SLIDER

Saturday, November 21, 2015

(Stuff The Bean Made) - It Is Written!

I told her school last week that my goal for F is to learn to write her name by herself before the end of the school year. Well, girlfriend just did it!


I guess I need to aim higher?

Friday, November 20, 2015

(44 Months) - 3 Years + 8 Months




Highlights from this month:

- She really enjoyed Halloween this year, totally getting the joy of trick-or treating, and giving out the candy

- She got a major fat lip when she fell running at the coffee shop. Only her second ever bigger "injury." There was lots of blood. And after she screamed and wailed she said, "My lip is inside out!"

- She talks more regularly about having dreams and even nightmares. They are usually the stuff of a 3.5 yo fear, like, "I dreamed all the neighbors were gone," or "I dreamed I woke up and no one was here."

- She has become much more independent in her playtime at home

- We had her first-ever teacher conference at her daycare/preschool. We learned a lot about her that we already know: she likes to play with everyone at school, but also to be alone; she loves to practice writing letters; she regularly uses her manners; is mostly ahead of the curve in all of her target/milestone areas; she talks a lot about her family; she loves eating breakfast every day with her daddy

- She basically sleeps in our bed every.single.night, and it's starting to drive me nuts

- She had her first-ever "play date," when we dropped her at Charlie and Iris's house and went to brunch by ourselves

- She no longer sits in a high chair, and has now taken over my stool at the head of the table

- She has a new baby doll toy, a cloth black boy, whom she named "BG"

- Dinner visit with Uncle Brian: "Daddy! Your brother is here!!!"

- No more diapers/pullups during nap time at school

- "The poop coming out of my butt really feels like a squashed pumpkin."

- While talking about who would maybe be our go-to babysitter in the future, if ever:
"Mama. would you ever leave me like that?"

- When walking with Daddy:
F: "I have friends in high school."
A: "Who are your friends in high school?"
F: "I don't know. Who are YOUR friends in high school."

- While getting a bath from Uncle Brian: "Mama, will you leave us alone please?"

- When choosing happy dreams, "I'm going to dream about your brother."

- Always curious to learn the good stuff:
F: "Mama, did I come out of your belly button?"
J: "No, you actually came out of my vagina."
F: "But how did I get in there?"
J: "Well, your daddy planted a tiny seed. And then you grew and grew and grew inside my tummy for lots of months, and then when you were born  you came out of my vagina."
F: "Did Daddy plant the seed in your belly button?"
J: "No."
F: "Where did he plant the seed?"
J: "It's a just a special way mommys and daddys plant seeds together."

- "I'm doctor Francine. Let me make you feel better" (hug)

- She got a flu shot and was so brave she never even cried!

- "If I had my own baby I would share it with everyone. If I walked by a person I would let it hold it."

- Potty talk is regular at our house:
Me: "Ooh, my butt smells. Sorry."
F: "I can't smell it. Do you have to go to the doctor?"
Me: "I hope not. "
F: "They could fix your butthole. That's what doctors do."

- While taking a flakily ride in the truck:
F: "What kind is your truck?"
A: "It's a Ford."
F: "I'm threed."

- After returning from my trip to Denver: "Mama I'm so glad you're still alive."

- "Soon he (Beebee) will die and no one will hang out with you. But I will."

- To Beebee: "I need to put on lipstick and make a few phone calls and then we can go to the museum."

- Mimi and Papa time for several days while I was at Denver.


Family portrait; we are laying down or swimming

Biking with Uncle Brian

Brothers



Channeling Wednesday Adams

Cake pop for flu shot

Twinsies: "Mama, I want to wear boots and a scarf like you."

Her photos skills need some coaching. Women don't love you to highlight their thighs.

Lunch date with Laura.

Monroe's 2nd bday party.

Francine + Harlow = cute kitties

Channeling Diane Feinstein and Madonna during our family photo shoot.

Best writing skills. Duh.

Channeling Grandma Nancy?

WHERE did she learn "smoking" and "cigarette"?!?

Children's Museum on a Beebee Day.

Marshmallow for Halloween.

She likes those big boys.

Zoo day with Mama. Loves maps too.

Fat lip :(

Playdate = Grownup-only brunch date

Tea Party with BG.

First sports class at SWCC.


