Finding ways to support stressed children now fills the day of an average community-based pediatrician and family doctor.
Ask any teacher or pediatrician what has been the single predominant shift in their work over the past two or three decades. The odds are high that many will admit that children and youth are experiencing a dramatic increase of medical conditions which previously were only seen in adults.
To see diabetes in children — previously called “adult-onset-diabetes” — is now so common that few people gasp. To see children whose coronary vessels have aged prematurely surprises few pediatric cardiologists. And the notion that childhood should be a time of innocence and playfulness, lasting well into the teen years, experienced a quiet death in the distant past. Pediatricians’ offices are now inundated by stressed and depressed teens suffering from hypertension — as opposed to the old days where infectious diseases ruled the day.
Neil Postman’s book The Disappearance of Childhood, published in 1982, raised some eyebrows. Today this book simply tells us that the sun rises in the East; we now know this cultural trend is a fact, but what to do about it remains less clear.
Finding ways to support stressed children now fills the day of an average community-based pediatrician and family doctor. Meanwhile, access to psychiatrists and psychologist has been almost dangerously compromised as mental health issues continue to explode with an ever-increasing frequency.
The Psychology Foundation of Canada (www.psychologyfoundation.org) runs a superb website on resources for children and youth who experience stress. Their tool known as Kids Have Stress Too remains perennially popular.
One of the growing concerns is the impact stress may have on the still-developing brain. A teenager’s brain is still under construction. The impact of stress hormones and toxic thoughts on the brain’s anatomy and physiology is well communicated in lay terms by Dr. Caroline Leaf in her bestselling book, Who Switched off my Brain?
A growing number of papers related to mindfulness have been published in academic journals. One of the most comprehensive reviews on this topic, written by Kim D. Rempel, appeared in The Canadian Journal of Counselling and Psychotherapy (Vol 46 No 3 Pages 201-220)
Mindfulness helps children to avoid the Band-Aid solutions of prescribed medications. Instead, they learn how to pay better attention to their thoughts, feelings and moods by seeing things in new non-judgmental ways. They learn better ways to deal with situations where their needs are not met, ending up with an increased awareness of how to clear their minds of automatic negative thinking.
Mindfulness has been shown to reduce anxiety, change the trajectory of depression, increase creativity, improve self-esteem, reduce headaches and abdominal pains associated with stress, improve mood disorders and assist children in being more present and thus enjoying routine school activities more.
The definition of mindfulness varies widely. Short-term outcomes are promising, but the long-term impact remains less clear. Studies continue to improve in methodological quality, thus inching closer to “passing muster” when it comes to evidence-based data. (The gold-standard before any educational changes are implemented.)
The feasibility of implementing school-based mindfulness is well documented by Napoli et al (Journal of Applied School Psychology in 2005.) Researchers may be keen to implement mindfulness training in schools, perhaps on a daily basis and for as short as 15 minutes, but school boards remain lukewarm at best.
Despite a growing body of research showing the benefits of mindfulness training, so far the majority of school administrators have yet to show that school-based mindfulness classes are a priority similar to mandating physical education classes. Proponents of teaching children and youth how to use mindfulness as a way to reduce stress and anxiety have taken notice of what it took to get school boards to adopt a later start time for teenagers. (A few years ago this was seen as a pipe-dream and the reality of huge volumes of work dictated early start times. Since then, research about the medical benefits of later start times moved some boards into action. Later start times are now a reality)
Teachers who have taught mindfulness on a limited basis, and with parental permission, claim finding time to do it is not an issue. — rather it’s about paying a higher cost when schools fail to do this. (Similar to the cost of not engaging children in a daily physical education program.)
The American Academy of Pediatrics has two active Sections on school health and integrative medicine. The latter section is one of the fastest growing Sections of the AAP, mostly because more pediatricians are veering away from prescribing medications to control the mood of teens and children. In Canada, the Canadian Paediatric Society lags in taking a position regarding teaching mindfulness to children and youth.
Mindfulness training led by teachers is not advised for children who experience personality disorders, psychosis, major depressive disorders and traumatic stress. (Shapiro and Carlson; American Psychological Association, 2009)
Dr. Peter Nieman is a community-based Pediatrician and the author of Moving Forward. He contributes bi-weekly to CTV Morning Live and serves as the President of the Alberta Chapter of the American Academy of Pediatrics.