WhiteCoat

You’re DEAD!

bt28This wasn’t my patient, because if it was my patient I would have spent the whole shift looking for people videotaping me to catch the looks on my face and the phrases coming out of my mouth.

A pediatric patient is brought in by ambulance for evaluation of suicidal and homicidal ideations. Great.
The kid is already seeing a psychiatrist and is taking Strattera and Clonidine. Fine. I have issues with kids being started on psych meds, but what do I know? I’m just a dumb emergency physician.
The social worker met the ambulance at the hospital and called the children’s psych facility immediately upon her arrival. She kept saying “He’s gotta go. This is it. This time he’s really gotta go.”
The parents had the patient brought in by ambulance and wanted him transferred to the children’s psych facility by ambulance because they didn’t know if they could control him in the car.

Did I mention that the child was THREE YEARS OLD?

The parents and social worker became concerned when he bit his sister on the leg and punched her a couple of times.
In the ED, he was drinking his bottle, then intermittently holding the bottle between his teeth while climbing on and off the bed.

One of the nurses called me at home to tell me about the patient. I had to talk to the other nurse, the secretary, and the EMT that was there to do the transport just to confirm that they weren’t BS’ing me. I still have my doubts.

The kid can’t even put together a sentence and the parents and social worker are saying he has suicidal ideations.

Maybe it’s me. Maybe he’s half Tasmanian Devil and can kick his parents’ collective asses with nary more than the sharp edges of the buckles from his car seat. Maybe was told that he’s got multidrug resistant peptostreptococcus on the six teeth that have managed to rupture through his gums and, with that knowledge, told his sister in baby language “Now you DIE!” before he bit her.  Right after that he told his parents in some variant of non-Mandarin Chinese baby talk that his Similac was really insecticide and that he was going to drink it so he could die of a cholinergic toxidrome. The parents must have called the AT&T Language Line to confirm before calling the social worker and 911, but by that time the child was faking as if he couldn’t really speak. Oh yeah, and to finish the plan, after he would drink the hidden insecticide but before he vomited, salivated, urinated, and defecated all over himself, he ga-ga goo-gooed his intent to beat the family chihuahua to death with his sister’s Hannah Montana microphone.

Back when I was a kid, punishment for hitting your sibling used to be a butt-whoopin from your parents. If you got in trouble at school, it was nothing compared to the trouble you got in when you got home. These days, school teachers are afraid to discipline kids because of lawsuits. Now proper punishment when kids get home is a time out – maybe some dish soap or Tabasco sauce in the mouth for biting or swearing.

Apparently now the paradigm is changing yet again. Soon we’ll be seeing papers on how the most effective form of punishment is a three day stint in the children’s psych ward. BYOD – bring your own diapers. Maybe they’ll start him on some kiddie Haldol just for good measure.

That’ll teach ‘em.

Picture credit here

UPDATE:
Because I have already received several comments questioning my abilities as a physician because of my incorrect assertions of developmental milestones in a three year old, let me clarify that the paragraph starting “Maybe it’s me …” was intended as hyperbole.
I am fully aware of the developmental milestones of a three year old. I witness them in my three year old child every day. I have yet to witness a three year old with sufficient abstract thought to grasp the notion of death, much less the notion of killing oneself. The fact that we imbue these qualities on children that I believe are incapable of having these qualities was the point of this post.
If children need inpatient psychiatric care for biting and hitting their siblings, then our society is in worse shape than I thought … and I need to find inpatient psych beds for all of my children.

72 Responses to “You’re DEAD!”

  1. Wayne Conrad says:

    A baby bottle at age 3? And did you infer diapers, too?

    Maybe letting him have the bottle & etc. are part of some necessary coping strategy to keep the little psycho from offing himself.

    Or maybe, as you suspect, the parents don’t know how to raise a kid.

  2. Matt says:

    “school teachers are afraid to discipline kids because of lawsuits?”. Is there any social ill you and the tobacco industry can’t blame on lawsuits? There are millions of kids in schools across the country. How many lawsuits over disciplining kids have ever been filed, much less won?

    You’re losing touch with reality. This kid has a PSYCHIATRIST and is 3 years old. Do you really think lawsuits are the cause?

    • WhiteCoat says:

      Lawsuits are not the cause of this kid’s problems, although I have had patients tell me that they are afraid to discipline their teenage children and now routinely call the police for fear of being reported to Child Welfare Services.

      Ever worked in a school, Matt? Ever witnessed what goes on? Even have any kids in school? Who cares about how many lawsuits about disciplining kids have been won? The motivating factor for the schools is the fear of being sued. The threat of a lawsuit and the money that must be spent to defend oneself is what people are afraid of. Your question is like asking “Why give money to bank robbers? How many tellers have been shot, much less killed?”
      Before posting rhetorical nonsense questions, here’s a tip: go to “www.google.com” and type in pertinent keywords such as “lawsuits,” “school,” and “discipline,” then read the results. I’ll post a few results below, but doing your homework for you is really getting irksome. Now I’ll wait for you to attack the veracity of the sources without once citing any data to support your position.

      Link #1
      Before 1965, there were only a handful of legal challenges in which schools were taken to court over their disciplinary procedures. Since then, there have been more than 1,500 cases in which a school’s right to discipline students was contested and considered in U.S. appellate courts. … “Clearly, just the threat of lawsuits restrains teachers and administrators from taking charge in their classrooms and schools,” said Arum, chair of the Humanities and Social Sciences Department in the Professions at NYU’s Steinhardt School of Education. “Rather than reaffirming civil liberties, litigation has prevented schools from enhancing educational opportunities for all.”

