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welcome to nurture 101!


what is nurture?
why is nurture important?
Bonding and Attachment
More About Empathy
More About Self-Awareness
More About Unconditional Love
More About Honesty
More About Respect
More About Encouragement
More About Safety
Results of Lack of Nurture
Nurturing Your Children
Turning Nurture Inward
Nurturing Mother Earth
Re-parenting / Self Parenting & Nurturing Adult Children
Nurturing Spirituality
Nurture in Business

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nurture 101!
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what's the definition of nurture?

  1. Training expected to produce a specific character or pattern of behavior, especially training that produces moral or mental improvement.

  2. Controlled behavior resulting from disciplinary training; self-control.

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Practice Positive Discipline

Attachment Parenting incorporates the "golden rule" of parenting; parents should treat their children the way they would want to be treated. Positive discipline is an overarching philosophy that helps a child develop a conscience guided by his own internal discipline and compassion for others. Positive discipline is rooted in a secure, trusting, connected relationship between parent and child. Discipline that is empathetic, loving and respectful strengthens that the connection between parent and child, while harsh or overly-punitive discipline weakens the connection. Remember that the ultimate goal of discipline is to help children develop self-control and self-discipline.

The Dangers of Traditional Discipline

  • Instilling fear in children serves no purpose and creates feelings of shame and humiliation. Fear has been shown to lead to an increased risk of future antisocial behavior including crime and substance abuse

  • Studies show that spanking and other physical discipline techniques can create ongoing behavioral and emotional problems

  • Harsh, physical discipline teaches children that violence is the only way to solve problems

  • Controlling or manipulative discipline compromises the trust between parent and child, and harms the attachment bond

  • It is a sign of strength and personal growth for a parent to examine his or her own childhood experiences and how they may negatively impact their parenting, and to seek help if they are unable to practice positive discipline

A Gentler Approach to Discipline

  • Positive discipline begins at birth. The bonds of attachment and trust that are formed when parents consistently and compassionately respond to an infant's needs become the foundation of discipline

  • Positive Discipline involves using such techniques as prevention, distraction, and substitution to gently guide children away from harm

  • Help your child explore safely, seeing the world through his eyes and empathizing as he experiences the natural consequences of his actions

  • Try to understand what need a child's behavior is communicating. Children often communicate their feelings through their behavior

  • Resolve problems together in a way that leaves everyone's dignity intact

  • Understand developmentally appropriate behavior, and tailor loving guidance to the needs and temperaments of your child

  • Children learn by example so it's important to strive to model positive actions and relationships within a family and in interactions with others

  • When parents react in a way that creates tension, anger or hurt feelings, they can repair any damage to the parent-child relationship by taking time to reconnect and apologize later

Tools for Positive Discipline

The full version of Practice Positive Discipline, which will be available in booklet form later in 2007, offers information on 25 practical tools that many parents find useful when practicing positive discipline. This list is not all-inclusive, and some techniques described may not be suitable for children of a particular age or temperament. Please contact an API Leader near you for more information on these tools.

  • Maintain a positive relationship
  • Use empathy and respect
  • Research positive discipline
  • Understand the unmet need
  • Work out a solution together
  • Be proactive
  • Understand the child's developmental abilities
  • Create a "yes" environment
  • Discipline through play
  • Change things up
  • State facts rather than making demands
  • Avoid labeling
  • Make requests in the affirmative
  • Allow natural consequences
  • Use care when offering praise
  • Use time-in rather than time-out
  • Use time-in as a parent, too
  • Talk to a child before intervening
  • Don't force apologies
  • Comfort the hurt child first
  • Offer choices
  • Be sensitive to strong emotions
  • Consider carefully before imposing the parent's will
  • Use logical consequences sparingly and with compassion
  • Use incentives creatively with older children

Learning to use positive discipline may not come easily for many parents especially if they were raised in a more traditional, authoritarian environment. That's why it's so important to attend API support groups, talk with other parents, or seek professional help.

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Discipline Problems: Outsmarting the Toddler

Barton D. Schmitt, MD

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Here is a typical toddler having a bad day, and here is a typical mother being dragged down to his level, and now there are no adults in the room. What should we do? Who should help this family? The family needs help. I would submit to you it should be pediatricians, pediatric nurse practitioners, physicians assistants, and other people who are involved in this business because nobody else is going to do it.

Mental health field can't provide the intervention that children like this need.

One of our goals when helping parents is to - and what the parents really need to be doing - is to help this child develop self-control, self-discipline, and to teach the child some adult standards and eventually something that will work in school.

