The Vitality of Youth

Much has been written about millennials and Gen Y students, a lot of it negative.  They have been variously characterized as lazy, self-absorbed, safely cocooned in electronics, and worse.  Some of this is based on real data.  But I am here to tell you, they may save us from the havoc we "adults" sometimes wreak.  We absolutely need them.

For one thing, they are apparently more optimistic than older adults.  They believe they will have more opportunity than their parents did, and that life is better today for them than it was "in the good old days."  It spite of the doom and gloom being written about the state of higher education in this country, they see it as a good investment in their future.  Who doesn't need freshness of opinion, and a hopeful view of the future?

I have written elsewhere in my blog about the energy and creativity of youth, so this item is really just another snapshot of the gifts they bring to the table.  As we older adults wrangle over chronic and confounding issues of our day, such as racism and military conflict, it is our youth who sometimes present brilliant and "never mind all your rules" approaches to problems.  Rule-breaking teens are even thought more likely to become successful entrepreneurs later in life.  I am reminded of a recent news item about a pre-teen who solved a centuries-old mathematical conundrum in just a few minutes, startling others in the room.  Their hopefulness and lack of constraint is very valuable indeed.  While adult members of faith argue over the "right" approach to inter-faith gathering and dialog, for example, younger folk go ahead and get together and talk.  This pattern has occurred among Christians, Muslims, Jews in the middle east, and among Protestants and Catholics in Northern Ireland.

If they can forge ahead there, what else can they do?  What will we encourage them to do?

Vignette 3: What Would You Do?

Juanita, a disoriented student

Background: Juanita has had her head on her desk throughout class.  She appears to be napping.  She is disoriented with slurred speech.  It is not clear if she is intoxicated or not.

Scene: Her professor approaches her desk after class.

Dr. Jones: Juanita class is over.  (No response)  Juanita?

Juanita: (Stirring around a little) Mmmmm?

Dr. Jones: Class is over, time to go.

Juanita: (Speech is slurred) Time to go where?

Dr. Jones: The class is over.  You can leave now.

Juanita: Books are at home.  Left them with my papers.  Be here tomorrow though.  (Giggles)

Dr. Jones: Look, it’s time to go.  What are you doing next?

Juanita: (Slurred) The big question.  No one really knows, do they?  Big planet, you know.  Time to go you say, so say you.

Dr. Jones: (More alarmed) Juanita, are you OK?  Where are you supposed to be?

Juanita: No worries, chief.  Doin’ okee dokee.  Gotta get to formica, need the ruzzle from there.

Dr. Jones: (Worriedly) What is your name?

Juanita: The one who shall not be named, in Madrid.

Dr. Jones: What is today?

Juanita: Today what?

Suggestions: Such behavior is generally an indication of a serious condition, which could be anything from intoxication, psychosis, or another medical crisis.  Consider a swift transport to the emergency department of a local hospital, or summoning paramedics.

Notes on the Matter of Suicide

Recent tragedies which have captivated national attention have raised both awareness and anxiety regarding college student suicide.  Though the reason for heightened awareness is of course unfortunate, the awareness is a positive development.  But the anxiety may or may not be, depending on what one does about it.

If the anxiety translates to knee-jerk reactions in policy and procedure, and in campus-wide interventions, we may not only be ineffective, we may actually unwittingly contribute to the problem.  Here's how.

Research shows that suicide prevalence rates in higher education settings is 4.3 per 100,000*.  This is in contrast to the same rates for same-age non-college peers, which fall between 11.0 and 14.0 per 100,000 according to the CDC and its data for states.  While any loss of life is a tragedy and deserving of prevention efforts, we can conclude that simply being in college offers some protection against suicide.

So one thing we could do to prevent suicide is make it easier for young adults to have dreams (thereby projecting into the future, a major protective factor as you will see below) and attend, stay in, and graduate from college.  Reflexively reacting to the fear of suicide may lead us to respond to less-than-honorable vendors who are hawking suicide reduction wares in higher education and other settings.  (Please note here that some of these may have merit, and some may not.)  In a setting in which the base rate is already considerably lower than that of the surrounding community, and depending on its features, such programs may unintentionally create an ecology of threat, making it appear that it is a larger problem than it truly is.  To the despairing, this may have the most unfortunate outcome of making it appear to be a viable option that others nearby are considering and acting upon.

Questions to ask such vendors are: What rate is your program designed to address?, and What rate will be the outcome of your program?

Surprising as it may seem, researchers are only now investigating motives for suicide among students, the "why" of suicide.  Research to date has focused largely on demographic factors, or the "who" of suicide.  A recent study tells us rather affirmatively where we might focus our attention.  The authors state it is time to move beyond "one size fits all approaches", and strongly indicate that hopelessness and overwhelming emotional pain are the two internal motivational risk factors most associated with suicide.