      Link #2
      Common Good is mobilizing a coalition to support the overwhelming majority of parents and teachers who, Wooden notes, recognize that “good discipline and behavior are prerequisites to a successful school.” We support freeing teachers from the pervasive fear of being sued and daunting procedural requirements that undermine their freedom to use common sense in day-to-day disciplinary decisions.

      Link #3 – Indiana is passing laws to protect teachers from lawsuits
      House Enrolled Act 1462 was passed by the Indiana General Assembly in April and became law July 1. If sued for disciplining a student, a teacher now will have stronger legal protections – and can be represented in court by the Indiana Attorney General’s Office.
      “If teachers have been reluctant to discipline out of fear of litigation, they can rest assured that the attorney general’s office will aggressively defend them in court,” Indiana Attorney General Greg Zoeller said. “Classroom misbehavior and disruptions deprive students of their state constitutional right to a public education, and that’s the greater risk to Indiana’s future.”

      Link #4 – School sued for disciplining cheerleaders over nude cellphone pics

      Link #5
      “Results indicate that the state-level judicial–legal climate does appear to influence administrators’ discipline policies”

      My hands are getting tired from typing, so I won’t include the other 1.5+ million articles that come up using those keywords.

      • Matt says:

        Actually my mother is a lifelong teacher, and my in laws are a superintendent and lifelong teacher. And I’ve represented local school districts.

        I noted none of your links actually involved a lawsuit over discipline. Telling. Millions of kids in school and you couldn’t produce one link? Heck, even I could find one, although the administrator actually tied the kid to a desk, so that might not be the best one to make your case.

        Looks like you’re letting your beliefs substitute for facts. You should be more skeptical and verify before adopting. Especially when the basis for much of those beliefs comes from corporate America’s lawyers.

      • Matt says:

        And by the way, the district usually picks up any defense cost for the teacher and that’s often covered by insurance.

        Tell me though, how would you prefer parents andschools solve their disputes if they can’t reach an agreement?

      • Matt says:

        Incidentally, there are about 50 million kids in public schools each year and 6 million in private. Average class size is 15.6 per teacher. So around 3 million teachers.

        Tell me, how many lawsuits by parents involving discipline are there? What number constitutes this epidemic you believe exists? Or is it like med mal, where you have no idea how many cases there are but are absolutely convinced it’s too many?

      • WhiteCoat says:

        “I noted none of your links actually involved a lawsuit over discipline.”

        Link #1 – “there have been more than 1,500 cases in which a school’s right to discipline students was contested and considered in U.S. appellate courts”
        Link #4 – School sued for disciplining cheerleaders over nude cellphone pics

        What flavor Kool-Aid have you been drinking this morning?

      • Matt says:

        56 million kids, 3 million teachers EACH YEAR and youre relying on 1500 appellate cases (which may not even be brought by parents) in nearly 20 years? So that many cases over that time when hundreds of millions of kids have been through school is the basis for your belief in this society changing epidemic? And I’m the one drinking the koolaid?

      • natural selection says:

        We all take our shoes off at airports because of one shoebomber. Millions and millions and millions of air travelers and only one shoebomber.

        Matt, lawyers are the shoebomber. They start the cascade with all the uninteded consequences.

      • Matt says:

        That doesn’t make much sense. But you knew that.

      • natural selection says:

        by the same token then you would agree your argument is not less silly, because it is the same argument

      • Matt says:

        You’re not making much sense, but that’s ok. But question for you-where’s your cascade? We’ve had billions of teacher student encounters and in nearly 20 years you can’t point to more than what? A few thousand lawsuits, the legitimacy of which you know nothing about?

        That makes your case for excessive litigation and the need for some form of tort reform? (and we all know the only tort reform is caps, which really doesn’t mean much here). If you say so.

      • EK says:

        Natural Selection’s point made perfect sense(at least I thought so): a few (or one) high-profile examples that constitute a very small minority of the population can have a exaggerated effect on the behavior on the remaining majority. Just as Richard Reid trying to blow up his shoe means that now everyone’s shoes must be x-rayed to get on an airplane, a few high-profile instances of teachers or schools being sued for over-zealously disciplining students results in teachers and schools that are much more reluctant to enforce stricter discipline. Did you really need that spelled out for you?

      • Matt says:

        “a few high-profile instances of teachers or schools being sued for over-zealously disciplining students results in teachers and schools that are much more reluctant to enforce stricter discipline.”

        Yet where’s the evidence this is true? I mean actual statistical evidence, not this or that poorly sourced anecdote?

        You might say – well, there’s less corporal punishment in schools. Perhaps, but do you really believe that’s a response to a statistically insignificant number of lawsuits or a reflection of corporal punishment no longer being embraced by society as readily as it was in generations predating the baby boomers?

        To attribute the response to lawsuits which we know next to nothing about makes little sense. We don’t even know if the schools involved in those suits changed their policies.

        The Reid analogy fails because we’re talking about a specific criminal act which resulted in a specific response that minimizes the likelihood of the act happening again. That’s not the case with these claims about disciplining no longer being a part of US schools because of lawsuits. You guys are simply guessing, about the lawsuits and about the results. Is that really how you reach conclusions? Guessing about the situations that underlie them?

      • Kevin says:

        Matt,

        Please just admit that you are wrong and stop trying to argue your point. Whitecoat has back up his point with MULTIPLE sources and you have posted NONE.

        All you are doing is making yourself look like a jackass.

      • Matt says:

        Kevin, not sure what you’re reading. The only source Whitecoat backed anything up was involved a study showing 1500 lawsuits since 1992. I pointed you to the number of kids and teachers (easily verifiable via google). Other than that, his “sources” included a tort reform lobbying group funded by the tobacco industry’s lawyers, a statement that Indiana is passing a law, and a story about nude cheerleaders.

