Conduct disorder is not caused by bad parenting

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I’m sure this adorable child never behaves badly.

 

Conduct disorder is when a child keeps behaving in a particularly bad way.  Behaviours indicative of conduct disorder in young children include lying, bullying, making threats, starting fights, damaging property, stealing, hurting animals, hurting people, and starting fires.  For older children, the list also includes sexual assault, staying out at night, and using weapons.

A recent longitudinal study in Massachusetts found that mothers’ level of warmth, over-reactivity or laxness had little to no association with early symptoms of conduct disorder in preschool children.  The researcher selected 197 children whose parents reported disruptive behaviour and followed them for three years, from ages 3-6.  Signs of disruptive behaviour were consistent across time as were parenting styles, but the two were mostly unrelated.  If anything, the study suggests that the children’s behaviour may negatively affect mothers’ warmth and lead them to over-react, rather than the other way around.  But even that’s a very weak relationship.

This finding goes against a deep running belief in our society that parents are to blame for their children’s behaviour.  It’s never been entirely clear whether the problem is supposed to be coercive parenting that sets a bad example or too lax parenting that makes children run wild.  But now it turns out it’s neither.  I’m not sure if it’s good news though because it would be nice to think that we could cure conduct disorder with no more than our own good behaviour.  The author does point to other studies that claim parenting makes a difference for older children, and for other behavioural problems such as defiance and attention-seeking.

Meanwhile, two researchers who interviewed snowboarding mothers note with dismay that motherhood leads to more cautious behaviour.  It’s true, it does.  Yes, voluntary risk taking can be a joyful thing, and yes, mothers are often depressed.  And yet… snowboarding mothers!  Snowboarding while pregnant!  I feel the shockingness, but maybe they’re right – maybe we restrict ourselves too much.

Mothers who get a positive CNV result

sleep-907769_1920When you’re pregnant, you can do a genetic test that gives you a Copy Number Variant (CNV) for your baby.  If the result is negative, all is probably well.  If it’s positive, however, it means that something could go wrong.  Or maybe not.  They don’t really know.  Nobody can really tell you what it means exactly, but it’s bad.  Maybe.

A recent study followed up 23 women who got positive CNV results during their pregnancies and went ahead to have their babies.  At 6-12 months, most of the babies (18 out of 23) were developing normally (the study didn’t say what was happening with the other 5).  Most of the mothers (16 out of 23) were very anxious about their children because of the test result.  Its ambiguous warning made them feel anxious about everything, from how much their baby smiled, to sleeping habits, to whether or not they would simply stop breathing.  Here are some quotes from the interviews:

Last night she was up crying for an hour and instead of knowing okay, shes teething, I go to does she have a kidney infection? Is there something wrong with her lung? Did she lose hearing in her other ear and now shes freaked out? So it is a constant…I try not to overreact but my mind is going all these places and then I can’t do anything about it—I cant ask anyone because nobody knows.
Once or twice it’s crept into my head where I’ve been like ’what if this microarray resultlike there’s something wrong with her and we don’t know and one day she just has SIDS and stops breathing. She’s got such a strangely mellow temperament so I think, ‘is there something wrong with her that she’s just so lovely’—which makes no sense.
To some extent this seems like ordinary, obsessive maternal concern with a bit of extra motivation.
But what about those handful of mothers who got the positive CNV result but who are not continually anxious?  How is that possible?
  • For one mother, it was her second child to have this positive test result.  She had been very anxious with the first one, who had ended up having no problems, and so she wasn’t so concerned for the second one.
  • One mother found that she had the same chromosomal condition herself, and because she was fine she didn’t worry about her child.
  • One mother had anticipated specific physical symptoms associated with a particular disorder, and when her baby looked normal at birth, she was no longer concerned.
  • Three mothers had babies with immediate health problems that they were dealing with, and so the CNV result was kind of irrelevant to them.

But most mothers were anxious and watchful in particular ways.  Some mothers had even started interventions with their children even though there were no signs of abnormal development (yet!).  Mostly, they relied on their health providers for assessments and on comparisons with other children.

The mothers interviewed for the study tended to speak in a positive way about the test.  One mother said,  I’m such a proponent of this testing and I talk about it with anyone that will listen to me.”   They know more about the test than I do; I didn’t get it when I was pregnant.  From the outside, though, the advantages of the test are not really obvious.  It’s not as if we’re not vigilant about our children’s development anyway.  What difference does it really make apart from making you feel bad?

