Preventing mental illness starts prenatally

Pregnant woman with apple, slice cake in hands on blue.

What if we could wipe out many forms of mental illness through the prenatal vitamins that a pregnant woman takes?  Sounds a little like science fiction, doesn’t it?  But, there are studies now showing that by adding the B vitamin, choline, the development of the fetal and child brain takes a more healthy growth trajectory than those who don’t get the supplementation. They did continue to give the choline supplementation after birth to the test group, which is also important to realize, since the brain does most of it’s growing in the first 3 years of life. This article on the results of a study of choline supplementation is an important read to understanding how maternal nutrition and subsequent childhood nutrition can affect mental health.

Some people say that we shouldn’t have to use supplements, preferring to have them receive the needed nutrients through food.  Unfortunately, it has been shown time and again that we don’t take in foods the way we should, with too much if it containing fats, sugars, and processed carbohydrates. This especially became the case by WW II when we began to have frozen dinners, and soon after began to have fast food chains. And yes, I remember how exciting it was when we first got a McDonald’s in our town in the 60’s.

When people ask why is there such an increase in mental health problems in adults, but especially in children, it is multifaceted, but nutrition definitely plays a part. We have to treat ourselves better in order to have fulfilling lives. Let’s start with nutrition.

Mindfulness Mini-Summit

There has been a great deal of buzz in the last few years about mindset and schools.  Of course it is also important in the business world but by helping our children it sets the stage for better working relationships in adulthood.
I recently had the opportunity to work with Mariam Herrmann, Achievement Coach, who has been an assistant principal, educational therapist, and learning strategist and coach over her career. She interviewed me for her Mindsets: Meet The Challenge mini summit which is now available online. You have the option of registering to view the content during the free access period of October 13th and 14th, 2016, or to purchase a pre-order packet that includes annotated videosvideo indexaudio recording, and transcripts. These are great for PD or future use with clients.
As Mariam says herself  “The way we think and the perspectives that we take can limit our success or drive us toward it. Mindsets: Meet the Challenge is an on-line mini-summit for education leaders, designed to broaden perspectives about mindset that support growth and learning. Speakers from a variety of professions share insights that support both individuals and groups. Throughout the interviews, we discuss specifics of the topic and practical uses for a school environment.”
Take advantage of Mariam’s expertise as well as the expertise of her special guests. I can assure you, you will not be disappointed.
Patricia McGuire MD FAAP
The Pediatric Profiler

50 Constructive Alternatives to Detention or Punishment — confident parents confident kids

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Children don’ have to be chronically anxious or depressed

This is a great article for parents and teachers to read which focuses on what I call the “whys” of behavior.  It is written by Confident Parents Confident Kids. We all would do better if we took time to understand the reasons for someone’s behavior before reacting. Let’s start doing this today.

Ideas for Parents and Educators “Are you okay, E?” I overheard a concerned classmate ask my son as he walked out of the school building yesterday at pick up time. “I’m okay.” he assured the friend. In my head, I was saying “Uh-oh!” bracing myself for the unknown challenge ahead. I ditched my errand-running plans […]

via 50 Constructive Alternatives to Detention or Punishment — confident parents confident kids

Seclusion rooms: yes or no?

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Where do you stand on the use of seclusion rooms?  What level of noncompliance should result in the use of seclusion rooms?  What are the federal and your state regulations on the use and when they should not be used?

These are questions being asked around the country, especially as we learn more about the ACE on future adults and the use without understanding the “whys” of the student’s behaviors.

I was recently interviewed by the Cedar Rapids (IA) Gazette about this topic after there were reports of seclusion rooms being misused in Iowa City.  Here is my LinkedIn article on it and the link to the original article in the Gazette.

Let me know your viewpoint after reading both of them.