We could call them school standards. Are they ever going to do that? Well, I think we just need to get back to good old psychology 101, behavioral modification for most of these things and remembering that all behavior, regardless of cause, can be changed.

Behavior is predominantly shaped by consequences, and if the consequence is an unpleasant one, something we used to call a punishment, the behavior is less likely to be repeated. If the consequence is pleasant for the child, the behavior is going to increase in frequency. 


So working with that, what is it that we can offer to the parents. The parents need what I call a discipline template. You might call it a frame of reference - something they can return to when they are working with their child or on another behavior they would like to remove and are sort of unsure where they should go with it.

To change a behavior, you need a rule, you need a consequence. Very important, that consequence. We need to teach the child a preferred behavior and we need to be sure somebody is serving as a good role model. The rule really addresses whatever is the target behavior, the behavior we are trying to remove so it could be as simple as no fighting, no hitting.

Children do need a reason even though they don't become very reasonable and very willing to negotiate in any consistent way until age 4, I think the reasons given to them over time do sink in and work to our advantage, and the reason in this case could be it hurts to hit other people. Or it could be as simple as grown-ups don't like it if we are talking about jumping on the bed, or spitting indoors, or wherever you want to draw your line in the sand. Grown-ups don't like it.

Consequences -- we are going to come back to a whole list of consequences, and parents need to feel, to be reminded that they have lots of options. What about teaching the preferred behavior - I call that the replacement behavior. I think it makes it much more likely that parents will succeed at what they are attempting.

So for example, we have a child who is fighting bedtime, we can remind them what a good sleeper is. We want you to be a good sleeper, once we say goodnight, you don't come out of your bedroom unless it is an emergency, but we get to define that and you don't make a lot of noise during the night and you don't wake up other people unless something serious is happening.

And then the parents role-modeling of the appropriate behavior is so important. Parents have to give up their bad behaviors before we can expect the child to. I think a great example is a game called Uproar and that's where the parent and the child keep yelling at each other and escalating and if the parent can't give up adult temper tantrums, there is little hope for the child giving up their childhood temper tantrums.

Let's turn to some consequences that usually are helpful and that parents need to be brought back to. Parents really are asking us for a consequence. They don't know they are asking us to help them better define the rules and to prioritize their rules and to only work on two or three problems at a time - problem behaviors.

But they would like a treatment package and that includes a consequence that has a guarantee with it. Not too likely. But there are some things to try and the least intrusive, least energy-depleting consequence that will be effective is one we want to start with. So we'll just go through a list of them and give you some examples.

We want to avoid certain settings. There are certain kids who should never be brought to a fancy restaurant or to a store with a lot of breakables or maybe to church or synagogue.

We can structure the environment. We can put latches and gates up in areas that we don't want children to fall into or destroy things. There can be a child-free room that they don't enter.

We can ignore some misbehaviors. Wish there were more, but we can certainly help parents identify harmless misbehaviors. One that comes readily to mind is - 

  • What the child says - pretty harmless.
  • How the child looks - faces the child makes, etc.
  • Slamming a door - we need to redirect or distract some children

We see that time and again in our waiting rooms. I imagine many of you have toys in your waiting rooms, but in some places that's not available and the smarter parents bring things with them.

They bring snacks, they bring books or different toys to keep the kid busy so he doesn't embarrass them too much in your waiting room.

Then we get a higher level of intervention or consequence. Verbal, nonverbal disapproval. And we sometimes see parents doing that in our office.

Of course, actually we often do, but not doing it effectively. They really say, it would be good if you stopped doing that. Why don't you come here and do something else.

Whereas they really need to effectively give disapproval and to say or no and stop. They need to get into the child's face. Maybe grab them around the shoulders and say "no hitting, no more of that. I don't want to see you doing that."

And really mean it. And not be like some of our fathers who see the child tearing up the office and sort of half-heartedly tell them to stop and on the other hand laughing and smiling at how powerful this kid is.

Physically move or escort a child is another intervention, and sometimes children just need to be told "do you want to take a time out on your own or do you want me to take you to time out?"

Temporary time out - we sort of talked about that.

And we will come back to that because it's so often used. Prolonged time out or grounding if the child really gets into some major trouble. Maybe he doesn't get to watch any TV for a week. Natural consequences based on the laws of physics, nature. Food gets cold if you don't come to dinner on time. If you play with that wagon or trike too vigorously, you get some road burn or you break it and then you don't have a trike for a while. There is a limit on how much a parent can be there doing all this for a child. Logical consequences are very useful when children again reach an age of reason and logic. Removal of a possession, if that possession has been misused such as crayons and writing on the wall. Removal of a privilege. One I often think of is when our son in junior high, used to get phone calls after 10 o'clock. That quickly ended. He didn't get to use the phone at all for a week and he had to notify during that week, notify all his friends and never call after 10 o'clock. But there are kids who jump on the bed. If you jump on the bed, you sleep on the floor tonight. You're not treating your bed well. Delay of a privilege or activity. First we work, then we play. It could be with TV vs. homework. Homework first. Restricting places where children misbehave on and on.

