Developing healthcare responsibility in your children

I am writing this fully knowing I am at risk of upsetting some parents. But this is the time of year we see more school aged kids for their annual physicals, so it is the time of year I think about how parents could help their kids grow into independent adults or hinder that growth by trying to be a good parent.

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I read an article recently (The Overprotected Kid) that really hit home with me about how parents try so hard to keep their kids safe that we sometimes prevent them from learning about real life. Although the article is based on allowing kids to roam and play with things that haven't been engineered to keep them safe, it did touch on the fact that parents hang around to answer for kids and speak up for them.

I find that parents often try to help their children during visits to my office by answering questions about their health, sometimes even what they are feeling. I'm sure they want to be sure I know their (parent) perspective. Maybe they are just trying to speed up the visit so they can leave and do the other things on their to do list. But it usually ends up taking longer, because I then spend more time trying to talk to the child.

When a question is directed at the child, let the child answer. If I need parental clarification, I'll ask for it. Obviously a pre-schooler needs more help than a high schooler, but if the teen has never had the opportunity to answer for himself, he might not have the skills and confidence to do it.

Sometimes a parent will start asking their child questions or tell them to tell me about .... I'm sure they are thinking that it is helping me, but it doesn't. (I'm not talking about the parent reminding the child to tell me something they previously discussed, I'm talking about the parent who in response to something I've asked tries to draw the child into conversation-- that's my job.) I have a set amount of time to assess a child's physical exam as well as other factors, and I have a process of evaluating all the points I must consider.

When I ask a child a question, I'm not only looking for the answer they are giving, but I'm also gaining valuable information about the child. Can they speak clearly? Do they understand a question that is age appropriate? Do they make eye contact? Are they developmentally mature for their age? Do they understand how their habits effect their health?

So often well intentioned parents pipe up and answer questions directed at the child. It doesn't matter if I'm looking directly at the child, the parent answers. Even if the child starts to answer. I will often redirect to the child for clarification and the parent still answers. Some of the kids roll their eyes. Others take it in stride without much of an expression at all, as if they're used to their parent taking care of everything. Some simply turn back to their hand held game and play, ignoring the grown ups in the room. Ugh! How does that help me get to know the kid?

Sometimes I wonder how the parent makes it through the day when the child is at school since they can't be there to speak up for the child all day there. It can be that bad.

I really worry about the older school aged kids, especially those in high school, who have parents answer for them. How will they be able to assume their healthcare responsibilties once they turn 18? If they don't know about their past medical history, allergies, and family medical history how can they eventually establish healthcare with a new physician without a parent? If they can't give a clear and concise summary of what their symptoms are for an illness, what will they do when you're not there?

And yes, I see parents piping up for their high schoolers.

I guess it's a learned behavior for all. Parents get used to answering the questions for pre-verbal kids, and they keep doing it.

Please stop.

Let kids in elementary school be prepared to order off the menu when the waitress comes to the table -- after discussing their choice before she gets there if they need help deciding on a healthy item. Have older elementary kids speak up at the store to ask for help when they need a dressing room or if they need a price check. Let them talk to their teachers first if they question a grade or need help learning a concept. Let them give their own health summaries at the doctor's office. You can be there for support along the way, but offer less and less as they get older and more experienced.

If your child has true inabilities to do these things there might be an underlying problem, such as anxiety or developmental delay. Those should be addressed. But by far and away most school aged kids can do these things. Let them.

They need to do these things to be able to one day live independently. Trust me, they will appreciate it some day! Too many college kids call home for parents to "fix" things that the young adult should be able to handle. But they can't jump into the deep end of the pool without learning to swim along the way.

Cut the cord... Give them the World!

We were recently having lunch at the office and the conversation turned to sending kids off to college. One person shared the story of a friend's very smart, straight A, "jammed on the ACT" child who flunked out of college because he never went to class and played video games all day.  The point being made was that person was going to keep closer tabs on their children when they went to college to avoid letting them fail.

Dr Mellick and I both chimed in at that point, each with very similar points of view.

By college a child is no longer a child, and is treated by the law and banks as an adult.  They should have learned self control and self management long ago.  If they fail to learn along the way under the supervision of parents life's lessons, they will fail in many ways.  I had two college friends (now parents themselves) who had parents that still tried to run their schedules and keep close tabs on them.  Mom or Dad would call every night to be sure the student was in the dorm by a certain hour.  This takes the responsibility away from the college student and puts it on the parents. The students then looked for ways to outsmart the parents, rather than ways to manage their lives. They knew they had to be home by a certain time, but then they left to party or stay at a friend's apartment after they hung up.  They hadn't learned self control or time management.  They had learned to manipulate the parents and the system.  Not what I want for my kids! Not what a potential boss wants from an employee. Not what makes for a caring and supportive spouse or parent.

