ADHD in Preschoolers: A Case of Polarizing Certainty

The rush to diagnose itself represents an intolerance of uncertainty. Sitting in the discomfort of not-knowing while taking time to make sense of the problem calls for a feeling of safety and community of support both of which are lacking for parents and professionals alike. Parents feel judged about their child’s behavior. Clinicians feel urged to find the answer in unrealistically brief visits under pressure of a waiting room full of kids.

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Listening for Loss: My Father’s Holocaust Story

Last week my husband Joe, our two dogs, and I shared a celebratory dinner with my parents on the occasion of my father’s 98th birthday. After a festive evening filled with hope against the backdrop of a darkening second winter of Covid, Joe suggested on the car ride home that I write about it. As readers of my blog know, I am immersed in work on a new book about listening for loss. I should practice what I preach.

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A Child’s Tantrums: Beyond the Dominant Narrative

A powerful new model named “At The Feet of Storytellers” was presented at the Zero To Three annual conference in October. Rooted in investigation of thoughts, observations, and experiences of African American families, the model of “Early Relational Health Conversations” puts time and space for non-judgmental listening at its core. A pilot study of implementation in pediatrics practice showed significant impact, with publication of findings forthcoming. Intentionally not a “screening tool,” it places the clinician literally on the floor, to learn about strengths of the family system and identify vulnerabilities and needs.

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Listening to a Young Family’s Suffering

In in my role as faculty of the University of Massachusetts Boston Infant-Parent Mental Health program. I recently listened to a presentation by Dr. Barbara Stroud in which she placed caring for young children and their families in the context of systemic racism. Describing “voices that have been silenced” she cautioned us to “stop talking, teaching, and intervening long enough to listen.” When a month later Dr. David Willis spoke for the same program about Early Relational Health, he put my struggle with both “screening” and “assessment” into a new and interesting frame. Alluding to their judgmental nature, he looked at these constructs as “white dominant cultural products.” He spoke of the need to attend to power dynamics in supporting relational health with a model of promotion and prevention. His language resonating for me with the idea of protecting space to listen from a place of not knowing; to take time to imagine our way into another persons’s experience.

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The Opioid Crisis: A Vicious Cycle of the Quick Fix

When a pill is the primary treatment without attention to the full relational and social context of individual suffering, people remain stuck in patterns of disconnection and harm. We see a downward spiral of intergenerational trauma and loss tearing apart the fabric of our society. One can argue that this is true of both physical and emotional pain.

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Cultural Humility as Listening: The Power of Not Knowing

As a physician in training, I learned the concept “cultural competence.” The term suggested that by acquiring knowledge and information we could become experts in people different from ourselves. The current term “cultural humility” reflects a kind of humbleness of not knowing; a necessary time when we feel awkward and uneasy.

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Autism Prevention in Infancy: A Broad Interpretation

Especially in the time of COVID parents are raising children in a highly stressful, unpredictable, and often overwhelming environments. Now more than ever, deliberate efforts to protect space and time to listen both to parents and infants using a simple, low-cost intervention, as described in Green’s research, might go a long way in mitigating the negative impact of these difficult and uncertain times.

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Sleepless New Parents: Navigating Uncertainty and Loss

Sleep itself represents among the earliest forms of separation. While sleep disruption inevitably accompanies new parenthood, when families suffer to the point that they find their way to my office, usually they are grappling with a deep sense of loss. A search for certainty becomes an obstacle to exploring the source(s) of that pain. Time and a safe space for listening offers families opportunity to move through grief to reclaim joy.

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Celebrating Pediatricians’ Embrace of Early Relational Health

The Frameworks Institute (that also developed the term “toxic stress”) wrote in a recent report: “Early relational health, although a new term, does not designate a new field nor a series of new discoveries. In fact, early relational health builds upon decades of research from the fields of child development, infant mental health and neurodevelopment that has established the centrality of relationships between caregivers and very young children for future health, development and social-emotional wellbeing.”

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A Child’s Joy in Growing Up: A View from the Pandemic

Typically, the process of separation of child from parent takes place both gradually and relentlessly. The pandemic put a long pause on this natural progression. As we begin to resume “normal” life many will manage re-entry without significant difficulty and get back on track. But for those with a variety of vulnerabilities, the expanse of time to live in the ambivalence may lead to developmental derailment. Whether 2, 12, or 20 these children and their families will need an extra dose of listening and support to find their way forward.

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