分类： 教育

孩子晚上不容易入睡除了大脑兴奋还可能是melatonin 分泌推迟。特别是青少年会比成人晚一两个小时。制造睡眠环境：暗淡的灯光、柔和的音乐、泡脚、按摩、打坐都会有帮助，要根据自己的情况选。另外就是睡觉前30分钟吃3mg的melatonin；如果看书，尽量看纸质的书，不要看电子的。我女儿从小就是晚上不容易睡，早上醒不来的。Melatonin对她入睡起了很大的作用。青少年的身体代谢melatonin 的速度比成人慢，他们早上还会有melatonin 在大脑中，因此不容易醒，醒来了也感觉情绪不好，没睡够。提前至少半个小时叫是个好办法，醒一下睡一下，慢慢清醒。到了一定年龄应该自己控制起床时间。我也有过一段时间的挣扎。她12岁上七年级了还是不愿意醒，叫她她还发脾气。我就准备采取让她迟到的方法。但还是有个几天的过程，前提是她自己并不想迟到。第一天她的闹钟响了，她不醒，我叫了她，告诉她这是第一次，我只会叫三次，之后就不会叫了，她第三次就真的起来了；第二天，她的闹钟还是叫不醒她，我说我会叫两次，之后就不叫了，她第二次就自己起来了；第三天，我又去叫她，而且说是最后一次，她也就起来了；第四天我期望她自己起来，但她就是不能被闹钟叫醒，我等到差10分钟校车要走了才叫她，说如果赶不上校车她要么自己走到学校（1.7英里），要么不上学了。她以最快的速度收拾完冲去坐校车，早饭也没来得及吃。第五天，她自己设了两个闹钟，都放在离床头较远，必须起来才够得着的地方。她自己把闹钟设置在出门前一个小时前叫她起床，吃完早饭她还会练20分钟左右的小提琴。从此以后，我就很少叫她起床了。周一是最难起床的，特别是如果周日有活动，睡得晚了，因此，偶尔我也会要叫她一下。她最近在iPhone上买了一个$1的App: sleep cycle，帮她调解睡眠周期，起床时还测她的心跳，告诉她她的睡眠质量，闹钟的声音柔和，但却能闹醒她！

关于副作用：
Melatonin 是帮助睡眠的药中副作用最小的，人体本身就分泌它。但每个人不一样，如果用，还是要观察孩子的反应，极少数人会更亢奋，就像有的婴儿和儿童在睡前要大哭大闹才能睡一样。有的孩子睡眠周期调节好了也可以停用。不会有withdraw或上瘾的现象。
Melatonin 的剂量要因人而异，小的孩子1mg可能就够了。为了准确，可以用液体的。Natrol牌子的melatonin 有液体的。

关于sleep cycle这个App：
它可以program从什么时候开始响，最后几点把你叫醒，可以是音乐也可以是铃声。女儿放了几段音乐给我，还以为是帮助睡觉的，但她能醒来。

关于网络：
我家孩子自控能力比较强，我们不限制他们的网络使用。儿子一直是不用操心，女儿有过一段挣扎，但现在好了。如果你培养对孩子的信任，他们最终不会让你失望；如果你总认为他们不可信，总想管着，放不开，他们不会相信自己能管住自己，也就不会向那个方向努力。当然这种培养是相当有挑战性的。

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自闭症：mrspock的回答
Judging from all of your conversation, my son, at age 25, is probably the oldest. When he was diagnosed at age 3.5, ABA was still considered controversial. Fortunately we were able to provide our own ABA program and he is doing well. He has 3 part time jobs (TJMaxx, CPA office, Insurance office) and enjoys playing saxophone, drum, and sing in a band that performs weekly. When he was young, he was super afraid of music and high pitched noise. It’s not until he was 19 years old when he went to music camp, started by his older sister for Friends of Children with Special Needs, and a flute teacher discovered his musical talents. So DO NOT GIVE UP. Your sons and daughters may not have special talents but will surprise you someday with his/her abilities. I firmly believe, with proper training, guidance, and love, they will all learn more and find a life of happiness. It may be as simple as enjoying Disney characters, or reading the same books every day. But do you know they are pure, simple, and happy in their own way!! If we don’t judge them with our worldly standards but try to be in their world, it will relieve a great deal of stress on ourselves, as well as our children and other members of the families. Accept them as they are, while do our best to help them learn basic communication and living skills. Find something they enjoy and let them be who they are.

下面是谢刚博士希望我转发给大家的：这位是我们 Fremont 的 王医生，Friends of Children with Special Needs 的创始人。应该对您的 自闭症群有用。

转一个有special needs 孩子家长的分享：Judging from all of your conversation, my son, at age 25, is probably the oldest. When he was diagnosed at age 3.5, ABA was still considered controversial. Fortunately we were able to provide our own ABA program and he is doing well. He has 3 part time jobs (TJMaxx, CPA office, Insurance office) and enjoys playing saxophone, drum, and sing in a band that performs weekly. When he was young, he was super afraid of music and high pitched noise. It’s not until he was 19 years old when he went to music camp, started by his older sister for Friends of Children with Special Needs, and a flute teacher discovered his musical talents. So DO NOT GIVE UP. Your sons and daughters may not have special talents but will surprise you someday with his/her abilities. I firmly believe, with proper training, guidance, and love, they will all learn more and find a life of happiness. It may be as simple as enjoying Disney characters, or reading the same books every day. But do you know they are pure, simple, and happy in their own way!! If we don’t judge them with our worldly standards but try to be in their world, it will relieve a great deal of stress on ourselves, as well as our children and other members of the families. Accept them as they are, while do our best to help them learn basic communication and living skills. Find something they enjoy and let them be who they are.

我在这篇博文里讲到这个孩子： http://www.overseaswindow.com/node/5963

@雷春 Thx for posting the piece from dr 謝剛 it’s the story of my son, first written here last night to hopefully support the hope of many parents here.

Check out this link. http://youtu.be/wKK160wPyoI

http://mp.weixin.qq.com/s?__biz=MzA3NzU2MjAwMQ==&mid=204345237&idx=1&sn=17fe380a2be9b59c1aad71da53a35cab&scene=1&from=groupmessage&isappinstalled=0#rd

如果你是在kaiser保險 可以考慮加入這個data bank
www.acphd.org/ddc

Spread the word! The child/young adult with autism does need to be a Kaiser member.

New Autism Family Genetics Study Launched

Quality

A three-year study of families and children is designed to make lives better by helping to speed the development of autism treatments and preventions.

By Janet Byron, Senior Communications Specialist, KP NCAL Division of Research

A new Kaiser Permanente study will gather genetic material from 5,000 member families in order to undertake urgently needed research on autism spectrum disorders.
“Our goal for this new research bank is to create a resource that helps guide the development of effective autism treatments,” said Lisa Croen, PhD, director of the Autism Research Program at the Kaiser Permanente Division of Research in Oakland.

Autism is a relatively common neurodevelopmental disorder — defined by impairments in social interaction and communication, and restricted and repetitive patterns of behavior — that occurs in 1 in 68 children.

“We don’t know what causes autism, or why it is increasingly prevalent,” said Croen, principal investigator on the new research bank. “This study can point us toward the answers.”
With the Autism Family Research Bank, researchers will for the first time have access to detailed genetic, medical, and environmental information on “trios” — two biological parents and their autistic child under age 26. (All data collected will be fully de-identified to protect member privacy.)
Research on twins and families has provided strong evidence for a genetic contribution to autism spectrum disorders, while a growing body of evidence also supports a critical role for environmental factors, especially during gestation and the early postnatal period.
The Autism Research Program received a $4.6 million grant from the Simons Foundation to create the autism research bank over the next 3 years, although the data will continue to be available to qualified researchers for years to come.
Because autism is a complex condition involving many genetic factors interacting with environmental conditions, studies require very large numbers of families to participate in genetic epidemiology research to find the underlying causes.
“Large numbers of participating families will also help speed the development of autism treatments and preventions by enabling the identification of patterns that would not be apparent by looking at each person individually,” said Neil Risch, PhD, director of the UCSF Institute for Human Genetics and co-investigator of the Autism Family Research Bank.
Members of Kaiser Permanente Northern California who have a child under age 26 with an autism spectrum disorder are being directed to email autism.research@kp.org or to call 866-279-0733. Researchers will be in touch this summer to request blood and/or saliva samples from both biological parents and the child with an autism spectrum disorder, and for completion of a short questionnaire.
“Family participation is critical,” Croen says. “We can’t do this without Kaiser Permanente members.”

