One of the greatest challenges of being a parent is helping children deal with adversity. How can parents protect children while also allowing them to take risks, face difficult circumstances, and learn to bounce back—abilities that are crucial to success at all stages of life?
Resilience can be defined as doing well in the face of challenges. How well does a child—or an adult—succeed when confronted with adversity? In order to explore this crucial topic, and how parents can help foster resilience in their children, the NYU Child Study Center presented a panel discussion on Feb. 29, 2012, entitled "The Resilient Child: Born or Built?" The panelists included CSC clinicians Glenn Hirsch, M.D.; Barbara Coffey, M.D.; Lori Evans, Ph.D.; Melissa Nishawala, M.D.; and Tim Verduin, Ph.D. Glenn N. Saxe, M.D., chair of the NYU Child Study Center and a specialist in childhood trauma, provided introductory remarks. The panel was moderated by Perri Peltz, host of SiriusXM Doctor Radio Reports. Below, you'll find a video of the main presentation, and an article summarizing the presenters' remarks.
Resilience has been deeply important to parents for millennia, because adversity is built into the fabric of human existence. It's not possible to get through childhood without facing adversity, and we wouldn't want it any other way. If we were able to magically eliminate childhood adversities from the human mix, it would not be a good thing. It would limit our children's ability to grow into successful adults. Hence the ancient, and sometimes heartrending dilemma for parents: How do you protect kids while also letting them stumble, so that they may learn to pick themselves up?
It's worth noting that there are a range of adversities children may face as they make their way to adulthood. All children will encounter conflicts with peers and family members; many will face divorce or family illness; and some, tragically, will be exposed to abuse, violence, or life-threatening illness or injury. In a career dedicated to fostering resilience in young people, Dr. Glenn N. Saxe has worked with many children in the last group. In his work with children hospitalized due to injuries and burns, he found good news: despite terrible suffering, 75 percent of these children displayed remarkable resilience.
In asking why this was the case, he concluded there is a common sense answer: Successful cultures and communities—those that have survived the ages—have had to develop practices that promote resilience as a prerequisite for that very survival. Much of this wisdom about how to help community members manage adversity and succeed in life gets passed down through the generations. As a result, many families and communities are able to tap into these practices today, sometimes without ever making a conscious effort to promote resilience in their kids.
Here are a few pieces of that wisdom:
- Children grow up in families and communities, and resilience cannot be understood independent of the social world in which a child is embedded.
- Reality is important—there are tremendous tradeoffs to shielding a child from the realities they must face. We must help children learn about, and learn to manage, the realities that confront them, however challenging.
- Loss—and losing—are part of life. To be successful adults, children must learn how to learn from losing. Children must find courage in the face of loss, and use courage to take risks that may result in loss.
- Children must learn to be accountable for their behavior. They must learn self-control. Ethics and good habits matter. There are no shortcuts to success. It always involves hard work over the long term.
Genes also have a role, and Dr. Saxe's research group has discovered two genes that relate to kids' ability to cope with trauma. But while parents can't change their children's genes, there is a lot they can do to raise children in a way that helps each child to be resilient and thrive.
A Meaningful Future: Belief and Community
Dr. Glenn Hirsch, Medical Director of the CSC, has seen many families coping with severe illness in the course of his 30 years of practice. They are often preoccupied with two ideas:
- What did we do wrong in the past that contributed to where we are now?
- What are my child's future chances for success?
The second idea holds a key to resilience that many families are able to tap. Having a meaningful vision for the future and taking steps to move toward it are important components of resilience.
By way of example, Dr. Hirsch spoke of a patient he'd first seen at age 10, with severe obsessive-compulsive disorder. Now, 25 years later, she is flourishing, with a family of her own. She credits her religion with helping her overcome her illness. For her, having a system of beliefs gave meaning to her life and future, as well as allowing her to connect with others. Relationships, communities and finding meaning in life—through religion, or otherwise—all have a profound impact on people's ability to work through life's difficulties and bounce back.
Dr. Hirsch also spoke about the importance of temperament. Children arrive in the world with different inclinations. His own first child was easygoing, even angelic; his second was very difficult. As parents, sometimes part of the work is to trump what children are given genetically, using our skills to instill behavior that will help our child succeed. Teaching children self-control, how to accept loss, how to deal with not getting what they want—all these can go a long way toward fostering resilience in children no matter their genetic predisposition.
Scaffolding: Providing Just Enough Support
As Director of the CSC's Institute for Attention Deficit Hyperactivity and Behavior Disorders, Dr. Tim Verduin sees many families that are struggling with behavioral issues, including difficulties with self-control. These parents sometimes wonder if their children will ever be self-reliant, able to organize their own backpacks and rein in impulsive behavior without constant parental support. Often these parents feel they are doing too much for their child, and yet in many cases, it is seemingly not enough.
Dr. Verduin talked about a concept known as "scaffolding." The idea is that parents give children the minimum amount of support they need to get by, always looking for opportunities to pull back and let children succeed—or learn from mistakes—independent of direct help from parents. He compared it to the idea of a sapling supported by stakes. When the tree grows strong enough, it is able to stand on its own.
