It's Nobody's Fault Read Online Free Page B

find a job. By the time he’s 22, he should have a good idea of what he wants to be when he “grows up.” The fifth and final developmental task of adolescence is
adjustment to the physical changes
that take place during this period. It’s important for a child to adjust not just to the specific changes themselves but also to the fact that his changes are different from those of his friends and are taking place at a different rate.
    Being mindful of the milestones of childhood and adolescence will help parents to identify problems their child might have. Parents should be on the lookout as well for specific abnormal behaviors that may indicate that a child has a psychological disorder. Some of them are: repetitive actions, such as tapping, hair-pulling, and hand-washing; unreasonable fears, such as not being able to sleep unless the parents are in the same room; agitation and excessive rigidity; nervousness about meeting people; motor or verbal tics; and extremely aggressive, disruptive behavior. The degree and the intensity of these symptoms are what really matter. Occasional lapses into peculiar behavior are not cause for concern.
    Parents who have children with brain disorders tend to end up in hospital emergency rooms more often than the average parent—because of accidents, suicide attempts, and other crises—and they’re always saying things like, “Whenever there’s trouble in the classroom, my kid is bound to be in the middle of it.” Being with these kids is challenging and terribly demanding. “I’m not having much fun with my child. I lovehim, but I’m exhausted after being with him. And no one else can stand him” is a statement I hear quite often from my patients’ mothers and fathers. Many parents are embarrassed by the child’s behavior.
    Even though they are nobody’s fault, there is a lot of parental guilt and blame attached to these disorders, and much of it comes about when parents are slow to notice a problem. One extremely conscientious mother of a boy with pervasive developmental disorder knew by the time her child was two years old that he needed some help, but she feels bad anyhow. She insists that she could have picked up the symptoms of PDD earlier if she had known what to look for. “Because of my son I got involved in a PDD program, and I saw babies who were four or five months old who were already showing signs of developmental delay. If I had known before what I know now, I would have taken him to the doctor much earlier than two.”
    Another mother and father whose child I’ve treated reproach themselves for not being aware of their daughter’s depression. “She was so good at masking everything. She fooled us,” they told me. And they’re right. Some children, unable or unwilling or ashamed to ask for help, are masters at disguising the symptoms of their disorders.
    A child should be evaluated by a child and adolescent psychiatrist if any of the items on this checklist describes his behavior for at least two weeks:
Stomachaches or headaches with no physical cause
Loss of interest in activities previously enjoyed
Change in sleep patterns
Change in eating patterns
Social withdrawal
Excessive anxiety or fearfulness upon separation from parents; refusal to sleep away from home or alone in his own bed
Refusal to go to school
Decline in school grades in several subjects
Persistent underachievement at school
Unacceptable behavior in the classroom
Aggressive behavior
Stealing, lying, breaking rules
Inability to speak to peers or adults other than family
Repetitive behavior; a child becomes overly upset if these actions are prevented or interrupted
Avoidance of objects or activities not previously avoided
Mood swings or a dramatic change in mood
A preoccupation with death or dying; suicidal wishes or threats
Change in personality, especially from cooperative to irritable or sullen
Odd or bizarre behavior or verbalizations
A tendency to confuse fantasy and reality
    This checklist