NBC’S DATELINE INVESTIGATES AUTISM’S ‘AGING OUT’ CRISIS IN “ON THE BRINK”

Kate Snow Shares Powerful Stories Of Young Adults Living With Autism And Their Families’ Desperate Search for Specialized Support

Dateline’s “On the Brink” Airs Sunday, April 12 at 7pm/6c

NEW YORK – April 9, 2015 – On Sunday, April 12 at 7pm/6c, NBC’s Dateline will air “On the Brink,” a powerful new report, three years in the making, that puts a spotlight on autism’s ‘aging out’ crisis. Over the next ten years, an estimated half a million young people with autism will turn 21 and ‘age out’ — losing their eligibility for help through the education system. The stability and structure they have had nearly their whole lives will end, and there’s no equivalent support system to take over. “On the Brink” takes an unprecedented look at the lives of young adults with autism and the extraordinary measures parents take to provide their children with specialized services and a better future.

Over a three-year period, Dateline chronicles the raw and emotional journeys of two New York-based young adults with autism and their families, as they transition from graduation to adulthood and make a leap towards an uncertain future. NBC News National Correspondent Kate Snow interviews two mothers who devote their lives to caring for their sons and helping them find a voice. Snow shares their heartbreaking stories and the tremendous challenges of navigating a broken system of programs that will allow their sons to progress in life. “On the Brink” documents both families’ ongoing fight to help their children and revolutionize the way autism is perceived in the U.S.

“We spent countless hours with these two families for over three years and it truly was an eye-opening experience,” said Snow. “It’s one thing to know that services end for people when they turn 21, and it’s another to see it play out. We are grateful that both families allowed us into their private lives, so we are able to share their compelling stories and shine a much-needed spotlight on this important issue.”

Snow also speaks about concerns surrounding the ‘aging out’ process with Sharon Lewis, Senior Advisor on Disability Policy to the U.S. Secretary of Health and Human Services, and Linda Walder, Executive Director of the Daniel Jordan Fiddle Foundation, a non-profit organization devoted to studying the issues facing adults with autism.

Watch a preview of “On the Brink” here: http://www.nbcnews.com/dateline/preview-brink-n338436

Early excerpts from Snow’s interviews will air on TODAY and NBC Nightly News, Friday, April 10. Dateline’s “On the Brink” airs Sunday, April 12 at 7pm/6c on NBC.

http://mp.weixin.qq.com/s?__biz=MzA3NzU2MjAwMQ==&mid=204314064&idx=1&sn=ffd7058c0c86a23c85c1835c1435b605&scene=1&from=groupmessage&isappinstalled=0#rd

Reading the earlier posts about genetics, sibling issues, I’d like to provide some science based answers.

sorry I type Chinese way too slow so using English. If anyone would like to translate this into Chinese and share with those in China, or those here who do not read English, please feel free to do so.

First, I’m a father of a 25 year old son with autism. He has an older sister, nearly 3 years older, and a younger sister, a little over 5 years younger. I am a physician, although trained and practice Internal Medicine so do not see children so do not have more than a handful of patients with autism. I am also on the Community Advisory Council of the MIND (Medical Investigation of Neuro-developmental Disorder) Institute, a premier research institute based in UC Davis doing research primarily on autism. I will qualify my statement by indicating whether my comments are research based or more my personal observation.

About genetics, this is research based and pretty up to date information. The current belief, based on the California Autism Twin Study conducted by UCSF, Stanford, UC Davis, etc with nearly 200 pairs of twins (some monozygotic, some dizygotic), is that genetics is responsible for roughly 55% of autism cause and environment about 37%. And because autism appears to start at a very young age, the environmental influence appears to be at a very early age, or even in the womb.

In the old days, some small studies have shown 90% concordance rate (both twins having autism) for monozygotic twins so autism was thought to be largely a genetic disease. It is no longer true.

Other studies have shown siblings (non-twin, different age siblings) rate of concordance between 3-14%. This is in answer to the question someone posted about concern about having another child. I had the same concern about my 3rd child. Since she was a girl, the rate would be much less than for a boy (as you know the rate of male to female is about 4 to 1).

Now the part that isn’t science. My own experience, and my observation of many other families with autism and normal developing siblings, is that it is definitely a positive to have a sibling for the autistic child.

Whether it is positive for the normal developing sibling is less certain. In my case, it was great for all. Both sisters just love my son and they are very helpful in helping him with social skills, communication. They form the base of “play groups” and bring their friends too. They also benefited by learning that there are people who are different and perhaps less fortunate. They learn to love people more and both have done a lot of volunteer work in different areas.

My youngest did have some concern about showing her friends she had a brother who is different. She also felt a little left out since the family’s focus was on her older brother ever since she was born. But as she gets older and matures into her teenage years, these feelings disappeared and she was proud of her brother’s overcoming so much difficulties and she became his best helper. She also volunteered in the organization I and my wife helped to found to support mainly Chinese families with disabled children. She took on a very young autistic boy and essentially became his older sister, helping him in our programs for some 8 years, watching him grow up. This boy is fairly severe and has little language and is hyperactive. But he responds to her very well. It is a great learning experience for my daughter, and helped someone in need at the same time.

@sophia Heavy metal is considered one of the environmental factors. However this probably accounts for a very small number of cases.

Just so that we’re all on the same page. This is not totally science based since no research has been done to prove it. But in generally all mainstream autism experts believe “autism” is not one disorder. It is simply lumped together based on a set of diagnostic criteria. It is really a “syndrome”, or a group of symptoms. It is like running nose+sore throat+cough and + possibly fever is what we know as “cold”. But it doesn’t mean we knew at the time this condition was described that it was caused by a virus. Similar symptoms can be caused by allergies, other infections, etc. So “autism” as defined today should not be thought of as having one cause. In fact, most experts believe there are numerous causes. This is partly why it’s so hard to find “the cause”. If we study 100 children with autism by comparing their genes, environmental exposure etc, and there are 25 causes, we won’t find any statistically significant pattern to determine any cause.

I remember seeing something about genetic testing for parents or the child with autism. There has been numerous studies on this and many genes were found to have some link to autism. But none is even close to being predictive, again because it is likely an interaction between many genes plus the environment that cause autism. So don’t believe people who tell you they can do a test and tell you whether you have the “autism gene”. There’s no such thing.

Fragile X is a well defined genetic disorder that makes children behave with autistic patterns. It is one of the causes of autism, but again it’s not 100% and only a very small number of autistic children (and adults) have Fragile X.

Gotta get back to work. Will continue when I have time. Sorry I’m so darn busy I cannot answer individual questions or I won’t get anything done in my life. If you have questions you can post it here and I will answer some (sorry, cannot answer all as my life is already busy enough) I think may benefit others. Like all of you, I’m a parent. I’m not an expert in autism but I have scientific training in medicine to help decipher some of the confusion and am happy to do so. But don’t think my word is the bible and take it as you see fit.

UCLA 和UCSD 都是自閉症研究重點中心。UCI 比較不清楚

GI issue for autism is very controversial ever since the days when my son was diagnosed back in the early 90’s. ‘Leaky gut’ is the center of this controversy. When I have more time I can write a simplified summary about the theory and controversy.

Generally speaking, if gluten and/or caseine free diet isn’t too hard to implement, I would say give it a try for 6 months and monitor. Testing for gluten sensitivity might be helpful but by no means definitive.

Because there’s variation of behavior, it’ll take time to see progression. There’s also residual gluten and caseine metabolites in the system that takes time to clear. So it’s best to do it for a long time.

It does need to be completely gluten and/or caseine free. I’ll write about the theory behind this so you’ll know why even a little bit of caseine may not work. Gluten is less so

The theory behind Caseine causing autistic behavior is as follows. I stress this is “theory”, not scientific fact.

In our nerve system, the communication is done by substance called neurotransmitters. There are various kinds of neurotransmitters. And most are “peptide”, or a molecule made up of amino acid. Proteins are peptides, but much larger (longer) than the neurotransmitters. Caseine, as the mild protein, is theorized to contain amino acid sequences similar to some neurotransmitters. Protein molecules, or even peptides of significant size, cannot cross the gut surface to go into our blood stream. Usually our digestive enzyme cuts such molecules into amino acid to be absorbed and used. If the gut is “leaky”, it may allow peptides to cross and get into the blood stream. If this peptide happens to be similar, or identical, to some neurotransmitter, it will confuse our nerves and brain. Usually neurotransmitters are tightly controlled with our own neuron’s signals. This is like a communication system such as telephone switch board or in a computer. When additional, uncontrolled random signals get into the system, you can imagine the confusion it will cause.

as to whether it should be continued lifelong, there are two “theories”. One is that of course it has to be continued as such confusing signal will affect people at any age. The other side of the argument is that, while the child’s brain is still developing and can be “damaged” by such confusion, a mature brain may have ways to sort things out and not be affected by it as much. Neither has scientific research backing it up, as far as I know (I’m not closely following this any more so it’s possible there might be some research study more recently published showing one way or the other).