Thursday, November 19, 2015

ASHA

How cool is it that my best friend from HS happens to be a speech path, too?!? I guess I kinda just copied her professional path, five years after she lead the way, but it's worked out pretty nicely for us so far. And it means we got to take a "work trip" together to Denver the annual ASHA convention last weekend.


Rach + Jo, PDX -> DEN

ASHA 2015, Colorado Convention Center

The conference was every bit as over-stimulating as I worried. I heard there were just over 14,000 people in attendance. It was hosted at the Colorado Convention Center in downtown Denver and also included sessions at a few of the neighboring hotels. I earned all remaining 21 hours of continuing education credits I need to renew my license before next month. And my brain hurt.

I learned about the role of early trauma on the development of executive functions, about the challenges of military culture on assessing and treating mTBI (duh), the role of resilience in rehabilitation (I have ZERO of the major qualities associated with resilience and positive prognostics, so here's hoping I never have a TBI or stroke), differential diagnosis for aphasia versus "confused speech" in TBI, Goal Attainment Scaling and a proposed app to assist with streamlining this approach to creating treatment goals. I was impressed by two Masters level SLPs who presented meditation as the missing link in neurorehab.

And concussion, concussion, and more concussion. Truth is, I could have presented many of those sessions, and I nary learned a new thing from those. Which I suppose is a good thing of sorts, meaning I actually know what I'm doing and am mostly up to speed on the latest and greatest clinical research.

I was somewhat disappointed with myself, and the lack of fire lit under my ass. I was hoping to leave exhausted, but inspired. Instead I left overwhelmed and eager to lay on my couch and watch the new-old huge TV that my in-laws installed while I was gone.

My only major take-away is that I am (finally) going to pursue developing group education for the OIF/OEF/OND veterans returning to school, and also look into piloting a modified-MBSR program for the veterans with mTBI/PTSD and subjective cognitive difficulties.

I did get to see a few familiar faces and former instructors, but mostly I attended sessions, texted with Rachel, and then hid out in dark and dusty corners of the massive conference center to recover between auditory assaults.

Rachel learned she needs to wear glasses. And the most interesting thing she saw was a black man. This isn't racist, let me explain. Everyone familiar with the profession knows that nearly 95% of SLPs are women. Of the 25 or so people in my graduate program, there was one dude, and he failed out. And while most of the SLPs in the NW certainly don't boast a broad spectrum of color, I did assume that the rest of the US provided for more diversity in the profession. Needless to say, I saw only a handful of black women, I was told there was a subgroup of Latina women (bilinguality is an attribute in this business), and maybe a few guys here and there. So when Rach told me she saw a black man, we were both like, "wow, what's he doing here!?"

The other major perk of my weekend in Denver was a stay with Stac and her family. I got to see and hang out with her kids without the constant chattering of my own kiddo, and was so impressed at how stable and happy the Shine Family seems in the chaos that is their life with 2 littles, demanding jobs, and a huge dog/house to take care of.

Selfie with Everett, 12 months.

Vivi, 2.5 years old, has got her Mama's fashion sense, with a bit less modesty.

Wednesday, November 18, 2015

Dream Writing Gig

A few weeks ago I discovered my "dream job." And I wouldn't even have to quit my real one! At this point, let's just go ahead and assume I didn't get it. So let's also just go ahead and not ask me about it, mmmkay? But just in case their hiring process is even 1/10th as slow as the federal government, I do want to put it out into the universe. I want this position.

When I first saw the job posting for a "part-time parenting writer" at Slate.com, my immediate reaction was pure excitement. And right on the heels, doubt and fear and negative self-talk. Regardless, I committed to hours re-structuring my resume to reflect writing experience (although it's been nearly a decade since I've worked for newspapers or magazines), and crafting a cover letter with the hopes to stand out. I also contacted a family friend who has written for and knows a guy at Slate, and begged him to put in a good word for me.

I haven't heard back from anyone there, and I guess maybe I feel a little bit disappointed. This writing thing is all about getting schooled in rejection. But I'm also trying out optimism and postive thinking for a minute. Like, maybe there's another even better opportunity just around the corner! Or, if this door closes, another one opens! Even, there's a reason for everything! I went to a lecture on resilience and I became aware that I have ZERO of the qualities most highly associated with resilience, optimism and a sense of purpose being two of them. So I'm trying it on for size. I told Alex I don't think it fits. 


