Category: law enforcement

Survey Results – How parents managed a crisis

Survey Results – How parents managed a crisis

In a small survey a couple of years ago, I asked parents how they handled their child’s mental health crisis.  It was completed by 16 people in one city–too few to get a broad picture.  Can you help learn what works and what doesn’t work by sharing your story?  Wherever you live in the world, your information can also help crisis responders, law enforcement officials, and schools to do a better job in a crisis. We need ideas, and “dos” and “don’ts”, for handling our really serious situations.

Please take this new survey about your experiences with your child’s mental health crises. Thank you.

Click the button below. The survey will take approximately 10 minutes.  It is completely anonymous.  The survey closes December 31, 2017, and results will be analyzed and published on this site and its Facebook page by January 15, 2018. (“Follow” to ensure you see results.)


Here’s what the first survey found:

Demographics (16 respondents from the greater Portland, Oregon region)

Child’s age range:  9 to 24 years of age
Child’s gender:   67% male, 33% female
Child’s diagnosis:  Everything!

Autism, ADD and ADHD, depression and bipolar disorder, schizoaffective disorder, brain injury, severe anxiety, PTSD, obsessive compulsive disorder, borderline personality disorder, oppositional defiant disorder, Tourette’s, reactive attachment disorder, and sensory processing disorders including PDD (pervasive developmental disorder).

This is a general summary of the results.  If you’re a geeky type, graphs of raw results are at the end of this article.

When your child had a mental health crisis, what did you do?

Parents had a variety of responses, with the most seeking help from mental health providers (hospital, crisis line, etc.).  Many tried to handle a crisis themselves, either by themselves or with the support of others.  Since many crises happen at school, the parents’ only option was taking their child home.  Many called the police at least once for a crisis, but a few called multiple times.

Of those who called the law enforcement:

Those parents who responded said the law enforcement officers mostly did a great job, and if the child was arrested, they agreed that the arrest was appropriate (these were parents who faced severe behavior: physical violence, psychotic rage, property damage, and credible threats of harm).  A few parents experienced criticism from the police, or their child was arrested and they did not agree with this.  A few also indicated their child had calmed down by the time the police arrived.

What kinds of help did parents seek?

Most parents sought help from other people (such as family members, friends, and neighbors) and from a mental health crisis line for information, emergency response, and support.  This was followed by seeking psychiatric care, or help from a school counselor if the child was at school.  A few didn’t seek help.

What worked best for managing a crisis?

By far, when parents had the help of friends and family, the crisis outcome was the best.  They also experience good results when they called a crisis line, which includes both for law enforcement police or mental health.   A few found hospitalization and other crisis responders helpful.

Comments:
“We implemented a crisis plan we’d made that included all options.”
“My child is 18 and I don’t know the adult system. Nothing’s worked thus far.”

What was the quality of the crisis resolution with each of these services available?

  • Most often, temporary improvement was the result of using the crisis support options available.
  • Also most often, crises worsened if a school was involved or a parent tried to manage it alone.
  • Next most often, the crisis results were good but the parents still had concerns. The police and psychiatric facilities were best at getting good results.
  • A “best possible outcome” was uncommon; only a 1 in 5 had this result.

Comments:
“The staff at the school made things much worse for my son. We had to find a different school.”
“My daughter did well after inpatient care, but there was no discharge plan.”
“The school counselor was useless, insisting that everything my daughter was acting normal for her age.”
“My ex played me as the “bad” guy.”
“Family and friends were clueless.”
“The police were helpful but temporary because they couldn’t help with underlying issues.”
“Hospitalization for a week helped her eventually get insight into her illness, but it took a long time.”

What have you done for self-care?

By far, parents took time off, and received therapy or medication for themselves.  This was followed by including the family in time off or in family therapy.  Half got help by attending a support group, followed by classes or involvement in a mental health organization.  Some sought respite care.

This is what we want: happy healthy children. Is that too much to ask?

What do you wish for the most?

This was an open-ended question and survey takers were encouraged to put down a sentence or two.  There were 29 comments for this question. Here is a general summary of the responses ranked from most to least, followed by a selection of quotes.

1. More, better, and affordable mental health treatment
2. A better life for my child
3. A break and rest
4. Emotional support
5. Better skills and knowledge for helping my child

Selected comments:

“Fewer financial barriers to health and wellness services”
“Easier access to the right care at the right time”
“For my daughter to feel safe and loved and at peace in her soul”
“For my son to feel better and participate in more everyday activities”
“More and restful sleep”
“People understanding us, including mental health professionals”
“Support group for spiritual development”
“Mentoring and positive community activities for teens”
“A cleaning lady (or man)”
“Knowledge of what to do and who to call”
“More understanding by my family members instead of judgment”
“To be more patient and calm”


RAW RESULTS

When you handled a mental health crisis, what did you do?  (% who responded, multiple responses possible)

Comments:
–We’ve responded in all of these ways.

If you’ve ever called law enforcement, how many times?   (% who responded)

What happened when you called law enforcement?  (% who responded, multiple responses possible)

Comments:
–Police took my child to a mental health facility.
–My son came home later, calmed down.

Did you seek help from other services?  (% responding, multiple responses possible)

Comments:
–If he wasn’t a danger to himself or others they could do nothing.
–Definitely have thought about who to call

What worked best to handle a mental health crisis?  (% who responded, multiple responses possible)

Comments:
–We implemented a crisis plan we’d made that included all options.
–My child is 18 and I don’t know the adult system. Nothing’s worked thus far.

What were the results?  (number who responded, multiple responses possible)

Comments:
–The staff at the school made things much worse for my son. We had to find a different school.
–My daughter did well after inpatient care, but then tanked and there was no discharge plan. I pushed hard to get her in a step-down facility, and then we got a good discharge plan.
–The school counselor was useless, insisting that everything my daughter was acting normal for her age. My ex played me as the “bad” guy. Family and Friends were clueless. The police were helpful but temporary because they couldn’t help with underlying issues. Hospitalization for a week helped her eventually get insight into her illness, but it took a long time.

Have you taken any action for self care?  (% who responded, multiple responses possible)

Comments:
–We got a companion pet.
–I built a support network of friends and colleagues with expertise in meditation and self-care.
–I got respite when my son was placed with his father temporarily.