There are certain things you can only do outside, you can only do in the basement. There are lots of options, lots of interventions including some very poor ones that we will come back to which is lecturing, which means that's how we teach kids to develop parent deafness, right?, as repeated lecturing and over-reasoning and yelling. If you want a yeller that's a sure way to go. And a lot of physical punishment can lead to aggressive kids.

OK, we want kids to succeed with these consequences and just some thoughts on that issue is, when possible, to give kids choices when there is a choice. There is no choice about the seatbelt, but there could be a choice about breakfast cereals, what clothes you wear, which matching shoes you wear and such things. Giving transitional time helps children succeed. Giving children the three-minute warning when they are playing with Legos and it's almost dinnertime helps them succeed and us succeed -- win, win situation.

I've talked about telling children the adaptive or replacement behavior, not making them guess at that. Actually teaching it. For example, there are kids who, at the end of the day, have no idea how to clean up the place, where things go. They need to be taught that several times. If you believe cleaning up, clearing the decks in part of your home in the evening in case somebody has to get up during the middle of the night and doesn't want to trip over something.

Giving the children the reasons behind the behavioral change and helping them promise to work on it. I do that a lot in my office. We come up with something the child has agreed to do with encopresis. They've agreed the poops do belong in the potty and they are going to start doing that today. I say "is that a promise, are you sure, are you going to work hard" and if I get yes, then I shake their hand. They don't sign contracts at that age. And practice runs to stores and so on to help kids succeed. Practice runs where the parent doesn't have a lot of other things on their mind.

OK, enough about consequences. Are you ready for some cases? We have three cases today.

The first one involves biting. Biting is a very powerful, intimidating behavior. The bitee backs off, withdraws, without paying any ransom. Who are the biters, in my way of thinking. They are all xys. All and above.? Twenty thousand years ago all they could do was go out and hunt.

But today we are trying to teach them to put their wants into words. So, we got a rule. Rule is no biting. Reason, it hurts. So far, so good. Consequence. Consequence has to be a pre-emptive strike, no-tolerance kind of consequence. Applied immediately. They are in time out before they know what hit them. They are in time out just before they bit somebody. They are on their way to bite somebody. The parent sees that. They need a lot of surveillance and they end up in time out.

Because this misbehavior is a sure-fire way to get expelled from daycare and preschool. Sharp verbal disapproval. Nothing ambiguous about it. No biting in a thunderous voice and so on. And if that fails, double the fine. Take away a toy. Take away all the TV for the rest of the day. Make sure the kid knows you mean business about biting on the front end so that it doesn't become something he learns to enjoy because of all the blood curdling screams he gets from the recipient.

What do we want to praise children for coming to us for help and we can help them even though they are a little verbal. Put into pointing or what have you, what is it they want. And they need to learn you don't go and hit somebody with a rock to play with the truck he is playing with. And the modeling, of course, in the parent has to be no biting back, and some parents are into some sort of vampire games with their kid or shark games or nipping and biting and so on as a game, and that's not a good idea.

I'm going to digress and make a few comments about time out -- such an important technique. Putting a kid in a boring place, taking away his liberty and pursuit of happiness and fun and helping the child regain control of his emotions and behavior. Of course, you all know it can be anywhere. It can be a corner, it can be a chair, it can be in the back seat of the car if you are in a parking lot, it can be any place in a shopping mall -- one minute per year of age

And yet we know how effective this is. We know when parents say it doesn't work what's next. That we're not holding back something. We don't have a trump card we are going to give them later. That this is our trump card. And when they say time out doesn't work, it's because of a misunderstanding. They will say "he won't stay in time out." That's easy. You hold him in time out. And then eventually you hold him in time out.

Eventually, you hold him from behind. You pretend you don't mind holding him. You whistle or read a book or hum a tune and after the time out is over, even though he has had to be held there the entire time, you say, that was a great time out, and eventually you are going to ask a child like that "do you want me to take you to time out or do you want to go on your own," and because of their desire to have some dignity, they eventually start going on their own and staying there.