BTW, “leaky gut” is not a universally accepted science either. There’s still a lot of argument over whether it exists? Or if it does whether it really leads to problems like the above, and a whole slew of others many non-traditional medicine people claim.

I want to provide some background too, on my comments. There are different levels of strength of evidence supporting some theory. The strongest is something out of controlled, doubled blind study. These are very very likely to be true. There are other evidence that is derived from some studies by comparing population groups doing different things, while controlling for all other variables (making the study and control group otherwise the same except for the variable being studied). these are pretty good too, but sometimes is subject to confounding factors. For example, there was a statement above that dementia is highly associated with “leaky gut”. I have not studied this so not sure if this is true. If it is, people may draw the conclusion that leaky gut causes, or at least leads to dementia. But maybe there’s some factor X that cause both dementia and leaky gut. And neither dementia causes leaky gut nor leaky gut causes dementia. They just happen to co-exist. So this degree of evidence is good, but must be taken with a grain of salt.

The next level is observation, like “his child has autism and did the GFCF diet and got better”. This is pretty unreliable since nearly all autistic children are also doing other therapy in addition to diet. And there are cases of spontaneous improvement of autism in kids without doing much of anything. And autistic behavior also improves with age. This is a good start to think about doing real scientific research on this topic, but by no means should be considered as facts. The last is some theories that have undergone research and proven to be false. There are not too many of these in autism yet since we’ve not done enough long term studies.

And of course all scientific research is based on statistics. It is basically saying that it is very very likely to happen each time such variable is applied to such disease/behavior, etc. But statistics isn’t fool proof. You can say that if you buy a lotto ticket you pretty much is not going to win the grand prize. But every so many drawings someone does win the grand prize. In the case of science research, buying a lottery ticket would be considered throwing money down the drain and it’s “proven a bad idea”. But anyway, we all know the odds of winning the lotto so in the great great great great .. . majority of the cases, research finds will hold.

Sorry to be so long winded. Just want to explain how I look at things and why sometimes it may seem like I don’t agree. It doesn’t mean I’m always right. Just means there’s a very high probability I would be right. Same should be applied to anyone else trying to sell you something or some service. At least I don’t intend to profit from information I provide here.

@mrspock 你是研究什么的？你的逻辑思维非常强，表述简洁易懂，论证基本符合事实也很严谨。大赞！谢谢分享！希望其他家长看得明白！

@mrspock 你怎么看疫苗？

Thanks. Gotta do more work. later!

Have a few minutes, thought I’d answer a few questions and give a bit of my experience.

To answer what I do, I’m an internal medicine doctor, practicing adult primary care. THE most important trait for a doctor is to be able to critically evaluate evidence since there’s so much mis-information in the very lucrative medical field. And I remember the Dean of my medical school’s speech during new student orientation. He said “starting today you will need to be careful with what you say. A doctor carries great responsibilities and credentials. Others will believe what you say so be sure to think twice before you say anything”. I remember this very well until this day, 35 years later!

As to blood brain barrier, some neurotransmitters can cross blood brain barrier. And they do not need to get directly to the brain to cause confusion in the nervous system since the sensory nerves all over our bodies feed signals to the brain based on inputs from its own (like ear for hearing and balance).

Also want to provide my basic rule for whether to try something.

Because so little research has been done on the exploding forms of “treatment” for autism, I cannot just rely on scientific evidence. So I follow the following basic rules you may want to consider.

It is actually very basic cost-benefit analysis. 1) Unless it is proven effective to be worth it, it should not cause harm (minimal side effect). This harm doesn’t just mean physical health harm. And it doesn’t mean just harm to the child. For example, if you’d like to try gluten free diet, but your child doesn’t eat much of anything and taking away gluten will cause malnutrition, you would want to think twice. And if making a child take Vit B6 creates serious commotions in the family each time the child resists taking it, you should also reconsider.

2) Unless it’s proven therapy, you should consider the cost. I know we would give anything to help our children improve. But spending too much money on one unproven therapy may mean you cannot afford to pay for another, more effective therapy.

3) Therapy should some common sense. shining some “special light” on the child makes little sense it would help a child get better. if it’s easy to do and cheap, I may consider. But if someone claims he can cure autism by doing something like this and charges thousands of $$, I would stay away.

Sharing a seminar info with you in case you’re in the Bay Area, especially if you have older children. FCSN SOUTH BAY Free Seminar Topic: “Learn Options to Custom Design Support Services for Our Special Needs Loved Ones”

Speaker: David Grady, M.A., State Council on Developmental Disabilities

Date/Time: Apr. 18, Saturday, 4:30-6:20pm
Place: Westhope Presbyterian Church, 12850 Saratoga Ave., Saratoga, CA 95070
Cost of Seminar: FREE
Children Classes and Dinner : ONLY available for registered South Bay Regular Family Support Gathering families (not available for walk-ins)

Self-Determination will soon be a reality in California. The new law, SB 468, has the potential to dramatically alter service delivery for people & their families and significantly impact their quality of life. This presentation will provide an overview of the law, with real-world examples. It will focus on the basics, assuming most people have only a vague understanding of the new law’s requirements and potential impact.

About the Speaker:
David Grady, M.A.
Mr. David Grady is the executive director at State Council on Developmental Disability, Area Board 7, San Francisco Bay Area Government Administration, which supports and advocates for the special needs community of 4 counties, Santa Clara, San Benito, San Cruz, and Monterey.

seminar is free. There are seminars in either Fremont or Saratoga every other week during school year, ending at the end of May. Next week’s will be about insurance coverage of autism issues. It’ll be in Fremont at the FCSN Center. This should be of great interest to many of you. Speakers Kristen Jacobson and Feda Almati are seasoned advocates. Their efforts have helped CA state legislature to pass insurance mandate for autism coverage, with some exceptions unfortunately.

@张钰鹏 北京可莘爸爸 don’t treat me as an expert. I’ve been on this road much longer than probably all of you. So I learned over time and also have historical perspective. But by no means I’m an expert.

I recall vaguely someone asking me about vaccines a few days ago. Sorry I’ve been too busy and also sick with a bad cough to spend much time here. Here’s my own impression on vaccines.

There are two possible problems with vaccines (theory, not proven). One is the direct toxicity of Thimerosol, a preservative containing mercury used to prevent contamination of vaccines. The other is the aberrant immune response of some children, causing one’s own immune response to attack his/her nervous system and causing neurologic problems. Many studies have been conducted on these. So far essentially none has found vaccine to cause increases in autism. Around year 2000, Thimerasol was removed from children’s vaccines (except some flu vaccines). Autism rate continued to increase after that, suggesting Thimerasol probably does not play a role in causing autism.

All that being said, you may recall the generally accepted concept of autism being just a “syndrome” (group of symptoms) and likely has many causes. So it may be possible that, if a study sample isn’t large enough that each of the many causes had many cases represented in the study group, some differences won’t show up as statistically significant if the sample size is too small. For example, if 100 children were in a study and there’s 10 different cause equally represented in the 100. An increase of 20-30% in that 10 kids may not show up as statistically significant in the larger 100 total population. So it won’t be detected. So if vaccines is causing 2% of autism cases, it will require an extremely large total sample to have enough of these cases. Even then, when divided into the large sample size, it will show up as a small difference only. Hope this makes sense.

So my “feeling” (not scientific at all) is that maybe in a very small number of cases vaccines played a small role (still need to have some predisposition, either in conjunction with other illnesses, toxic exposure, or genetics) in developing autism.

So what should we do. I can share with you what I did, but again without scientific evidence, just my gut feeling.

Since an immature brain is more likely to be damaged by toxins or an immunologic attack, just like a baby is more vulnerable to many infections, I had my third child (recall my second child is the one with autism) delay some of the vaccines until she was about 3-4 (can’t remember, she’s 20 now). I figured, in the relatively clean environment here in suburban California, her chance of catching stuff is pretty small in a 2 year time span. But I did have her vaccinated because, with international travelers everywhere, the risk of catching something serious is still real. So I feel it’s important to protect her. Vaccination also has very important public health benefits. If a population is, say 80% vaccinated, it’s much harder to transmit some disease when only 2 out of 10 people an infected person meets can get it and pass it further. So instead of 1-10-100-1000-10000, it’s more like 1-2-4-8-16. You can see the reasoning behind this.