As a parent of a troubled child, what do you wish for most?  (number responding, up to 3 choices possible)

 

–Margaret

How to Handle a Child’s Mental Health Crisis

How to Handle a Child’s Mental Health Crisis

You can sense there will be a crisis long before it happens. You have days when you’re so concerned about your child and family (and work and responsibilities) that you can’t think straight.  You can’t even spend time on little things like chatting with a friend or reading a magazine.  Your intuition says it’s only a matter of time and you won’t be able to handle it.

Before this happens, make a Crisis Plan with these priorities in order:

  1. Safety for everyone comes first
  2. Stabilization and treatment for your child
  3. Stress reduction for the family afterwards
  4. Lessons learned

What constitutes a mental health crisis?

  • When something dangerous has happened or is likely to happen because of a child’s behavior, words, plans, or triggering events that they experience.
  • Anytime a child’s behavior leads to harm or imminent harm to the child or someone else (including pets), or significant damage to property. Harm also includes emotional harm, threats, running away to unsafe places or doing unsafe things.

Trust your gut and trust your intuition.

Examples of a crisis when you must act

  • Watch. Pay attention to evidence your child has plans for suicide, which may include seeking dangerous items; or making multiple references to hating life; or they have a worsening mental state, or there’s been a prior suicide attempt.  Try this: “Use the “S” word: talk openly with your child about suicide.”
  • Look for increasingly troubled behavior over time that leads to extreme behavior:  non-stop raging, assault, repeated running away, threatening, talking about strange things, or spending too much time alone.
  • Pay attention following a traumatic event, such as someone else’s suicide or a newsworthy major tragedy. These can trigger a child to act dangerously on thoughts they already have.
  • The child runs away while psychotic, or depressed, or with a dangerous person–perhaps another troubled child–or under the influence of drugs or alcohol.
  • Psychosis of any kind including hallucinating or hearing voices; odd ideas; extreme agitation, anxiety, or paranoia; or a belief they have special powers.

The Crisis Plan

Have a crisis plan for home, school, and any other place where the child spends time.  For some, it’s also the parents’ workplace.  If a child is in college, a student adviser or someone in the campus health clinic needs to be a contact for checking in on your child.

Plan A:  call 911. You will not be bothering the police or emergency responders!

Plan B:  Answer these questions

For a runaway.  Who gets on the phone to call 911, and who goes out to look for the child and bring him or her back without mutual endangerment?  Both should know how to work with police and other community members.  There is no waiting period in a missing person’s report.  Check this article for what to say in call and do when police arrive. “How to work with police once you’ve called 911.”

Note: children have been known to behave perfectly once the police arrive, and police sometimes implicate the parents as having the problem. Don’t let this bother you.  You have demonstrated to your child that you are willing to call the police, and you’ve asserted your authority.  You might point this out to them–another episode of extreme behavior will be countered with significant action on your part. Use a neutral tone and avoid making this sound like a threat!

Who else knows your child and is trustworthy: others parents, businesses, teachers, their friends?  Are any of them able to assist you with talking to your child or keeping them safe?  Can any them help you “hold the fort” while waiting for an emergency responder?  Build a support network in advance:

Who gets on the phone and calls for extra assistance?  And is there a list of phone numbers?  Does your town or city have a crisis response team for kids?  What about a crisis line run by the mental health authority?  Check.  They are there to help.

Who should be appointed to communicate with the child?  This should be a family member or friend or teacher that the child trusts.  Communication with the right person can solve things fast, but with the wrong person can backfire, even from a parent… perhaps especially from a parent.

Who should step in and break up a fight, physical or emotional?  And what specifically should they do or say to de-escalate a situation spinning out of control?  Think about this:  your troubled child can often tell you exactly what works best and what makes things worse.  Listen to them.  It doesn’t have to sound rational to you as long as it works.

How should a time-out work?  Who counts to 10, or who can leave the house and go out for a walk?  Where can someone run to to feel safe and be left alone for a while?  What are the emotional safety rules for when the time out ends?  How can you and your child trust each other enough not to upset a fragile stability?

What should teachers or co-workers or others do to calm down a situation and get their classroom or office back to normal as quickly as possible?

Can a sibling stay at someone else’s house until things cool down at home?  Which house?  Sibling(s) can benefit from an escape to a friend’s house to protect them emotionally until a crisis has passed.  Ask them.

Teamwork

Think of your family and support network as a team that springs into action when someone sounds the Red Alert that your child is in danger.  Talk to family members and friends or neighbors ahead of time and give them an assigned role.  Let each should know they will be backed up.  This will be tremendously reassuring.  Your child’s crisis will be an upsetting event, but reasonable people will pull together when they know what’s going on and what they should do.  “Gang up on your kids:  Parent networks for tracking runaway children

Experiences and evidence shows that a rapid reduction of stress is effective at reducing the emotional wounds of a crisis.  Rapid cooling down of emotions, or “de-escalation,” is what prevents or limits the fallout from a crises.  You and your family can develop de-escalation techniques for bouncing back in tough situations.  The goal is “resilience.”  More than anyone, families with troubled children need resilience.

After the crisis

Everyone gets a mental health break.  This could be anything:  a day off, eating out, ice cream, going out for a movie…  Do something to get everyone back to an OK place and on their feet.  There should always be a reward for bravery, team work, and a job well done.

Next time it happens

There will be a next time.  A troubled child will be fine for many months and you’ll be so relieved, and then WHAM.  Use a previous crisis as a learning experience.  What can be done better next time?

Your long-term goal is to reduce crisis frequency over time, or prevent them from happening in the first place. 

Many parents have taken these steps to prevent a crisis or limit its severity.

  • Communicate directly with a police officer or precinct, school counselor, or juvenile justice official to explain your child’s legitimate mental health disability and your willingness to cooperate. Build a working relationship with them.
  • Locks on doors: a sibling can protect him or herself and their belongings; a parent can protect belongings, prescriptions, valuables, and money.
  • Track via technology – Track where your child goes and what they see online, and let them know you are doing this. This is legal.
  • Track via eyes and ears on the street – Befriend or build trust with your child’s friends, their parents, their teachers, neighbors, and businesses where they hang out.  Ask for a report if they see or hear something of concern. They may not be able to do anything but just report.
  • Search the child’s room for evidence of unsafe behavior, anything from razors for cutting themselves, harmful substances, porn, weapons, unusual ‘stockpiles’ of stuff (lengthy explanation goes here… just trust your gut if something is out of place). Room searches in your home are legal, but keep them secret and avoid acting on other things you find that aren’t 100% related to danger
  • Lock up dangerous items even though it’s inconvenient for you–kitchen knives, weapons, alcohol, drugs and prescriptions, matches, etc.
  • Lock up money, credit cards, and valuables. With money in hand, your child is on a path to victim-hood or association with people with criminal behavior. For example, they can buy drugs and alcohol from inappropriate people who then rob or assault them.
  • Confront people who undermine your authority. This is often a friend’s parents or other person who thinks you are abusing your child (because your child has told them so). They ‘rescue’ your child and offer safe harbor, and actively help them run away.  This is completely against the law, and they are subject to police action and criminal charges.  People who do this do not have your child’s safety in mind.