The Homework Debate

difficult school homework

A few times in my career, I wrote medical excuses to keep students from doing homework. I know it sounds ridiculous, but what I saw were students who were in great mental pain, as were their families, from homework that was way beyond their means, especially due to significant mental health disorders that affected their ability to learn and their ability to even engage in the process of learning or wanting to be in a learning environment. When they got home all they wanted to do was crawl under their blankets, but instead their parents felt that they must drag them to the kitchen table and make them do homework. There were a number of times that the student would go off the deep end and the police were called.

Removing homework stabilized the families. The schools had to find a different means of working with the student. In the end, the students didn’t fail – although they would have if they hadn’t turned in their homework. The students did learn.

Here is a link to an article on homework I wrote on LinkedIn.

Now if your student does have to do homework and has ADHD, I have also written an ebook on Amazon entitled The Pediatric Profiler’s Guide to ADHD & Homework.  This may help you understand why your student struggles and how to help.

What it will take to engage students

tired boy doing difficult homework

Tired boring boy doing his difficult school homework

How long does it take to turn around a student who can’t engage due to the emotional baggage he brings with him everywhere? One week? Four weeks? Three months? Throughout his entire K-12 education?

The answer is “We don’t know”. But it’s much longer than the current system allows for. We can see this by looking at the success rates of most IEPs, especially for students served under the EBD (emotional behavioral disorder) label.

Let’s look at the needs of all students to be engaged in school:

1) A safe, secure home – We all want to provide our children with safe, secure homes. This allows them to be able to focus on other aspects of their life, such as social interactions, and academics. Unfortunately, according to the American Journal of Public Health in 2013, 1 child in 30  is homeless. The definition of homeless is that the child lives in a shelter, hotel, motel, shared housing with others, or no housing, such as living in a car.  This creates stress for the child which then decreases his ability to become engaged with learning.

2) Food security – Nutrition is important for good health and learning. In our country 21% of children experience food insecurity, meaning that they are not sure of reliable access to adequate and nutritious food that is affordable on a regular basis.  Many children end up eating fast food or food from convenience stores which are high in fat and salt, and low in nutrition.  This does not allow proper growth and energy in the brain for effective learning.

3) Basic hygiene– There are not a lot of studies on how basic access to hygiene affects children but Whirlpool as started a program called Care Counts working with 2 school districts. They found that providing the students with a means to having their clothes cleaned, they were able to increase school attendance, school engagement, and student motivation to do well in school.

4) A safe community – ¼ of all children are exposed to traumatic stress. According to Child Trends, in the 2011/2012 school year 13% of children lived in neighborhoods described as never or only sometimes safe. Another 30% lived in neighborhoods described as usually safe.  Children living in unsafe neighborhoods are witnesses and victims of violence, including domestic violence.  This leads to their limbic system being in overdrive (fight or flight) so that they are unable to use their prefrontal and frontal lobes for learning and social interactions.

5) Pro-social support – According to, for high-risk students, it is the school which will need to build pro-social skills since the parents are frequently unable to due to their own stresses. This means that the schools need to focus on building peer supports and a greater sense of social safety from the staff so that trust can be built and blossom into relationships. This will then lead to a decrease in the activity of the limbic system, allowing for more engagement and learning.

6) A stable family – According to Pew Research in 2013,  46% of children live in nontraditional families, with 34% living in one parent households. This is up significantly from the 1960’s when it was 9 %. This creates a great deal of stress due to the co-morbidity of under or unemployment, maternal depression, and a significant decrease in mothers availability to be emotionally there for their children.

7) Adequate sleep – Despite all the discussions about the need for adequate sleep for children and adults, studies show 1/5th of children have inadequate sleep. Children who live in less safe neighborhoods actually have more problems with 41.9% of them having sleep problems according to the journal Sleep in 2013. The Journal of Clinical Sleep Medicine in 2014 looked at 4 factors (too bright, too loud, too hot, too cold)  which can affect sleep in a preschool populations. They found that the children who experienced one or more of these factors slept an average of 27 less minutes per night than peers without these factors. This lack of sleep, especially when chronic, is a significant factor in behavioral and learning problems in children. What wasn’t found in studies were the issues of bed sharing which can create problems for some children, but which happens often in low income families.

