March 26, 2015

Reading Kids’ Social Cues is Hard Enough

 
Jenny Radesky MD, FAAP
Assistant Professor of Developmental Behavioral Pediatrics
Boston University School of Medicine


Last summer, a small but fascinating study in the journal Computers in Human Behavior,  showed that if you take  away  preteens’ mobile devices and make them hang out with their peers in the country for one week, they get better at reading other people’s facial expressions.  So which has more influence on preteen social skills, the unplugged time with peers or communing with nature?  Hard to tell, but developmental science suggests the former plays a large role. 

Reading someone else’s facial expressions and other body language such as gestures, posture, how their eyes look, how their voice sounds is key for social and emotional communication.  Developmental psychologists believe these nonverbal cues are central to infant-caregiver attachment.  For example, infants come to understand their own emotional states and experiences by looking at  trusted caregivers and reading their facial expressions, and modulating their reactions accordingly.  (“This is new…is mom OK? Alright then I’m OK”). 

Toddlers and preschoolers develop social skills by learning to reference, read, and react to other people’s behavior.  My patients with ADHD and autism often struggle to read peer social cues correctly, with frustrating consequences.  We spend lots of time, energy, and money trying to explicitly teach these children social skills through  the practice of interacting with others over and over again to tighten up the synaptic connections that regulate social communication.  What is lost when preteens and teens look at smartphones and devices for so many hours a day are opportunities for practicing face-to-face social interactions.  This may explain the study’s findings.

However my chief concern regarding reading social cues (and my focus of research) is parents of children under 6, especially parents of fussy, intensely reactive, or poorly regulated children.  These children can be hard to read.  What did that cry mean?  That tantrum out of the blue?  This insistence on suddenly refusing baths?

In order to effectively teach children how to regulate their behavior, we need to interact with them in what psychologist Lev Vygotsky termed the child’s “Zone of Proximal Development (ZPD).”  This means  knowing their cognitive and emotional sweet spots: what they can do on their own, what they can’t do, and what they can do and learn with an adult’s help.  You can’t fit the puzzle pieces in yet?   Let me guide your hand a little bit until you figure it out by yourself.  You can’t calm down when you’re frustrated yet.   Let me help you identify what emotion you’re feeling and then show you some options for calming your body down.  And I’ll slowly take my support away until you can do this skill on your own.

Caregivers need to be tuned in to a child’s temperament, developmental stage, and emotional state to be able to read her social cues and teach her within her ZPD.  In order to be attuned to a child, adults need practice observing him, over and over, through multiple experiences, interactions, reactions, and social settings, to know his rhythms and quirks.  We don’t need to be helicopter parents, observing and attuning to every single detail, but we do need a ‘good enough’ amount of experiences to know what the child might need when he or she is acting out.

Which brings me to why I study parent mobile device use, specifically the absorption that occurs with the multitudes of important or attention-grabbing things we do with our mobile devices.  With this sort of competition for attention, infants can’t always get a facial expression reaction that helps them understand their experience; toddlers may act out more (at least mine does) to get our attention, which is unpleasant when we are trying to concentrate on something important on the device. When we are absorbed with devices, we may not be as cognitively flexible or emotionally ready to “read” what annoying child behavior means and how to meet children in their zone.  We may miss important social-emotional teaching opportunities.  So far, my research findings suggest that when parents’ attention is directed at a device, they are less conversationally responsive, have fewer nonverbal interactions with children, and are potentially more hostile when children make bids for their attention.  I am crafting my future studies to understand the mechanisms of these findings, so that guidance for parents can be developed. 

In the meantime, we can continue to recommend unplugged family time, family dinners, and parent-child play, so parents can know their child’s zones.  These Common Sense Media videos are also a good start:




March 2, 2015

The Role of Media on Children's Body Image




Jacqueline Dougé, MD, MPH, FAAP
Medical Director    Bureau of Child Health, Howard County Health Department


I remember watching this year’s Super bowl with my family and the Monday morning discussion that was not about the game but about the commercials. One commercial in particular caught my attention, Always #LikeaGirl.  The video featured individuals answering the question, “What is it to be like a girl?” The video starts with adults and a young boy and ends with younger girls.  The adults and boy had a remarkably different definition of what a girl is than the younger girls.  The younger girls were more positive The point of the commercial was that as young girls grow up, their image of themselves grows more negative.  The message hit me hard and made me think about myself and if I had experienced the same feelings as I grew up.  The answer was a resounding yes, and I’m not the only one. 

The other day while I was watching a talk show, one of the TV hosts was brought to tears discussing the pain and stigma she felt because she was overweight. I could only imagine what young women and girls experience when they think of themselves. 

Common Sense Media’s recently released research article, Children, Teens, Media, and Body Image,  examines the role of media on how children view their body image.  Highlights from the research indicate the following:

         Body image has an impact on self-esteem and health.  Poor body image is linked to low    self-esteem and depression 
  Young children have body image issues
         Both boys and girls experience body image issues
         Parents’ views about their own body image can influence their children
         Social media could be used as an intervention strategy

Both girls and boys are surrounded by images of what is perfect.  Most TV shows have thin and attractive lead characters whereas the side kick is usually heavier and not seen as attractive.  Children are also exposed to distorted images in magazines, toys (Barbie dolls and action figures) and online.  But traditional media is not solely responsible for how children determine their own body images.  Family, parents, peers and society also play an important role.  How many times have you heard yourself say that you don’t look pretty enough or you’re too fat? How many times do you tell yourself that  you need to lose 5-10 pounds?  How many times do we tell ourselves that we’re not good enough?  Our kids are listening to and watching us. 

There is opportunity to change the conversation about what beauty or handsomeness means.  Common Sense Media has provided resources for parents and providers  to have positive discussions about body image:



All children should be able to feel good about themselves. Adults too.  We all don’t like something about ourselves, but we must also consider that those things are what make us unique and beautiful.  We can’t just believe the negative.  Our visions of ourselves impact how our children see themselves. 

Something to think about.