Other than the part about studies showing no relationship between vaccines and autism, the rest of the above are my own thoughts based on my general knowledge of medicine, immunology, epidemiology, etc.

窦维平：@雷春G12B15Fort Collins, Colorado 这个群估计内向的、有stage anxiety的孩子较多，可不可以清专家针对这些孩子还个讲座？
我们孩子还是相当不同的，有两点我比较struggle。1)上台可以表演比如弹钢琴一点没问题，但是不愿对着大家说话；2)跟完全陌生的人说话时不愿看着别人。
有合适的建议欢迎大家提供

蔡华俭：都属于社交焦虑或社交恐惧类的，需要多带出去进行群体活动。

Xiaoyan: 我老二以前在学校不轻易开口, 和熟悉的人在一起时没问题。后来我发现她和比她小的孩子, 就算不熟悉也敢说话, 就有意地找一些比她小一两岁的, 或者和她同龄但是各方面比她弱一些的孩子和她玩。感觉她开朗很多, 在学校也敢讲话了。所以有时觉得孩子不在外面讲话, 其实是自信心不够, 我们应该先树立她的自信心。

Sandra Liu: @ 窦维平 不愿说话要尊重孩子的意愿和性格。“不能”说话才是SM。她们很想说单身anxiety让她们不能震动声带或不能控制soundbox 肌肉。 是因为anxiety产生的肌体组织功能丧失。

Junelu: @Sandra Liu 说的非常好！ [ThumbsUp]。I could not agree more ! It took my kid three years to reach the first milestone: whisper to her teacher at school. Now, She is doing very fine at school, even better than her older sister.
For SM kids, never ever PUSH !
Keep in mind that it’s the anxiety that is the root cause, push will only make it worse.
We parents need to focus on how we can provide them a relaxing and comfortable environment so that they eventually will feel comfortable to come out. Last night, I was reflecting on what I have done during that time period and tried to pinpoint what helped her most.
I just could not single any out. I guess it’s a collaborative effect.

Sandra Liu: @junelu whisper 是孩子自己的能动性起来了。真为你高兴。很快了。加油。

Junelu: But we parents do need to have acceptance and love: accept them as is, love them who they are unconditionally.
@Sandra Liu thanks! That happened 4 years ago when she was in kindergarten. The minute she whispered, I knew she would be fine. [Grin]

Sandra Liu: 坏消息是孩子可能SM，克服之后，99%仍是个anxiety爆棚的孩子。在各方面都容易表现出来。我女儿在小学前克服SM，坚持到三年级，虽然老师说没问题，我观察到孩子放学回来好像self regulation 已经耗尽的样子。越来越坏。三年级第二个月我就给她转到一个放羊学校。有点像“床前的小豆豆”学校。直到8年级。孩子现在性格坚毅，兴趣广，非常独特出色。@junelu 说的对，关键是减压再减压。这些孩子自我意识超强，减压之后焕发出的能动性比家长能引诱出来的不知道高多少。我每天感恩不尽！
@junelu OK，我太紧张了[Smile]当年的挣扎太痛苦。黑暗中摸索。网上找了一个SM组织，后来发现很不health表示家长彼此帮助的。 真希望给所有在摸索的妈妈爸爸们一点亮光！

Junelu: I know. It’s a tough journey and battle. I’m willing to help to shed any light. Still trying to gather my thoughts. Now only have the principles in mind.

Sandra Liu: 焦虑症不是public speaking 的问题。同意。我们家长先要稳住。我在AT&T工作，原来电话的网路设计是由一位严重害羞，非常不social的朋友一个人设计出来的。Jerry Ash. 我认识他时他都快退休了。我伸手，他竟然不伸手握手，反而脸红红的很不礼貌的样子。后来成为朋友。他太太EQ很高。学术会后的晚餐基本是他的代言人。 allow our kids be themselves, but help them to overcome anxiety disorder. 我们帮孩子忙的。we are only helpers not our kids owners.

Jinghua: 我家老大上幼儿园好几年都不怎么说话，只跟最好的朋友说。老师说他是沉默的反抗。跟中国人在一起就很愿意说。上台表演一点不紧张，但是要他当着大家说话或者唱歌，那就是难为他了。两年音乐课，愣是没有开口唱过歌，我很多次都要崩溃了。后来逼的太狠，他直接要求退出音乐课。早点知道这个是SM就好了，走了很多弯路。

Sandra Liu: @jinghua 不要逼逼没有用。跟孩子真是斗勇斗志[Grin]。

Jinghua: 所有的人都告诉我，既然他跟说中文的大人说话没有问题，那就没事，可能是英语落后。我们儿医也这么说，我觉得哪里不对，又说不上来。
后来我也明白了，现在他又肯去上音乐课了，虽然每次换新班就会别扭一下。

Sandra Liu: 我是在理解孩子之后，第二天孩子就开始whisper了。第二个奇迹是3个月后，我送孩子上幼儿园。正好学校有演出，当时音响坏了，冷场，我自告奋勇，抱着孩子上台，帮她唱一首她最喜欢的歌，给小朋友们。我唱歌很不好，第一遍太高了没唱下去，第二遍太低了没唱下去，第三遍才勉强唱完。孩子在我怀里僵硬的像一个石头。我觉得好心办坏事，非常内疚，向她道歉。她说“不，妈妈你很勇敢”。當天下午她開始大聲喊著說話，喊了一個星期，声音正常了。 她接纳了我的要命的尴尬情形，竟然自己克服了anxiety。 回想起来，这个孩子真是特别tough。让妈妈感动。 带孩子，尤其有问题的孩子，关键是制造机会，给环境，让他们里面的能动性起来。 尔后他们彰显出来的能力，能吓我们一跳！ 孩子们向上的能力太强了。我们只是负责让这个小火山喷发起来。
看上去像吹自己[Shy]。事后我想了又想，非常感叹孩子向好的心和努力的力度。我当时让她上两个学前学校。一个是她自己学校，一个是我们区中心办幼儿教育课的实习班 每个“小白鼠”有两个高中大哥哥姐姐带。每周四个半天。我变成12 点上班5点下班，晚上再补一点。事业一落千丈。家长这些实实在在的努力，孩子都知道。孩子的努力，我们可能看不见，但已经在积累。全家都是必胜的信心 （只是不知道哪天才能胜），我们做能做的，其他耐心等待。 她的whisper，她的喊话都突如其来，好孩子已经积蓄了多么大的内能啊。 分享了鼓励大家。孩子们比我们还想改变。我们是facilitate.
难处只是能不能真正接纳孩子 as-is。我老二非常善良，有点懦弱，不自信。今天学校有表演。完事了孩子们追逐嬉戏，我二女儿推个大拖把，一边拖地，一边很开心地看同学们玩。满脸都是笑。把个地拖的好像也在和同学一起嬉戏一样。我事后就夸她，“多么美的一幕啊”。其事我和老公对她的懦弱都挺犯愁。一次次讨论如何鼓励她改变。屡不奏效。最近意识到她就是她。也很美。将来谁娶她可有福了 （但娶我大女儿就得很她一样tough）
孩子不让我们改变她们，我们只能改变自己。
我大女儿说 “妈妈你本来是个tiger mom by nature. 我粉碎了你的虎妈梦，让你变成普通妈妈了”。 小家伙看得很准。孩子们教我们，还可以治愈我们自己的很多心态病。
大女儿说这话时11岁唉。这个小SM后来让妈妈心醉！