        How does that prove the point that schools aren’t disciplining kids because of too many lawsuits? As I pointed out, given the hundreds of millions of kids and the millions of teachers that have gone through the schools since 1992, you’d think that he’d come up with more than 1500, wouldn’t you?

        As for making myself look like a jackass, who knows. It’s entirely likely. Honestly, I don’t really care what you think of me personally, since we don’t know each other and will probably never meet. And I’m not really all that fond of people who have strong opinions based on minimal facts.

      • Kevin says:

        So, in link #1 where it clearly states

        “Clearly, just the threat of lawsuits restrains teachers and administrators from taking charge in their classrooms and schools,” said Arum, chair of the Humanities and Social Sciences Department in the Professions at NYU’s Steinhardt School of Education. “Rather than reaffirming civil liberties, litigation has prevented schools from enhancing educational opportunities for all.”

        I would naturally assume that a chairman, of the SOCIAL SCIENCES department, in a Nationally recognized school, has a very informed and educated opinion. And I agree with him. So does Whitecoat, and apparently a lot of other people. But, I guess that an opinion from a reliable source such as that must not be credible because it disagrees with you.

        Do you not agree that the cheerleaders who posed nude for photos should have been suspended? Is that not a perfectly rational disciplinary action? And yet the school was sued for it. But, you don’t seem to agree that the article is proving reinforcing his statement that schools are being sued for disciplining kids. Apparently it must be wrong.

        And the fact that Indiana had to pass a law to protect it’s teachers doesn’t show that they are reacting to a SPECIFIC issue regarding discipline? Apparently it doesn’t. Because you MUST be right.

        Just an off the cuff comment…. I assume you voted for Obama??

      • Matt says:

        Kevin,

        “I would naturally assume that a chairman, of the SOCIAL SCIENCES department, in a Nationally recognized school, has a very informed and educated opinion. And I agree with him.”

        I would think that too, but without seeing the basis for his conclusions it’s impossible to know. Someone recently posted a study here from the University of Wisconsin conducted by a couple of professors there. Turns out that all their conclusions were based on information supplied to them by tort reform lobbying groups when you read the report.

        So based on that press release, I don’t know how you can reach much of a conclusion, other than only 1500 cases in over a decade isn’t many given the number of teacher-student interactions. Particularly when we don’t even know if those cases were justified or not.

        “Do you not agree that the cheerleaders who posed nude for photos should have been suspended? Is that not a perfectly rational disciplinary action? And yet the school was sued for it.”

        Actually, Kevin, that’s not why the school was sued. Even their lawyer said they weren’t challenging the sanction imposed, they were challenging the fact that the photos were shared with other staff at the school and no punishment was inflicted on those who had distributed the photos. It seems you reached a conclusion without the facts. Incidentally, I cannot find what the outcome of the case was, do you know? Perhaps the judge said no case, reaffirming the school’s action.

        “And the fact that Indiana had to pass a law to protect it’s teachers doesn’t show that they are reacting to a SPECIFIC issue regarding discipline.”

        You are correct, I do not believe that every time a legislature passes a law, that it is response to an actual problem and is necessary. Do you? Until I see some evidence that Indiana administrators and teachers were being sued willy nilly, it may just be feel good legislation. In fact, if you read the press release, that’s all it really was. Instead of the school’s liability carrier defending claims, apparently if he/she wants the state attorney general can get involved. That appears to be the extent of it. Did I miss something?

        Actually, I didn’t vote for Obama. I’ve been a McCain supporter for a long time. I’m more libertarian than anything, and not a member of either major party.

        And, as a further aside, there is nothing “conservative” about tort reform. What tort reform says is that politicians, well funded by lobbyists, don’t think the voters who elected them are smart enough to judge whether corporate America has acted negligently and if so, what the value of the harm was. That’s it. Juries are apparently to be trusted in putting people in prison for life or even imposing the death penalty, but saying how much a negligent physician’s insurer should pay? No, can’t be trusted to do that. If you’re a believer in limited government, I don’t see how you support taking more power from the individual and putting it in the hands of the government. Particularly when we’re dealing with a Constitutional right.

        But that’s just me.

      • Griffin3 says:

        Bless your heart, Matt, but the study said 1500 appellate court cases in 20 years. So, this is just the subset of cases that were appealed. The number of court cases is higher than this, unless you believe every course filed was appealed; possibly much higher. I was under the impression they taught these things in law school.

      • Matt says:

        I know what the study said, I was going off of what we KNEW. Everything else is just pure assumptions, but feel free to assume there are 10 times more cases that were never appealed. Hell, assume 100, or 150,000. That’s still less than 1/2 of 1 percent of the kids that go through the system in a single year. And this study covered from 1992 until some period before the book was released in 2003. Surely the relative insignificance of that percentage was taught in whatever school you went to.

        Doesn’t change my point, but thanks for the blessings.

      • WhiteCoat says:

        8:55 AM yesterday: “Now I’ll wait for you to attack the veracity of the sources without once citing any data to support your position.”

        8:55 today: Multiple attacks on sources, not one iota of data to support your position.

        Priceless.

      • Matt says:

        I’m wondering if you can read WC. I actually used your own sources to show that you didn’t read them closely and understand the claim (nude cheerleader suit) and that the claims were an infinitesimal number (the rest). Your sources didn’t make your case. Not sure why you relied on them at all.

