Helping Children Out Of Growing Pains
Our children live in a fast-paced world. They are exposed to all sorts of stress much earlier in their lives. As they progress through each stage leading up to the adolescent stage, it can be tumultuous time, one after another. We often hear the word “emo” being used unsparingly to refer to this or that child who comes across as ‘difficult’, ‘sensitive’ or simply, ‘doesn’t obey instructions’. This labelling is not helpful for it glosses over the multifaceted nature of growing pains. Worse, it puts the child in the spotlight as the one who is at fault and needs to be fixed. This article examines what is involved when working with children by drawing on important research by psychologists. This information would shed light on how we, as parents, therapist/counsellor, or both working together, can support children to be masters of their thoughts and emotions.
Developmental stages of a child
Working with children can be challenging. The child undergoes various stages of development, each with its distinct challenges that can influence the therapy session, in terms of how therapy is be conducted, and the type of activities and interventions that we select for the child. A 6-year-old child and a 14-year-old teenager have different different abilities such as attention span and language abilities, and the communication style we use to engage with one would be very different from that used with the other. It is therefore important to consider the multifaceted developmental aspects – cognitive, psychosocial, emotional and physical – which we now turn to.
(i) Cognitive development
The work of Piaget has been instrumental in illuminating the stages of cognitive development in children. According to Santrock (2013), Piaget’s theory delineates the four stages of cognitive development that children go through as they make sense of the world: sensorimotor (0 to 2), preoperational (2 to 7), concrete operational (7 to 11) and formal operational (11 through to adulthood), the numbers in brackets indicating ages. Children in the preoperational stage for example, are able to communicate through words, play and drawings but lack the ability to process logical thinking. This is primarily due to the lack of adequate language ability as the brain continues to grow through experiences and learning. As such, when working with children, it is worth noting that questions designed for adults such as “why are you unhappy?” become unsuitable for children at this stage. Instead, as children are more capable of understanding than they are in expressing themselves (Locke, 1993), more information can be elicited through other creative ways such as drawings and play. This form of creative interaction at the child level can also enhance engagement and connection with the child, making it easier for the child to learn and grow.
Understanding the different stages of cognitive development also allows issues to be appropriately addressed and interactions to be appropriately structured for a family who has children of different ages. For example, a 6-year old child who is bed-wetting will likely to have a different perspective of this issue from a 13-year-old sibling, or from his/her parents. Although Piaget’s theory provides an extremely useful guideline, it is important to note that the cognitive development of children in the 21st century may have progressed a lot further since Piaget’s time, and age alone should not be the only consideration when working with children. Rather, other factors such as family environment, educational system and cultural background should form part of the consideration in understanding the child holistically. In today’s digital age, children are exposed to technology and information a lot earlier as parents are better educated and the educational system is better equipped to transfer knowledge to children.
(ii) Psychosocial development
Erikson’s (1963) psychosocial development theory provides a useful extension to Piaget’s work on cognitive development. A revised version of Erikson’s psychosocial stages by Newman and Newman (2011) again suggests the need for such revisions, to stay relevant to the current psychosocial development of humans in the 21st century. Children in the early childhood stage (2 to 4 years of age) for example, will need to master basic developmental tasks so as to gain autonomy in preparation for greater challenges in later life. Parents who are over-indulging or hyper-critical of their children are likely to cause, in these children, self-doubt about their own abilities giving rise to low self-esteem. Hence, being aware of such issues is critical so that children can be raised in a nurturing and supportive environment, where autonomy is provided instead of shame and doubt being invoked. Nevertheless, it may be challenging to detect these issues, as they only surface when the children face difficulties that are out of their comfort zone, or much later, in adult life.
(iii) Emotional intelligence
The emotional aspect of a child is often neglected or not considered as a priority by many parents and other professionals. For example, a child with learning difficulties is expected to be “fixed” so that he or she can perform academically soon enough. Yet, other aspects such as self-esteem and peer-to-peer relationships are just as important. In fact, a number of abilities and skills other than cognitive intelligence, such as emotional intelligence, are just as important if not more for a child to acquire. Salovey and Mayer (1990) elucidated the linking of emotion and intelligence by defining emotional intelligence as “the ability to monitor one’s own and others’ feelings and emotions, to discriminate among them and to use this information to guide one’s thinking and actions”. Emotional intelligence involves problem-solving and making sound decisions using both thoughts and feelings.