November 5, 2015
To: Slate Magazine
Re: Parenting Writer part-time position
“Hey Mama, does your sparkly pajama shirt make you feel like a motherf#@$er?”
You know, Bean, I’ve never thought about it that way. But yeah, yeah it does. And I think I’ll wear it while I apply for this position, because this job would make me feel like a motherf*$&ing superwoman.
I have been training for this parenting writer job at Slate for the last decade.
I thrived as a newspaper reporter for a small-town daily. I excelled in my Master’s degree program and now work part-time as a devoted speech-language pathologist (SLP) to veterans with brain injury. And I am the proud parent of a precocious preschooler. Between my editors, professors, and my daughter, I’ve had the Dream Team of personal trainers. Like Jillian Michaels meets Dr. McKay Sohlberg meets Richard Simmons meets Michelle Tanner.
And all along the way, I’ve written. News stories. For an entertainment weekly. Local magazines. Thank you cards. A joint travel blog with my now-husband. A Master’s thesis. For a (now defunct) online magazine. Epic family Christmas letters. Chart notes. And a personal blog, chronicling everything from managing my Dead Mom Issues while pregnant, to researching and advocating for family-wide flu vaccinations, to ambivalence about my secondary infertility.
(It practically goes without saying) I love Slate, which along with Salon, The Atlantic, and NPR are my media resources of choice. I aspire to be like many of my favorite writers. I’ve even been known to write them fan-email. Because I’m that kind of eager and enthusiastic. Ayelet Waldman. Nate Jackson. Rebecca Schuman. Sarah Hepola. Anne-Marie Slaughter. Cheryl Strayed. Po Bronson. Anne Lamott. Raffi. But I’m not them, I’m me. And I’ve got ideas, resources, experiences, opinions and words of my own just as ready for publication.
I already read and write about parenting because I love it. I already stay up-to-date on research about early literacy, follow mommy-blogs, laugh at toddlersareassholes on Instagram and pore over the latest parenting books. But you know what I would love even more?!? Continuing to read, research and write about the things I love, but with access to a broader audience and the validation of a regular byline and actual paycheck.
I have an insatiable curiosity. I ask too many questions but listen to the answers. I have been described as “saying what others don’t.” I am open to learning and growing as both a parent and a writer. I have excellent professional references from employers, instructors and supervisors, and also from my daughter (yesterday she told her teacher that her mama is her very best friend), and my blog reader/s (hi, Dad!). In short, this would be a journalistic match made in heaven. The KJ Dell’Antonia to your Motherlode. The Martha Beck to your Oprah. I could be the Parenting Writer peanut butter to your Slate jelly.
Thank you for your time and attention. I look forward to working for you in the very near future (hands clasped in a “manifestation meditation”)!
Warmly,
Joanna Close

Play Date/Day Date




The Hubs and I discovered a few weekends ago the magic of a 3.5 year old "play date." The Bean goes to school with twins Charlie and Iris, who invited Francine over for a Saturday morning play date. We drove over to their house, chatted with their mom, Mary, and then left! For two+ hours of grown-up only time! Where we ate brunch! Seated at the bar! Apparently now we should offer to reciprocate. I need to write that on my to-do list.

Sunday, November 8, 2015

(Dead Mom Issues) - This time of year, apparently, does matter


The couples therapist mentioned last week that issues can "bubble up" in parenting a child when they become the same age as when the parent experienced their own "trauma" of sorts. This idea resonated with me, and I mentioned it briefly in my post about our first visit with the counselor. I also became aware that about this time last year I started to become interested and seeking answers to "what's wrong with me"; somewhere along the way I reached out to a few of my mom's oldest friends. I have a terrible, horrible habit of not checking my voicemail. Like, a serious avoidance/denial. I currently have 11 un-played messages, including one from a friend of my mom's, Gina, that she left November 13th, 2014. Nearly one whole year ago. So yeah, I'm that bad about it. I sent Gina an email this week, to confess that I never did (and still haven't) retrieved her voicemail. I again shared this not-so-secret idea about taking Francine on a trip back to the Bay Area, to meet and talk at length with my mom's friends, learn things that my 33 year old brain will understand differently than it did in my 20s, or even when my mom was still alive. I discovered that it is this time of year when I find myself the most interested in the travel idea. I casually mentioned the bizarre timing to my dad, the fact that this time last year I was reaching out to my Aunt Sue, Gina, Marilyn. And then this year, I've become aware that I feel inclined to do so yet again. 