Kids need to learn so many things before they move out of the house to become well rounded adults who can hold down a job, lead a family, and contribute to society.  This is a process ~ not something they learn the summer before college, and hopefully not something they learn after falling on their face in life.  A recent article in the New Yorker, Spoiled Rotten Why do kids rule the roost?  highlights why American children are so spoiled they become adultescents (adults who have yet to grow up). Worth the read!

Life skills to learn:

• how to eat nutritious foods in proper portions
• to spend, save, and give wisely
• when to recognize they are tired and to get enough sleep
• time management: work, school, social/fun, rest, chores, projects, exercise, etc
• self control
• study habits
• how to clean the home 
• simple repairs around the house
• cooking
• laundry
• how to pay bills on time
• exercise daily
• following routine dental and medical care
• how to stay within a budget
• caring for others
• respect for self and others

None of these things are learned by someone telling kids how to do them.  They are best learned over time by doing each of them.  Skills build upon previous skills, so first learning basic daily needs (dressing, brushing teeth, washing body, picking up after self) and then learning to do each more independently and finally being able to organize their own schedule to get it all done.  Many of these are learned by sometimes failing, and that is okay.  For more information specifically on chores, see my past post Chores for kids become chores for parents.

Even young children can be taught to help with daily chores.  Starting with preschoolers, the "chores" can be self-skills, such as picking out weather - appropriate clothes and getting dressed, brushing teeth, and other daily activities.  It is much faster for a parent to dress a child (usually) than having a young child do it themselves, but at some point they need to learn, and the earlier, the better!  If they choose weather- inappropriate clothes after discussion of the anticipated forecast, you can help with suggestions.  Sometimes the best way for them to learn is to wear something inappropriate and seeing what it feels like to be too hot or too cold.  This is within reason, of course-- a parent needs to be sure kids are safe: the younger the child, the more supervision needed.  When they were young, I would make them carry another layer if they were underdressed, but I feel no guilt in allowing my middle schoolers to choose shorts in the winter-- their choice!

We follow this process of increasing expectations in our office. Have you noticed as your kids get older  I ask more history from them, not the parent? When Mom or Dad chimes in with the answer, I try to redirect to the child to let them answer what the symptoms are, how long they've been there, what treatments have been tried and if they worked or not. Please let your kids answer ~ they know this stuff! Eventually we offer if the kids want the parents out of the room for privacy. This allows tweens and teens to start accepting responsibility for their healthcare. 

Kids will fail, and that is okay. All part of the learning process. Allow them to learn from failure when the risks are lower as young kids, not when the risk is higher as a teen or young adult.  Kids tend to just get mad if parents always point out the failure but then "save" them by not enforcing consequences.  Examples would be yelling at a child who didn't finish chores and continuing to remind them that they didn't do the chore and you had to do it for them, yet allowing the activities they want to do. Their chore has now become your problem.  They don't own it, so they don't care.  They will continue to allow you to own that chore.  They simply have to listen to you complain about it, which doesn't build strong family bonds, but doesn't require any work on their part.  

Often parents "own" the child's work: the parents keep harping on the child to do his homework, but the child is not motivated. I have previously written about the Homework Battle Plan, and I suggest reading it if your child struggles.  Too often parents "help" by doing much of the work for the child, who complains every step of the way. There are many parents who bring in the forgotten homework because the child forgets it routinely and the parent doesn't want the grades to suffer.  Are you going to drive the homework to the college professor too?  Let young kids suffer the consequence of a bad grade to hopefully learn.  If you keep "helping" them through elementary, middle, and high school, they have never learned what is really important: being responsible for your own work. 

Each stage of growing up has a new set of skills kids can learn to help with.  As kids grow and want to be away from home more, begin by training them how a decision is made, how to spend appropriately, how to make healthy choices.

A family calendar is a great way to let them help with time management.  I love the Google Calendar for this.  Everyone who is invited to the calendar can view it (and add to it if permission is given) so potential conflicts can be identified before they even ask if something is okay to do.  

Start going through questions that are pertinent to the situation so they can learn to think about it themselves:  Is all work done before doing an activity? How will you get there and back safely?  What time do you plan to be home and what time do you have to get up in the morning-- is that enough sleep? How much does this activity cost, and do you have the money to do it? Who will be there and who will be supervising? You still make the final decision, but you might also see the light click when they realize they have other priorities that need to be done first.