Shaming EU mothers who buy formula

A mother shopping at Tescos in the UK was refused a free parking voucher because she was buying infant formula.  If she had been buying beer or doughnuts or baby shampoo or almost any other product, she would have received the voucher.  Only cigarettes and infant formula were excluded from the voucher program, in accordance with EU regulations which forbid the advertising and promotion of those products.

Laura Leeks felt shamed and guilt-tripped by the staff at Tescos and felt the need to explain the reasons why she was formula feeding rather than breastfeeding in a detailed personal account on their Facebook page.   I hope Tescos listens to her and changes their policies.  Giving parking vouchers for any product does not seem like promotion of particular products and an overly strict application of the regulation.

I saw the opposite of this a few weeks ago in Peru.   Marketers for Pediasure, a product from the US company Abbott, came through the waiting rooms of the paediatric section of the hospital, where mothers were waiting for their infant check-ups, handing out leaflets and balloons for children.  Their leaflet explained that Pediasure would help children grow taller!  Two centimetres every 120 days!

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These promises were based on a research paper, cited on the back of the leaflet.    The research paper was produced by employees of Abbott.  They recruited 200 children in Manila, chosen specially because they were small and thin for their age.  At baseline, most of them were eating less than the recommended daily calorie intake.   Then, the Abbott employees gave the parents free formula and asked them to feed it to their children every day, boosting their diets by 450 kcal every day for a year.

Turns out, giving underfed children extra calories makes them grow slightly bigger!  The weight for height percentiles of their sample averaged 16% at baseline (very thin) and 30% at the end (thin).  Height for age percentiles averaged 14% at the beginning (small for their age) and 17% at the end (small for their age), a negligible difference.

How would those results compare to giving those children calories from another source – say, fresh food – for a year?  We will never know.  Obviously, Abbott employees have no interest in making such a comparison.

So yeah.  Let’s restrict the marketing opportunities of these sorts of companies.  I’m sorry that Laura Leeks and other EU mothers got shamed though.

 

Motherhood and the Watt Governor

Inspired by Louise Barrett’s brilliant book about ecological psychology, I’ve been thinking about the ways we can model human cognition.  It’s true that the computational metaphor has dominated cognitive psychology, and I’m particularly interested in alternatives because the computation model just seems like a bad fit for maternal psychology.  Characteristics of a computations framework include breaking a cognitive task down into parts and then linking the parts together sequentially.  For example, The Health Belief Model is one of many models of cognition that has discrete cognitive operations linked together in a flow chart.

Today I read van Gelder’s paper from 20 years ago called What Might Cognition Be, If Not Computation? (pdf), where he argues that using the computer as our main metaphor for conceiving human cognition is not essential, and that there are other metaphors we can use.  In particular, he describes a dynamical framework as an alternative to a computational framework for understanding cognition.

In order to explain the difference between computational and dynamical models, van Gelder begins with a description of two different ways of approaching the problem of governing the speed of a steam engine.  Here’s an adaptation of the computational model he put forward:

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Computational model for governing the speed of a steam engine.  Adapted from van Gelder (1995)

This is compared with the Watt Governor, the device that was actually used to govern the speed of steam engines in the olden days.  How it works is, the engine is coupled to a fly wheel, which spins faster the faster the engine is going.  The faster the wheel spins, the higher the arms go, and the arms are linked to the throttle valve which controls how much steam is released.  So the higher the arms, the more the steam is blocked and the engine slows down.

 

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Watt Governor

 

Most notably, the Watt Governor doesn’t need to work out engine speed or do any other calculations.  Also, it’s linked moment to moment with the engine in a way that the computational mechanism is not.  The goal of the Watt Governor is to maintain the train’s speed at a constant rate.  Of course, by goal, I mean the goal of the person who designed the Watt Governor or the person who purchased it and put it on the train.  The Watt Governor itself has no sense of a goal.  Similarly, living things can act towards supposed evolutionary goals without themselves desiring those goals or being aware of them.