Yesterday my dad emailed me that my mom had her cancer surgery 12/5/1985. And that she was diagnosed that November with 'ductal and lobular carcinoma.' I'm not so much a believer in psychics or horoscopes or coincidences or any nice fantasies of the sort, but I am oddly struck and awed by the fact that her first breast cancer diagnosis was EXACTLY 30 years ago. And that I was EXACTLY the Bean's age (well, ~3 weeks different). Granted, my mom was 8 years older when she had me than I was when I had Francie, but still, the timing is striking. Naturally, I texted my best girlfriends to share my discovery. And, naturally, they said supportive and validating things.

I try to imagine how the Bean might respond if our family were faced with a parental illness. I imagine she would be sweet, care-taking, and concerned. I imagine she would be pretty flexible and resilient, because she tends to be so in her day-to-day life. I imagine her pretend doctor play might ratchet up a few notches. By all accounts I was mostly "fine" and adaptable in the times of my mom's illness. But our memories are remarkably fallible, and each historian has their own 30-year-old lens. Or maybe I developed early defense mechanisms like compartmentalizing, denial, avoiding, faking, or anything else that might prove useful to a 3 year old faced with the threat of a death of her primary caregiver.

I never put a lot of stock in anniversaries, not the good ones, not the bad ones. But it seems my neurological pathways have different plans. They seem to remember significant timing and events even better than my conscious brain.

Thursday, November 5, 2015

(Just Work) - The truth about veterans and concussion


“My TBI is getting worse … I can’t remember anything.”


I overheard a 30-something Army veteran tell this to another combat veteran during a short break in a group education class I was co-teaching for veterans struggling with attention and memory difficulties.


The wars in Iraq and Afghanistan have been going on for well over a decade now. Some 330,000 service members have sustained concussions while serving since 2000, sometimes related to IED or mortar blasts, other times during training activities, or most often while involved in activities such as recreational sports or motor-vehicle accidents. Of note, the Department of Defense reports that more than 80% of traumatic brain injuries are diagnosed in non-deployed settings, and the majority call in the “mild” classification, which we prefer to call concussion. Yet traumatic brain injury, or TBI, has been touted as the “signature injury” of our military involvement in the most recent conflicts in the Middle East. There are now federal mandates ordering the Department of Defense (DoD), Department of Veterans Affairs (VA) and the Centers for Disease Control and Prevention (CDC) to collaborate in collecting incidence and prevalence, disseminating the information, and improving upon diagnostic and treatment tools.


Statistically speaking, mild traumatic brain injury (mTBI), or concussion, has indeed been a problem for servicemembers, a problem which by all accounts is now being addressed. First of all, concussions are being evaluated for in the field. Second, service members who fail certain objective tests are being pulled out, given time to heal and reducing the risk of another head insult.


As a speech-language pathologist specializing in cognitive rehabilitation, my job is to assist people with attention, memory and executive functioning difficulties, often as a result of a TBI. I might teach a compensatory strategy, such as writing down information that would be important to remember. I often connect patients to assistive memory devices - such as a smartphone, tablet, or day planner - to help keep track of their appointments, medication, contacts, and tasks. I often teach what are called “metacognitive strategies,” which is a fancy way of talking about methods to think about thinking. Attention exercises have their role in rehabilitation, at times, but the research about the validity of brain training, for either the injured or the healthy brain, remains mixed.


My main job, however, is education. Early education about the signs and symptoms of concussion, and positive prognostic expectations, is a key treatment factor. Research demonstrates the strong correlation between early patient and family education and reduced likelihood of later somatic or cognitive complaints.


In my current position at the VA in a specialty clinic designed to treat veterans with traumatic brain injuries, I do in fact see a few people with the kind of polytraumatic blast-related injuries that you might expect from the news. Adam, for example, is now 23 and married to his high school sweetheart. By all accounts, he’s lucky to be alive. A former Army specialist, he stepped on an IED while serving in Afghanistan, just two weeks remaining in his tour. He lost both his legs, several fingers, broke numerous bones, and sustained a traumatic brain injury that left him in a coma for more than six months. Now, he relies almost entirely on his family and paid caregivers, and is at the VA near daily for various therapies and medical appointments.