来自廖冰的心理健康四群

Ling：各位老師好，談論的內容很受啟發。我兒子做作業很快，很毛糙，因為他想趕快做完好做他喜歡的事，比如打遊戲。這種情況如何引導哪？請教請教，謝謝啦[Smile]
雷春：游戏时间应是固定的。比如一个小时。如果作业不达标，要扣下次玩的时间。比如他应该可以到达90%正确率，但只对了60%。那么下次的游戏就只有40分钟。如果能做对100%，可以加10分钟。@Ling
May：@雷春 同意！建议制定这个‘规矩’时，与孩子一起，共同达成一致。利于执行。
Lynn：@Ling 我儿子以前也这样着急写作业，早上还为了玩什么早早6点多就起床。后来狠心把周一至周五全部的电子game&TV时间全拿掉了。只限周末也限时，而且是功课没有不及格才开放电子game&TV时间。但各种棋类，lego, 读书周日开放。开始他报怨呀，现在适应后也很开心。help a lot! 不光作业质量好很多，上课走神都改进很多。@雷春 总结教训后的领悟呀[Sweat]@Ling 周六和他必去图书馆保持他喜欢的书更新, 加几本CD可听的书很受欢迎。他8岁，斗志斗勇斗毅力呀，开始说为什么别的小孩可以随便玩随便看电视?? 甚至以哭，发脾气相逼… 过了就好了… 坚持住别心软父母一致, 不一致也不当他面讲是main key。
Kathy：@Lynn-Morgan贷款 跟我想的差不多。这还是一个听话的年纪。等到了teen，真的完全不一样了。有了自己的想法，觉得自己应该自主，再加上周围孩子的影响。管起来非常难。祝你在孩子长大的过程中，坚持住。一旦放开，就再也收不回来。
Lynn：@Kathy 是啊，所以在这个群里及时充电，学习教和育中的智慧。
Kathy：@Lynn-Morgan贷款 共同学习。家有13岁的孩子，看到不听话的变化很心痛。我知道我给了他很多压力，但是总不舍得取消任何一个。看看大家的帖子，很有启发。要想好怎么才能逐渐减压。同时又有孩子潜能是无限的观念在驱使我。矛盾中，观察中，思考中，自己的压力也很大啊[Sweat]。这样下去，总有一天，他有能力独立了，却再也不想回来了[Frown]。
茉莉：@Kathy 必须减压，如果孩子真有潜能的话，你想压也压不住，还是会发光的。孩子在家也没几年了，我宁愿她在家的时候我们快快乐乐的，以后在外面受委屈了还能想回家。我女儿也13岁了，还4年就要离家了，想着都舍不得。
Lynn：@Kathy 有时我在想太强势“推妈”固然不对，太让孩子自主也是问题。读上面前輩的文章，有句话我觉的很受用：“别把孩子小时候当大人，但等他们长大了再把他们当小孩”…
Lynn：@Kathy 慢慢来，不着急。一旦你不着急了，他看到你的不同，他会思考，他会改变。你有没有试着要讲他时改为自己为他祷告？好像前面还有一篇文章，是讲跟他讲话时拿一杯水，当你忍不住要讲他了，就喝囗水堵住嘴…
廖冰：所说的孩子以前“听话”但入了青春期就“不听话”，也许跟在他们还“听话”的时候，没有帮他们学会独立problem-solving的过程。家长通常都是为孩子做决定，孩子愿听，家长就很”欣慰“了，哪里顾得上教孩子学会这个过程。当然每个孩子都不同。
我儿子小的时候，他会“求”我帮他拿主意，因为他怕做错决定。我就尽量坚持让他自己做决定，说，将来你会有一天不要听我的了，要自己拿主意了。如果你那个时候已经学会怎么做决定，我跟你的矛盾就少。因此，你要现在就开始学习怎么做决定，做错决定没有关系，就是要学会怎么面对后果。[Smile]
我们当家长的有时太怕孩子“走弯路”，做错决定，就不敢放手，有些孩子等到了上大学，没人管了，就有很多问题。
Daixin: @Bonnie廖冰NJ ，很棒的提醒！我家大儿从小不听话，很有自己的主意，这么说来也不全是坏事[Tongue] 谢谢你引导儿子做决定的分享。这可能是天生个性，我小儿子也是常常自己拿不了主意，哪怕是很简单无关紧要的小事，如果要他二选一或多选一，他都会犹豫不决“我不知道”。
廖冰：当然，这种让孩子学做决定（problem-solving）都不等于完全放羊。可以过一段时间（或几天）坐下来review 一下，看是否需要开始新一轮的“brainstorming” – 自己选择新solution。总之，一定要教会孩子这个problem-solving的过程：

让孩子把所有可能的alternatives/options 不加判断地都列出来（你也可以不经意地提供2-3个），等都写完了，让孩子在每个后面写上consequence。然后，让孩子自己做决定，不要“支招”。说好review 时间 （过几天）。如果所做决定不work，就再来一遍。你这样跟他做几次后，他就明白，大人的决定都是这么做出来的。只不过大人有经验了，不一定要都写出来。我们总是不满孩子做决定的时候考虑不周，殊不知他们没有这样一个process ，他们当然是第一时间想到什么solution，就是什么了！这个不教给他，不让他从小懂得consequnce 会有多么重要，那他到了teenager，就要重新学，错决定的代价也会更高（比如影响高中学习成绩）。当让他学会做决定还是最重要的，至少可以有你在旁边provide support if needed。如果这个时候还是怕他走弯路（说穿了，就是把他上不了“好大学”），还是不放手，那有些孩子到了大学（成人的年龄）付的“学费”就更高了！
Lynn：@Bonnie廖冰NJ [ThumbsUp][ThumbsUp] 这个很捧！不容易实施，我会初衷让他做决定，发现他决定的不是我要的，我就千方百计“教导”他立刻改回“对的”… 学不会真放手呀…
妞妞朱莉亚：我儿子快十一岁了，我最近做的一件事就是家里的电脑和iPad都解禁了。以前是加密码限制时间（周末不玩，周末一个小时）。虽然解禁了，我还要管，但是口头上鼓励他自我安排时间。我心里是想着往青春期过渡，孩子必须慢慢学会自我管理。因为没有硬性管理了，要防止一放就乱，我必须多花时间和他闲聊。一是可以占用他时间，省的他老是无聊，二是走入他的世界。我第一次饶有兴趣的问他他爱玩的游戏到底怎么回事，他竟然特别不好意思的说“感到guilty，和妈妈讲妈妈不care的电脑游戏”。真是有意思。
@妞妞朱丽娅 ，佩服你敢放手！能分享一下解禁后的变化吗？我儿子已经11.5岁，时间管理上自制力较差，家里电脑iPad也是密码加限时，常常timer响了还停不下来[Angry]，所以解禁我虽向往可不敢尝试呢。
Lei：@Daixin 同意朱利娅，在孩子还小的时候解禁，先让他明白打游戏的坏处，再填满课余时间。
妞妞朱莉娅：我经历过解禁，重新加密，再解禁，再加密，好几轮了。所以还在摸索。我理解解禁后家长的任务更大了。更要多花时间，效果不会自动来。再者，不管解不解禁，都要虚心的去看看他到底在玩什么。也是亲子沟通的一个媒介。这次解禁才一周，[Sweat]，比以前好，玩电脑的时间肯定比加密时多，但是喊他洗碗吃饭干活什么的都比以前积极。[Chuckle]继续观察，也希望得到大家的意见。
Lei：我家没有加密过，自控确实很难，但说好一天玩多久，实在控制不住可以理解，拉出去玩玩。陪着孩子做些其他事。
廖冰：在“How Children Succeed“一书中，Paul Tough 提到 7种最能预测孩子将来成功的character strengths： grit, self-control, curiosity, gratitude, zest, optimism, social skills. 这个grit就是遇到挫折不放弃的坚韧性 – 最最重要。这个self-control是否能通过玩游戏培养？各个孩子不同，但假如你孩子经过努力，真的可以self-control了，那就是最值的。
这就是为什么要说好要有review 和 follow-up，因为你会帮助孩子走过这个上下起伏的过程，又不能强推自己的solution （等于没有培养孩子的self-control)
May：@Bonnie廖冰NJ [ThumbsUp][ThumbsUp]我的孩子就是凡事喜欢问我怎么办，我让她自己决定，她似乎难以决定。看来是家长没有训练她，教她方法[Smile]。我家的IPAD现在没有加密，其实孩子不希望加密。但是她会玩的忘乎所以，后来谈了一次，我说如果再发生类似的事情，就是加密。孩子也明白不加密是对她的信任，所以她现在努力在做到self-control。我也希望她能够成功[Smile]。
茉莉：@Bonnie廖冰NJ 非常同意！我一直都是主张让孩子犯错，从错误中学习（当然不会是关人命的错误啦）像@Daixin 一样，我们家也是从小不听话，我没有办法只好让她自己决定，从中建议指引。
Ling：謝謝大家的好建議！我兒子12 歲，自尊心很強，愛玩，也計較成績。有很多課外活動，有時候，sport or School test 成績不好就很沮喪，說 I am not good at it. 安慰他，他說你說的都不是真的。真心請教如何引導他樂觀，積極？
廖冰：你怎么安慰他？[Smile]要先acknowledge his emotion。这点我们不习惯。”You seem to be upset.” “I would have felt disappointed as well if I were you.” … Sometimes we are too worry about children “lose confidence” in themselves so we’d jump in right away and start giving advice or dismissing the negative emotion (Don’t worry about it. It’s just a test …). 其实最要做的是要跟孩子站在一个战壕里，对他的负面情感表示接受和理解，尽管你不一定同意他的做法。这一步没有做到位，下面说什么都白搭，甚至事与愿违。有的孩子会在很多年后还记得家长当年如何 “did not care how I felt”，以至于开始有故意不好好念书等“逆反行为” – “if you don’t care about me, why would I care about you!” 把很多家长在意的事情当作是”如果我做好了，你会更高兴“而反着来。
Zhuyan: 接受孩子的情绪非常非常重要。
廖冰：@zhuyan [Shake] 不接受孩子的情绪，其它都先免谈。
Yw15: @Ling 他是在下意识地跟人比，兄长？同学？朋友？他得明白没有谁good at everything all the time. 他比着的人也都如此。
冯斌：有些时候我们会劝他们说,这是一个小事,没什么大不了的,没必要这么紧张,但是对孩子来说,这点小事就是大事,如果我们不和他们站进同一条战壕里去,我们就看不到孩子自己的心理高度,所以我们会做很多无效的甚至是反作用的管教。
Ling：@Bonnie廖冰NJ @zhuyan @yw15 @冯斌 謝謝了！我以前很push 孩子，希望他樣樣好，所以也許給孩子一些不好的影響。現在已經認識到。認同他的情緒的確很重要。孩子上的是私利學校，他總跟他的同學比。我只有他一個孩子，他也很孤單，常常想什麼都好來贏得同學的尊重。真希望他健康，快樂的成長，其他都是次要的。