Here’s how van Gelder describes the dynamical conception of cognition, which would be based on the Watt-Governor sort of metaphor:

In this vision, the cognitive system is not just the encapsulated brain; rather, since the nervous system, body, and environment are all constantly changing and simultaneously influencing each other, the true cognitive system is a single unified system embracing all three.  The cognitive system does not interact with the body and the external world by means of the occasional status symbolic inputs and outputs; rather, interaction between the inner and outer is best thought of as a matter of coupling, such that both sets of processes [are] continually influencing each other’s direction of change.  At the level at which the mechanisms are best described, cognitive processing is not sequential and cyclic, for all aspects of the cognitive system are undergoing change all the time. (p.373)

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mothering in action

Because the regulation is continuous, you can’t watch in a sequential way how the Watt Governor manages the speed of the steam engine once it’s going.  It just settles into a constant speed, which is the point.  Superficially, this seems like a very good metaphor for motherhood, for thinking and doing.  Not getting anything done is a theme that keeps coming up in motherhood discussion (here is a joke about it).  Also, being constantly busy and exhausted without being able to articulate what you’ve been doing.
Last week, someone asked me what my plans were for the rest of the day, and I said to react to my children until it’s time to sleep.  She thought I was joking, and I was, although what I said was at least as true as any other answer I could have given.  I suppose it’s because we’re not supposed to react as mothers.  We’re supposed to respond.  Even though the two words mean basically the same thing.

So what would a Watt-Governor-type system need self-awareness for?

What does flow have to do with parenting?

Here’s what you need to achieve Flow, according to Csikszentmihalyi:

  1. a situation where you can concentrate properly on a few limited things
  2. you can use your skills to meet clear demands
  3. you can forget your day-to-day problems
  4. you can forget your own separate identity
  5. you obtain a feeling of control over your environment
  6. you may achieve “a transcendence of ego boundaries and consequent psychic integration with metapersonal systems”.

I don’t know what 6 means, but my assessment is that 1-5 are impossible for mothers of small children.  Personally, I can only achieve these requirements by leaving the house and my children and going to do something else entirely.

The concept of flow annoys me (and not because Csikszentmihalyi has two sons whose care probably interrupted the flow of someone other than him on a day-to-day basis when they were small because, after all, I don’t know anything about his personal life).  It’s the reverence with which it’s described.  Flow is characteristically present in play, in artistic and religious activities.  It’s almost as if there is something moral about achieving flow in your life.  Czikszentmihalyi writes, “when an activity involves the person completely with its demands for action, “selfish” considerations become irrelevant.”

So, for example, my friend who is at home with her three small children is not achieving flow unlike her husband who is playing golf right now.  He only needs to concentrate on the position of the ball, the slope of the ground.  He has a feeling of complete control as he selects a club and lines up to perform his well-practiced swing.  He is one with the club, with the sky, with the whole world.  His day-to-day problems (such as the mushed up weetbix on the floor, the broken dishwasher, the pile of laundry, his daughter’s failure to crawl) are far from his mind.  It’s almost a religious experience or, as Csikszentmihalyi puts it, “a loss of ego”.

It reminds me of the time I did a meditation retreat in Thailand.  There, Buddhist monks and other trainees work towards mental detachment through meditation.  The practice is supported by lay women who do most of the shopping and cooking.

The other reason I don’t like flow is because it’s supposed to exist when the task requirements meet your optimal level of capability.  If a situation is too hard and overwhelming, you can’t achieve flow because you’re too stressed.  If a situation is too easy, it’s too boring to achieve flow.  But motherhood is both overwhelming and stressful AND boring.  All at once.

 

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The reason I was reading about flow in the first place was because of this idea of it being autotelic, which means done for its own sake, without extrinsic goals.  Rock climbing is autotelic because climbers are not really motivated to reach the top of the mountain (in many cases they could just drive up there or walk an easier way), but are climbing for the joy of it.  Art is all about process, not outcome.  Similarly, I don’t think we are looking after our children in order to produce adequate adults some day, although no doubt we could produce an answer like that when pressed.  We’re doing it for the joy of it.  Except that, of course, when it’s not joyful we still do it.

Parenting is goalless (?), but parenting is the opposite of flow as described by Csikszentmihalyi.  Sometimes people talk about the joys of parenting, but I don’t think it’s reasonable to conclude that parenting is a joy-based choice in the same way that rock-climbing is.