        But as an aside, do you not believe the source of information matters? If ATLA puts out a press release stating more malpractice claims need to be filed, do you simply accept that without further inquiry merely because it’s in writing? Or only with “sources” that confirm your preconceived beliefs. I would hope you apply more critical thinking in your work than you do your politics.

        The truth, which we both know, is that there are maybe 3 or 4 studies total on the issue where the info was gathered without upfront bias, and is put out without bias or only releasing selective data favorable to the releasing group. The CBO study Max has cited and the Studdert study. You know neither support your many dubious claims so you choose to ignore them. Which is fine, I guess, but doesn’t speak well of your honesty with regard to the issue.

        Oh well, at least one benefit of single payer is that victims will have a cheaper, if not faster, way to put forth their case. Don’t know how the govt will deal with negligent physicians, though. I’m betting you won’t like it regardless.

      • WhiteCoat says:

        The only sources that you find fault with are the ones that disagree with your opinion.
        Your criticisms of the links I published did not rebut the fact that school systems are being sued more and more often and have fear of lawsuits.
        I hope that you don’t practice law in the same way that you respond to arguments on this blog.

    • Matt says:

      All you cite are poorly sourced lobbying group studies. I have no problem with criticisms of the system from honest studies. Incidentally, none of your links prove your conclusion as to more sued over discipline each year. You believe that, and so you think that’s what they say, but they don’t. Read them closely.

      Like your claim that there are too many malpractice claims. You have no idea how many there are. Not a clue.

      • DefendUSA says:

        Matt says ‘poorly sourced lobbying studies’!!

        Well, Cowboy, go ahead cite some studies that you have found to be relevant according to you.

        We’re waiting.

      • Matt says:

        I already mentioned them, m’lady. The GAO one, the CBO one, both of which Max has provided links to previously, and the Studdert study which was published in the NEJM a couple years ago. None of which are relying on interest groups, on either side.

      • Fyrdoc says:

        I don’t see what the problem is with this kid WC. He is selfish, demanding his own way and willing to hurt anyone in the way.

        Matt, I assume you have been in contact with WC to get the kid’s name so you can recommend him to the appropriate state bar?!?

      • Matt says:

        Of your attempts at humor, that’s by far the best. Not bad! Although it would probably work better if you applied it to surgeons.

      • WarmSocks says:

        Matt, you are sadly lacking in knowledge of what public schools are like. A few anecdotes from my student teaching many many years ago. Yes, these are anecdotes. These incidents and zillions like them never make the newspapers. You won’t see these things in the court report because schools operate in such a manner to minimize the chances of there ever being a lawsuit.

        1) For the entire semester, a kid earned 3/400 points (from another teacher, this was not my class). That’s less than 1% of the possible points. The teacher gave him a passing grade because black kids would sue claiming discrimination when they failed a class.

        2) I witnessed a drug sale. The kids realized I’d seen them and tossed everything out the window. The teacher in charge of the class said there was nothing we could do about it once they’d ditched the evidence. Apparently this was a common occurence. Kids’ parents would just hire an attorney and the kids would be let off. It wasn’t worth the school’s time to continually deal with police and have teachers spending time testifying when the lawyers were the only ones getting any benefit, so they chose to ignore it.

        3) A kid brought a gun to school. Not a squirt-gun or a toy. A real pistol. With ammo. He carried it around in his backpack, showed it off to other kids, and threatened to use it on anyone who told. Nearly every kid in the school knew about it, but everyone was afraid to report it. At lunch a teacher saw the gun and the situation was finally resolved peacefully and safely. Despite the district’s automatic-expulsion policy, the kid’s dad hired an attorney and the kid was allowed back in school.

        This is what it’s really like in our public schools. Teachers are not allowed to discipline students; they generate reams of paperwork instead. Gross behavior problems are documented. These kids need consequences, not documentation. Nothing happens because parents can sue to keep their criminal offspring in school. If you think that teachers don’t run their classrooms based on what the lawyers might do, you are seriously misinformed.

  3. Correction says:

    Just so you know, 3 year olds do not drink from bottles or wear diapers, and most speak in complete sentences. They also have 20 teeth. By one year of age, the average child has 8 teeth, so a child with 6 teeth would be presumed to be a few months old. Exceptions to these things are not the norm.

    As a school teacher, I can tell you that there are 3 year olds who behave like little devils and who are in need of help, whether by a psychologist, psychiatrist or otherwise. (I’m not sure which!) I commend these parents for reaching out for help, even if they went about it the wrong way. Too many parents turn a blind eye, and it’s often too late to effectively correct childrens’ behaviour by the time someone else tries to intervene years down the road.

    Btw, I too am against giving psyche meds to children, but then again I am not a medical professional.

    • Liz says:

      Any kid who goes off at this young an age is either a born sociopath or has really crappy parenting. That’s it.

    • Throckmorton says:

      Correction:

      I see 4 year olds come into the office with diapers, I see parents who tell us that their 2 year old is bipolar and have parents who take thier kids pain medication after the child has had surgery.

      If you want to see the real underbelly of our culture, vist the ER at 2 in the morning.

  4. Nurse K says:

    I’ve written about it before, but how many times have you seen a nice calm, cooperative kid come in with parents that are in your face demanding “med adjustments” and “admits” for things like “yelling at his brother” or “disobeying his father”.

    “Well, that’s normal behavior for a kid his age. I’m pretty sure most 9 year olds have argued with a sibling or parent. Why are you concerned?”

    “Just trust me, he needs a med adjustment!!!”

    Ugh, sorry kid that your parents are crayzee.

    • DreamingTree says:

      Agreed. Medicating does seem to be an easier solution than effectively disciplining/parenting your kids. But, I’d hate to see us swing the pendulum back to smacking the crap out of kids when they step out of line. The sad part is that you need a license to drive, but anyone can have kids.

