Tarnow Articles

Preparing Your Child Through Self-Management

What is self-management? Self-management is the ability to direct/supervise various skills on one's own across various settings. So what is neuropsychology? It is the examination of brain function and behavior in the individual. How can these two areas work together in order to improve the quality of life in children, adolescents, and adults?

Many parents desire to know how they can prepare their child for the skills and self-management needed for a successful life. Children today are expected to learn many things at an earlier and earlier age. But we must keep in mind that development plays a large part in learning. Perhaps we are requesting too much of particular learning when the brain has not yet fully developed in particular areas. Could we be asking some children to learn when their brain development has not reached the appropriate maturation? Would we think of asking a paraplegic who is will chair bound to run track for physical health and then punish them for possessing the capability? Of course not!! But are we doing that even now with our children to get them in the "Ivy League" Schools, or even beyond our own level of capabilities? Many parents ask "How can I prepare my child for the future?

Learning things the earlier the better, but it must be in conjunction with the appropriate developmental timing and presentation of appropriate tasks and skills. One would never dream of asking an infant with no teeth to consume a steak dinner. Let us commence with the actual brain development in order to see where their accountability begins and our own accountability ends. It is important to understand to examine development from a holistic perspective. One model is called the "diathesis-stress model" where in that we may be prone to certain diseases or struggles in life that may or may not occur depending on what is introduced into the individual's environment. One excellent example is the psychiatric disorder of schizophrenia. We do know that if schizophrenia exists in the familial lineage, there exists a probability that it may occur down the line. However, it may never occur unless enough stress is placed on the individual. So it is true for many disorders. The following diagram is an example of this concept, which illustrates why an integrative approach towards self-management is very important. This is the reason that knowledge of family medical and psychiatric history, as well as proper prenatal care is vitally important to the development of a healthy individual.

Brain development begins within the prenatal stages. In fact this is the time when the fastest rate of growth occurs. Brain development begins at 25 weeks of gestation. The fastest rate is estimated at 250,00 brain cells are formed every minute, and occurs at the most rapid rate between 25 and 40 weeks of gestation. At this time, the neural pathways or highways that allow for information to travel to the required areas of the brain are developing. This is the reason that alcohol and drug use, certain medications, malnutrition, disease, injury, and even significant stress can be significantly dangerous as it has been shown to interfere with adequate brain development.

Post-natal development is also a highly critical stage. The pathways continue develop rapidly during this time, as well. There are 4 major growth spurts in these early years of development. These include from ages 2 to 4 years, 6 to 8 years, 10 to 12 years, and 14 to 16+ years. These spurts are directly associated with acoustical, visual, and sensory development. Again, as in the prenatal stage, malnutrition, injury, disease and/or lack of stimulation can affect the developmental process, and eventually affect the ability to learn. Various portions of the brain develop at different rates .The following table demonstrates the variety of functions and the approximate ages at which they occur.

Recognition Table

The brain continues to grow throughout the life span; however, there are critical periods for recuperation of damage. The earlier the damage occurs, the better chance of recuperation. However, few studies have shown complete recovery beyond the age of 10. And although the brain does continue to develop, it is fully matured between the ages of 14 and 15 years of age, making recovery or learning new skills more difficult, but not totally impossible as some skills may peak, emerge or prematurely degenerate. It is interesting to note the prefrontal cortex (the very front portion of your forehead) continues to develop until approximately 21 years of age. The pre-frontal is responsible for such tasks as mediation, regulation and control of affective emotional behavior, judgment, insight, organizational ability and the development of self-management skills, all of which falls under the umbrella of what is known as executive functioning. Therefore, since this area is the last to fully develop, many of parents lament that their adolescents seem to not have a complete mind---and they are right!! It has been discovered that adults use the pre-frontal lobe when making decisions whereas adolescents use the portion of the brain that involves emotions. Ah, ah, that explains a lot!!!

However, some common questions arise pertaining to neuropsychological evaluations. Such as, (1) how does a neuropsychological evaluation differ from an educational evaluation or a psychological evaluation? (2) How does a neuropsychological evaluation assist in understanding an individual? (3) When should a neuropsychological evaluation be requested?

An educational evaluation examines the factors that deal directly with what occurs in the classroom, how it may affect behavior and examine learning style and skills (IQ, achievement and perhaps speech and language). A psychological examines how social/emotional factors may influence academics and behavior. But the neuropsychological approach includes all those factors as well as examining the direct parts of the brain that exhibits strengths and weaknesses. The neuropsychological evaluation includes not only the above factors but significant background/developmental, family and academic history, visual spatial perception with and without motor involvement, gross motor (hopping and jumping), fine motor (handwriting), attention and concentration (visual and auditory), behavioral factors, and perhaps the most important, long-term and short-term, and visual and auditory memory. And without a well-functioning memory, it is impossible to retain information and thus, results in poor academic performance. Then once, all this that is collected, it is integrated into the individual's strengths and weakness. Although there are several models of neuropsychology, the one used at The Tarnow Center for Self-Management is the processing approach. This allows the opportunity to examine the processes, by pass the weaknesses, focus on the strengths and use compensatory measures to improve performance. The recommendations include academic to increase learning, family assistance, and the development, of course, for improved self-management.

The last question is when should a neuropsychological evaluation be requested? When ever there is some question on the overall processing ability of the individual. These can include difficulties that consist of what is known as soft signs (those not identified by CAT Scans such as ADHD and learning disabilities) and hard signs (those that can be identified by CAT Scans such as head trauma or tumors), but the focus is always on the processing ability and the use of compensatory measures to improve various skills, and most of all the ability to manage self---self-management.

Some Practical Recommendations in Brain Development

• Play, play, play—play with your child and let them play with others. This helps teach socialization, exploration of their environment, and gross motor skills.
• Read as much as possible, even if it is the same book over and over again.
• Talk to you child as much as possible, and do not get frustration when they ask one million questions in two minutes; they are learning and you are the source of their information.
• Do not grill them on colors or objects, but may a game out of it. When out driving, ask what color is the stop sign or the sky, or what is that object overhead (an airplane!)
• Let them help you in the kitchen or doing chores (even if it gets messy or takes longer) this helps with both, their gross and fine coordination. 6.Give your children two choices when they are younger (such as vegetables or clothing), and several options when children are older. This promotes the development of self-management.
• Last, but not least, have fun with your child; a child is only a child once before they are grown and gone---but with the correct training, they will carry on the skills and the self-management to be a successful adult.