Extreme measures

There may be times when, for reasons of safety, you may to do things you are uncomfortable with while you wait for police, ambulance, or friends to arrive.  These are things parents have done in a crisis:  tackle a child and hold them down; or trick a child to get in a car and then have someone hold them down until they arrive at an emergency room (commonly needed in rural areas).  The way to avoid the risk of being charged by your child with abuse or assault is to have those open relationships with the authorities, teachers, and other parents who know your situation.  A letter from a doctor can be really important here.  I was glad I had one.

There will be fallout if you use force or trickery. Your child will not accept your reasoning or the necessity for your actions.  You can truly apologize for upsetting your child but without admitting guilt. Instead, ask what they want to happen next time they are in a crisis.  You should also honestly reassure them you will never use extreme methods again unless there is a safety issue.

To recap:

  • Trust your gut
  • Act immediately
  • Follow a plan that includes others working as a team
  • Take care of everyone afterwards
  • Prepare for extreme measures
  • Retain your authority as a parent by establishing supportive relationships.

You can handle this!

 

–Margaret

“You’re under arrest!”: Crime and Troubled Teens

“You’re under arrest!”: Crime and Troubled Teens

You’ve tried everything. Now you watch helplessly as your troubled teenager starts down a path leading to jail, and you wait for that call from the police. There’s been a crime. It finally happened like you thought it would.  But this bad news can be good news. This may be the point when things start to turn around.

“Experts estimate that from 40 percent to 70 percent of youth in the juvenile justice system suffer from some form of mental health disorder or an illness – anything from ADHD to full-blown psychosis. About 15 percent to 25 percent have mental illnesses “severe enough to significantly impair their ability to function.”” (see “Mentally ill minors put in juvenile hall” at end of this post)

Juvenile crime is considered as serious as adult crime, and juvenile “detention” is just like jail for adults. Yet there is one critical distinction between teenage and adult justice: teens are given a second chance for a clean record and an education.  If your jurisdiction is enlightened, they will get treatment for mental illness or addictions. An adult criminal record is forever a barrier and an embarrassment. It comes up when a former convict applies for a job, a loan, a college degree, military service, a rental, or even a volunteer opportunity.

The juvenile justice system is only partially punitive because society recognizes that the teenage brain is the problem that causes much crime, whether or not they have a mental disorder or addiction.  Enlightened juvenile court judges want their rulings to be “rehabilitative” or “restorative” justice. Enlightened agency directors understand the need for additional support services for learning disabilities, addiction, mental illness, and vocational training.

In the system, teen criminals (“adjudicated youth”) are required to participate in consequences and treatment; it’s a “carrot and stick” approach.

  • The carrot:  The teens attend school and receive training for vocations such as car repair or catering.  They participate in positive character-building activities such as training dogs for adoption, building and maintaining hiking trails, or constructing homes for Habitat for Humanity.
  • The stick: Teens have a complete lack of freedom, whether in detention or out on probation, intensive monitoring (including random urinalysis), immediate consequences for behavior violations, and physical labor to pay back victims (community work programs).

When a police officer calls to say your son or daughter has been arrested, use this as an opportunity to help your kid. It’s a perfect teachable moment. Not only do you have their attention, you can hand the problem over to the Law to enforce their behavior and treat their disorders or addictions. Your son or daughter cannot refuse—when held or convicted on criminal charges, your child has no rights to anything except humane treatment and an appearance before a judge. You are off the hook. You can step back and relax… and be the Good Guy for once.

How to work with the juvenile justice system:

  • Be an active partner with the court. Cooperate fully with the judge, court counselor or therapist, and any attorney, case worker, or probation officer involved.
  • Show up for everything:  visitation, family therapy, court hearings, and parenting classes even if you don’t think you need them.
  • Stand shoulder-to-shoulder with staff.  If your teen has a probation officer, do what they tell you, even if it means tattling on your kid.
  • Be cooperative with staff, and they will work harder for you and your son or daughter. Support the programs required for your teen, and support your teen when they struggle. Your involvement will someday impress on your child that you’re on their side and care.
  • Change your ways.  If you’ve been too harsh with your teen in the past, go easy on them now and let him or her see your good side. If you’ve been too easy on them or too protective, demonstrate backbone. Show you know what’s best for them and that you will remain in charge once they are released.
  • Stick with your child.  If your teenager becomes a Frequent Flyer in the system, it doesn’t mean they are lost.  Remember, they have that uncontrollable teenaged brain and need more time and lessons for it to reach maturity.

Once they come home on probation you need to set strict limits on their activities, and work with the probation officer or social worker to enforce them. These are harsh at first, but should be negotiated later when behavior improves, with consultation with the juvenile justice staff.

Remove risks:

  • Don’t allow them to stay out late ever. Set an early curfew, and report them to their probation officer if they are late.  When they get angry about this, explain that you are bound by the law and that they should discuss their concerns with the officer.
  • Not negotiable: ban drugs and alcohol, especially marijuana. (“Marijuana is uniquely dangerous for troubled teens”.)  Hide prescription drugs and alcohol if you use them. You have the right to search their room and belongings.  If pertinent, hide weapons, matches, or other means of harm to themselves or others.
  • Stop or limit contact with risky friends. This may mean monitoring visits, monitoring cell phone use and internet access, or blocking access entirely if used for crime.
  • Limit access to money to prevent drug/alcohol purchases or escape plans. Get receipts if necessary.
  • Reduce free time. Busy them with as many activities as you can–a job is the ideal.
  • Build your own network of other concerned parents to track your kid… in other words, to spy on them.  Besides other parents, I even contacted businesses where my teen was known to hang out, such as a mall and cafe.  See  “Gang up on your kids: Parent networks for tracking at-risk children.”

