I have one more week here before I go to Canada to fulfill my psych rotation. I'm excited to go, but I don't wish to get ahead of myself. I still have one more important week here. For this week I will remain in pediatric neurology. Tomorrow I'll be in the office in addition to meeting with a behavior consultant. The behavior consultant will ensure that I understand the protocol for an extended behavioral observation.
The extended behavior observation will happen on Tuesday. It's not a job I will do as a physician -- I'll have underlings of my own to handle such tasks once I'm an actual physician -- but because it will be my responsibility to direct others in doing this task and because I will make decisions as a physician based on the data I will gather in this task, it's best if I actually perform the task myself at least once. I will have additional opportunities to perform this task and other related tasks if I choose to do my externship in the area of pediatric neurology.
My superiors have warned me that in doing this observation and in the behavioral intervention of which I will be a part later in the week, I will encounter behaviors that I have likely never witnessed before. I was the "bad child" in my family (in part because my parents didn't know about some things my brother did in high school), buy my badness was limited to very minor back-talking, refusal to eat what I was told to eat in a timely manner, and rolling my eyes. Even branching out into the dysfunctional extended family, children very often essentially did as they were told. The MD supervising me warned me that I would hear words I've possibly never spoken myself uttered by a five-year-old.
The MD is underestimating me, but that is a subject for another day's blog.
This weekend I watched videos of bratty children shouting obscenities at their mothers and engaging in many other varieties of unacceptable behaviors. My source was YouTube, which made available a selection of videos ranging from Supernanny to random footage shot by spectators while preschoolers hurled epithets and merchandise at their parents, grandparents, and siblings in the aisles of Walmart. I was appalled at the behaviors tolerated by parents and other care-providers.
When you have a child who routinely kicks, hits, bites, scratches, and spits at his parents and siblings, how did it reach that point? Didn't parents see it coming when the child was younger and perhaps was only hitting? I acknowledge that civilizing a human being isn't an easy task, but the parent must have done essentially nothing to stop the behavior in some of the cases I viewed. I'm not necessarily advocating the violence of corporal punishment in response to the violence of a child attacking parents or siblings, but I will say that if it were applied consistently at all, even that would be better than doing nothing. In the 1950's or even early 1960's, a TV program such as Supernanny probably couldn't have been filmed in the U.S. because it would have been difficult to find enough families with truly outrageously-behaving children. The footage actually obtained would have bored viewers to sleep. While children of that generation were far from perfect in every way, the prevalence of parent-attacking toddlers simply wasn't to be found at the time. The single biggest reason for this lack of misbehaving children was probably the fear of corporal punishment.
Before going any further with a discussion of the merits and drawbacks of corporal punishment, I would like to first interject that corporal punishment is one thing and abuse is quite another. I will not discuss abusive forms of punishment in later paragraphs; if I mention corporal punishment, it would mean a slap or slaps with the open hand that did not leave marks. Anything beyond that is and always was abuse. Abuse was always pejorative in every sense even when it was tolerated by society. Abuse never helped any child in any way. While society permitted some abusive practices in disciplining children in previous generations, that does not make such practices retrospectively non-abusive regardless of when it happened. Beatings that left marks for longer than ten minutes or so were abusive even if the law did not forbid it at the time. Kicks and punches from parents to children always were and always will be abuse.
I will suggest that the reasonable use of corporal punishment led, for the most part, to children who were generally compliant with adult authority. What corporal punishment failed to accomplish, however, was to teach children anything about self-governance or why it was that they should behave in certain ways. I'm not sure it's a bad thing for a child to know that in a real pinch, a parent has the right to whack him or her. I suspect that knowledge is what kept young children of early generations from physically assaulting their parents in the way that the kids in Supernanny or in the Walmart footage did. The worst bullies on a playground don't hit anyone who will hit them back just as hard, nor do they hit anyone whose big brother will nail them after school. It's a survival concept that nearly everyone grasps. It is preferable that the survival concept eventually be supplemented by higher-level reasoning skills and development of a sense of right and wrong, but for a time, that knowledge serves its purpose.
So these parents have children who will repeatedly scratch, bite, kick, punch, spit at, pinch, and slap anyone who comes near them in the midst of their meltdowns, and the parents, who have allowed it to evolve to this point, are now clueless as to how to check the behavior. I acknowledge that anything we see on Supernanny has been edited to, in many cases, allow families' dysfunction to be maximized. Still, the produces of Supernanny didn't put words in the childrens' mouths, nor did they use computer simulations to create actions the children did not actually commit. Anything that a child is seen or heard doing or saying, the child actually did say or do.
Over the weekend I saw portions and entire episodes of Supernanny featuring close to 100 different families. Of these Supernanny cases, I recall three families with remotely normal dynamics. One of the "normal" families was the family of Wendy Wilson, who is the daughter of Brian Wilson of the Beach Boys and is herself a singer. Ms. Wilson and her husband were a family of four with two toddler sons until they were joined by twins. (I don't know how old the episode I saw was.) The family was remarkably functional compared to the usual Supernanny clientele. The parents had a few questions about how to get the toddlers into bed more efficiently and about eliminating pacifiers for the toddlers. This episode would have been boring if someone in the family were not a celebrity. They simply had very little in common with the Supernanny regulars. They were all normal and civilized people.
There were other two episodes I saw in which I perceived the families as being somewhat mainstream. One of these families had a child with Down Syndrome. The parents struggled a bit with the need for different expectations for their special-needs child, which is a very real problem for parents. How does a parent justify to a young child that his older special-needs sibling isn't held to as high a standard as he is? The supernanny convinced the parents that they weren't being unreasonable in their expectations for their neurotypical children and that they weren't being overly lenient in not requiring the same of their child with significant delays due to Down Syndrome. In the other episode in which the family seemed vaguely normal, I couldn't quite discern why this family with two adorable preschoolers was even considered for Supernanny inclusion.
One thing that struck me about the cases with children being horribly abusive to their parents was just how much pain it caused the parents to hear their children scream and cry. Maybe it's because I'm missing the "caring parent" gene, or maybe it's just because I have not yet had children of my own, but if I had children who behaved as horribly as most of the children shown on Supernanny behaved (in fairness, sometimes there was one child in the family with issues while the rest of the children were at least moderately well-behaved), I would not like those children even if they were my own. Does something happen when a person uses his or her own gonads to make a baby that causes the person to like that baby no matter how obnoxious a child he eventually becomes? There was nothing about the cries of those tantruming children that would elicit the slightest degree of sympathy in me. I would probably want to make them unhappy because they had done nothing to deserve even a shred of happiness. Perhaps I'm a bad person and shouldn't become a parent.
In any event, the kid I observe on Tuesday will need to pull out all sorts of bells and whistles from his arsenal of behaviors if he hopes to impress me with his badness.
|Their parents will sue Walmart for compensation for the head injuries that occur when they fall.|