over all the dangers of the place with the younger boys -- the waves that could pull you under, the slippery rocks, the stream, which shouldn't be messed with.

Urbanmamas_oswaldwest_beach
I turned around when my dad shouted, "Monroe!" He was in the center of the stream, right before it hit the sand and widened -- where it was deep enough to come up to his chest. Dad had seen him just charge right into the center of it, just run right into the stream, and get pushed under by the current. He had to wade in to get him out, and there we were, a soaking wet kid and a grandpa with his shoes all squelchy, with the wind ripping around us and the rain and the less-than-40 degrees temperature. I scooped Monroe up. "I shouldn't have done that, right?" he said to me.

"No, sweetie! Do you know why you did that?" I asked.

"No, why?" he asked me.

No amount of discussion or gentle questioning would yield an answer. He just didn't know why he'd run into the water. We talked a long time about thinking first as we drove him back to Grandma and Grandpa's house, stripped down then wrapped in my scarf and his brother's hoodie.

I'd hoped it might have a little impact, such a scary thing to happen, yes? But I kept seeing him do smaller, less dangerous things -- running fast up a small stone wall and falling when it became too narrow. Running around the corner at Truman's school and right into another kid. Jumping off a couch back that was too high and hurting his feet. Holding a full mug of milk and jumping off a stool.

Today, he did another one: I bought a cup of coffee in a thermos with a top that pours. It's somewhat badly designed, and when he asked if he could take a drink out of the top I showed him how I usually take the top off and pour it into my mug. "I don't drink from the top," I said, "because it spills a bunch when I do that."

I turned 30 seconds later when he started screaming in pain, having just taken a drink right out of the top, spilling all over himself and burning his chest and tongue. "I shouldn't have done that, right?" he said as I carried him, sobbing and sniffling, up to a cool bath. Nope.

I know there's no real answer here; I'm already working hard as I can to teach him to think before he acts, model impulse control, talk about what went wrong afterward, coach him through the thinking when I see it about to happen. I think I have this how-to-parent-my-kids stuff handled. It's just not working, at least, not very well or fast, and if this post is for anything it's to get a kind listening ear and hear your stories.

Sometimes I think his impulse control is getting worse. Has that happened for you? Has your small child gone through periods of less thinking, more acting, when you thought that skill was improving?

He stops at all the corners, now, at least, when we're walking (i.e. running). That's something... (though I have to apologize for All The Drivers who have had heart attacks when he ran full-speed to the corner and then skidded to a halt an inch from the curb. sorry. I can't say it won't happen again.)

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oh my gosh my heart goes out to you! being a parent IS so hard!

Hugs, Mama. DS has major issues with impulse control (in our case it originates from Asperger's Syndrome, although I suspect there's some ADHD thrown in there for good measure.) He's now 9 and we are seeing very slow improvement. In fact, it's part of one of his IEP goals at school. Fortunately for us, he's never really had problems with unsafe actions (except for his tendency to bolt when stressed... yeah, the last school really had major issues with that one). Just keep on keepin on and you are making progress. Celebrate the progress, accept the limitations.

My kids both have developmental and behavioral issues, including big struggles with impulse control. I hear you about how frustrating it is, and how hard it is to tell if progress is happening. I think the important thing to remember is that it's a neurological issue, not a parenting issue — some kids are just not born with the same capacity for self-restraint. Yes, we have to do our best to help them learn it, and keep them safe along the way, but there's no point in feeling like failed parents because our four-year-olds make bad decisions (contrary to the opinion of lots of random strangers in grocery stores).

I don't have any great practical suggestions, but I did think this NYTimes article from a few years ago was very interesting: http://www.nytimes.com/2009/09/27/magazine/27tools-t.html?pagewanted=all. It's about methods for teaching impulse control to young kids. The takeaway is that behaviorism is not effective for teaching this skill, although it's the primary method used in classrooms—rewards/punishments to encourage compliant behavior (earning gold stars for good behavior, "Look how nicely Cindy is sitting still," timeouts, etc.)

Best line in the article, from a teacher in an experimental classroom working with kids on impulse control: “We pretty much try not to use this whole concept of misbehavior… These kids are not born criminals. Even if they do something that is completely out of bounds, they do it because they can’t stop themselves.”