选择性缄默的症状：
1. 首先是发现在学校不说话超过1-2个月；
2. 在家说话完全没有任何障碍；
3. 有的在其它非正规学校环境会说但非常腼腆；
4. 在学校会有1-2个朋友替他/她说话，并称为最好的朋友（实际是给那个好心的孩子极大的负担，不能和其他人玩和交朋友）；
5. 和老师没有直接交流，眼睛不正视老师。
程度因人而异，有轻有重。我知道的比较重的一个女孩连到家里的朋友都基本不说话，但可以点头摇头。我女儿是对任何到家里来的人都说话，因此稍微轻些。

有个“选择性缄默”的网页：http://www.selectivemutismnetwork.org 希望大家能找到有用的信息。家长要理解孩子的焦虑，和老师沟通好，给孩子一个宽松的、能得到关爱的学习环境是至关重要的。

我的措施：
1. 为孩子找性格温和的老师，不对学生大吼大叫，小时候本人就属于害羞性的最好；
2. 老师们，同时也要老师教育同学们，只字不提孩子不说话之事，把她/他完全当正常孩子对待；
3. 允许孩子带一个让她/他感到安全的能发声的玩具（我女儿是毛绒玩具羊），并允许孩子假装是这个玩具，并替它说话，老师也可以直接与玩具对话（projection)；
4. 老师家访会很有帮助，但不是每个老师都愿意做的；
5. 尽可能多地参加活动和运动，就算孩子显出极度的焦虑和哭闹也不放弃，耐心耐心再耐心地陪着（我女儿参加过的校内外项目：体操、跳舞、游泳、网球、中文学校、钢琴、小提琴、法国圆号、学校越野长跑、学校田径、滑雪、旅游、暑期夏令营等，现在还保留有其中的不少项目，给她接触不同人的机会，增强自信心；
6. 年龄6-7岁时是用低剂量的Prozac 最有效的时期，一定要在懂这个病的Psychiatrist的监控下使用，丹佛的Children’s Hospital 的Dr. Cook是一流的专家，其他州也应该有，但当年在亚特兰大没有找到；
7. 多安排与同学的Playdate；
8. 家长尽可能多地去学校做志愿者，以积极、愉快的形象多出现在孩子视线里，放学后可以在学校多逗留，去图书馆读书，和老师打招呼和交谈，鼓励孩子与父母一起为老师做课堂准备；
9. 孩子与老师的交流要循序渐进：点头摇头、yes和no、单个词、读句子但不看老师眼睛、举手替玩具说话、只和自己班的老师说话–整整用了女儿5个月；
10. 每次升级或转学都写信给校长争取支持，找到适合的老师，并在暑假前拜访新教室和新老师，次数越多越好。
11. 4岁时陪孩子在课堂朗读。

我们的小故事和体会：

我女儿第一次上体操课时不肯做任何动作，我就陪着她坐着看；第二次上课时，她躲在一个障碍物的后面，偷偷地学一点；第三次上课时，她离老师和其他孩子又近一些，但仍然躲在障碍物后，做的动作多了不少；第四次她只是在障碍物旁边做，没有全挡住，老师抓住机会，把她抱进那群孩子中。整整一个月的时间。所以我说耐心耐心再耐心！

每一项运动都有它的优点。我比较喜欢游泳给孩子的磨练。女儿6岁进游泳队。由于她严重的社会焦虑症SM，进游泳馆时常常以泪洗面。但她有个非常有爱心的大学生教练，只要她下了水，她的教练就会把她逗开心。正式比赛她也参加，而且要去附近不同的城市比。刚开始她也极度紧张，而且6岁要和8岁的一起赛，不可能拿奖品，她的很多动作也不到位。等到8岁时，她每次比赛都能拿不少奖条（前15名），她对得奖也就淡化了。当她9岁要和10岁的一起比时，又是一个奖也拿不到了，但她自己不着急，说她只要练下去，10岁时肯定会拿奖的。这种心理素质训练对她克服选择性缄默的焦虑起到了非常积极的作用。

孩子游泳是特别磨练家长耐性的[Smile]。他们的成绩不是一天两天，一周两周，甚至一个月两个月能看到的。很多时候孩子这次比赛的成绩（时间，不是名次）比两个月前还差，你咋办？耐心鼓励是唯一的办法。孩子在生长发育的阶段，那根骨头长长了，哪块肌肉跟不上其他部位的长速了，等等很多因素。我只要看她现在比一年前有进步就好。这真的没有打球来得快。如果家长急功近利的思想不改，很难让孩子游泳。

美国的“小升初”–心理老师笔记
作者：心桥

H初中是加州学业表现指数(Academic Performance Index, API) 最高的公立初中，1000的满分今年居然达到995，也难怪华人不顾昂贵的房价趋之若骛，近1100名学生中欧裔不足10%。与此成鲜明对比的是50多教职员工中绝大多数都是欧裔，加我在内只有两名会讲中文的(另外一名是代数老师)，所以中美文化在教育上的差异常常从不同角度体现出来。

这不，刚开学不到五周，咨询员(Counselor) 又在办公室摇头叹息，见我路过赶紧道一肚子不解。原来是一位刚入学的七年级学生，智力是没得说，早在三年级就被鉴定为资优生(Gifted)，所以智商肯定是130(top 2%)以上。也是因为这个原因，依据校区规定可以优先选择快班的课(Honor’s Classes)，所以看六门的课表上除体育和美术外，从英文，历史到代数，科学，主课是一码的快班。他数学还好，但其它三门学得很吃力，特别是科学课，每到教室他就把头放在桌子上，几次哭出声，还在笔记本上写“不想活了!”之类的话。

加州5150号法案规定，如果学生在校期间显示任何自杀倾向，学校有权在通知家长前先报警，学生会被警察直接带到精神病院监护72小时。这种情况每年在华人聚集，成绩优异的中学都屡有发生，让家长措手不及。好在这位学生在其它课上并未有这种现象，所以学校归结到他选课的不妥，打电话征求父母同意，换成普通班的科学课。原本小事一桩，让咨询员吃惊的是家长反应强烈，坚持认为是学校偷懒，不帮孩子努力适应有难度的课，反而给他容易的选择，岂不是让他养成知难而退的态度？所以换课万万不能!