Other parents say "well, it didn't work because I've been told that they've got to be quiet in time out. It's got to be three minutes of quiet time." Your kids may take a three-minute quiet time out. The kids that people bring to you and ask for help with cannot achieve that goal, so you've got to redefine success, and success is spending five minutes in time out, even though they are having a tantrum throughout. If they had their tantrum somewhere else, we would ignore it, so let's ignore it also in time out.

This is the intervention of choice for the irrational years, 1 to 3.

There are also parents who say no consequences work. I submit to you that those children have ADD -- they have affection deficit disorder. They have a very low tank when it comes to feeling good about themselves. They are getting so many corrections and punishments every day that they are just not willing to carry out and abide by the rules the parents are laying down.

So children need more than limits. They need love and physical affection. For every time out, they need two or more time ins. Time in is a term I learned from __________________. It strictly means physical affection. It means a touch, an embrace, a hug. It's not words, it's all done through touch.

If you talk to marriage counselors, they call it the love letter zinger equation, but love letters have to outweigh zingers -- they say 10 to one to keep a marriage strong. And this is also something some people call special time that a child can look forward to every day, 10 minutes or more with their parent doing something the child wants as long as it's not TV. Doing something with the parent, no matter how bad a day they have had, they still get this.

Next case, screaming child. Screams when they don't get their way.

Rule can be no screaming in our house. The reason can be it hurts our ears. The consequences are we don't listen to it. You have to go back and ask yourself "what is screaming." Screaming is just a high powered, high octane kind of temper tantrum. It's a very disruptive temper tantrum. It's not something that needs an LP and spinal fluid analysis. There are parents who come to me with screaming who think they have read somewhere this has to be neurochemical. This has to be neurological. No, this is just a kid who can get great mileage out of screaming, so consequence, if we don't listen to it, we walk away. If they follow us and won't let us get our sanity back, they end up in time out. They need lots of opportunities to get out of time out, like every five minutes. Give them a chance to come out because usually if we put them in the screaming chair, we say come out when you are done screaming and want to talk. He is not rewarding screaming by giving in. That's what the child wants. And once screaming starts, we don't want to pick up and try to calm that child. If we see a child going into a tailspin, if we see a child who is falling apart and starting to lost control, that's the time to help them calm down and get centered again, but not after they are in the midst of one of these. And we want to praise them to putting their wants into words using a calm voice, and we need parents who use a calm, loving voice to correct their children. And if the parent does play uproar, we talked about earlier, this parent yells and gets into it with this child, it's going to get worse. There is a differential diagnosis for tantrums. I think most of you realize that, but I want to go through it very quickly. And of course the one we just talked about is a real disruptive tantrum -- it needs a time out. But many tantrums occur when kids are tired and they need a nap or some quiet time or they start to have tantrum when they are very hungry. When you pick them up after daycare, they need a snack. And they will pull out of this tantrum they are slipping into. Or they are sick. Or they are doing something that is very difficult -- in terms of the level of a puzzle they are trying to do or something. They need some help. There are other kids who have demanding classic tantrum -- a demanding, attention-seeking tantrum occurring as they are leaving a hardware store or some other store and they see the candy counter and they want candy now. And they have a meltdown. It's really important the parent not give in, ignore it, get out of there. Maybe say once "we are here to buy a fan, not to buy candy." And then there are refusal or avoidance-type tantrums that really need manual guidance. The child needs to go to bed, and you wonder if he needs a bath. "Do you want a fun, slow bath tonight or do you want a real fast carwash kind of bath tonight."

Pestering -- do this one quickly. There are kids -- almost all of these are xx. These are the high verbal kids. The screaming is sort of equally boys and girls, but the ones who pester us, who won't take no for an answer, who don't understand that the parent means what they say and that the parent has the final word and the parent has veto power and who will continue to make requests, sometimes in a pleasant voice, sometimes in a whiny voice, need help. So the rule would be no arguing. This decision is final. If you're a lawyer, you'd say this case is closed. I don't change my mind. Consequences -- we give them an understanding statement. I understand how you feel. I know you want to go see that movie another time because your friends have seen it four times, but we are not going to see it again. And we'll see it when it comes on the Disney channel. Redirect them to other options. We are trying to help this child succeed. Redirect them to some game or some books or even a TV show. And then we try to ignore the pestering, the bugging of us, let them have the last word, let them have a monologue keeping in mind that they can play point-counterpoint for hours, for they have no meals to cook, no carpools to take, no schedule to keep, no charts to dictate, etc. So you've got to let them slip into a monologue and get bored. If necessary, go to another room. Warn them again, we are going to double the penalty if they keep this up. And praise them for accepting decisions, parent decisions, especially if the parent says we will do that later, we'll do it after dinner, that's a pretty good deal. We need to teach children how to wait. We all know that because waiting is part of the human condition.