  5. DreamingTree says:

    You seem to be strongly siding with nurture in the ongoing nature vs nurture battle. While it’s incredibly sad to consider, it is possible that a 3 year old could have a mental illness so severe that his parents would seek inpt psych. There could be a genetic predisposition, or the possibility that the child has been abused — or both. I would hope that this would be uncommon, but it happens enough that they are researching it: http://ajp.psychiatryonline.org/cgi/content/abstract/141/4/520

    I really doubt that lack of physical punishment is the cause of a child behaving like this. Ineffective, inconsistent discipline is a problem, but that doesn’t mean that more physical consequences are needed. I didn’t spank my kids and they are normal & well-behaved.

  6. DaveyNC says:

    People ought to have to get a license to have kids.

    I’m coaching a U10 youth soccer team right now. Last week, my littlest guy got kicked in the calf. Now, it was a hard shot and I’m sure it hurt, so I picked him up and moved him out of the way so he wouldn’t get stomped on. By the time I walked 10 steps with him and started to set him down, his mother had covered 50 yards and was screaming wanting to know what happened. She immediately dropped to her knees, cradled him and hugged him. All on the practice field. This same kid asks me to tie his shoes for him and when I refuse, he gets one of the other kids to do it for him.

    She’s a sweet lady, and loves her son, but she isn’t doing him any favors with this type of helicoptering. Getting kicked is part of soccer; I tell the kids at the start of the season that it will happen and that if they want to play, they need to accept that. Two minutes later he was up and running around again. After his Mom let him go.

    Don’t get me started on what I’ve seen in the schools. Our schools have been made effeminate and are run, as WC says, to avoid lawsuits.

  7. hannah says:

    Meh, I was IP with a kid who was systematically killing off the family pets by the age of six. Psssyyychoooopath. I’ve also seen some really, really angry little kids. How do you even have so much anger when you’ve only been on this earth for four years? It makes me sad.

  8. hannah says:

    (Although, on second thought, the SADDEST thing I ever saw was this little preschool-ish aged kid who’d been IP for several weeks & I don’t think his parents had visited once. So the kid is crying for his mom every night, not staying in his bed, etc. and you’ve got the nurses threatening to “shoot him in the butt” with a tranq if he doesn’t shut-up. Second was the psych resident who told this retarded girl that she “couldn’t have her mommy” because she now “belonged to the state. We’re your mommy now.”)

  9. NursieC says:

    This reminds me of a friend of mine whose son was “dignosed” as being “bipolar” at the age of three. Aren’t all 3-year olds a little bipolar?

  10. mrsslats says:

    Wow. Ok. It’s time to take my son to the psych ward. Lets see… What has he done TODAY?
    He’s hit his 1 year old sister several times. He’s lied to me 5 times (and counting). He’s hit me. He’s refused breakfast. He wants to watch Cars and Nemo.

    Diagnosis:
    Pathalogical liar. Homicidal (several attempts on life of sister and mother). Suicidal (attempts by starvation, fantasizing about getting hit by a car).
    Lets break out the meds!

    Nah. I’ll go with time out with a little swat on his behind to remind him he’s not in charge.

  11. Marilyn says:

    Too many young parents don’t have a clue what they are doing because they don’t know that the goal of parenting is to raise responsible adults. They misunderstand the meaning of the word “discipline”, and they think their job is to keep their kids from any kind of disappointment, protect their kids from any kind of unpleasantness. Over-indulgence and over-protectiveness is an extreme problem in young parents these days.

    Society needs to accept that every kid is different and one-size-fits-all parenting is a dangerous philosophy to bring into our society. Not all spanking is abuse, and the “no-spank” crowd needs to get over themselves. Some kids need it. And parents need to “man up” and be the boss. Period.

    One of the reasons we home schooled our kids was so that we didn’t have to battle continually to undo a value system that would have been imposed in the public schools. We didn’t have to be afraid of an overbearing social services department getting into our lives and removing our children just because we might have laid a well-placed smack on a very rebellious butt. Not that I’m advocating a lot of beating, I don’t think I spanked any of mine more than half a dozen times in their entire life.

    Kids need to learn that they won’t die if they don’t get everything they want. Parents need to learn that kids won’t die if told “no”. Put the kid in a safe place, then ignore the tantrum. The tantrums stop pretty quickly when they don’t pay off.

    Parents need also to learn the difference between irresponsibility that is natural to children, and true rebellion. I see so many parents laying down harsh discipline on kids that are just being kids. Whatever happened to “natural consequences”? If a kid makes a mess, he cleans it up. If a kid lets the dog eat his ice cream cone, he needs to live with the loss.

    The parents of this three-year old need to be apprenticed to a pair who successfully raised some kids. In the old days that was called “grand-parenting”.

    Sad. Very sad.

  12. ERP says:

    In terms of this lawsuit in school issue – WC is right – it has nothing to do with the actual numbers of successful suits or amts of payout. It just creates the fear that drives behaviour. I have been sued and released once in 10 years and it has made me fearful. My colleages who have never been sued have fear. School RN’s are fearful. The lawsuit’s most powerful tool is the creation of fear.

    • Matt says:

      I can point you to a case of a contractor suing a homeowner for nonpayment, when the homeowner thought the house was built incorrectly – are you now going to refuse to hire a contractor or ever build a home? I can show you a case of a seller suing a buyer of a home for fraud – are you now going to choose to rent? I can show you a case of a landlord suing a tenant for destroying the place – are you now going to choose to squat in an open field?