Three Goals:
     1)   stay at home
     2)  stay in school
3)  stay out of trouble

Three House Rules:
     1)  continue mental health treatment
     2)  no violence when upset
     3)  clean body, clean clothes

Build their esteem as you would for any troubled child. Guide them to their strengths. Give your teenager something to do that they good at, and allow them ample opportunity to shine. More at  The good things about bad kids.

Extreme measures. I know of three cases where parents took drastic steps to help their son or daughter stay out of trouble, and these worked!

True story – a single father was worried about his son’s gang involvement, especially since the son was still on probation for a crime, and additional charges would draw lengthy prison time. Dad sold the family home and bought another one in a neighborhood ‘run’ by an opposing gang. The son was terrified to leave the house except for his new school, a long way from his gang brothers. This son graduated high school and left the area for college… alive, uninjured, and with a clean record.

True story – After a couple of years trying to keep their daughter out of trouble, parents started looking for work in a smaller town.  They wanted to find a safer place with fewer risks and more eyes. After she completed her mandated one year probation, the family moved.  She was upset to leave her friends, but they were the problem friends. Her crime sprees ended.

True story – a single mother was on the edge of sanity and financial ruin trying to manage the world her son created.  While visiting a juvenile justice counselor with her son, the counselor made an off-hand comment about handing him over to foster care so that she could get her job back and sleep at night.  With a heavy heart, she went forward and obtained a “voluntary placement” for him (temporary state custody), and he went to a foster home.  After two years, he was ready to come home and she was ready and empowered to support him.

A note of caution:  You may have seen ads for outdoor programs or “boot camps” for at-risk teens. Some of these programs are extremely inappropriate for troubled youth, even traumatizing. Or some may not allow teens with a criminal history. Get advice about therapeutic programs for your at-risk teenager from a counselor or social worker, not just from the program itself.  Your teen’s providers often know which ones are appropriate.

The people in the Juvenile Justice System

In my personal experience, 99% of employees in juvenile justice are there because they care about teens, they like teens and “get it” about them, and they believe in the power of what they do. My co-workers have many success stories among their cases. Some former delinquents come back to work for the juvenile justice system and use their hard-won experience to help the next generation.  Ironically, it’s the one job where a criminal record helps!

If you are concerned about what your child will experience in the juvenile justice system, just call and ask.  You may be surprised.

Challenges, risks, and potentially serious problems

  • A troubled young person in detention or incarceration is exposed to others with criminal behavior. They may bully or be bullied or both.  They may meet fellow inmates to sell drugs to when they get out, or learn who can supply them with drugs. Depression is common, and presents as anger or self-destructive behavior, such as getting in trouble on purpose.
  • Not all juvenile departments provide mental health treatment, or treatment is inadequate.  And sadly, there are still places where staff and citizens don’t believe in the mental health “excuse” for bad behavior.  You may need to be an assertive advocate for treatment.  Work with your child’s public defender, who is provided by the court, and give them evidence of mental health problems in  medical records.  Your child will need to sign a waiver for the attorney to have the records.
  • Some states have Mandatory Minimums–pray it’s not yours. Certain crimes lead to long prison sentences regardless of the circumstances of the crime or the mental illness of your child. My state of Oregon will incarcerate anyone over age 15 for seven years if they commit one of these crimes. This made sense to the voters who put it into law, but the reality is a worst-case scenario for how NOT to rehabilitate youth.  No one I’ve ever met in our state, from judges to prosecuting attorneys to sheriffs to probation officers, thinks it’s a good idea–the outcomes have been horrible for reasons too lengthy to go into here.
  • Each county and state has a different culture and attitude towards juvenile delinquents. Some are exceptionally harsh, or they neglect the kids’ legitimate needs; some are reluctant to treat kids like individuals with different needs and strengths; some get that right balance of punishment and rehabilitation. It depends on the judges, the county, and the state. Each is different.

Is your child at risk from criminal involvement or charged in a crime?  Please comment so other parents who read it can learn from your experience.  Thank you.

How am I doing?  Please rate this article above, thank you.

–Margaret


Mentally ill minors put in juvenile hall (excerpt)
Daily Bulletin, Mediha Fejzagic DiMartino, June 12, 2010

“Juvenile halls have become catch-all basins for severely mentally ill youth.  Designed as secure holding facilities for minors who are going through the court system, juvenile detention centers now double as a default placement option for youth diagnosed with schizophrenia, bipolar disorder or major depression.   “There is no place for them in [our system],” said a county juvenile court judge in California.  “We can’t just arrest our way out of the problem. Juvenile hall is not a place to house mentally ill.”

Why teens run, and what you can do about it

Why teens run, and what you can do about it

It’s an emotional shock when your teen runs away the first time. Your feelings are complex:  anger at his or her rebelliousness; fear for his or her safety; shame that you may be called a “bad” parent or that your behavior caused your child to run.  Runaway teens also have complex reasons for running, and they may or may not be the parents’ fault.

Why they run

Basic teenage development All teens go through a stage where they define themselves as unique, and start demanding two things: 1. freedom; 2. a say in their life.  These are necessary and important for maturity—some do it gracefully and some don’t.  Even teens with a mental illness will go through this normal phase.

Rebellion Most rebellious teens do not run away because they may have better survival instincts.  If a teen is emotionally behind their peers, using drugs or alcohol, and part of a risky crowd that encourages them and undermines their parents’ authority, it’s likely they’ll run.

Mental disorders Mental health problems magnify any or all negative aspects of rebellion and immaturity.  They also disrupt a teen’s thought patterns and cause irrational ideas and fantasies.  They have a high likelihood of running.

