Saturday, November 27, 2010

Children Raised in Adverse Environments

My paternal grandmother was diagnosed with schizophrenia years before my father was born.  After my father's birth, her condition worsened, and he was sent to live with some neighbors for several years.  He remembers these neighbors being very good to him and treating him as if he were their own child.  However, after his mother was released from the hospital, he was brought back home to be with his natural parents.


Unfortunately, his mother's condition had not lessened.  She was considered untreatable.  At this point, my grandfather went into a deep depression.  He went to work every day and he supported his family financially, but he stayed in the garage once he was home and spoke to no one.  He disengaged himself from his family other than his obligation to provide for them financially.


I have heard many stories of growing up with a schizophrenic mother.  First of all, because neither of his parents were mentally or emotionally able to provide for their children, my father often went hungry and shoeless.  He lived in a small town where everybody knew about his mother's condition, and therefore had no friends at school.  He would go out to farmers fields and pick fruits and vegetables to eat, and this was one of the ways he survived.


One day my father had come home to find that dinner had been prepared.  He opened the pot to find his pet rabbit boiling in a stew.  His mother had, on this day, remembered that she should feed her family, but had forgotten that the rabbit was a pet.


My grandmother was very paranoid.  She lived in fear of outside forces that would attack.  At times she  felt certain that aliens were going to invade, other times it was simply "bad men" that she feared.  She was sometimes certain that the end of the world was imminent and that everyone must pray for the salvation of their souls.  When my father was a teenager, he came into the house and his mother attempted to shoot him (luckily there were no bullets in the gun.  She thought he was one of the invaders she feared and did not recognize him as her son.


My father was blessed by his intellect.  He spent most of his free time alone outdoors.  He invented things wit natural objects that he found and explored the properties of nature.  He knew from a young age that he did not want to stay in the town where he lived, and he viewed school as his means to liberation.   He got perfect grades, and won a scholarship to The University of Illinois.  He became a successful chemist, married and had two children, and now has six grandchildren.


Not all children of mentally ill parents are so lucky.  According to the American Academy of Child and Adolescent Psychiatry, children of mentally ill parents run a high risk of developing mental illness themselves.  Additionally, because living with mental illness is stressful for the whole family, children are at harm due to neglect.


The following are behaviors often seen in children of mentally ill parents:



YOUNGER CHILDREN 
  • Marked fall in school performance
  • Poor grades in school despite trying very hard
  • Severe worry or anxiety, as shown by regular refusal to go to school, go to sleep or take part in activities that are normal for the child's age
  • Frequent physical complaints
  • Hyperactivity; fidgeting; constant movement beyond regular playing with or without difficulty paying attention
  • Persistent nightmares
  • Persistent disobedience or aggression (longer than 6 months) and provocative opposition to authority figures
  • Frequent, unexplainable temper tantrums
  • Threatens to harm or kill oneself
PRE-ADOLESCENTS AND ADOLESCENTS 
  • Marked decline in school performance
  • Inability to cope with problems and daily activities
  • Marked changes in sleeping and/or eating habits
  • Extreme difficulties in concentrating that get in the way at school or at home
  • Sexual acting out
  • Depression shown by sustained, prolonged negative mood and attitude, often accompanied by poor appetite, difficulty sleeping or thoughts of death
  • Severe mood swings
  • Strong worries or anxieties that get in the way of daily life, such as at school or socializing
  • Repeated use of alcohol and/or drugs
  • Intense fear of becoming obese with no relationship to actual body weight, excessive dieting, throwing up or using laxatives to loose weight
  • Persistent nightmares
  • Threats of self-harm or harm to others
  • Self-injury or self destructive behavior
  • Frequent outbursts of anger, aggression
  • Repeated threats to run away
  • Aggressive or non-aggressive consistent violation of rights of others; opposition to authority, truancy, thefts, or vandalism
  • Strange thoughts, beliefs, feelings, or unusual behaviors
Often, professionals concentrate on the mental health of the parent and do not consider the health of the whole family.  In order to stop the cycle of mental illness in families, the following steps are necessary for the health of children:


  • Knowledge that their parent(s) is ill and that they are not to blame
  • Help and support from family members
  • A stable home environment
  • Psychotherapy for the child and the parent(s)
  • A sense of being loved by the ill parent
  • A naturally stable personality in the child
  • Positive self esteem
  • Inner strength and good coping skills in the child
  • A strong relationship with a healthy adult
  • Friendships, positive peer relationships
  • Interest in and success at school
  • Healthy interests outside the home for the child
  • Help from outside the family to improve the family environment (for example, marital psychotherapy or parenting classes)

It is amazing to find that children being raised in war-torn countries can suffer many of the same effects as children of mentally ill parents.  And, as in the case of parental mental illness, "For young children, quality of care is the most important protective factor; caregivers play a critical shielding role as does the lack of understanding or awareness of the full meaning of the situation." Ann Masten  


The description of the film "Children In War" states "At the end of the 20th Century, the targeting and killing of children in war has become another crime against humanity. Although the Principles of Protection and the Convention on the Rights of the Child in wartime are clearly defined by international law, these accepted standards of decency are routinely violated by governments and military leaders. In today's wars 90 percent of the casualties are civilians, compared to 50 percent in World War II. In the past ten years, two million children have been killed in wars throughout the world."  

The following statistics refer to the effects of the Bosnian War on children:

BOSNIA
An estimated 15,000 children died in this three-year-long civil war.
UNICEF
An estimated 200,000 people were killed during the war which also produced 3 million refugees who were forcibly expelled from their homes by Serbian and Croatian ethnic cleansing.
UNHCR
After the Dayton Peace Accord, fewer than 10 percent of refugees were able to return home. The majority of refugees were displaced throughout the former Yugoslavia and the world.
UNHCR


Children living through wars cannot feel safety and security because those concepts are not a part of their reality.  These children are hiding in bomb shelters listening to the sounds of mortar fire all around them.  They emerge to see homes and cities destroyed - and then their parents go to fight in the war, leaving them feeling less protected than before.  During the Bosnian War it was common practice for soldiers to rape and murder children and women, and now the children of the rape victims are coming to an age of understanding of their origins.  Children who survived this time were traumatized, separated from their families, orphaned and terrified.  

There are several organizations who have attempted to help lessen the psychological effects of war on the surviving children.  Through art therapy and self-expression.  However, the long-term effects are only now becoming apparent.

The only way to truly protect children from the effects of war is to stop war all together.

Masten, A. (2009). Effects of War on Children and Child Development. New York: The Melissa Institute.
Psychiatry, A. A. (2010). When to Seek Help for Your Family. Retrieved november 27, 2010, from American Academy of Child Adolescent Psychiatry: http://www.aacap.org/cs/root/facts_for_families/children_of_parents_with_mental_illness
Raymond, A. a. (2003). Children In War. Retrieved November 27, 2010, from Children In War: http://www.videoverite.tv/childreninwar/thefilm.html




Saturday, November 13, 2010

The Effects of Nutrition on Child Development

For several years I have been making an effort to improve my own health and nutrition as well as that of my family.   I came to understand the importance of proper nutrition in people being the best that they can be.  A nutritious diet as well as an active lifestyle improve health, body image, energy levels, thinking skills and emotional health.  I have worked hard at lifestyle changes that would improve the well-being of my family as well as give my children the foundations for a happy and successful life.

The more I have learned about the importance of proper nutrition, however, the more I have come to realize the magnitude of the problems that worldwide malnutrition is causing and will cause in the future, the more concerned I have become.  The statistics are bleak, and if major efforts to improve humankind's dietary intake are not made, the results could be devastating.

The World Health Organization's website "Nutrition for Health and Development," http://www.who.int/nutrition/en/ states the following statistics:

  • On the average, a person dies every second as a direct or indirect result of malnutrition - 4000 every hour - 100 000 each day - 36 million each year - 58 % of all deaths (2001-2004 estimates).
  • On the average, a child dies every 5 seconds as a direct or indirect result of malnutrition - 700 every hour - 16 000 each day - 6 million each year - 60% of all child deaths (2002-2008 estimates).

Those are huge numbers, especially when you consider the fact that providing people with education and access to good food could virtually eradicate the problem.  This sounds like a simple solution, but we have a long way to go.  