The thing is, Adam is the exception to the rule. He is a perfect example of what most civilians think when I tell them what I do for a living. That I work in a “polytrauma clinic.” That I provide cognitive therapy for people with “traumatic brain injury.” As an individual patient, I truly love working with Adam. He’s got a great sense of humor, he is motivated to learn to read again, and he consistently participates in therapy activities both in my clinic and at home. He makes a great, heart-warming story about combat veterans and sacrifice, reminding us to honor those who have served. As we should. But the thing is, most of the people coming through my team’s TBI clinic, they look nothing like Adam. The majority of people on my caseload - those with “TBI” diagnoses, those earning service-connected funds for “traumatic brain disease” - they would better be described as having a “history of concussion.”


These veterans, their stories are complicated, but not necessarily by that one time they hit their head on the MRAP. They need our help and support, without a doubt, but not because they may or may not have lost consciousness for a few seconds many months or even a few years ago. Their attention, memory, and communication difficulties are what we like to call “multifactorial in nature.”


***
The current scientific literature actually purports that the overall prognosis for patients who sustain a single mTBI or concussion is good. Most of these patients will recover within hours or days with no prolonged effects. It is estimated that 85-90% of individuals with concussion will recover from headaches, sleep disturbance, dizziness, reduced attention, or irritability within 30 days. We don’t yet know much about how and why the “miserable minority” experiences longer-lasting signs and symptoms of concussion. We do know that a complex mix of factors such as physical, genetic, and psychosocial may account for slower recovery. And we do know that a concussion doesn’t “get worse.”


Difficulty sleeping. Increased irritability. Reduced concentration. Headache. Anxiety and depression. Increased forgetting. These can all be symptoms of what current diagnostic measures call “post concussion syndrome.” But also, of PTSD. Of adjustment disorder. Of hormonal imbalances. Of medication effects. Of anxiety and depression.”


And there’s a difference between the civilian that sustains a concussion, and the service member who sustains a concussion while in combat. He or she is exposed to myriad additional factors, complicating both the diagnosis and treatment of common complaints following a concussion. There’s chronic pain, disordered sleep, medication effects, social factors such as homelessness and substance use or abuse, mental health factors from anxiety to depression to PTSD. Individually, each of these can impact our cognitive function, even in the best of scenarios. And then there’s the adjustment from military life to civilian life. Adjustment from the Middle East to the United States. Adjustment from a combat zone to a family home. Mix them all together and we have what I like to call a clusterfuck.

It’s not fair to call this “traumatic brain injury” and chalk it up to a single “signature injury,” concussion. It’s a disservice to the current scientific literature, and certainly to the veteran his/herself. It distills the very complicated picture into a simplistic one, encourages our veterans to identify as “having a brain injury,” and undermining their motivation and ability to incorporate back into being productive members of our civilian society.


With no intention to undermine the experiences of returning service men and women - those with and without a history of concussion, those with and without combat exposure, those with and without PTSD - we are in fact doing a disservice by pathologizing concussion, attributing all the vague but similar signs and symptoms to a brain injury. The pendulum has swung from “who cares about concussion” to “concussion is forever,” when in fact it should rest somewhere in the middle.


For this very specific population - these veterans who have indeed served in combat zones, who have been exposed to stressful or traumatic events, who may or may not have sustained a concussion whether combat-related or not, who are exposed to “moral injury,” who may have had pre-existing mental health issues, who are struggling to maintain regular sleep schedules, who are on multiple medications to address myriad of issues, who are experiencing chronic musculoskeletal discomfort and pain, who are transitioning from a highly routinized environment to one that provides little structure - let’s call this something different. Let’s allow language and thus space for these veterans to attribute their current difficulties to everything that they’ve experienced and are experiencing now, to give equal credence to the many environmental, social, emotional, spiritual, and physiological factors influencing them from every angle. Let’s call this “post-deployment syndrome,” or “OIF/OEF/OND disorder,” or “combat adjustment disorder,” or anything else other than just “TBI” or just “PTSD.” And then let’s create new treatment regimens, integrative approaches to treating not just the individual symptoms, but the whole person. What we are doing currently, it isn’t working. At least, not well enough.

Writing Aspirations: A Children's Book - "Just One More"




"Mamaaaaaa. Daaaaaaaddy. I'm ready to go downstairs for breakfast now."


That's Francine. Her parents call her Bean. She is three years old, and she'll tell you just that while holding up her thumb, pointer, and middle fingers, the way her Beebee taught her. She lives with her Mama, her Daddy, and her grandpa, whom she calls Beebee, lives in another house in the back yard.