Family stress This is the biggest reason: “65% of youth reported running away because of family conflict.”* Think about what’s going on at home that a teenager can’t handle (they are not as strong as they act).  Is there non-stop fighting between members?  Are they being nagged or constantly criticized, and not shown support or love?  Like all children, teens still deserve support and love.  Are they being bullied, or physically or sexually abused?  *National Runaway Switchboard at 1-800-RUNAWAY

What you might observe that foretells running

  • Changes in behaviors or normal patterns mean something is wrong.
  • Teens who suddenly stop eating or begin to overeat, sleep all day or never sleep, spend all their time with friends, or never want to leave their room.  Sudden mood swings mean teens are unsettled and restless, and they’re not coping well with stress.
  • Outward rebellious behavior is often the start of trouble, but not always.  Inward rebellion is also a problem, such as depression and isolating from their family.
  • Falling grades, truancy, school behavior, and breaking house rules are all symptoms that your child is having problems.
  • Disclosure of intentions to run away.  Some teens will hint that they want to run away and some will outright threaten their family with running.
  • Expressing fantasies that they will ‘divorce’ their family.  Teens often believe they can be legally emancipated before age 18, skip high school and get a GED* and a job, and be free.  A juvenile court judge told me otherwise!  The legal test for emancipation is very restrictive.  *General Educational Development exam–a less valuable substitute for a high school diploma.
  • Accumulation of money and possessions. To survive, runaway teens need resources. Some prepare for their run by saving any money they receive.  They might keep a bag or backpack of clothes and food in the closet to make a quick escape.
  • Risky friends have a very powerful influence on the decision to run away.  Relationships like these almost always include substance abuse.  The risky associates include adults who undermine the parents, and who coach teens how to get away from home. They provide them with cigarettes and drugs, and possibly take advantage of them.
  • Full time access to unmonitored and unrestricted communication, and easy access to transportation, especially a car or an at-risk acquaintance with a car.

What to do if you suspect your teen might run away

“Clearly and calmly let your teen know you are concerned about them, and that their behavior makes you afraid they might run away from home. Invite them to talk with you or someone else about what is troubling them and be supportive of finding positive ways of dealing with their stress.”

Let them know you don’t want them to run away and you’re committed to helping the family work things out, and let them know you are concerned about their safety.

If your teen is intent on running away, give them the phone number of the National Runaway Switchboard* so that they can find safe options while out on their own.”  This does not mean you approve.  A good analogy is informing your kids about contraceptives even though you don’t want them to have sex.  *1-800-RUNAWAY

Give them some facts: Your teen should know the laws, and they should know about youth shelters.  This may help them recognize that you are concerned for their safety… just like you told them.

– – – – – – – – – –

Are you thinking about running away?

Are you worried about staying with a friend and getting your friend or their parents into trouble? Does it matter if you’re reported as a runaway or not? Deciding on whether or not to run away and where to go can be difficult. Here’s what you should know:

  • In most states it is not illegal to run away.
  • If you leave home without permission or stay away longer than you’re supposed to, and you are under the age of 18, your parents can file you as a runaway with the police.
  • If the police find you, you will be taken home or to police headquarters, and your parents will be called to pick you up.
  • If you are staying at a friend’s house or somewhere your parents didn’t give you permission to be, they can face possibly legal consequences.
  • If you are filed as a runaway, your parents can press charges against those allowing you stay with them or abiding you.
  • If you go to a youth shelter, generally they have to contact your parents within a certain amount of time to obtain consent for your stay.  Often, you are allowed to stay only 72 hours (3 days) before you must return home.  This gives you and your parents time to cool off.
  • If you are staying with a friend, in most cases the police are only allowed to do a courtesy check; which means they are not allowed to search your friend’s home without a warrant.
  • It is always best to check with your local non-emergency police hotline or legal aid when it comes to specifics because the law varies.

Hopefully the information listed here answered some of the questions you may have had. If not, you can give us a call and we can help.  1-800-RUNAWAY

(Parent: list the names and addresses of local youth shelters here—not adult shelters)

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Get to know their friends and their friends’ parents.  If anyone who knows them is concerned about your child’s safety, they may help you if there’s a problem.  Other parents can keep an eye out for your child as well as their own.

Statistics indicate that most children stay in the same general area that they live in. Some go only as far as a friend or relative.  You must know where and be able to communicate with the responsible adults.

Get to know the at-risk youth

and adults that your teen associates with. “At-risk kids hang out together, they know each other’s stories (true or not), protect each other, and keep parents out of the loop.  What if parents got together too, shared stories, and supported each other?  Everyone has the same goal of protecting their child.  Kids’ unsafe plans and activities are no match for the many eyes and ears (and cleverness and wisdom) of all their parents combined.”  Gang up on your kids: Parent networks for tracking at-risk children

If your teen is staying at a friends’, this may be helpful.  You might negotiate with the parent for a friendly arrangement for ‘shelter’ until things calm down.  If you cannot communicate with this parent, they may be guilty of custodial interference.  This is illegal and should be reported to the police.  More often than known, some parents actively encourage other parents’ children to leave home, as well as provide them with alcohol and drugs.

What to do if they run

Notify the police and file a missing persons report.  If your teen has a mental disorder, bring this up on the call and be specific (he needs to take medications, she has a history of assaulting others, he has threatened suicide, she might be out of control and unable to respond if you shout at her…).

Are you worried that your police report will go on your child’s record?  Don’t.  Even if your child is charged and convicted as a juvenile, his or her record can be expunged (erased) at age 18 with good behavior.

The National Runaway Switchboard at 1-800-RUNAWAY operates a 24-hour confidential hotline for teens and their families. Leave a message with them for your child, www.nrscrisisline.org. They also provides bus tickets to get kids back home to their families

Spread the word among friends and your child’s friends that you reported your child, and ask them to ask your child to call or give a message to you if they see them.  Also spread the word that protecting a runaway is a crime.

Track.  “Friend” your child on Facebook, or find someone who can and will report to you.  Set your computer up to track and store web search history and email.  Search their room.  Get their cell phone contacts if possible, track their GPS location by cell phone, and get every address and phone number of every friend.  All of this is legal.

Investigate.  This is not a situation where you respect your teen’s privacy.  Besides tracking their activities above, drive around and look for them.  Be sure they and their friends see you because then the risky friends will avoid your child.

Check in with your child’s teachers or counselor for any information that might be useful.

Take care of yourself and your other children. This is a difficult time and you don’t have to deal with it alone. Turn to people you know and trust for support. The NRS is available 24 hours every day and offers information and support for parents too.

Ask yourself the hard questions:  Is life at home that bad?  Is there abuse (emotional or physical)?  What changes am I willing to make to reduce my child’s stress at home or at school.

Good news from statistics

  • 85% parents reported that the issues that led the youth to run away were somewhat, mostly, or completely resolved within a month.
  • Most parents reported that their youth used alcohol or other substances less once they returned (68%).
  • Most reported they engaged in physical fights less (64%).
  • Most reported they broke the law less (66%).
  • Of those who ran once, 75% did not leave home again.