The website "An End To World Hunger:  Hope For The Future," http://library.thinkquest.org/C002291/high/present/stats.htm  lists the following trends in the worldwide nutrition problem:


  • In the Asian, African and Latin American countries, well over 500 million people are living in what the World Bank has called "absolute poverty"
  • Every year 15 million children die of hunger
  • For the price of one missile, a school full of hungry children could eat lunch every day for 5 years
  • The World Health Organization estimates that one-third of the world is well-fed, one-third is under-fed one-third is starving- Since you've entered this site at least 200 people have died of starvation. Over 4 million will die this year.
  • One in twelve people worldwide is malnourished, including 160 million children under the age of 5. 
  • The Indian subcontinent has nearly half the world's hungry people. Africa and the rest of Asia together have approximately 40%, and the remaining hungry people are found in Latin America and other parts of the world. Hunger in Global Economy
  • Nearly one in four people, 1.3 billion - a majority of humanity - live on less than $1 per day, while the world's 358 billionaires have assets exceeding the combined annual incomes of countries with 45 percent of the world's people. UNICEF
  • 3 billion people in the world today struggle to survive on US$2/day.
  • In 1994 the Urban Institute in Washington DC estimated that one out of 6 elderly people in the U.S. has an inadequate diet.
  • In the U.S. hunger and race are related. In 1991 46% of African-American children were chronically hungry, and 40% of Latino children were chronically hungry compared to 16% of white children.
  • The infant mortality rate is closely linked to inadequate nutrition among pregnant women. The U.S. ranks 23rd among industrial nations in infant mortality. African-American infants die at nearly twice the rate of white infants.
  • One out of every eight children under the age of twelve in the U.S. goes to bed hungry every night.
  • Half of all children under five years of age in South Asia and one third of those in sub-Saharan Africa are malnourished.
  • In 1997 alone, the lives of at least 300,000 young children were saved by vitamin A supplementation programmes in developing countries.
  • Malnutrition is implicated in more than half of all child deaths worldwide - a proportion unmatched by any infectious disease since the Black Death
  • About 183 million children weigh less than they should for their age
  • To satisfy the world's sanitation and food requirements would cost only US$13 billion- what the people of the United States and the European Union spend on perfume each year.
  • The assets of the world's three richest men are more than the combined GNP of all the least developed countries on the planet.
  • Every 3.6 seconds someone dies of hunger
  • It is estimated that some 800 million people in the world suffer from hunger and malnutrition, about 100 times as many as those who actually die from it each year.


Malnutrition causes more child deaths, more low-birth rate babies and more stillbirths than any other factor in existence.  Children who are malnourished and survive suffer from poor health, stunted growth and decreased ability to learn.  For example, iodine deficiency lowers intelligence by 10 to 15 I.Q. points.  Additionally, studies have shown that children who are hungry cannot concentrate at school.  I know that I can neither concentrate nor be pleasant when I am hungry (and I am far from starving).

according to the World Health Organization, "If a pregnant woman is malnourished, her child may weigh less at birth and have a lower chance of survival. Vitamin A deficiency from malnutrition is the chief cause of preventable blindness in the developing world, and kids with severe vitamin A deficiency have a greater chance of getting sick or dying from infections such as diarrhea or measles. Iodine deficiency, another form of malnutrition, can cause mental retardation and delayed development. Iron deficiency can make kids less active and less able to concentrate. Teens who are malnourished often have trouble keeping up in school."

While malnutrition is considered to be a third world problem, in 2009 it was estimated that more than a million children in the United States go to bed hungry every night.  This number is expected to rise as the recession continues.  http://www.guardian.co.uk/world/2009/nov/17/millions-hungry-households-us-report
The following are signs and symptoms of malnutrition.  If children are displaying problems with behavior or academics, teachers should consider hunger as a possible cause:
  • fatigue and low energy
  • dizziness
  • poor immune function (which can hamper the body's ability to fight off infections)
  • dry, scaly skin
  • swollen and bleeding gums
  • decaying teeth
  • slowed reaction times and trouble paying attention
  • underweight
  • poor growth
  • muscle weakness
  • bloated stomach
  • osteoporosis, or fragile bones that break easily
  • problems with organ function
  • problems learning
While the statistics of world hunger are staggering, I found something really shocking during my research.  While it is commonly understood that hunger and malnutrition go hand in hand - there is another dietary factor that leads to malnutrition, and it is a problem that is steadily increasing worldwide.  Childhood obesity and malnutrition are just as strongly related as hunger and malnutrition.