      I can probably point you to a case of a driver being sued for running a light and hitting someone while he looked down to change the radio station – are you going to stop changing the station? I can probably point you to a case involving a driver being sued for getting in a wreck as a result of speeding – will you stop speeding? I can point you to cases of doctors suing each other over partnership agreements and spending tens of thousands over years of litigation – are you never going to join a practice group?

      These claims of fear completely changing your lives don’t make any sense, unless of course the above is true. You literally don’t do anything.

      As for WC being right, almost all of WC’s belief in these “exploding litigation” claims comes from lobbying groups funded by the likes of the tobacco industry and the insurance industry. Is skepticism dead in this country? Why do you guys believe these “studies” are being pushed? Because they’re interested in justice?

      Oh, and please, tell me how many school RNs have been sued for malpractice. Point me to the case, I beg you.

      However, single payer makes all your malpractice fears at least go away. You will still have to be afraid that your little munchkins might not be thoroughly disciplined at school. At least until we get the administrators and teachers full immunity for all their acts. We wouldn’t want people like the guy who tied the kid to the desk to be held accountable, would we?

      • Kevin says:

        Matt,

        Please go back to your troll cave and leave the grown-up discussions to the adults who can discuss opinions backed up with FACTS and be open minded about things.

      • ladyk73 says:

        Matt,

        I see the logically map that you are trying to make. However you are denying that anecdotal evidence can have an effect on individual and group behavior. I am not going to link to research studies, because my arguement has face validity. Many examples of this idea (faulty statistics and anecdotal evidence can effect individual behavior) has already been mentioned.

      • Matt says:

        Actually Kevin, if you know of some facts that contradict me, please let me know.

        And by facts, I’m not talking about selectively released numbers put out by lobbying groups on either side – be it the American Tort Reform Association, the AMA and state medical societies or the American Trial Lawyers Association and Public Citizen. I’m talking about independent information based on neutral sources.

        If you feel I’m making something up, please, ask me for my source and I’ll be glad to give it to you. It will typically not be a lobbying group, and if it is I will tell you to take it with a grain of salt.

        As it stands, and being as open minded as possible, when it comes to medical malpractice, there are really only two legitimate criticisms of the current system. One, that it’s too expensive. Two, that it takes too long. These conclusions arise from the Studdert study of a few years back, which was the most complete and neutral study of the issue to date. You can easily find it online. It was not sponsored by any industry groups nor did it rely upon their information as the basis for its conclusions.

        If you have a tort reform proposal that addresses those things, I’m all ears. But having the government arbitrarily decide the value of cases without regard to the facts doesn’t do that. And that, my friend, is the only tort reform proposal out there. Why you might ask? Because at the end of the day, the real beneficiaries and primary backers of tort reform, corporate America and the insurance industry specifically, isn’t really interested in paying more people faster, regardless of the legitimacy of their case.

        Perhaps you can contemplate that further in your cave of enlighted open mindedness.

      • Matt says:

        lady,

        I would agree with you. However, what I don’t understand is why this anecdotal evidence only seems to inhibit certain people in certain ways. And curiously, in ways that are then turned around and used as the need for this or that “reform” limiting corporate America’s ability to be held accountable before a jury. Is that an odd correlation or is it just me?

        There are certainly far more people being sued in homeowner-builder disputes than in teacher-student discipline suits, so why are people still building homes?

        I think that credit has to be given to the backers of tort reform, who publicize ever outlier verdict ad nauseum, every suit filed regardless of when it’s dismissed, and every large verdict regardless of the facts or whether it’s subsequently knocked down. If you read their press releases, you wouldn’t know that tort filings are down, average payouts are down, etc. It’s truly impressive marketing that has led to these fears.

      • Kevin says:

        Matt…. the only point you seem to be trying to make is that you don’t believe that lawsuits and the fear of litigation is causing teachers to not discipline their students.

        And you have provided ZERO facts to back that up. As I stated in my reply above, the links that WC put up reinforce his (and mine) opinion on the fact that it DIRECTLY affects the teachers abilities.

        Your analogies about the contractor and the driver are on completely different levels than that of how overprotective parents are and how our society has become significantly weaker because everyone wants the easy way out.

        The parents medicate their kids because they don’t want to deal with the trials that come with raising a child.

        Parents sue teachers and schools because they just want money and don’t want to work.

        We live in an overly litigious society and until the judges and our court system learns to dismiss frivolous lawsuits we will always live in fear of being sued. And when you are a teacher, the risk of having your credentials and teaching license revoked because of some over-protective parents who can’t control their own kids didn’t like the fact that the teacher had to punish their kids for them – the risk is sometimes not worth it so they don’t do anything.

      • Matt says:

        Kevin,

        You’re right. I have zero empirical studies to show that. Nor do you have any empirical studies to support your conclusion that they are. And more importantly, you don’t have any empirical studies to support your conclusion that the cause of lack of school discipline is lawsuits, as opposed to parents, economics, etc.

        As for the links you mentioned, I addressed them above. They simply don’t make your case. If you believe the Indiana law dealt with this issue though, can you show me a marked improvement in discipline in their schools? That would seem to make your case.

        “The parents medicate their kids because they don’t want to deal with the trials that come with raising a child.”

        I agree.

        “Parents sue teachers and schools because they just want money and don’t want to work.”

        I’m unaware of a rash of big payouts in these cases which would allow one not to work for extended periods of time. Most of them appear to be asking for injunctive relief related to the discipline. And there’s also a fair number of free speech related cases in schools, but those don’t typically involve big dollars. I know facts are important to you, so what’s the factual basis for this belief? Do you know what the average payout in these cases is?