Creative things other parents did that worked

True story.  A father made business cards to give to everyone who was ever in contact with his 15-year-old daughter.  It had her photo, contact information, and the message that he and her mother loved (name) and wanted to ensure her safety and appropriate behavior.  He made a point of personally visiting with her friend parents where daughter went.  She hated her dad for this, but never ran again, and every time she visited a friend, the parents always reminded her to call her own parents and report her whereabouts

True story.  Two 13-year-old girlfriends decided it would be fun to run away and party.  During the week they went missing, their frantic mothers collaborated on a ‘full court press’ to notify others and get their daughters back safe and sound.  They printed flyers with photos of their daughters, their phone numbers, and offered a $25 reward, no questions asked.  These were given to the police, posted at school, at youth shelters downtown, and at business hangouts the girls were known to frequent (a mall, a fast food place, a big box retailer).  Both girls were eventually returned safe and sound, and they were really angry.  Apparently, street kids and risky adults spurned the girls because of the flyers, for fear of attracting the attention of law enforcement.

–Margaret

 

Do you have a runaway story?  Please comment on what worked to return your child, or what didn’t work.  Thank you.

ADHD kids become troubled adults

ADHD kids become troubled adults

I have been so wrong about ADHD.  I confess I used to think attention disorders were not as serious as other disorders.  Sure, these kids had big problems, but they didn’t seem to compare with the disabling, even dangerous, symptoms of disorders like bipolar or schizophrenia.  ADHD kids just seemed more ‘functional’ to me, and the treatments seemed to work better.  While other families talked about psychotic breaks, suicide, and uncontrollable rages, I heard parents of ADHD kids talk about intense frustration and daily calls from school.  Heck, ADHD kids could attend school!  When I attended children’s mental health conferences, the ‘youth-talk-back’ workshops were all led by young people with ADHD.  They were articulate about their experiences and needs, answered questions, and interacted appropriately with audiences.  So many strengths!  Youth with other disorders are challenged by all of these tasks.

I confess, I also found ADHD funny…

…but my perception changed radically when I found recently published research on children with ADHD who were followed from childhood to adulthood.  These studies revealed deeply unsettling news—the long-term effects of ADHD can be serious.  Adults with ADHD have a higher risk of developing other psychiatric problems, being victimized and incarcerated, and facing lifetime struggles with education and employment.  Summaries from 10 research studies on the long term prognoses of ADHD are found at the end of this post.

Children and teens with ADHD deserve the chance to reach adulthood with skills that keep them from sliding inexorably downhill, which studies show is common.

Treatment is imperative, not optional!  ADHD hits hardest in adulthood, but starts in childhood when parents have an opportunity to change it’s course.  Parents and caregivers should aggressively and persistently seek an appropriate treatment for their ADHD child that improves functioning:  behavior at school and home, school attendance and educational attainment, self-esteem, and self-actualization.  In addition to medical/medication treatment as recommended, the child must learn self-management and self-calming skills so they can control impulses when they reach adulthood.

Little things start adding up – Without skills (and/or medication), a person with ADHD slips up on life’s daily little challenges–losing, forgetting, neglecting, overreacting, disappointing others, and undermining themselves in a thousand different ways.
Needing others and resenting it – I’ve noticed that those with ADHD seem to find or attract others they can depend on.  They seek and get support to be functional, but the effort can weigh heavily on their “caretakers” (spouse, friends, co-workers) and family.  They lose opportunities to practice self-reliance when this happens, and they resent their dependence on others.  Who wants to be stuck within other’s limits, and on the receiving end of their frustration and impatience?

 
Unfinished business – Those with ADHD drag unfinished projects with them indefinitely, keeping them in an actual or metaphorical garage full of costly but unfinished projects.  Little repairs become big expensive repairs through lack of maintenance.  Bills don’t get paid, licenses don’t get renewed, debtors get away with never paying them back.
 
Guide your child to his or her gifts –
From personal experience with ADHD children and adults, I know they can love, be affectionate, funny, generous, and show empathy for others.  They strive to be better.  Think of careers your child or teen might pursue that require creativity, energy, and enthusiasm.  Introduce them to experiences that challenge them, and ignore the myth that they can’t focus or that they mess things up, not true.  ADHD kids readily focus on projects they enjoy, demonstrate mental nimbleness with complexities, multitask with accuracy, and shine in emergencies, whether debugging software, making music, or even doing surgery.

Writer’s commentary: To medicate or not to medicate?  Two extremes, neither appropriate. I’ve read articles that question the existence of ADHD, or vilify the families that treat with medications. Prejudice against this disorder and parents is common. Even uninformed people think they understand ADHD, and comfortably spread personal opinions about the use of medications or consequences for ADHD behaviors. This is unhelpful. Public controversy over ADHD negatively influences parents’ decisions regarding diagnosis and their choice of a child’s treatment.

At one extreme: some think medications turn children into zombies, and that ADHD is a fake diagnosis or treatable with natural substances or meditation, etc. Non-drug options may help, but what if the results are marginal and short-lived? What if a parent stubbornly sticks with a treatment that fits a personal goal and refuses to notice that it’s not working? If a non-drug remedy is effective, there will be hard proof: the child will keep up with school, maintain grade level, exhibit behaviors appropriate for their age, and show signs of self-control. These are more important to a child’s future than a parent’s loyalty to a belief.

Ironically, the choice of drugs for those of us with children with severe disorders may be easier than for parents of ADHD kids. Drugs keep psychotic kids safe and alive, here and now. Worrying about side effects is a luxury.

At the other extreme: some parents want a “quick fix” with pills, but chemical control also makes it easier for these parents to avoid hard parenting work like teaching their child to check impulses and set boundaries. And if parents are happy with the drug, might they overlook their child’s discomfort with side effects and ignore this child’s need for an adjustment? Might they also overlook how their home environment promotes distraction and chaos? A pill will compensate for bad parenting and a crazy-making lifestyle until the child reaches adulthood, having never been taught to make choices that promote their gift of creativity and reduce their risk of addiction, or having never been taught self-discipline.