Campuses would do well, then, to focus on community interventions which promote hope and future orientation toward maximizing and manifesting student gifts, talents, and dreams.  It is important that students feel they belong, that their identity matters and is wanted and needed by others.  They would also do well to promote the adequate funding of mental health resources, so that those in unbearable pain have a place to go for help.  To date, most of the vendors described above appear to focus on identifying those in pain, not their ultimate assistance.  Most college counseling centers can already tell you how to identify those in distress, and their perspectives are based in local experience and not the marketing of a product.  Listen to what these professionals have to say, then make it possible for the suffering to be assisted by them.

*Schwartz, A. J. (2011). Rate, relative risk and method of suicide by students at four-year colleges and universities in the United States, 2004-05 through 2008-09. Suicide and Life-Threatening Behavior; 41(4), 353-371. 

The Incubator

Late adolescents and young adults need space and time to develop an authentic self.  While there are of course a great many contexts in which this can occur, perhaps few are better suited to the purpose than the higher education environment.  In my view, when carried out well, this is a major benefit of the college experience.

During such a time, youth are exposed to ideas, knowledge, experiences, social feedback, and a wide range of relationships which either enhance or detract from personal growth and fulfillment of latent promise.  A forming adult can benefit immensely from this environment, which represents an incubator of the emerging self.  In this way students experiment, explore and try on various selves to see for themselves which one fits and works the best.

It is both an exciting and trying time, for students as well as those around them, especially loved ones.  The experimentation brings highs and lows, successes and failures, flashes of brilliance and the pain of mistakes.  But these ups and downs are absolutely necessary, assuming we all want to produce healthy, competent and productive adults.  Older adults, be they professors, administrators, family members or friends, simply must respect the need for this period of incubation.  Sheltering young adults from all pains can harm them significantly, though we should of course protect them from the most serious ones if we are capable of doing so.  There were times in human history when there was no such thing as this kind of incubation, due to the hardship of living many faced.  But we are able to, and should, provide this now.

Respect requires allowing enough space and time for growth to occur.  For parents this means gritting one's teeth, teaching what one knows but allowing students to venture off, even when mistakes are a near certainty.  Doing this, a sense of faith and trust is communicated, which is the fuel on which the emerging self thrives.  It means patience in the face of a tattoo, purple hair, exploring a major which is a "bad choice", financial incompetence, or partnering which causes heartburn.  The incubation can take a very long time, but learning does in fact occur.  Students learn on their own what will and won't sustain them in life, because life itself teaches them.  We parents don't always have to do the teaching, as much as we want to.  Attempting to do that, we actually interfere with natural consequences and learning, slowing down and disrupting the entire process of development.

So give them space and time to incubate the self.  Trust that the self will unfold in the way it should, one way or another.  Students, take the opportunity to learn about and become who you are.  Just as you have the freedom to do so, so do you have the responsibility to accept the feedback you will receive, and to adjust accordingly.

Listening Always Comes First

So there's a great little video called It's Not About the Nail out in the electronic ether, all about the importance of listening.  Upon watching it one thinks about relationship contexts mainly, especially the oft-seen tendency of men to fix things instead of just empathizing and supporting their partners.

Ah but the video is a great object lesson for professional helpers.  There is a strong sense of urgency among many healthcare providers to quickly and efficiently apply the "intervention" to the "symptom", because that is what the diagnosing/insurance/billing industrial complex demands. The forces behind this complex are tremendous and so embedded in some helping systems that many don't stop and think for a moment about how this form of "helping" may be affecting the "helped".

Sometimes, it doesn't matter how "right" the helper is.  The one receiving the help must feel heard and understood first, as this facilitates acceptance and motivation to be helped in the first place.  I recall a story about a homeless woman, hungry and cold, who upbraided a good Samaritan for "throwing me a bone".  Before she received food and clothing, she wanted to be understood.  In particular she wanted her pain to be understood.  That was her primary need at the moment.  Her "helpers" assumed her physical needs were more fundamental than her emotional or spiritual needs.  This is where many of us go awry.

The video takes us back to the early days of our training.  We were first taught basic helping skills, such as empathy, genuineness, positive regard and active listening.  Somehow the systems we work in may distract us from these elemental approaches to human suffering.  Let's go back then, and learn this all over again.  If you are involved in training the next generation of helpers, consider showing them the video.  After the jokes subside, tell them to get serious about this one.

Vignette 2: What Would You Do?

Sarah, a depressed student

Imagine you are in the position of advising a college student about her classes.  She walks into your office unexpectedly, looking for help.

Background: Sarah is a junior and does well in class and is usually perky and energetic.  Lately though she appears fatigued, quiet, and withdrawn.  Instead of being her usual talkative self, her close friends notice she just keeps her head down and seems to mope around.  Others haven’t seen her in a while and don’t know what is going on.

Scene: Sarah meets with her advisor about next fall’s schedule of classes.

Mr. Hayes: Hey Sarah!  Haven’t seen you in a while.  (He notices her appearance, which is unkempt and tired) How are you?

Sarah: (Looks down, emotionally flat) OK.