Talk about money management without worrying kids about family finances. If kids want a new game, don't get it for them, have them save. Talk about how much they need to save each week to have enough money by a deadline. How will they earn the money? When kids beg to eat out, talk about how much it costs for the family to eat at XYZ restaurant and how much it would cost buy similar food at the grocery store to eat at home. (One that comes up often at my house is going out for ice cream.  How much it costs to go out for ice cream vs buy one container for home is easy to calculate and makes a great point.)  Allow teens to get a job and help them balance money spending and saving. Require that they pay for certain needs or desires.

Have young kids help with simple chores around the house, then increase responsibilities as they get older. My kids loved putting clothes on hangers as preschoolers. I admit that now my kids choose to keep their clean laundry in a pile rather than putting it away, but I suspect they will learn that it is easier to find clothes when put away in their place eventually. Kids can learn to vacuum, dust, and even clean toilets in elementary school. Initially supervising and teaching takes more time than doing it yourself, but when kids learn the skills, that time spent pays off! 

If  kids learn the complex process parents go through to make sure kids will be safe and the activity doesn't conflict with other things, they will start to learn to think through all those things too.  Model good behaviors with time and money management.  Spend quality fun family time together to build strong bonds so they will ask for help when needed ~ but don't give answers, just direction!  Over the years you will watch them grow and mature and they have the world in their hands!

Homework Battle Plan

Any parent with school aged children knows that homework can be a battle.  Even good students can procrastinate, prefer to play, or have practice after school leaving little time for homework.  Then there are the kids who struggle...

I think I threw my son's middle school homeroom teacher for a loop on back to school night.  She mentioned that I can always look on line to see the assignments, and I replied something to the effect of, "I don't have homework, so I'll never look.  It is his responsibility to know what is due."  I am not an absent parent.  I do ask about his day, what he's doing in class, and what his plans are with friends.  He knows I care because I show interest in him, but I don't micro-manage his day.  I do not want to be the parent responsible for the college kid who fails because Mommy can't manage his schedule.  Of course, I know my son and he's self motivated and capable of keeping track of assignments.  Another child might need more help, but at this age I would recommend covertly looking at the assignments and guiding with questions and looking for the student to offer solutions and plans to get the work done.


How can you help your kids with homework without letting it become your problem?  I am a firm believer that kids are the students, not the parents.  Kids need to take ownership of their homework and all other aspects of school.  Of course, for many kids this is easier said than done, but I hear all too often of college kids who have Mommy call the Professor to question a grade.  That is totally unacceptable.  Kids need to practice ownership from early on.  Parents need to guide always, but manage less and less as the kids grow.

Not every solution comes from a cookie cutter mold.  Kids have different personalities and abilities.  You know your kids best.  Think how they work and what makes them tick.

Many parents underestimate the problem with missing out on basics:  sleep, nutrition, and exercise.  If kids don't get the amount of sleep they need, healthy foods, and regular exercise, they will not be as successful academically.  I have blogged on this previously, and really feel that finding balance is important for everyone.


Kids have different problems with homework at different times, and they each deserve their own solutions. Not one of these "types" fits every child perfectly. Most kids have more than one of these qualities, but tend to fit into one type best.

Procrastination:  There is always something more fun to do than work.  Kids will put off overwhelming tasks or big projects because, well, there's a lot to do.

Ask not only what homework they have for tomorrow, but if there are any big projects due in the future.  See if they can estimate how much time it will take to do the project and help them plan how much to do each night to get it done on time.  

Breaking big assignments or long worksheets into small pieces with short breaks in between can help kids focus.  Use a timer for breaks or do a fun quick activity, like silly dance to one song.

Allow kids to have some "down" time after school for a healthy snack (brain food) and to run off energy.  Limit this time with a timer to 30 minutes or so.  The timer helps kids know there is an end point to the fun, and then it's time for work.  Play can resume when work is done correctly.

Poor Self Confidence: Kids who are afraid they won't understand their homework might fear even starting. They blame the teacher for not teaching it correctly. They might complain that they are stupid or everyone else is smarter. They blame the class for being too loud, causing distraction and therefore more homework.  They might complain of chronic headaches or belly aches.

Be sure to praise when kids do things right and when they give a good try.  Be honest, but try to think of something positive to tell them each day.  When they don't meet expectations, first see if they can see the mistake and find a solution themselves.   Guide without giving the solution.  Then praise the effort!

Find their strengths and allow them to follow those.  If they are poor in math but love art, keep art materials at home and display their projects with pride.  Consider an art class.  Remember to budget time.  Over scheduling can result in anxiety, contributing to the problems. 