Margaret

 
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All T-shirt photos found at Dr. Kenny Handelman’s
ADD ADHD Blog

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High School Students With ADHD: The Group Most Likely to…Fizzle

 Breslau J, Miller E, Joanie Chung WJ, Schweitzer JB.Childhood and adolescent onset psychiatric disorders, substance use, and failure to graduate high school on time. Journal of Psychiatric Research.  Jul 15 2010

 Adolescents with attention deficit/hyperactivity disorder (ADHD), conduct disorder, or who smoke cigarettes are least likely to finish high school (HS) on time or most likely to drop out altogether, researchers at the University of California, Davis, School of Medicine (UC Davis) have found.

Lead investigator Joshua Breslau, PhD, ScD, medical anthropologist and psychiatric epidemiologist reported that of a total of 29,662 respondents, about one third (32.3%) of students with combined-type ADHD were more likely to drop out of high school than students with other psychiatric disorders. This figure was twice that of teens with no reported mental health problems (15%) who did not graduate. Students with conduct disorder were the second at-risk group (31%) to drop out or not finish on time. Cigarette smokers were third in line, with a staggering 29% who did not finish high school in a timely manner.

Educational achievement squelched in children with ADHD
Newsletter – NYU Child Study Center, New York, NY, February 2009
Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common disorders in childhood and adolescence, with prevalence estimates ranging from five to ten percent.  Children with untreated ADHD drop out of high school 10 times more often than other children.

Adult psychiatric outcomes of girls with attention deficit hyperactivity disorder
American Journal of Psychiatry, January 2010
Researchers studied age 6 to 18-year-old girls with diagnosed ADHD and followed up after 11 years.  Conclusions:  By young adulthood, girls with ADHD were at high risk for antisocial, addictive, mood, anxiety, and eating disorders. However, ADHD medications appear to reduce the prevalence of multiple disorders at least in the short term.  These findings, also documented in boys with ADHD, provide further evidence for negative long-term impacts ADHD across the life cycle.

Brain abnormality found in boys with attention deficit hyperactivity disorder
Journal of Abnormal Psychology, March 2009
Researchers trying to uncover the mechanisms that cause ADHD and conduct disorder found an abnormality in the brains of adolescent boys suffering from the conditions. The research focused on two brain areas, the “mid brain” striatal, and cerebral cortex.  The mid brain motivates people to engage in pleasurable or rewarding behavior.  The cortex notices if an expected reward stops and considers options. However, this doesn’t occur as quickly in boys with ADHD or conduct disorders.  Instead, the mid brain region keeps trying for rewards, which is a quality of addictive behavior.

Kids with ADHD more likely to bully, and those pushed around tend to exhibit attention problems
Developmental Medicine & Child Neurology, February 2008
Children with attention deficit hyperactivity disorder are almost four times as likely as others to be bullies. And, in an intriguing corollary, the children with ADHD symptoms were almost 10 times as likely as others to have been regular targets of bullies prior to the onset of those symptoms.  Bullies were the kids in class who couldn’t sit still and listen, didn’t do their homework and were almost constantly in motion.  Children with ADHD symptoms make life miserable for their fellow students, and they too can develop attention problems related to the stress of being bullied.

Girls’ hyperactivity and physical aggression during childhood and adjustment problems in early adulthood:  A 15-year longitudinal study.
Archives of General Psychiatry, March 2008
Girls with hyperactive behavior such as restlessness, jumping up and down, and difficulty keeping still or fidgety, and girls exhibiting physical aggression such as fighting, bullying, kicking, biting or hitting, all signs of ADHD, were found to have a high risk of developing adjustment problems in adulthood.

Teen’s inattentive symptoms may determine how long they stay in school
Forum for Health Economic & Policy, November 2009
Poor mental health of children and teenagers has a large impact on the length of time they will stay in school, based on the fact that at conception there are differences in genetic inheritance among siblings. This study provides strong evidence that inattentive symptoms of ADHD in childhood and depression in adolescents are linked to the number of years of completed schooling.

Children with ADHD more likely to participate in crimes
Yale School of Public Health and University of Wisconsin at Madison, October 2009
Children with ADHD are more likely to participate in crimes such as burglary, theft and drug dealing as adults.  Those who had attention deficit hyperactivity disorder as children were at increased risk of developing criminal behaviors.  Researchers said one reason is that children with ADHD tend to have lower amounts of schooling.

ADHD may affect adults’ occupational and educational attainments
Journal of Clinical Psychiatry September 2008
Adults who have ADHD generally have lower occupational and educational attainments as adults than they might have reached if they didn’t have the disorder, at least compared to what attainments would have been expected given their intellect.  “Educational and occupational deficits… are a consequence of ADHD and not IQ,” lead researchers Dr. Joseph Biederman said. The finding strongly underscores the need for “diagnosing and treating ADHD to avert these serious consequences,” he said.

Attention-deficit/hyperactivity disorder (ADHD) in the course of life.
European Archives of Psychiatry and Clinical Neuroscience, September 2006.
ADHD is a pervasive disorder that extensively impairs  quality of life and that can lead to serious secondary problems.  Long-term studies have demonstrated that the disorder is not limited to childhood and adolescence. The clinical experience indicates substantial difficulties for adults whose ADHD is not diagnosed and treated, and they often create extensive costs for the welfare system. The evidence-based psychiatric treatment available is highly effective and inexpensive.

70% of crystal meth (methamphetamine) inpatients had ADHD
Journal of  Addiction Disorders. 2005, and the blog: Adult ADHD Strengths.
Methamphetamine-dependent inpatients were screened for childhood attention deficit hyperactivity disorder (ADHD), and of the participants, 70.6% screened positive for ADHD and reported significantly more frequent methamphetamine use prior to baseline.  ADHD participants exhibited significantly worse psychiatric symptomatology.  At a three-week follow- up, all who didn’t complete treatment screened positive for ADHD.

 

Things that protect troubled girls from delinquency

Things that protect troubled girls from delinquency

 

Both boys and girls get in trouble with the law.  Boys are in the majority for arrests for crime, but statistics indicate that girls’ arrests are increasing:  “…between 1996 and 2005, girls’ arrest for simple assault increased 24%.”  Of 1528 girls studied over a period from 1992 and 2008, 22% committed serious property offenses and 17 % committed serious assaults.  (Girls Study Group, U.S. Department of Justice, 2008. www.ojp.usdoj.gov).