Waiting for the day when every school system adopts this as part of its mission statement…

thanks all for the as-requested kind comments :) Sarah S., I'm surprised I never saw that piece in the NY Times. that sentiment -- that kids do things, not because they are psychotic killers in training, or because they are "manipulating" the situation for their own evil aim, but because they are unable NOT to -- is something that is seriously missing from PPS classrooms and most of the other ones nationwide. I'm with you on the grocery store strangers and, Jen. S., my oldest is a bolter too -- he's also nine -- and boy do schools not like that!

Thank you for writing this. It is just good to know we're not alone. I am eating up this post and comments!

Lots of free play with mixed age kids, good nutrition (fish oil! vitamin D), and time-- certain parts of the brain responsible for executive function just need time to develop (frontal cortex)...

((Hugs)) and lots of hugs for mama and the boy.

It is true that being parent is so hard. Being a parent is a lifetime commitment. We love our kid's without any expectations.

As someone who tends to question psychiatric disorder diagnosis anyway (remember, these are the same people who used to classify homosexuality as a disorder), I'm frequently struck by when is it just an active kid versus a diagnosis?

Remember, the US has a much higher percentage of kids diagnosed with ADHD than any other civilized country in the world. Much of modern diagnosis also stems from our society placing huge value on conformity and docile behavior.

It's fascinating to me how often we look for psychological underpinnings for thngs much mroe easily explained:

e.g. My daughter is dyslexic. I figured this out in mid-second grade. And we're talking classic, textbook dyslexia here. Despite this, PPS has continuously looked for a deeper, darker reasons for her failure to perform at grade level, despite an average/above average intelligence.

Why? PPS (and particularly her grade school) don't really believe that dyslexia (affecting 20% of the population) even exists. Most recently, her CORE teacher has tried to search for deep psychological underpinnings for my daughter sometimes forgetting things or having trouble with complicated directions. This even includes my dauhgter's left/right confusion.

As for impulse control--even that I wonder about. Some of the biggest destruction/misbehavior in my home was done by my kid's supposedly completely normal, generally compliant friends (including the full trashing of two Andirondack chairs in the back yard). I've seen truly disturbed kids, too---I just think our society nowadays labels every kid that fails to conform placidly as somehow abnormal.

Lastly, I'm reminded of the South Park episode where every kid is diagnosed with ADHD because they're all bored to tears by the monotone reading of a long, adult novel---and then asked to recall a minor detail in the middle.

Hugs from Zach's mom (Everett's buddy from Ms.R's class at Bridger). We are going through a rough patch with third grade. Last yr he was doing great but is seriously struggling. And like Monroe after he does X he looks up wondering how and why he got there.

I feel for you! Our Occupational Therapist recommended a book that has been useful. The name is a bit misleading 'cause it's not all about explosive kids. The techniques and insights I found much more broadly applicable.
The Explosive Child: A New Approach for Parenting Easily Frustrated, Chronically Inflexible Children
by Ross W. Green, PhD
http://www.cpsconnection.com/

I have a 7 year old that struggles with impulse control and outsized, over-the-top energy, a particularly challenging combination. In retrospect, I think the impulse control was the most difficult to deal with around 4. As he became an older 4, he seemed to understand consequences so much better. Despite all my vows never to use timeouts, I started using them when he was 4 (I had a newborn and simply could not chase him down). For some reason, that really got through to him, and I didn't have to use them much (and almost never do now). Impulse control is still a struggle but doesn't feel as dangerous as it did then.

