What's the matter with kids today . . . "Bye Bye Birdie"
DR. WILLIAM Beardslee believes kids today are scared. Beardslee participated in a survey showing that many were frightened by the threat of nuclear war but, he told some fellow child psychiatrists, "we're not claiming anything about this being the moving fear kids have. We didn't ask about the economic situation or getting into college or auto accidents or drinking, drugs or all the other bad things.
"I think children are very frightened . . . much more frightened than adults. We as adults can develop systems of denial and defense mechanisms that allow us not to think about it fear very much. But I think kids do. And I think they feel generally alone with that fear."
Last week almost half of the nation's 2,500 child psychiatrists met at the Sheraton Washington Hotel here to examine some current aspects of America's youngsters. For four days, in 116 scientific papers, 27 panel discussions and 13 workshops, the 1,200 developmental, analytic, teaching, practicing and consulting members of the American Academy of Child Psychiatrists exchanged research, findings, horror stories and worries, not the least of which was reduced psychiatric insurance coverage. They addressed the effects of the threat of nuclear holocaust on young psyches, the impact of television, the loss of funds for child welfare programs and the effects of adolescents not being able to find jobs when they get out of school.
And in their spare time they listened to both a musical and a psychiatric analysis of Wolfgang Amadeus Mozart's something-less-than-normal childhood and how it affected his music and his short adult life. Observe and Absorb
"Your role," a television industry spokesman once told then Senate communications subcommittee staff member Nicholas Miller, "is not to tell us what to do. It's to keep the heat on us so the people in the business who want to do better have a license from the people who run the network to do better. You have to create the pressure, the ambiance, the reward system that allows the good people in the industry who would really like to do better to do what they are capable of doing."
That heat, that pressure, is what has dissipated under the Reagan administration, according to members of the convention's kid-vid panel: Children's Television -- 25 Years of Controversy.
It was never more clearly underscored that children are not just small adults. Their undeveloped filters passively absorb whatever information the moving box suggests.
"For children, seeing is believing," says the narrator on the film "Kids for Sale." "They do not know commercials are commercials. There are 18 an hour, 20,000 a year and they don't know what they are."
The film, produced by Action for Children's Television (ACT), also includes a child talking about a potato chip commercial that influenced him to try a back flip. He is saying he ate the chips but "only did half a back flip so I fell on my head."
Dr. Michael Rothenberg, a child psychiatrist from Seattle, Wash., and co-moderator of the panel, says, "Everyone always laughs at that. And it is funny until you remind yourself of a study done at Boston Children's Hospital in 1976 where 34 children were admitted either directly or eventually with permanent paraplegia as a direct result of trying to duplicate on a bicycle or tricycle the stunts performed in a then-current commercial representation of Evel Knievel plastic replicas."
Miller, now a Washington-based communications lawyer, wondered to a group of about 50 attending the seminar "why it is our society does not perceive children as a special class that is worthy of special protection and why it is that the professionals in this society who deal exclusively with children have not taken it on themselves to convey that message in Washington, D.C."
"We are," said FTC member and former chairman Michael Pertschuk, "the only civilized country where we permit the commercial exploitation of children."
"Why," asked ACT founder and executive director Peggy Charren, "is possibly the most important educational institution in America -- TV -- discriminating against children?"
The 10-year update of the surgeon general's report on the relationship of television to behavior has confirmed the link of TV violence to aggressive behavior, as well as many other conceptions and misconceptions.
Some current misconceptions, Peggy Charren said, are found in:
* the popular NBC cartoon feature "The Smurfs," which involves a town of 99 men and one girl. "It is advertised as 'for family viewing.' " Is this Any Town, U.S.A.?
* the virtually blind Mister Magoo, the prototype of the handicapped person. Conclusion? Handicapped is to laugh at.
From the 1982 update "Television and Behavior":
"Almost all the evidence testifies to television's role as a formidable educator whose effects are both pervasive and cumulative. Television can no longer be considered a casual part of daily life as an electronic toy. Research findings have long since destroyed the illusion that television is merely innocuous entertainment."
The kind of "heat" that used to be kept on the TV industry, said Miller, "created the progress in children's programming of the '70s. What we've seen since the 1980 election is the absolute opposite signal being given the industry and the advances made in the mid '70s have largely been lost."
A quote Michael Pertschuk likes to use:
"It is inconceivable that we should allow so great a possibility for service, for news, for entertainment, for education and for vital commercial purposes to be drowned in advertising chatter."
It was made, about radio, in 1922, by then-secretary of commerce Herbert Hoover.
Peggy Charren notes this: There are no more daily children's programs on commercial television, Monday through Friday.