Perfectionist:  While the desire to do everything right has it's benefits, it can cause a lot of anxiety in kids.  These kids think through things so much that they can't complete the task.  See also the "poor self confidence" section above, because these kids are at risk for feeling they are failures if they don't get a 100% on everything.  They can have melt downs if the directions don't make sense or if they have a lot of work to do.

Help your child learn organizational techniques, such as write down assignments and estimate time to do each project. Plan how much time to spend each day on big projects and limit to that time.  Help them review their progress in the middle of big projects to see if they are on track.  If not, have them establish another calendar and learn to review why they are behind.  (No self-blame.  Is it because one step took longer than projected, they were invited to a movie and skipped a day, they got sick and were not able to work...  This helps plan the next project and builds on planning skills.)

 Remember to give attention and praise for just being your kid.  These kids feel pressure to succeed, but they need to remember that they are loved unconditionally.  

If you notice they have an incorrect answer,  state "that isn't quite right. Is there another way to approach the problem?"  

Not everything is about the grade.  Praise the effort they put into all they do, not the end point.  Make positive comments on other attributes: a funny thing they said, how they helped a younger child, how they showed concern for someone who was hurt.

Encourage them to try something new that is outside their talent.  Not only are they exploring life, but they are developing new skills, and learning to be humble if they aren't the best at this activity.  Help them praise others.  Model this behavior in your own life.  

Co-dependence:  Helicopter parenting is a term often used to describe the parent hovering over the child in everything they do. This does not allow a child to learn from failing. It does not allow a child to grow into independence.  It allows the parent to "own" the problem of homework.  These kids call home when they leave the homework or lunch on the kitchen table for Mommy to bring it to school.  These kids grow up blaming everyone when things don't go their way and Mommy can't fix it. They don't learn to stand up for themselves.  They seem constantly immature with life situations.

Young children need more guidance, but gradually decrease this as they get older.  Teachers can help guide you on age appropriate needs.  Most parents must sign a planner of younger kids, but as kids get older the kids become more responsible for knowing what the homework is.  Many schools now have websites that parents can check homework assignments, but be sure the kids own the task of knowing what is due too.  

Have a place that children can work on homework without distraction (tv, kids playing, etc).

Be available to answer questions, but don't do the work for them.  If they need help, find another way to ask the question that might help them see the solution. Get a piece of scrap paper that they can try to work through the problem.  If they have problems with reading comprehension, have them read a few lines then summarize to you what they read.   They can take notes on their summary, then read the notes after the entire chapter to get a full summary.

Busy, busy, busy:  Some kids are really busy with after school activities, others just rush through homework to get it done so they can play.

Set limits on how much screen time (tv, video games, computer time) kids can have each week day and week end.  A maximum of 10 hours per week of screen time is recommended by experts.  If they know they can't watch more than 30 minutes of tv, they are less likely to rush through homework to get to the tv.  

Ask kids to double check their work and then give to you to double check if you know they make careless mistakes.  Don't correct the mistakes, but kindly point them out and ask if they can find a better answer.  Once they learn that they have to sit at the homework station until all the work is done correctly, they might not be so quick to rush. 

If kids have after school activities the time allowed for home work and down time are affected.  Avoid over scheduling, especially in elementary school.  Be sure they have time for homework, sleep, healthy meals, and free time in addition to their activities.  Are the activities really so important that they should interfere with the basic needs of the child? Is the child mature enough to handle the work load?

Kids who are in constant motion can't seem to sit still long enough to do homework.  Be sure they have the proper balance of sleep, nutrition, and exercise or all else will fail.   Praise their efforts when they are successful.  Set a timer after school to let them play hard for 30 minutes, but then make them sit. Help little ones organize what needs to be done and break homework into several smaller jobs.  Set regular 5 minute breaks every 30 minutes so they can release energy.  Set a timer to remind them to get back to work and compliment them when they get back on task.

Struggling despite help:  There are many reasons kids struggle academically.  Reasons vary, such as behavior problems, anxiety, illness, learning disabilities, bullying, and more.

If they are struggling academically, talk with the teacher to see if there are any areas that can be worked on in class or with extra help at school.  Can the teacher offer suggestions for what to work on at home?

If kids have chronic pains or school avoidance, ask what is going on.  Depression and anxiety aren't obvious and can have vague symptoms that are different than adult symptoms.  Bullying can lead to many consequences, and many kids suffer in silence.  If your child won't talk to you, consider a trained counselor.

Talk with your pediatrician if your child is struggling academically despite resource help at school or if he suffers from chronic headaches or tummy aches.  Treating the underlying illness and ruling out medical causes of pain is important.  Depression, anxiety, ADHD, and other learning disorders can be difficult to identify, but with proper diagnosis and treatment, these kids can really succeed and improve their self confidence!