I am increasingly troubled by the disconnect between what I hear from OTs, teachers, and counselors about the behavior of kids who act up or have impulse control issues and the reaction of my good friend who is a child psychiatrist. The former often seem quick to diagnose all sorts of "disorders" and acknowledgement of developmental stages are surprisingly absent. At a recent teacher/parent conference, for example, we were told that our son "denies responsibility" for things. The incident was getting in trouble for talking with a friend during quiet time and saying in response, "He started it." After some discussion, she then mentioned as an aside, "But I guess it could be a six year old thing . . ." Do you think? On the other hand, my doctor friend is always quick to note that resistance to rules, anxiety, testing boundaries out for themselves (my crazy son ran right into an icy lake, too, all the way up to his neck!) are all pretty normal developmental stages. Sometimes he even says, "I'd be more worried if he weren't doing some of these things." His main point is that children's brains are always developing, always finding new neural paths to fire, always testing and growing. There are going to be bumps all along the way and this is going to manifest itself in different kids in different ways--brains have growing pains, too. To him, impulse control is one of those very clear developmental stage milestones and it takes awhile for a kid's brain to actually be able to get it and to do it. I think he finds a lot of these early fixed categorizations of kids pretty frustrating and I have to say, I'm starting to feel that way, too. Of course, we work on appropriate discipline, emphasizing actions and consequences, all that, but if my son is supposed to have a completely mature brain at 6, then let's let him drive, vote and drink, too.

Mookie, ITA. For whatever reason, we, as a society, now see pathologies everywhere (one psychiatrist estimates at least 50% of the population will be diagnosed with a psychiatric disorder in their lifetime), particularly in children.

What I find interesting is I frequently see children better controlling their behavior than plenty of normal, fully functioning adults. Yet in the case of a temper tantrum throwing gorwn up, we just shrug it off as "under a lot of stress right now" or something similar. Likewise, I see plenty of adults making plenty of stupid decisions, wihtout any regard for the consequences.

In the case of school administrators and teachers, one routinely sees juvenile, vindictive behavior from the adults any time their control is remotely threatened. I do mean over petty, minor things---which frankly, if my daughter pitched a fit at 4 or 5, let alone 11, I would tell her to chill and get over it.

I got a lot of perspective and empathy for my impulsive child by reading Dr. Daniel Amen's books on brain activity and how to impact it. The gist is that impulsivity is not a personality problem, nor the symptom of a parenting problem. It's a neurological problem which can be seen in brain scans. Scanning technology proves that people who are impulsive have significantly less activity in the frontal lobe than "normal" people. Causes could range from genetics to brain trauma, but the important point is that there are things you can do to increase that activity. The staff at my child's school (Chief Joseph) has been wonderful at working with us to help him learn better coping skills and it's really paying off. We have used motivational reward systems, although he hasn't needed them lately. For him, dietary intervention has been key (no gluten, dairy, sugars).

on the one hand, our society wants to put everything into a little box, or category, hence the quick diagnoses of ADHD so often. on the other hand, parents today- especially west coast liberal "progressive" parents prefer to raise their kids sometimes in a way conducive to not having any impulse control (e.g. no boundaries, no discipline, do -what -you- want- when -you- want-as-long-as-you're-a-nice-person type of parenting).

My daughter is 6, and I see a lot of these behaviors in her. She definitely cannot ever tell me why she did something, and I am driven crazy by her erratic behavior! And just like Sarah, no one else sees it, but they all cringe when I tell them the stories. I don't think she has some sort of diagnosis (I'm an LCSW, so I sometimes try to diagnose, but hold back!) but I do think she feels extra safe at home to test the waters that she wouldn't test at school or with friends. Sometimes I am relieved when others tell me they have seen some of these behaviors when they are with her, as it is validating to know that it is not all in my imagination! I am hoping she will outgrow some of this, but not all of it, as she is also very adventurous and a a true free spirit. I would definitely not want to squelch those qualities (especially with meds!)!

Sarah, I've just moved from Portland to the east coast and a few women I know are taking their kids to this place: brainbalancecenters.com .

I have just a few of my own stories to add, I hope they help give some perspective on what normal kids can do. I remember doing a few very dangerous stupid things quite on purpose for no good reason when I was little. I can't tell you now why I did them, even though I knew they were stupid and risky and could hurt me.

They include:
* Removing a light bulb from a lamp and sticking my finger in the light socket (and being hurt by the electric shock).
* Sticking a fork into an electrical outlet (and being hurt by the electric shock).
* Placing my hand flat on a hot clothes iron and burning myself.
* Placing my hand flat on a hot electric stove burner and burning myself.
* Taunting a neighbors dog relentlessly until he bit me.

I am now a highly well adjusted, very normal, very impulse controlled adult. I got straight A's in school, etc etc. I do not and have never been diagnosed with ADHD or anything else.

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