So how do we help students who are experiencing one or more of these stressors which can negatively affect their engagement and learning in school? Likely as Hilary Clinton said her 1996 book, it takes a village. And the school needs to be the core for providing this help through collaborations with the agencies and organizations who can provide aspects of each of the 7 areas.

1) Homes that are safe and secure – Parents may need assistance to coordinate with HUD, Habitat for Humanity, and other agencies that assist families in securing housing. Having an outreach person for schools on designated days can help.

2) Food Security – The Child Nutrition Programs through the USDA is already  helping students with breakfast and lunch programs. They also have the Fruit and Vegetable Program and the Summer Food Service Program. We need to make sure that all of these are utilized to the fullest. One could also look to organizations such as Target, where their volunteers have been known to have bag pickup days at schools that are filled with food to take home. If possible, schools could also see if they could create vegetable gardens on their land to increase students awareness of the process and a greater likelihood of wanting to eat what they have grown.

3) Basic hygiene – Students who don’t feel good about themselves are more likely to avoid school. Having availability to brush their teeth, wash themselves, and wash their clothes allow them to feel more presentable and more likely to come to school, participate, and be more motivated to do well. This is where working with local hotels/motels for donations of unused toiletries can be of help. In addition contacting Whirlpool about it’s Care Counts program could bring in a washer and drier to the school so that students’ clothes can be cleaned while they are in class. The schools could also approach detergent companies to donate detergent and softener to clean the clothes with.

4) A safe community – This is harder due to fear and distrust in the neighborhoods of both the people who make it unsafe and the police who are there to protect. There would need to be the development of task force or council where all stakeholders will meet and sit down to develop the relationships to strengthen the neighborhoods’ belief in themselves as entitled to safe surroundings.

5) Pro-social support – Working to provide home visiting programs and enrichment programs to as many low-income families as possible would help lay the foundation of parenting skills which are more empathetic to the realities of young child development. Programs such as Parents as Teachers, Early Head Start, and Head Start have been effective to increasing the well-being of children. There needs to be an increased emphasis on combined public and private funding to maintain or increase services which requires continued advocacy from various agencies to our elected officials.  Students also need to be surrounded by schools which are more pro-social in nature, where teachers focus on understanding the emotions below the behaviors demonstrated in order to help students trust and engage with the teachers.

6) A stable family – This is another area where one has to look at how we help students learn about relationships, cooperation, compromise, and empathy so that when they are old enough to have families they will be stronger to handle the stresses. But for the current families, the need is for developing means of creating relationships with organizations and agencies who can provide counseling, housing, food, medical and emotional support so that they can rise above their current stressors. It is through helping parents learn and be able to utilize resilience in their own lives that they will be more available to their children.

7) Adequate sleep – Help here could be related to helping families to have a safe and secure home. It might relate to just being able to have pajamas – which are a symbol of comfort and rest – along with a book to be read at bedtime to establish a bedtime routine promoting adequate sleep. It might be helping the student who comes to school tired after having to sleep on the couch in the apartment or house shared with other families, by providing him a place for a nap. There could be after school time where students could choose to stay after to have a quiet place to take a nap, thus allowing them to be more refreshed for homework or to handle life at home.

As can be seen by the 7 factors listed above, things will not turn around quickly for students but with a closer collaboration between schools and agencies (and less turf issues), life can be stabilized for more students, leading to more completing high school, going on to further education, be it college or trade schools, and having more mental health rather than disease.



One Child in Six

xnormal distribution homework.uoregon.eduHave you ever noticed that the number quoted about high risk problems all seem to settle on or at one in six? This would mean that the vast majority of us live okay lives. But for those who live at the left far end of the bell curve, it means excessive stressors and dysfunction.

Here is a link to a recent article I published on LinkedIn, looking at the concerns of these children. Society sees these children as challenging since the stressors frequently lead to unwanted behavior and our feeling that we must control it.

Let me know what you think.