Mr. Hayes: OK, well, what did you have in mind today?

Sarah: I guess I need to set up classes for the fall.  I am not sure though…what I want or need.  Or even it it’s important.

Mr. Hayes: I have to tell you, that surprises me.  You’re usually right on top of everything.

Sarah: (Angrily) I wish everyone would stop saying that!  I am so tired of doing what everyone expects me to do!

Mr. Hayes: Whoa, Sarah.  I’m not really telling you what to do.  I’m just surprised, that’s all.  What is going on?  You seem different.

Sarah: I’m not who you think I am…

Mr. Hayes: What do you mean?

Sarah: I’m bored.  I don’t care about anything anymore.  All this school stuff is stupid.  I just want to sleep and be left alone.  I’m tired of people calling me, asking me stuff.  (Tears start to flow) My boyfriend doesn’t deserve this, so I avoid him too.  He’s getting frustrated, just like you.  Just like everyone else.  I guess I can’t blame them…all I’ve done for a couple months is sleep and watch TV and eat junk.  But I don’t care.  Goodbye Mr. Hayes, you won’t be seeing me anymore.

Suggestions: First, that last statement requires clarification.  Ask Sarah exactly what she means by that before she leaves your office.  If safety appears to be an issue, contact your campus counseling service for assistance right away.  If safety does not appear to be an issue make an attempt to understand her obvious distress.  Say "Please tell me more about what is bothering you, I'd like to help."  Asking questions about basic things like eating, sleeping, going to class, family and friendships will often reveal a lot about the type of issues Sarah struggles with.  Once you have an understanding of her concerns, focus on empathizing and not judging Sarah.  Then offer to help her see someone who can help her further.  Say "We have a great counseling center and I'd like to help you get an appointment there."  Offer to make the call for her right there in your office.  But then hand the telephone to Sarah when it is time to set the appointment.  Or you could offer to walk with her to the center yourself.  Later, follow up with her and ask her about her appointment, and encourage her to go if she has not done so.  Benign encouragement and persistence can go a long way in getting students the help they need.

Childhood Disability Rates Rising For The Past 10 Years

A recent study shows a rise among children with disabilities over the past 10 years. The same study also revealed that disabilities relating to physical health conditions have decreased, while disabilities relating to neurodevelopment and mental health have increased dramatically. In addition, the most significant increase has occurred among children from higher-income families.

Lead author Amy J. Houtrow, MD, PhD, MPH, chief, Division of Pediatric Rehabilitation Medicine at Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center and associate professor of physical medicine and rehabilitation and pediatrics at University of Pittsburgh School of Medicine admits that previous studies have already demonstrated that the prevalence of childhood disability is on the rise. "Nearly 6 million kids had a disability in 2009-2010 -- almost 1 million more than in 2001-2002" says Houtrow.

Results were derived from the analysis of data gathered from 102,468 parents of children ages 0-17 years of age that participated in the National Health Interview Survey conducted by the Centers for Disease Control and Prevention in 2001-2002 and survey data from 2009-2010.

The surveys questioned parents on whether their child…

• had any limitations in play or activity
• received special education services
• needed help with personal care
• had difficulty walking without equipment
• had difficulty with memory
• had any other limitation

If parents responded yes to any of the preceding questions, the surveys questioned whether their child's limitations were due to…

• a vision or hearing problem
• an asthma or breathing problem
• a joint, bone or muscle problem
• an intellectual deficit or mental retardation
• an emotional or behavioral problem
• epilepsy
• a learning disability
• a speech problem
• attention-deficit/hyperactivity disorder
• a birth defect
• an injury
• some other developmental problem

Meanwhile, researchers classified conditions into three groups:

1. Physical
2. neurodevelopmental/mental health
3. other

Their research uncovered that “the prevalence of disability increased by 16.3% from 2001-2002 to 2009-2010”. In particular, the neurodevelopmental and mental health-related disabilities increased while those disabilities resulting from physical conditions had decreased over the decade. Remarkably, the increase was most significant among children less than 6 years of age, as their rate of neurodevelopmental disabilities nearly doubled over the decade.

Furthermore, results demonstrated higher rates of disabilities among children living in poverty over the entire period of study without any real increase; however the highest rate of growth was identified among children living in higher income households (i.e. household incomes at or above 300% of the federal poverty level or $66,000 a year for a family of four).

Unfortunately, Dr. Houtrow states: "the survey did not break out autism, but we suspect that some of the increase in neurodevelopmental disabilities is due to the rising incidence or recognition of autism spectrum disorders".

Evidently this study has put a broader perspective on an area in desperate need of research. The study leaves the several unanswered questions. Why are rates of disabilities rising among children? What could these demographics really mean? Could it be that children living in poverty are simply being undiagnosed? Could it be that affluent families are more persistent in obtaining a diagnosis? Could there be other reasons or factors yet to be revealed?

Childhood Disability Rate Jumps 16 Percent Over Past Decade

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