七年级学生在班上情绪失控的情况已经是开学后第四次发生了。欧裔的咨询员和任课老师百思不得其解，为什么这些看似光鲜但并不适合自己孩子的难课对亚裔父母来说比孩子的健康更重要呢？难道他们不了解良好的情绪对学习有多重要吗？特别是在孩子刚升入中学的巨大转变过程中。

* * *

在美国的“小升初”，因为公立学校都是就近入学，无需任何考试，所以很少引起家长重视。实际上美国的初中，不管是两年还是三年制(有的校区只包括七，八年级，有的是六到八年级)，在教学的方式和内容上和小学都有质的跨越。主要区别在以下几个方面：

小学期间学生都有自己固定的教室，每学年内老师和同学也是相对固定的。30个左右的孩子组成一个班，朝夕相处。每升一年级才会换老师和教室。除了极少数接受特殊教育的学生，同一个班级上的课完全相同。85%以上的科目，如英文，数学，社会科学甚至美术等都由一位老师教授，只有自然科学实验，音乐，电脑等需要到其它教室上。

到了初中就截然不同了。一般的中学是四门主课外加体育和类似美术，戏剧，法语等的选修课，学生开始根据自己的程度和喜好选课，背着书包在校园里六个不同的地点间穿梭。主课一般都分快班和普通班，虽然教材一样，但讲的深度和进度差别很大，同学间难免互相攀比。没有班主任，老师教的科目以自己考过的资格证书为准。学生需要去适应六位单科老师不同的教学风格和六个班里不同的同学。

小学老师每年只负责自己班内的30位左右学生，不光教学并记录他们的学业进步，连同伴间的人际冲突到行为管理都要照顾到，有时真感觉像“代理妈妈”。这一点从小学多达70多项的评估标准(report card) 就可以略见一斑，从自制/社交能力等行为(citizenship/conduct) 到学习习惯(organization skills/work habits)无所不及。

中学里没有班主任制，每位单科老师每天都至少教160位学生，所以没有时间对每位学生的特点有太细致的了解。成绩单锐减到A到F的考核，对学习习惯和自理能力都有更高的要求。任何行为问题都会立刻送到负责纪律的副校长办公室处理。

社交压力大很多。小学时虽然每一年级的同班同学不尽相同，但因为每一年级吃午饭和课间休息都在同一时间，所以同级的孩子都多少认识，所以并不陌生。中学的学生是由周边几个小学的毕业生组成，所以每年级的人数至少是小学的三四倍，大多是新的面孔。小学吃午饭时是以班为单位有固定区域坐的，初中虽然不象高中那样是开放的校园(午饭时间可以离开)，但没有固定的座位。如果没有人愿意和你一起聊天儿，那在三五成群的食堂里还是蛮显眼的。

体育课从小学的一星期两次到初中的每天必修，项目从球类到举重无所不包，对一些不爱运动的亚裔孩子是新的挑战。美国的体育课重视活动的参与，同时还传授各项目的理论知识，每月都要有书面作业，主要是术语的理解，还要跟踪各赛季的体育新闻，目的是培养孩子终生的兴趣。这个形式的体育课一直到十年级都是必修，高中最后两年才变成选修。体育是美国文化重要的组成部分，根据地域或上过的大学，成人大多都有自己心仪的球队。工作之余为自己的队加油助威，不失为生活中的另一种寄托，其乐无穷。在工作单位对体育多少了解的人才可能在同事热烈的讨论中插上话，对社交能力有帮助。所以在小学期间对运动没有太大兴趣的孩子，华裔家长不妨按体育课表的进程，多带他们接触熟悉一下各类运动，并在家看看体育新闻，讨论赛事。不但锻炼了身体，还一起学习到美国这方面独特的文化，一举两得。

* * *

初中工作的这五年，我感觉它象分水岭，是孩子通往独立最重要的转折和过渡期。智力上乘，在小学时成绩优异但到了中学出现滑坡的孩子屡见不鲜。究其原因，学习习惯不良占一定比例，对情绪缺乏调控能力，因而不能再专心，尽心学习的居大多数。

在学习上我们很容易能看到逻辑推理，记忆力，理解力等理性能力的影响，这些传统意义上的“智力”是许多家长关心的重点。与之相反，感性的情绪发展，虽然同样每时每刻影响着孩子在课堂上的注意力等表现，却很少引起亚裔家长的重视。许多脑科学的研究证明，任何信息在经由神经传达到脑部后会在归类分析之前先路过总管情绪的部分。如果情绪反应过激，那会超过所有理智能控制的范围。成人尚且如此，何况是对生活经验和计划调控能力还在慢慢积累过程中的青少年。

从1995年Daniel Goleman博士出版<>一书后，关于情绪管理的研究引起社会各界广泛关注。Goleman博士认为对自己的情绪体验正确的观察了解和适度控制，再加上自我激励，移情(empathy)和社交能力，对人生的成功与幸福起决定性作用。类似观点在世界许多成功人士中屡有认同。

十二，三岁的青少年初期，随着荷尔蒙的变化本身情绪就开始不稳定。再加上初中开始课业进度差距增大，同伴压力大，都让那些有积极的自我概念，较强的人际沟通和挫折承受力的孩子转眼间胜出。我常常在中学看到，相似的智力下，对自己的情绪调整力强的孩子自尊也尊重他人，冲突中头脑保持客观冷静，困难压力下不失信心与目标，更快乐。相反，缺乏积极的自我概念，一有压力就紧张，冲突时容易冲动，或表达能力弱都会给孩子在学校及生活中充分发挥自己的智力潜能造成负面影响。不良情绪还常常影响到身体健康。这些学生经常抱怨头疼肚子疼等，但到医院却查不出任何生理原因。

管理情绪的能力有一半基因的因素，但相对智力来讲，它的可塑性还是很强的。如果孩子的情绪从小就能引起家长的重视，引导他们用适当的语言表达出来，日积月累，他们控制情绪的能力就会加强。象篇头的孩子，他就需要学习正确表达自己挫折感的方式，而不是通过“哭”或过激的言语。家长如果在生活工作中不顺时保持乐观向上的精神，对孩子的挫折承受力无形中也是最好的引导。最起码，家长不要给孩子不必要的压力。象选课，一门初中的普通课不是世界末日。说实际一点，申请大学也不会要九年级以前的成绩，着什么急呢？初中是为高中做准备的，巩固优良的学习习惯和态度才是重点。今后还要上个十年以上的学，来日方长，孩子的求知欲才是他取之不尽的动力源泉。最佳的课业程度是自己稍做努力就可以达到的水平，课太难会打击他们学习的兴趣，甚至导致厌学，得不偿失。

另外，很多情绪问题来自孩子内心的不安全感，所以自尊和自信是健康情绪的基石。我们在日常生活中要时刻提醒自己多看到孩子做得好的地方，多夸他们付出的努力，不要用成绩的高低来决定自己对孩子的态度，打击他们的自尊和自信。曾有一位七年级的华裔学生一大早开始就在教室里不住地留眼泪，完全没有办法听讲。被老师送到咨询员的办公室后才发现，妈妈早上开车送她到学校的路上，越谈她头一天代数课上得的B-越生气，大骂一顿后把她赶出车，自己扬长而去，孩子一路哭着走到学校。在这样的情绪状态下怎么能奢望一个12岁的孩子去集中精力学习呢？校方差一点给儿童保护服务中心(CPS-Children’s Protective Service)打电话把她带走，因为这可以算作精神折磨(emotional abuse)，在西方法律上和生理折磨(physical abuse)一视同仁，不管伤疤是留在身上还是心里。

情绪调整不好会发展为精神障碍。比如抑郁，小学期间的发病率平均为33分之一，从中学开始就翻了四倍，达到八分之一。越是压力大的中学比例越高，远远超过全国的平均数。这在公立校区的服务上也能清楚地看出来：因为加州教育经费的裁减，小学没有咨询员的预算。幸运的学校一周有一到两天的咨询服务，是由校外心理健康机构的实习生提供。到了初中每个学校必配一名全职咨询员，这还不够，大多初中还有一到两个实习生提供心理健康咨询。高中基本上是每700名学生配备一名咨询员，另外还有一到两个咨询实习生。大多数学生的情绪问题如果有正确的引导，短期内完全可以调整好。少数会发展到病理程度，需要专业的精神障碍特殊教育班服务。我所在的F市和邻近的其它两个市加起来近40个小学只需共用一个精神障碍的特教班；到了初中就成立了一个本校区专用的班；高中时达到五个。接管M高中的时候，每年平均有四名曾被鉴定为智商超常的亚裔学生因严重的抑郁或焦虑最终退学，让人扼腕。究其历史，明显的症状都是在初中开始出现的。家庭遗传的生理原因我们是无法控制，但我总是想，如果早发现并重视孩子的情绪调整，他们还会在九年级后成为自己情绪的奴隶吗？