Francine loves breakfast food, whether it's morning, noon, or night.
"One more pancake please, daddy?
"You can have just one more, because you're the cutest little piglet I ever did see eat."


Francine loves to play at the park near her house.
"One more swing please, mama?
"I'll give you just one more push, because you're the cutest little butterfly I ever did see fly."


Francine loves to play ukulele while her daddy sings and plays guitar.
"One more song please, daddy?
"We'll play just one more song together, because you're the sweetest little songbird I ever did hear."


Francine loves bathtime, splashing and swimming in her tub.
"One more bubble squirt, pretty please?
"Here is a bit more soap, because you're the cutest little fish I ever did watch swim."


Francine loves to read before bed at night.
"One more book please,daddy."
"Okay, we'll read just one more story, because you're the cutest little bookworm I ever did see."


Francine does not love going to sleep at night.
"Lay with me just one more minute, mama?
"Okay, we can snuggle just one more minute, because you're the cutest little cuddlebug I ever did hug."
"Give me one more kiss?"
"Okay, I'll give you just one more kiss, because you're the sweetest little lovebug I ever did know."


Francine finally went to sleep for the night. But before the sun had time to come over the horizon the next day, Francine was raring to go.


"Mama, I'm ready to go downstairs for breakfast."
"One more minute, please Bean," Mama said sleepily.
"Daddy, I'm ready to go downstairs for breakfast."
"One more minute," Daddy croaked like a frog.


"Okay, mama and daddy, you can sleep for just one more minute, because you guys are the biggest sleepy bears I ever did see."

"Was that one minute yet? Because I'm ready to go downstairs for breakfast now."