According to the CDC, childhood obesity rates in The United States alone have triples in the past 30 years, and doubled in preschool age children.  Malnutrition is not simply caused by lack of food, it is caused by lack of nutritious foods.  With the increased popularity of fat foods and processed convenience foods, children are living on a diet of grease and salt with little or no nutritional value.  According to the CDC's website "Childhood Overweight and Obesity," http://www.cdc.gov/obesity/childhood/index.htmlObese children can suffer from all of the same conditions as hungry children with the addition of:


  • Hypertension
  • Heart Disease
  • High Cholesterol
  • Pre Diabetes and Diabetes
  • Gastrointestinal Disease
  • Depression
  • Poor Self –Esteem
  • Sleep Apnea
  • Early Puberty
  • Bone Disease
  • Reproductive Problems    

As a teacher, I think it is important to teach children and families about the importance of a healthy diet and lifestyle.  Additionally, it is my obligation to help hungry families locate resources for healthy foods.  Finally, I am committed to working with my school's food program in order to help ensure that the children we care for receive healthy meals and snacks every day.

Resources:

Websites:

the CDC's website: Childhood Overweight and Obesity

Guardian: Record Numbers Go Hungry In The US

An End To World Hunger:  Hope For The Future http://library.thinkquest.org/C002291/high/present/stats.htm 

The World Health Organization's website: Nutrition for Health and Development

Articles:

"The World Health Organization Global Database on Child Growth and Malnutrition: methodology and applications"  Mercedes de Onis and Monika Blössner

"Childhood obesity: Public-health crisis, common sense cure" Cara B Ebbeling; Dorota B Pawlak; David S Ludwig
"Worldwide Trends in Childhood Overweight and Obesity"  Youfa Wang and Tim Lobstein
"Long-term Poverty and Child Development in the United States"  Sanders Korenman
"Child development in developing countries 2: Child development: risk factors"Susan P Walker

Saturday, November 6, 2010

Giving Birth

I have actually given birth five times.  The first was a hospital birth (18 years ago).  The second was a hospital birth with midwives.  The third was a home birth with midwives.  The fifth was a hospital stillbirth at 18 weeks gestation.  The fifth, (five years ago this coming Tuesday) was meant to be a hospital birth with midwives, but ended up being an emergency c-section with a physician.

Each experience was very different from the others, and each was beautiful in it's own way.  By far, however, the most positive experience I had was the home birth of my third son which was attended by midwives from the Alivio Medical center in Chicago, Illinois.  http://aliviomedicalcenter.org/.

This planned home birth had the advantages of both a traditional birth and modern healthcare.  I had most of my prenatal appointments at the medical center, and received all of the standard tests that American women receive.  In addition, I had two prenatal appointments in my home, with the midwives coming to me.

When I started feeling labor pains, I stayed at home and relaxed.  When the pains began to get closer together, I did not have to grab my bags and head for the hospital - I called my midwives and stayed right where I was.  Being at home was comfortable and much less stressful than the ride to the hospital and the procedures that take place before arriving in the sterile delivery room.

The midwives came, and they checked my progress from time to time, but the whole process was very private for my husband and I.  Things were calm and comfortable, it was the two of us together supporting each other at home, and the whole birth process felt natural and beautiful instead of feeling like a huge risk with the possibility of complications.

The midwives were present, however, to offer advice and comfort.  For pain, I took a hot bath, or got a massage.  The pain never reached a point of being unbearable.  I attribute this to the stress-free, comfortable feeling of being supported in my own home.

When it came close to time to push, the midwives became much more active.  With their encouragement and support, I gave birth to an 8 lb baby boy, Milan Yapp,  in my own bed, leaning against my husband, who then cut the cord.  We were allowed to keep the placenta so that we could bury it in the ground and plant a tree in the same spot.

Milan Yapp - 8 years later

I read an article about a hospital in Ecuador that does vertical birth, with the mother standing and squatting rather than lying horizontal in a bed.  http://www.womensenews.org/story/health/090215/gravity-birth-pulls-women-ecuador-hospital..  At this hospital modern medicine is truly integrated with traditional practices.  The women give birth vertically so that gravity can speed the birth process, and they are given traditional herbal teas and traditional shamans are present.  However, obstetricians and modern medicines are available as well, and the hospital has an infant mortality rate half that of the rest of the country.

I would recommend that anyone interested in a more traditional birthing seriously explore the options.  It is so much more pleasant than a hospital birth.