An education system where the focus has been mainly on academic achievement (as the one in Singapore) can cause the child’s emotional development to be overlooked. A child should be given the opportunity to develop his character, acquire emotional stability and cultivate good interpersonal skills. Having the skills associated with emotional intelligence not only helps children manage unpleasant emotions such as anxiety and frustration, but also helps promote pleasant ones, and in the process, increasing their mental wellbeing. These skills are so important to cultivate from young because they play a crucial role in the way a person will later interact with others in adulthood. For example, at their place of work, they can interact effectively with their colleagues as well as use effective strategies to manage conflicts and stress as they arise resulting in increased job performance (Ashkanasy & Daus, 2005).
The onus thus lies in the hands of those working with children to be cognisant of the emotional development of the child. More importantly, they must be able to gather and use crucial information – insights from observing the family holistically e.g., paying particular attention to the quality of the parent-child interaction – when formulating intervention plans. The emotional development of the child cannot be divorced from the quality of the attachment between the child and parents (Sigelman & Rider, 2012), and the use of the attachment theory and knowledge of emotional development enables us to consider both in tandem. For example, a better outcome is likely to be attained if the intervention involves working with the parents on long-term strategies to increase the child’s positive attachment at home, compared with just working with the child alone in the session once a week. Further, it is imperative to look out for any signs of stress or trauma that the child may have experienced or may be experiencing as they are likely to have a huge impact on the child’s socio-emotional growth.
(iv) Physical development
Another important issue to consider when working with children is their physical development, by keeping a lookout for any signs of abnormal development which can be easily overlooked. For instance, developmental delays in areas such as motor skills, impairment in hearing and speech, and health status, to name a few. Previous diagnosis if any, such as Autism Spectrum Disorder, must also be taken into serious consideration. In addition, childhood developmental disorders such as Attention Deficit Hyperactivity Disorder and learning difficulties such as dyslexia need to be screened out. A child with dyslexia for example, is likely to struggle with schoolwork and may be inappropriately labelled as lazy and inattentive. Hence, having an understanding of the child’s developmental stages as well as developmental history will generate useful insights or clues to point us to the right assessments and treatment plans. Often, it may even be necessary to collaborate with the school where the child attends for interventions to be effective. As giving diagnosis to a child can be an emotional and overwhelming experience for the parents, it is essential that this be done sensitively and constructively.
The role of the family
When working with children, it is almost impossible not to consider family and systemic factors given that they are so heavily intertwined with one another. The development of the child is fundamentally a social process whereby the family is the centre of the social context (Carr, 2006). According to Solomon (1973), in troubled marital relationships where parents use children as ‘buffers’ during conflicts, these children’s growth towards independence would be curtailed and singling them out for therapy is unlikely to be helpful in improving the functioning of the whole family. In this scenario, the focus on the primary relationships between the family members takes precedence (parents to work on their relationship), and understanding the developmental stages of the family as a whole is as crucial as understanding the developmental stages of the child.
The 8 stages of family lifecycle
Drawing upon Carter and McGoldrick’s (1999) eight stages of family lifecycle, particular attention needs to be paid to Stage 5 (family with young children) and Stage 6 (family with adolescents) when working with children and their families. Transition is a stressful time for the person undergoing the transition and all other family members (Minuchin, 1985), and children are likely to generate additional stress as they undergo distinct developmental stages. For example, young children will require substantial close interaction with and supervision by their parents. Adolescents on the other hand, in their need to gain autonomy, may create tension for the parents as the latter struggle to let go of control. This may in turn have an impact on the other younger children within the family. Hence, a multifaceted and holistic approach is necessary, whereby the family receives help, instead of the child being singled out as the sole problem.
The parent-child-therapist triangle
Finally, the parents’ motivation to be involved and stay engaged in their child’s improvement process, as well as the need for the therapist to engage with both the child and the parents, cannot be emphasised enough (Morrissey-Kane & Prinz, 1999). The role of a therapist goes beyond that of facilitating interventions. He or she needs to maintain the highest level of professionalism, staying focused on the therapy goals and at the same time, demonstrating empathy throughout the therapy. In cases of past abuse and trauma, while transference of the child’s feelings unto the therapist may be necessary, the therapist needs to be self-aware and maintain clear boundaries away from the child or the parents. This is vital to ensure that the child receives respect as an individual. An authoritative style of therapy, whether it be towards the child or the parents is unlikely to bring about positive outcomes.
In conclusion, working with children requires a good comprehension of the developmental stage he is in and the family lifecycle stage. It requires the involvement of the family. It relies on, in no small measure, the good judgement of the therapist to ask the right questions and obtain the relevant insights for customising a therapy that works for the child.
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