        “We live in an overly litigious society and until the judges and our court system learns to dismiss frivolous lawsuits we will always live in fear of being sued”

        I don’t know how you define “overly litigious” – is there an optimal number you’re shooting for or would expect and if so what is it? I’m guessing you have no idea how many lawsuits are filed and cannot break them down by type, so I’m not sure how you reach this conclusion. Nor am I sure how you reach the conclusion that frivolous lawsuits are not dismissed. Take the nude cheerleaders case – it may well have been dismissed shortly after filing but I can’t find out. Can you?

        ” And when you are a teacher, the risk of having your credentials and teaching license revoked because of some over-protective parents who can’t control their own kids didn’t like the fact that the teacher had to punish their kids for them.”

        It’s not that easy to get rid of a teacher. If nothing else the NEA is good at that. But I would agree with you that parents are too overprotective- I believe the term is “helicoptering”. But that’s a societal issue, not a lawsuit one.

      • natural selection says:

        Kevin,

        Matt has a hard time with obvious common sense. He has been so lawyer indoctrinated that it has permanently rewired and distorted his brain.

        You can’t find one single randomized controlled study that shows that jumping out of an airplane with a parachute is safer than jumping out without one. If he really believed what he says then he would jump out without a parachute.

      • Matt says:

        natural, I’m not surprised this is where you ended up. When one can’t find any facts to back up their beliefs, one ends up simply tossing up nonsense.

        The one thing that is unique to law school is that you are taught to always examine both sides of the issue and review the issue with an eye toward seeing it from all sides and understanding it from all sides.

        Most of the public, as you tort reformers here indicate, simply believe something and discard any evidence to the contrary, and cling to anything that supports them no matter how dubious. It’s why people believe GW planned 9/11, or think Michael Moore has it all figured out. Admittedly, it’s comforting to have that kind of certainty, however ill informed. It’s what allows you to think that think tanks funded by the insurance industry are being straightforward with you. It’s what allows me to appreciate the difference between an honest examination of an issue, and an examination with the conclusion predetermined and the statistics following the conclusion instead of vice versa. If you’re a lawyer who does any adversarial work at all, reaching conclusions backwards like you do is a fatal mistake professionally.

  13. brighid says:

    Like you, I’m flabbergasted that anyone can form a reasonable belief that any 3-year-old actually has suicidal and homicidal ideation. At age 3, they usually still don’t understand the concept of “next week” (Your grandparents are coming NEXT WEEK. You start playgroup NEXT WEEK. Your birthday is NEXT WEEK.), let alone the concept of “death is forever.”

    Yet he has a psychiatrist and a social worker who apparently believe.

    I’d sure love to know the backstory on all of this. Are the psychiatrist and the social worker crackpots, too? Or does this kid have an IQ of 220 and a history of setting fire to his sibling’s crib?

  14. ladyk73 says:

    That person gave social workers a bad name. I know that young children, many with developmental delays, can have troubling behavior. This behavior could be injurying themselves (head banging) or others (biting others, harming animals, etc…). Behavior can be communication, creating or reacting to stimuli, or stereotypical. But to label these signs as suicidal or homicidal? It just not equate with our knowledge of human development. I have never seen this in a DSM or clinical textbook.

    I do know that there are some children with severe disabilities who may need chemical restraints. These children had state reviewed behavior plans.

    To show up at an ER? wtf

    • DreamingTree says:

      I have a masters degree in psychology and can assure you that this isn’t contrary to what we know of human development. It seems that many are drawing conclusions based on their own personal experiences. Most of us are used to dealing with normal preschoolers who can be rambunctious and moody. We find it hard to imagine a 3 year old who would be destructive to others & self in a manner so extreme to be labeled this way. But, those of you who work in the medical field should really know better. We see the extremes all the time in medicine, so why not in mental health?

      Since becoming a nurse, I’ve found that many of my co-workers have little patience for mental health disorders. Many are suspicious and think that people are faking their symptoms. It’s really sad. It’s even sadder, though that a preschooler may have such problems. Maybe this is why most of you want to doubt it — it’s sad to consider a child wanting to die.

      Regardless, it’s possible. I posted one link on research that has been done. Here are a couple other links on the subject:

      http://www.depressedchild.org/weinberg%20chapter.htm
      http://www.eurekalert.org/pub_releases/2003-03/wuso-idi030703.php

      • hannah says:

        At three, ‘tho? You’re more likely to get the kid copying behaviors and feelings that he sees from his parents. If a parent reacts to their three year-old by screaming at him and/or hitting him, the kid is likely to do the same. So the kid gets pissed off at his preschool teacher & threatens her, maybe throws something at her and then is diagnosed with ODD. So the kid picks up this horrible label at a very young age, something that he has to carry with him from school to school — the teachers react with the expectation that he will act XYZ way, thus conditioning the kid to continue to act out.

        I’ve also found that younger kids really want to please the adults around them and they are VERY good at picking up cues. So the psych asks questions to reaffirm X diagnosis and the child, wanting to please the adult, says what the psych wants to hear. “Do you hear voices?” “Do the voices tell you to do bad things?” suddenly it’s childhood schizophrenia.

      • DreamingTree says:

        reply for hannah (couldn’t reply under your comment for some reason…):

        It’s incredibly hard to imagine this in a 3 year old, and I understand the point you are making. But, consider that there’s a great deal of neural development occurring in the first 3 years of life. A child who has been abused during those critical years is at great risk for mental health problems — their wiring is all screwed up. Isn’t fair, but it’s hard to correct (not saying impossible — I’m an optimist at heart). Or, maybe the child wasn’t abused, but through the crap shoot of reproduction, he has the luck of faulty wiring from the start.