青少年初期逆反心理加强，需要父母更多的耐心。很多父母纳闷：原来的乖乖仔怎么好象突然一夜之间在家里一言不发了？如果他们暂时不想把心事告诉父母请千万别逼问，给他们空间寻找自己。只要之前亲子关系良好，让孩子知道如果他想倾诉，父母的门随时为他开着就够了。这期间同伴对孩子的影响会超过父母，所以留心一下孩子常交往的同学还是有必要的。

孩子到教室，带来的远远不止是书包里的笔和书，更能影响到他们学习效果和效率的是他们的精神/情绪状态。有积极的学习态度/习惯和乐观的情绪武装，他们才可以放心地迎接中学的挑战，为高中和大学打下坚固的基础。

家长反馈：
潘女士：一点感想，对孩子，不是原则问题，尽量不要反对，反对多了，你一直站在孩子的对立面，孩子一定什么都不听你的。

戴女士：@雷春 你的这个提纲非常覆盖的非常全面啊！我的三点：1. 针孩子还小的父母，一定要在孩子的成长过程中（婴幼儿期，童年期）培养建立融洽的亲子关系，有了这个基础，青少年时期父母的话，孩子才能听进去一些。2，孩子十岁左右，父母和孩子最好一起学习如何期待即将来到的青春期，都有个心理准备（身体变化，荷尔蒙作用，大脑发育，潜在威胁，当然还有很多正面的东西）3，父母要认识到孩子终要离开我们独立生活，青少年时期正是在父母的帮助监护下为这个独立而做准备工作。4，列个参考书单，供对某个方面感兴趣的家长深入研读。

黄女士：青少年逆反的行为：比如青少年知道过多玩电子游戏不好，但很难控制自己。很多家长为此很烦恼，与孩子有很多的争吵，如果你从科学的角度来讲，家长就比较容易理解孩子。

Hans：@雷春 男生女生区别还蛮大的你在讲座中能不能和分开来谈一下对这个男生女生逆反心理的应对方法？

孩子不想长大属不属于青春期问题？
@崔进 是。孩子对长大有焦虑，要给他们信心

交流与厌学：续（一）

Jane：你看到他的问题，不管好像

2015年4月18日晚美国西部时间8点

青少年逆反的行为：
1. 容易发脾气
2. 生气时不理人
3. 你指东他往西
4. 冒险行为
5. 无法终止不良行为
6. 穿着打扮
7. 撒谎
8. 以自我为中心，不尊重父母
9. 打人、损坏财产
10. 不守纪律，不计后果
11. 故意惹人生气

正常逆反原因：
1. 希望独立、寻找自我
2. 自己思考、不循规蹈矩
3. 自己做决定
4. 测试父母的容忍限度
5. 模仿同龄人行为
6. 过于自信，认为超越父母
7. 对权威的挑战

非健康逆反原因：
1. 父母冷漠–寻求关注
2. 父母过于强势，方法欠佳
3. 家庭混乱：父母酗酒、虐待、经济压力
4. 交友不慎
5. 害怕失败
6. 不自爱

青少年情绪化的生理因素：
1. 过度疲劳：睡眠不足
2. 大脑分泌多巴胺的量大，持续时间长，过度刺激神经：非常高兴与非常低落交替出现。
3. 性激素第一次作用于产生情绪的杏仁核；杏仁核发射神经过于活跃，信号强烈，不知如何处理。
4. 前额叶抑制神经发育不全，调控杏仁核的情绪的功能不足，特别是在危急时刻，很难控制情绪。
5. 压力下产生的肾上腺素反应强烈：心率和呼吸加快、血流向四肢、脑供血不足。
6. 青少年的情绪和经历是双重难题。他们的大脑负责将经历过的情绪信息和记忆整合到一起的部位还处于发育阶段，因此他们更容易对事件作出应急式的反应，而缺乏分析处理能力。
7. 成人焦虑时分泌的对成人有镇静作用的激素，在青少年的作用正好相反，使得他们更加焦虑。
8. 女孩子更容易情绪化是由于她们肾上腺皮质醇的水平比成人高，容易产生压力、担心、焦虑、生气、孤独等负面情绪。
9. 成人的大脑对紧张因素造成的损害有较强的修复能力；而青少年在这方面相对能力较低。时间过长，有可能造成永久性的损伤：额叶和海马体中神经连线减少、髓鞘包裹不全、杏仁核体积增大–情绪失控。
10. 生活环境发生变化。

父母情绪化的原因：
1. 不理解孩子情绪化的因素，作出应急反应而缺乏思考，以愤怒对愤怒，引起争执；
2. 对孩子自律的期望值超出孩子的能力；
3. 权威受到挑战；
4. 多次重复告诫无效；
5. 只看到孩子的错，不注意孩子积极的一面，挑剔型；
6. 害怕孩子失败，过于保护；
7. 把孩子与其他孩子比。
8. 睡眠不足，过于疲劳。
9. 工作、生活、经济压力太大。
10. 身体和或精神不健康。

父母对青少年逆反的措施：
1. （父母）指出行为
2. （父母）理解情绪
3. （共同）分析问题
4. （父母）引导（孩子得出）答案
5. （父母）尊重选择
6. （父母）允许失败
7. （孩子）承担后果
8. （父母）无条件关爱
9. （父母）欣赏渐变或蜕变

其它建议：
1. 要从发育的角度看待孩子的行为问题。这个阶段是暂时的。父母养孩子的最终目的是把他们培养成人，而不是永远做你们的孩子。
2. 无人受伤、无人有生命危险时，可以从1数到10后，再做出反应。甚至延迟到第二天再回答。
3. 经常认可孩子的每一点努力和进步，注重强项、发挥特长，要孩子与自己比。
4. 与孩子共同制定家规和惩罚措施。
5. 孩子天生倾向于用最少的努力来得到最大的奖赏：父母的挑战是如何区别努力与懒惰。
6. 与逆反相反的行为：希望留在家、拒绝承担生活责任、害怕做决定。这是我们不希望的。
7. 给孩子无伤大雅的探索空间，避免因小事而引发的反叛，导致更大的伤害和烦恼。“不要为了小的争斗，而失去了一场战争。”–最终的目的是帮助他们通过在没有长远的负面影响的条件下进行本能的尝试，让他们充分认识自己的优缺点。
8. 不要武断地批评青少年的行为：马虎、无条理、忘事、缺乏同情心、容易发怒、容易分散注意力、不听家长的话、容易感到无聊都是他们这个阶段的正常行为。
9. 家长要温和地、不厌其烦地提醒孩子该做的事情，不要因为他们忘了而恼火。同时对孩子的反面教育也不能松懈：毒品的危害、聚会中酒精的危险、开车的注意事项等，要抓住每一个教育机会。反反复复地把各种概念植入他们的大脑。
10. 青少年对负面情绪的处理能力不足。他们有屏蔽掉负面信息和指令的倾向。因此正面的引导会比负面的指责更有效。
11. 不要一次给青少年过多任务，他们并不善于一心多用。
12. 帮助他们学会做计划。
13. 青少年不是成人，不要用成人的标准要求他们。
14. 他们的非逻辑、冲动和过于敏感都是他们大脑生理发育的结果，不是他们的错。但也要要求他们学会控制情绪，不能以此为借口来做害人害己的事。
15. 成人从错误中吸取教训的能力远高于青少年。如果后果不是很强烈，青少年会不断地犯同样的错误，因此惩戒对严重的行为是必要的。
16. 追求满足感是青少年骨子里的东西，是他们冲动的原动力。要引导他们从他们感兴趣的活动和运动中得到满足感；远离毒品和不良行为；要适当控制电子产品的使用。
17. 引导他们结交良友，并判断现有朋友的好坏：列一个朋友单，把每个人的健康的爱好以及孩子如何帮助朋友成就他们的爱好的措施写出来；罗列自己的健康的爱好以及朋友们如何帮助自己成就自己的爱好也写出来。Finding good Friends： list friends’ healthy interests and how to help them to achieve; list of own healthy interests and how those friends can help you to achieve.
18. 注意孩子的精神健康。
19. 论事不论人。
20. 注重过程，省略结果。
21. 把“猴子”（责任）交给他们。
22. 拒绝时要：冷静、不带任何情绪；简明扼要（Less is more.)；不要训斥、指责和进行逻辑辩论。
23. 经常讲你自己年轻时犯的错和吸取的教训，让他们知道父母和他们一样不完美，还在不断学习，甚至向他们学习。
24. 孩子要有选择，但两个就够了，不要超过三个。太多的选择会造成焦虑