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Overview of Social Issues Affecting Children

By Steven D. Blatt, MD, Professor of Pediatrics, Director, Division of Pediatrics; Director, ENHANCE Services for Children in Foster Care, State University of New York, Upstate Medical University; State University of New York, Upstate Medical University

To thrive, a child must experience the consistent and ongoing care by a loving, nurturing caregiver, whether that person is a parent or substitute caregiver. The security and support that such an adult can provide gives a child the self-confidence and resiliency to cope effectively with stress.

To mature emotionally and socially, children must interact with people outside the home. These interactions typically occur with close relatives, friends, neighbors, and people at child care sites, schools, churches, and sports teams or other activities. By coping with the minor stresses and conflicts inherent in these interactions, children gradually acquire the skills to handle more significant stressors. Children also learn by watching how the adults in their lives handle distress.

Did You Know...

  • Illness or death in an infant or a child often makes parents feel guilty, even when they are not at fault.

  • Sometimes children need to hear the same message about a difficult issue over and over.

  • Children who are bullied are often too frightened or embarrassed to tell an adult.

Certain major events that disrupt the family structure or routine, such as illness and divorce, may challenge a child's abilities to cope. These events may also interfere with the child's emotional and social development. For example, a chronic illness may prevent a child from participating in activities and also impair performance in school.

Events affecting the child may also have negative consequences for people close to the child. Everyone who cares for a sick child, or a child who has serious behavioral problems, is under stress. The consequences of such stress vary with the nature and severity of the illness or behavioral problem and with the family's emotional resources and other resources and supports.

Talking With Children About Difficult Topics

Many life events, including illness or death of someone close (see Death of a Family Member or Loved One), divorce, and bullying, are scary or unpleasant for children. Even events that do not directly affect the child, such as natural disasters, war, or terrorism, may cause anxiety. Fears about all of these, rational or irrational, can preoccupy a child.

Children often have difficulty talking about unpleasant topics. However, open discussion can help the child deal with difficult or embarrassing topics and dispel irrational fears. A child needs to know that anxiety is normal and that anxious feelings will lessen over time. Parents who routinely discuss difficult topics with their children from an early age often find their children more open to talking about the complex issues they face as adolescents.

Parents should discuss difficult topics during a quiet time, in a safe and comfortable place, and when the child is interested. Parents should remain calm, present factual information, and give the child undivided attention. Acknowledging what the child says with phrases such as "I understand" or with a quiet nod encourages the child to confide. Reflecting back what the child says is also encouraging. For example, if a child mentions anger about a divorce, a parent could say, "So the divorce makes you angry" or "Tell me more about that." Asking how the child feels can also encourage discussion of sensitive emotions or fears. For example, fear of abandonment by the noncustodial parent during a divorce or guilt for causing the divorce.

By talking about their own feelings, parents encourage children to acknowledge their fears and concerns. For example, about a divorce, a parent might say, "I am sad about the divorce, too. But, I also know it is the right thing for mommy and daddy to do. Even though we cannot live together anymore, we will both always love you and take care of you." By doing this, parents are able to discuss their own feelings, offer reassurance, and explain that divorce is the right choice for them. Many children, particularly younger ones, need to hear the same message repeatedly. Parents should not underestimate the value of the reassurance offered by these messages.

A parent may also have to address a difficult aspect of the child's own behavior. For example, a parent who suspects the child or adolescent of using drugs or alcohol should address the issue directly with the child. A parent might say, "I am worried that you are using drugs. I feel this way because. . . ." It is important for the parent to speak in a clear and calm manner, expressing both the concerns about the child's behavior as well as their support and love. After the parent's concerns have been stated, the child should be offered an opportunity to speak. The child and the parent should develop a plan of action that may include an appointment with a pediatrician or a counselor.

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