Tempermentally, Dr. Verduin points out that many children with ADHD might be described more accurately as brittle than resilient. But yet, many years later, teens and adults report that the challenges they faced growing up with ADHD shaped them in positive ways—the very model of how managing adversity can set the stage for success.
Managing Parental Anxiety to Allow Kids Independence
Dr. Melissa Nishawala, Medical Director of the CSC's Autism Spectrum Disorders Clinical and Research Program, sees many children who are among the most rigid, some with severe difficulties adapting to unexpected situations. However, her story of one patient demonstrates how sometimes it's parents who inadvertently make it more difficult for children to respond to challenges.
Dr. Nishawala had an 11-year-old patient with high-functioning autism. Her family lives in a safe neighborhood, and her parents had recently given her permission to walk to the corner store by herself and buy a snack. Shortly after the first time she did this, she revealed in her therapy session that a man had approached her on her way to the store and asked for her money. Why, Dr. Nishawala wondered, did she choose to bring this up in her therapy session, as opposed to telling her parents immediately after the fact?
Parents, in their desire to protect, can react without thinking when a child reveals that she has been at risk of harm. This girl knew that Dr. Nishawala's presence would ensure that everyone would stay calm, that she would be allowed to talk about what happened, and that her parents would not overreact. In part, she had been afraid that if she shared her story first with Mom and Dad, they would never let her go to the store by herself again. The story is an excellent case study in managing risks and a scary situation—and how parents might be tempted to deny a child confidence-building experiences out of fears over safety.
For parents, Dr. Nishawala emphasized the importance of not always reacting instantly, taking the time to listen to children, and even asking questions to help create a safe space for kids to open up. For kids, she outlined a number of key ideas to keep in mind, encapsulated in the words "I have . . . ," "I am . . . ," and "I can . . . ,":
- Parents who love me.
- Rules and structures that keep me safe.
- People who encourage and support me to take steps toward independence.
- Faith in a higher power and/or my community.
- Caring, for the feelings of others and what happens to them.
- Optimistic about my future.
- Rely on myself.
- Learn from challenging situations.
- Turn to my family for support when I need it.
The Interplay of Genetics and Environment
Dr. Barbara Coffey, Director of the CSC's Tics and Tourette's Clinical and Research Program, talked about the interplay between brain anatomy and functioning, and upbringing and environment in influencing resilience. While there is a firm foundation in neuroscience for mood disorders such as depression, for instance—meaning there are observable differences in brain chemistry and functioning—we also know that the conditions in which a child is raised have a profound effect. As an example, Dr. Coffey mentioned a study that showed significant effects on brain development in mice that received more grooming, caretaking behaviors as babies.
Around five years ago, a 12-year-old patient was referred to Dr. Coffey for a second opinion. The medication he had been prescribed for a debilitating case of Tourette's Syndrome had caused him to gain a lot of weight, and now he was refusing to go to school. With Dr. Coffey's help, his family took a multi-pronged approach to fostering resilience that included physical exercise, which is known to have neural-protective effects. It also included being involved in a community group that allowed him to share information about his illness with peers and others, giving him a sense of control by helping educate others about mental illness. One way of promoting resilience for kids who can be targets of misunderstanding—and often teasing—is to find the strength to share the source of their differences with others. Dr. Coffey emphasized that awareness can go a long way in getting peers to accept kids with Tourette's and Tic disorders.
At age 17, Dr. Coffey's patient is thriving and had the courage to seek out a role model, in the form of an actor who made a documentary about his own case of Tourette's Syndrome. Dr. Coffey's patient no longer needs medication. His case is a prime example of how environment and the choices kids and families make can have a powerful impact on biology.
Learning from Losing, and Giving Back
Dr. Lori Evans, the CSC's Deputy Director of clinical practice and Director of Training in psychology, talked about the particular difficulties of encouraging resilience in tweens and teens, as parents navigate the transition from fostering good habits from the roots in childhood, to giving fledgling adults the wings to fly on their own.
Dr. Evans emphasized a few key pieces of advice for kids in this age range:
- Model the resilient behaviors and coping skills you hope to encourage in your kids. Dr. Evans talked about how after the terrorist attacks of September 11, 2001, she witnessed enormous resilience on the part of kids who returned to school and kept moving forward with their lives in the face of profound fear and loss. Often their parents were their role models in finding the strength to keep going. Respond to difficult events in the way you hope your children will respond. This doesn't mean ignoring grief and loss, but managing them.
- Help kids face their "failures." The trophy not won, the "A" not earned, can help kids learn vital lessons. Dr. Evans talked about a patient who had attempted suicide. She recovered and was doing well when, many months later, she made sure Dr. Evans was with her as she waited to find out if she'd been accepted to college early decision. The patient was able to cope well with the news that she had been deferred. Thanks in part to Dr. Evans' help, she was able to see the news in a positive light. College is about finding a good match for an individual student, and Dr. Evans helped reassure her patient that she would.
- Helping others can give kids a great sense of mastery and self-esteem. Rather than going through life with the sense that things happen to you and are beyond your control, volunteering gives kids the experience of having a positive effect on the world around them. Dr. Evans pointed out that many schools now include community service programs as part of their curricula. Kids need more than high academic standards in order to grow into capable, caring adults.