Some final comments on parenting in general. There are three general ingredients in the recipe for being a good parent. There is always more than love. And it's love, limits, and then get out of the way and let them grow up as much as we can as long as they don't hurt themselves when we get out of the way.

And the spectrum of parenting in terms of limit setting -- there are sort of six stations along the way. One is the neglectful parent who doesn't set any limits, who doesn't pay much attention to their children. Permissive or lenient parent -- we'll come back to. Plenty of those in America who give tentative limits or optional limits and back down. The best parenting is called authoritative or supportive parenting where the parent makes the rules but gives the reasons and cares about their kids and presents things acknowledging and taking into account the child's feelings. There are 30 years of research on authoritative parenting and it gives us our most self-disciplined children. There is a strict or rigid kind of parenting -- my way or the highway -- do it because I said so, that turns out is rather effective if you're growing up in the inner city and you want to keep your child alive. There is verbal, abusive kind of parenting. Try to change parent to children through scapegoating, through putdowns. There is harsh physical punishment we will come back to.

We want to help parents to avoid the two extremes of being a lenient parent and on the other side being a harsh or rather cruel parent. There are three kinds of physical punishment we will talk about and then we will come back to lenient parents. We are going to be talking about physical abuse, physical punishment that is harsh and physical punishment that is rather mild. Physical abuse, we all know what that is. Society is strongly opposed to that. Everyone in the room is. There are 40 years or more of laws on the books that is opposed to this.

Let's go to mild physical punishment. You could call it mild spanking. Some people would call it safe spanking. The AAP may be opposed to this and some of the American psychological and psychiatric kind of organizations, but the truth is society is not opposed to this. Eighty per cent of parents spank their kids occasionally. Sixty per cent of pediatricians on the last survey thought there was a place for this occasionally. So there is not any proof this is harmful, if used infrequently. There is not any proof it is beneficial. There is not any proof you need to raise your child, some of this in raising your children, but I don't recommend it. I never tell a parent you should spank your child, but on the other hand, I am very much a realist. I don't try to argue with parents about this if this is what they are doing occasionally. One swat on the buttocks or leg, open hand through clothing. But it is unnecessary and it doesn't teach adult problem solving. What society is undecided about is something I would call harsh physical punishment.

I am strongly opposed to it. I want to be sure all of you are opposed to this. This is using a paddle or belt on children, hitting until the child cries, using that as the end point. Hitting multiple times, hitting infants, slapping on the face, shaking the child or doing other potentially dangerous interventions. We should be opposed to this, the reason being, this causes angry kids. This causes almost every bully you will ever see. This causes kids who are part of our violent society, and there is plenty of evidence for that. So take your stand here, if you're going to take your stand in the physical punishment arena.

I want to switch to the other end of the spectrum. The child who is elevated to ruler of the family and we live in this child's house and abide by their rules. I want to switch to a mini-epidemic in our country that we all see and it's called spoiled children. How would we define a spoiled child? One who is undisciplined, manipulative, rather unpleasant to be with, doesn't follow the rules, rather bossy, other kids don't care much for this child. Doesn't respond to no or stop. Insists on having things their own way. Teachers don't like these children. Eventually the parent doesn't like this child they created. They frequently whine. They throw tantrums. They scream. They pester us because it works in these families, in these lenient, permissive families. And what is so sad about this -- these are some of our most loving, devoted, caring parents who would do anything -- they would walk through fire for their children, and they end up with a spoiled child.

Because left to their own devices, most children would spoil themselves, something you learn after your first child perhaps. How do we prevent spoiled children? We gradually give them a reality base, provide age-appropriate limit setting. We never give into tantrums or screaming. We teach the child to wait -- part of the human condition. Deal with frustration. There is something that is called the optimal level of frustration for normal child development. We don't overlook discipline during quality times. Just because we are at an amusement park or the zoo or the non-custodial parent has the children doesn't mean the children don't need discipline when they get out of line. And we teach children to respect parent's rights. Because in the process, they are learning about respecting other adult rights and other children's rights. I submit to you, in a way this is parent abuse.

The child becomes as powerful. And a few final thoughts on spoiled children, is that limits are really good for kids. They are a way of showing our love. And it's the parents' job to set limits and present the world as it is and will be for this child. And it is the child's job to object to the limits, to grind us down, to try to get us to change our mind through normal protest crying and normal protest screaming and pestering, etc. In fact, if your child likes you all the time, all the time, you're not being a good parent. And if you want an appreciation in life, buy a dog and name him Buddy. Thank you very much.

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