  

Troubled girls easily become criminal, but also risk being a victim

 

Girls who have behavioral disorders, from addictions or past trauma or emotional disorders, begin to have delinquent or criminal behaviors as early as middle school.  What makes a girl’s criminal activities different from boys is that girls put themselves at high risk of being victimized themselves.  How can a parent or caregiver prevent their daughter from engaging in criminal behavior, and trapping themselves in a social world where their stresses and disorders can worsen?

 

The Girls Study Group quoted above studied which factors protected girls from becoming criminal, or helped them stop and reengage in activities that improve and stabilize their lives.  Protective factors did not prevent all criminal activity however, yet the first one has been shown to be the most effective.

 

  • Support from a caring adult.  THIS IS THE SINGLE MOST IMPORTANT FACTOR in preventing girls from criminal activities of any kind.
  • Success in school helped prevent aggression against people, but not property crimes.
  • “Religiousity,” or how important religion was to troubled girls, meant they were less likely to be involved with drugs.

Risks to girls that are different from boys: 

    

Early puberty is a risk if the girl has a difficult family and comes from a disadvantaged neighborhood.  Biological maturity before social maturity causes more conflicts with parents and more negative associations with older boys or men.

 

Sexual abuse, which girls experience much more than boys, including sexual assault, rape, and harassment.  But abuse of any kind affects both boys and girls equally.

 

Depression and anxiety, which girls tend to suffer more from than boys.

 

Romantic partners.  Girls who commit less serious crimes are influenced by their boyfriends.  But for serious offenses, both boys and girls are equally influenced by a romantic partner.

 

Once she’s regularly breaking rules, it’s not easy to turn things around for a troubled girl.  It requires constant, persistent efforts to:

  • Keep her away from risky associates.
  • Keep her in school and up with studies. 
  • Keep telling her what’s great about her, what’s special, what’s powerful and good.

If you are a parent or caregiver, and you are lucky enough to have a strong mentoring relationship with your troubled daughter, keep it up despite any occasional law-breaking activities.  She’ll need consequences, but they should be obstacles to overcome rather than punishments—such as earning back privileges by having good behavior for a period of weeks or months.

 

If you don’t or can’t have a mentoring relationship, find out who can (or already does).  Admit you might not be the sole support for her success, and work in partnership with a caring adult.  Find out who believes in her already.  Find out who she asks for help if she’s feeling fearful or down about herself.  Listen to her if she talks about someone she’s grateful for for helping her through difficulties.  Girls respond really well to someone who believes in them.

 


Teen girls can be turned around and it’s always worth the effort.  She might be hard to take sometimes, but find something, anything, that’s good about her and let her know.  Over time, you’ll start noticing more and more great things about her, and then she’ll start noticing them too.

How to work with police once you’ve called 911.

How to work with police once you’ve called 911.

 

Q: Should I call 911?  I’ve been told I should call the police or mental health hotline when there’s a crisis, but how do I know when it’s a real crisis?


A:  If your child is doing something dangerous to him or herself, or others (including a pet), or property, and if you can’t manage it or stop it, call.  “Dangerous” means threatening, harmful, or abusive.  Emergency 911 dispatchers, police, and mental health crisis workers all encourage anyone to call, anytime.  You will not bother them.  I once visited a 911 facility and got a chance to ask to speak with the staff and this was their message.  They described the many ways they can respond when a child or teen “blows out,” runs, or becomes suicidal.

 


Once you call the police:

Advice from the Federation of Families for Children’s Mental Health (www.ffcmh.org).

  

1.   Remain as calm as you possibly can.

 

2.   Provide only facts as quickly and clearly as possible.

EXAMPLE:  I am calling from [address].  My 13-year-old son is threatening to cut his sister.  He has [diagnosis] and may be off his medication and under the influence of alcohol.  There are 4 of us in the house: my mother, my son and daughter, and myself.

 

3.   Identify weapons in the vicinity or in your child’s possession and alert the dispatcher

 

4.   Be specific about what type of police assistance you are asking for.

EXAMPLE:  We want to protect ourselves and get my son to the emergency room for a psychiatric evaluation, but cannot do that by ourselves.  Please send help.

 

5.   Answer any questions the dispatcher asks.  Do not take offense when you are asked to repeat information.  This is done to double-check details and better assist you.

 

6.   Offer information to the dispatcher about how an officer can help your child calm down.

 

7.   Tell the dispatcher any addition information you can about what might cause you child’s behavior to become more dangerous—suggest actions the officer should avoid.

EXAMPLE:  Please don’t tell him to stand still.  He cannot hold his body still until he calms.  If you can get him to walk with you, he can listen and respond better.  He is terrified of being handcuffed.  Please tell him what he needs to do to avoid being handcuffed.

 

REMEMBER:  Your primary role in this situation is to be a good communicator.  Your ability to remain calm and provide factual details is critical the outcome of this situation.” 

– – – – – – –

 

What is your local police force like?  Call the non-emergency line and check, ask questions about how police typically respond to situations where a child or teenager is diagnosed with a mental disorder and out of control.

 

In many parents’ experiences, including mine, the police were very helpful.  Others have had poor experiences.  Some said their child calmed down and appeared normal once the police arrived, and they felt the police assumed they were exaggerating.  Some said the police only aggravated the crisis, and in a very few cases, the encounter lead to tragedy.

In 2007, I attended the national conference of the Federation of Families in Washington DC, and learned from the President of the National Association of Chiefs of Police, Ronald C. Ruecker, that the NACP has made a commitment to promote police training in crisis response to children with mental disorders, including information about the disorders and their manifestations.

Parent to Parent Guidance

Parent to Parent Guidance

Margaret Puckette is a Certified Parent Support Provider, and assists parents on how to effectively raise their troubled child. She believes parents need realistic practical guidance for family life and school, not just information about disorders. Margaret has mentored families for over 20 years. She is an author & speaker, and knows from personal experience there is reason for hope.

You Can Handle This.

You Can Handle This.

You are not alone. It's no one's fault. Behavior disorders are disabilities! Troubled children need a very different parenting approach than 'normal' kids.

Care for yourself first, then set new goals:
1. Physical and emotional safety for all
2. Acceptance of the way things are
3. Family balance, meet the needs of all
4. One step at a time, one day at a time

Practical Guide for Parents

Practical Guide for Parents

A guide with practical steps for reducing stress at home and successfully raising a troubled child. You use the same proven techniques as mental health and other professionals. It starts by taking care of your wellbeing first, then taking an entirely different approach to parenting.
Amazon $14.99, Kindle $5.99