(Stuff Jo Thinks She Knows) - An Editorial on Screen Time

“This is a nice ride … I don’t think I’ve ever heard our kids this quiet before,” the commercial mom, whose nametag says Jill, happily tells her husband while test-driving a new compact SUV, the one boasting in-car 4G LTE Wi-Fi. Their two daughters are in the backseat, each with a tablet, each wearing headphones, each silent as can be.
The scene changes to show a different family test-driving a car without Wi-Fi access. The kids are made to seem rowdy and unruly, and the parents are made to appear frazzled and overwhelmed. The two girls, however, are just talking about wanting ice cream, and then chanting to each other about their favorite flavors. “Choco-late-chip, choco-late chip,” sings one. “Straw-berr-y, straw-berr-y,” sings the other. “I’m jumping on the chocolate trampoline,” the first one sings. “Mu-sic, mu-sic,” the second one chimes in.
The scene changes back to the first family, the one who test-drove the wireless-equipped car. “It was so quiet,” one parent reports. “That was awesome,” the other parent raves. The kids beg to get back in the car and go for another ride.
I have a physiological reaction when viewing this commercial, disgusted at the ways we are told to use technology to “better” our lives. To reduce or even eliminate interaction. To substitute cyber-communication for actual talking. To submerge ourselves in an alternate reality. To silence our children. There’s a time and a place for screens in our modern tech-dependent age, of course, but I don’t believe family drives around town is one of them.
(Full disclosure, this is one of the lengthy commercials in rotation on the NBC app, the one I use to watch my shows, on my iPad, while exercising on my elliptical machine. Irony duly noted.)
So what is it with the need to shut-up and pacify our kids all.the.time? What about those missed opportunities for learning, connecting, raising the next generation? In the Quiet Car, the one with Wi-Fi access, you hear almost nothing. There is a brief interaction between husband and wife, mostly empty comments about the absence of the noise they are used to their children producing. But no conversation of substance, not about their work, about their family, about their feelings, not even about what’s for dinner. As for the children, you don’t even hear their voices. At least, not until they arrive at their destination but beg to go for another ride. In the Noisy Car, you hear a lot – singing, scolding, silliness. If you listen closely, you can hear one of the girls saying “I feel sad.” I hear creativity. I hear music. I hear sharing. I hear connection. I hear family.
I’m still in close touch with a family whose young kids I nannied for the summer after I graduated high school. They’re a wealthier family, whose kids later attended a private school across town. Years ago I made a comment about what a pain it must be to drive them to and from school everyday, so much time wasted in the car. Patti disagreed, shedding a new perspective on their daily commute. “Actually, driving to and from school is some of our best time together. It’s a great opportunity for the kids not only to decompress, but decompress with their mother or each other. The kids share about their day, look to me for advice, and can rely on the consistent routine of our daily commute time, regardless of sports, homework, or whatever else they might be have going on.”
Now imagine if those same kids had access to not only smartphone and tablet applications, but now Internet. Why on earth would they ever to choose to actually interact with their parents?!?
The American Academy of Pediatrics recently announced it is working to revise its recommendations for digital exposure – television, computers, tablets, smartphones, video games – for the first time in well over a decade. Old recommendations included no screen time for kids under 2 years old, and a maximum of two hours per day for those 2 years and older. These guidelines were created long before educators would tout the benefits of learning apps, games, and shows, which is typical of health policy – research often lags far behind advances in technology. In the AAP piece, title “Beyond ‘turn it off’: How to advise families on media use,” the various AAP chairs and councilmen assert the need for re-evaluation of guidelines in order to keep up with the times. They’ve done away with the concrete hours-per-day limit, and instead now provide “key messages” in advising parents in their children’s media use.
“Media is just another environment … media can have positive and negative effects.”
“The same parenting rules apply to your children’s real and virtual environments. Play with them. Set limits; kids need and expect them. Teach kindness …”
“Role modeling is critical. Limit your own media use, and model online etiquette …”
“We learn from each other. Neuroscience research shows that very young children learn best via two-way communication …”
“Content matters …”
“Curation helps ...”
“Co-engagement counts ...”
“Playtime is important …”
That’s chicken shit. Since when do guidelines provide only vague direction? Isn’t the AAP supposed to be our master resource for recommendations that form the basis of preventative pediatric health care?!?
This is a little bit like saying “Eat healthy.” “Veggies are good for you.” “So are fruits.” “Sugar is bad.” “Exercise is important.” Instead, the American Heart Association, for example, provides clear, concrete recommendations for infants and children to promote cardiovascular health. “Breastfeeding is ideal nutrition and sufficient to support optimal growth and development for about the first 4-6 months after birth. Try to maintain breastfeeding for 12 months. Transition to other sources of nutrients should begin at about 4-6 months of age to ensure sufficient micronutrients in the diet.” Or, “Keep total fat intake between 30 to 35 percent of calories for children 2 to 3 years of age and between 25 to 35 percent of calories for children and adolescents 4 to 18 years of age, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils.” Four to six months. Thirty to thirty-five percent. Four to 8 years of age. Concrete. Simple. Relevant. You get the point.
I do, in fact, recognize the many conveniences of living in a world with our modern technology. And it can be a major setback to be media-illiterate, whether at work or in school. Tablets, television, smartphones, and computers all have their role. To trick myself into exercising, for example, I bribe myself with my favorite primetime shows on my iPad (have you seen Quantico? I’m loving it; and that leading lady is a total badass). At work I rely entirely on my desktop computer to respond to emails, write chart notes, and read the latest research on concussions. On my iPhone, I group text with my BFFs, check-in with my husband, and make childcare and dinner arrangements with my dad. In the evenings, when lazing around on the couch with my husband recovering from a long day of work/family/life, I am so grateful for Netflix and the invention of “bingewatching.”
But for my 3 year old daughter? There are far fewer appropriate times/places for the screen. Her brain is still developing. Years of research support books, boardgames, and playing outside as good for our children. Sure, there are times for technology, but I’d argue they are fewer and further between than even the most well-intentioned parent practices. An interactive book on the iPad when waiting for the sedatives to kick in for her first dental filling. An app downloaded in anticipation for a cross-country flight to visit uncles. A popcorn-and-smoothie family movie night. Caillou on the TV so her parents can sneak in a quick hump upstairs on Sunday. Or occasionally to get through meal prep, an important phone call, or paying bills for a few uninterrupted minutes.
The AAP said in a recent publication, “In a world where ‘screen time’ is becoming simply ‘time,’ our policies must evolve or become obsolete.” I don’t disagree; the evidence-based recommendations should always try to keep up with the ever-evolving technology. But I would argue that in a world where today’s children are reported to spend an average of seven hours (7 hours!?!?) each day engaged with digital media, it is the AAP’s job to set limits, not just weakly incline parents to model good media use or watch TV together.
I’m okay living in a world where my smartphone is also my camera, my mini-computer, and my link to a cyber-social network, but I do not accept living in a world where parents silence their children with tablets and Wi-Fi access for a drive across town, and where “screen time” is “simply time.” You can do better, AAP, and so can we.

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