The panel had been intended as a debate, Rothenberg said, but its organizers were unable to find industry "representatives who were interested in defending current practices in children's television."
Highlighting the update, Dr. Larry Silver, deputy director of NIMH and outgoing secretary of the American Academy of Child Psychiatrists, noted its findings that despite fires, explosions, auto accidents and other calamitous events "injury and death never happen on TV," and that given the television set as a "role model" for children, they may indeed draw unrealistic conclusions. Behaviorists and TV-commercial writers have found, he said, "that the children between 3 and 6 like body-damage themes. It's great if you have somebody blown to bits in one scene and back together in the next . . ."
A separate panel on children and suicide heard a finding that some children under 10 who had thought or talked about suicide or who had actually made suicide attempts did not believe their own deaths were irreversible. Other deaths might be, the children believed, but they felt they could "come back from suicide. "Tell It to a Box
"Do you want to see how you can hypnotize yourself with a computer?" demanded a psychiatrist.
Sure enough, in a room full of passive presentations, a lonely Apple computer and a box full of floppy discs shared billing with Dr. Ronald Levy, a child psychiatrist from Williamsville, N.Y.
Depending on what floppy disc program is inserted, CEPEC (Computerized Emulation of Personality and Environmental Conflict) lets a patient, who might not want to talk to a shrink, open up to a computer. Or progressively relax according to the computer's instructions, step by step as the patient/client punches answers to one of a series of multiple-choice questions. Levy, who helped develop CEPEC, finds it useful in his own practice.
Child psychiatrists must go through four or five years of specialized residencies after medical school.
Can it all end up on a floppy disc? A Little Night Music
Mozart's childhood is a veritable gold mine for child psychiatrists.
And between Dr. James Anthony, president of the academy, and Tony Rudel, program director of New York City's classical music station, WQXR, virtually every academy member, visitor, spouse and significant other around for the meeting filled the Sheraton ballroom for Rudel's play-and-tell presentation about the precocious Wolfgang Amadeus (he changed it from Gottleib) Mozart.
Mozart's problem was his mother. (He wasn't around her enough.) Or maybe it was his father, who trotted the little genius around the thrones of Europe for much of his childhood. And he was, Rudel recounted, lionized, petted, spoiled, hailed -- in short, a worldwide success.
But as Rudel put it, "The world was ready to embrace the freak, the child prodigy, but the same world turned a deaf ear on the genius-turned-composer. What happened? Where was the happiness and adulation he had come to expect?"
Mozart became much the kind of childish, irresponsible adult depicted by playwright Peter Shaffer in "Amadeus," and, says Rudel, "his adulthood was a painful wish to recapitulate the early fantasy, the adulation, the joy."
The psychiatrists who gathered two centuries later, one suggested, would love to have gotten their hands on the Mozarts . . .
Nevertheless, he produced 625 compositions in the 35 years of his life, and, as Rudel noted, "the odds are good that at any given moment, somebody, somewhere is listening to something Mozart wrote . . . "Under the Cloud
I don't have the power to say whether the bombs are to be or not. I don't have the control to say whether we make nuclear weapons or not. I can protest. I can get arrested -- you know what I mean -- but the politicians think of it as a joke. I mean you have your little demonstration and that is that. I mean it doesn't stop the production of nuclear weapons. It doesn't and that's one scariness. Another scariness is knowing that any second, well, not any second, but the minute you get into war, any minute the bomb . . . So DumDum makes a mistake and fires something at Russia first and Russia fires at us. I don't know what kind of thing would happen, but at any minute, there goes the bomb. You know, it scares me a lot, this kind of emptiness, this kind of hollowness, like being in a tunnel and having to fight and nothing is around you and you're clawing at everything trying to find something . . . That's the kind of feeling . . . --A 16-year-old female high school student from Cambridge, Mass., in an interview on the impact of the arms race
Members of the antinuclear medical organization Physicians for Social Responsibility were in evidence at the AACP meeting.
At a special session called "The Nuclear Threat--Implications for Child Psychiatry," Dr. Frederick Stoddard, a Boston specialist in the psychiatric treatment of severely burned children, made a presentation on the burned children of Hiroshima, the inevitability of such burns in a nuclear exchange as well as the kind of complex and expensive treatment now required for treating such burns today. He cited up to 40 surgical procedures costing up to $400,000.
Never mind, suggested NIMH deputy director Larry Silver, "If there were a nuclear holocaust you won't be practicing child psychiatry. You'll be treating fractures . . ."
But most interesting to the child specialists was the report published earlier this year by the American Psychiatric Association, the sibling group to the AACP, on the Psychosocial Aspects of Nuclear Developments.