        I would like to think that a child psychologist knows how to interview a preschooler without using leading questions. Of course, we all know people who suck at their jobs, so your scenario could happen. Same for the teacher. Again, not fair, but yeah, it happens.

        Consider this, though: it’s would also be a shame to not properly treat a child because we base our opinions on our experiences versus research (& yeah, I know we have plenty of flawed research). The longer we delay treatment, the harder it is to help the child adapt. I’m not a fan of psych meds for kids (uncharted territory), but I recognize there are times that they are needed. Of course, I’d rather see behavioral modification (for the kids AND the parents).

      • ladyk73 says:

        dreaming tree, a normally developed three year old would be at a preoperational stage of cognitive development (Piaget). Children at that age have not yet begun to have concrete logical thoughts. I absolutely think that children that age can have profound sadness and be “depressed.” However homicidal and suicidal thoughts are abstract concepts. Children at three have trouble understanding death for these same reasons.

      • DreamingTree says:

        I’m well aware of the cognitive development stages. It’s a credit to Piaget that his theory has lasted this long; however, it is not a perfect theory, and has its limitations. Sure, a 3 year old doesn’t sit around thinking about suicide the way a depressed adult would. But, can a 3 year act in a manner that shows an utter disregard for his life or others (more so than your average, rambunctious preschooler)? Messed up neural connections can cause a variety of problems — why not severe mental health issues? Because we can’t conceive of a suicidal preschooler, it must not be true?

      • WhiteCoat says:

        Don’t necessarily believe that it can’t be true, but I also don’t think that we can just take some common trait in a preschooler – such as biting and hitting one’s sister – and make that de facto evidence of one’s homicidal intent.
        Big difference between depression/behavioral control problems and intent to take the life of another human being.

      • DreamingTree says:

        Absolutely. If the only signs were biting/hitting sister, then that would certainly be a shaky diagnosis. But, you hadn’t been the doctor treating this child, nor have any of the others who have doubted the diagnosis. It’s kind of like the “medical experts” who testified against you in your lawsuit. Could the psychiatrist be full of crap? Sure — happens all the time. But, we need to realize that it is possible for a preschooler to have a severe mental illness (sad, but true). I have a problem with people jumping on the parents, jumping on the psychiatrist or social worker when they have no knowledge of the true situation. People tend to be extremely skeptical of psychological diagnoses.

        With all of that said, I do believe that there is a problem with helicopter, permissive, & abusive parenting. All of these types create problems.

      • My little brother was “a biter” as my parents put it, and ALSO had a propensity for ripping all his clothes off and chasing people while trying to hit them with handy objects…
        VERY agressive? oh hell yes.
        Bit crazy? probly, in a three-year-old sort of way.

        I really hope this wasn’t ALL that was wrong with this poor kid!

        ps. havent the parents heard of locking carseats? the kind with the bar that comes down and can’t be undone when you’re sitting in it? TWO adults couldn’t control a THREE YEAR OLD if they put him in one? What is he, telekinetic?

  15. ladyk73 says:

    My friend’s child, at age three, put the cat in the microwave. AND TURNED IT ON! Thankfully mom was there is a sec. Cat is fine.

    • brighid says:

      My sister, at age 3, bent a hamster backwards (hamster survived, but never walked well afterwards). My sister had no idea what she was doing. She didn’t intend to hurt the hamster, and was heartbroken when she understood she had inadvertently done so. Hamsters are soft little things, much like plush toys; who knew they didn’t bend like plush toys? As far as the cat and the microwave are concerned, the kid had surely seen his mom use the microwave; it may not have dawned on him yet that the microwave is only used on FOOD. Just because the cat is what came to hand when he wanted to stuff something in the microwave doesn’t mean he had malicious intent toward the cat.

      There’s a wise saying to the effect that one should never impute to malice what stupidity alone can explain. I’m still of the opinion that most 3-year-old behavior is essentially stupidity (well, Ignorance with a side of No Appreciation For Consequences). Most kids of that age are in need of teaching, not drugs and psych admissions.

  16. Sarah says:

    So, I’m in in child psychology and have seen some truly messed up little kids but I find an ambulance transfer and inpatient bed for a three year old ridiculous! A child at that age cannot have suicidal and homicidal intent because true “intent” requires not only a threat of harm to self or others but also a plan for hurting oneself and the availability of lethal means. So unless the parents are providing absolutely no supervision of the three year old and allowing him to play with a loaded gun, he’s not likely to do much more harm than biting a sibling. Wow.

  17. Sarah says:

    Wow, I work in child and adolescent mental health, and the youngest I’ve ever heard of for our service was an 8 year old with psychosis (and that was especially florid!). I do find it difficult that he had suicidal intent – self harming I could understand.

  18. hannah says:

    Ah, I guess that I’ve just been there, done that. I’ve been hospitalized with many kiddos. I probably had around 20 IP stays from the age of 13 to 17. I’ve seen kids that needed it, kids that didn’t. I’ve /handled/ so-called ODD/ADHD kids, as a patient. I’ve seen the worst that child-care-givers have to offer. I’ve seen six year-olds who will be psychopaths, children barely above that age who have sexually abused younger children.

Leave a Reply


× three = 24

Popular Authors

  • Greg Henry
  • Rick Bukata
  • Mark Plaster
  • Kevin Klauer
  • Jesse Pines
  • David Newman
  • Rich Levitan
  • Ghazala Sharieff
  • Nicholas Genes
  • Jeannette Wolfe
  • William Sullivan
  • Michael Silverman

Subscribe to EPM