William Beardslee, coauthor of the portion of the report dealing with "the Impact on Children and Adolescents of Nuclear Developments," described interviews he and his colleagues conducted with 1,160 youngsters and teens in 1978, 1979 and 1980.
Beardslee, of the Children's Hospital Medical Center in Boston and Harvard Medical School, concludes that "for most of these young people the terror and horror of nuclear war is immediate and vivid. They live in daily fear that it will come, if not right away, then in a relatively short time.
"For many of them there's a sense of inevitability that nuclear death will occur sooner or later."
Specifically the adolescents, he said, "tend to see a future that is foreshortened and their sense of time has changed . . . they experience very little safety or security from nuclear arms. These teen-agers experience an intense sense of things being out of control."
The survey was conducted in Los Angeles, Boston, Baltimore and Philadelphia. Some answers to the question "Have thermonuclear advances affected your way of thinking (about the future, your view of the world, time)?":
* "I am constantly aware that at any second the world might blow up in my face. It makes living more interesting."
* "I don't really worry about it, but it's terrifying to think that the world may not be here in a half-hour. But I'm still going to live for now."
* "I have now accepted the fact that there quite possibly will be an 'end of time.' "
"The emphasis in our society on immediate pleasures and satisfactions, the distrust of enduring relationships and an unwillingness to plan for the future," said Beardslee in the report, "is often attributed to faulty child-rearing practices, the abnegation of parental responsibility or the tendency of parents to indulge their children's wishes too strongly. Perhaps there is something in this. But it needs also to be stressed that the building of enduring values within an individual depends upon the day of present satisfactions in favor of future goals and satisfactions.
"But the formation of the psychic structures upon which such development depends is compromised in a setting in which the possibility of a future appears to have been destroyed by the adults to whom its preservation was ostensibly entrusted. "Between the Cracks
One of the dilemmas facing people who work with children from a public policy point of view is that we hear statements to the effect that children are our most important resource, and yet we see public policy regarding children's services dictated by fiscal constraints rather than children's developmental needs. We take a shortsighted view and then we end up paying a greater price down the line. . . -- Dr. John Sikorsky, child psychiatrist, San Francisco
Other AACP sessions dealt with the effects of the economy. An increase in child abuse is considered almost inevitable, for example, along with other cracks in family structure. The unavailability of jobs for high school dropouts and graduates, especially blacks and Hispanics, poses increased concern for the child professionals.
Sikorsky, who has consulted with juvenile court authorities, sees another growing problem.
Sikorsky, now on the clinical staff of the University of California Medical Center, says that two mid-'70s Supreme Court decisions changed juvenile court standards from an emphasis on what was best for the youngster to a "legalistic emphasis on due process."
"The result," says Sikorsky, "is that fewer children experience the juvenile court as a place where they have to face their problems. More and more frequently either the juvenile court dismisses the case with an admonition or, even if the child is guilty, he gets off on a technicality because proper due process was not followed.
"The effect of this on children," he says, "is that they feel they can get other adults to collude or conspire with them in denying what they know they have done."
The average age of inmates at San Quentin, says Sikorsky, is now 23. The average sentence is 25 to 35 years.
Six years ago, he says, "most of the adults now serving 25-year sentences were in the juvenile court, and in interviews they have begged us, 'Why didn't we get stopped when we were teen-agers.' "
In the early '70s, says Sikorsky, "when I consulted at juvenile court, we had 18 people in the psychiatric clinic and one public defender in the juvenile court. Now there are 4.7 full-time employes in the psychiatric clinic and six full-time public defenders.
"Society eventually has to pay the consequences of not properly providing guidance and limits for the children," he said. The Century of the Child?
We have a sentimental feeling of responsibility for children in our society which we do not implement in...programs that are beneficial for children. But you can't expect the child psychiatrist to enter the political arena by himself . . .
-- Dr. Sidney Berman, Children's Hospital National Medical Center and past president of the American Academy of Child Psychiatrists
The world is not a wonderful place for children these days, many of the concerns addressed at the AACP would lead one to believe.
A smattering of titles: Children Who Witness Parental Murder; Diagnosis of Depression; Antisocial and Aggressive Behavior; The Bereaved Child. There were sessions on suicide -- the second or third leading cause of death among adolescents -- and on eating disorders, on autism and hyperactivity, substance abuse and schizophrenia.
But the overriding concern was about pressures from the outside: poverty, lost services, discrimination, threat of war . . .
"This was to be the century of the child," said Dr. Robert Stubblefield, one of the televison panel's organizers. "Then came the atomic age so we thought we'd have a child's decade. Then came the Middle East wars and other things and we settled for the International Year of the Child which went by pretty fast.
"I think we got about a week out of that year . . ."