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Child Psychiatry

Dr. Tuckson speaks with child and adolescent psychiatry specialist Dr. Timothy Peters.
Season 15 Episode 1 Length 27:15 Premiere: 10/06/19

About

Join host Dr. Wayne Tuckson, a colorectal surgeon, as he interviews experts from around the state to discuss health topics important to Kentuckians.


Funding for this program is made possible in part by:


About the Host

A native of Washington, D.C., Dr. Wayne Tuckson is a retired colon and rectal surgeon based in Louisville. For more than 20 years, he has served as host for Kentucky Health, a weekly program on KET that explores important health issues affecting people across the Commonwealth. A graduate of Howard University School of Medicine, Tuckson is a past president of the Greater Louisville Medical Society and is a recipient of the Community Service Award from the Kentucky Medical Society, the Thomas J. Wallace Award for “Leadership in Promoting Health Awareness and Wellbeing for the Citizens of Jefferson County” given by the City of Louisville and the Lyman T. Johnson Distinguished Leadership Award given by the Louisville Central Community Centers.

How the Adolescent Mind Affects Behavior

Anyone who has been closely involved with children and teenagers, whether through parenting, teaching, coaching, or mentoring, has often wondered why kids behave in surprising ways. By learning new research findings into childhood and adolescent development, adults can better understand kids’ actions and also adjust their own behavior as grown-ups to become good listeners and role models.

In the 2019-20 season premiere episode of Kentucky Health, host Dr. Wayne Tuckson welcomes a Louisville child psychiatrist to discuss how the developing brain functions and shapes complex behavior patterns through adolescence and into early adulthood.

Dr. Timothy Peters is a child and adolescent psychiatry specialist practicing in Louisville. He is also a parent.

“We all have the sense when we’re young that life is simple,” Peters says, “but we’re all in the midst of developing into who we’re going to be as adults. It’s a minefield, and it’s a challenge, at each stage.”

Adolescent Behavior, Parenting Choices, and Social Media

Peters says the human brain is not intellectually mature until a person reaches their mid-twenties. Young people have more connections between pathways in the brain, sparking curiosity and learning but also resulting in less stable decision-making. Adults have fewer neuron connections, but those connections are stronger and more stable, Peters explains.

“When we’re young, we’re very emotionally driven, and it’s hard to have the self-control, the wherewithal, to think things through in a linear way,” he says. “Children, by their nature, are more impulsive. They have stronger inputs in terms of their emotions and less ability to stop and think things through. Those are skills that we gain over our adolescence and well into our young adulthood.”

Teenagers are constantly learning how to develop their thought patterns and keep emotions in check, and Peters says that the tech revolution and ubiquity of mobile digital media has made a huge impact on adolescent behavior.

“A lot of kids have a constant stream of inputs coming from other sources,” he says. “Instead of the face-to-face interactions and the life experiences that help a child to mature and learn and shape our abilities to interact socially, a lot of that is coming from a screen.”

That constant digital presence in teenage life is challenging for parents, Peters adds. Parents have a responsibility to make the right judgment about how many hours per day their kids should be allowed to spend online, or whether their data access on mobile phones should be restricted. Peters says that he favors limiting but not totally restricting access, pointing out that digital media also has benefits for young people, such as creating new communities of friendship and support.

Increased demands in school – from classwork, sports, and other extra-curricular activities – mean that kids in modern society have little down time. “There’s less time for the brain to just rest, and dream, and explore,” Peters says. The constant activity and pressure makes adolescents more vulnerable to anxiety and depression.

Peters says that parents should try to provide structure in their kids’ lives, allowing time for family endeavors and one-to-one conversation. They should be on the lookout for a child who stops doing what they used to love to do and becomes withdrawn, staying in their room more often.

“Those are certainly important warning signs for the possible onset of depression or anxiety, also potentially for more complicated adolescent problems like substance abuse,” he says.

Parents often have difficulty communicating with their children, especially during the teen years. The stereotype of the sullen teen who wants to stand apart from their parents and other grown-ups is well-known, but Peters takes a different view of the kid-parent exchange: “I would turn it around somewhat and say it’s really hard for parents to take the time to listen.”

Peters points out that being a parent has helped his professional development as a child psychiatrist. He says that when talking to his own child, he always reminds to check his emotions at the door, and focus his energy and attention toward really listening to what his child is saying.

“I think it’s hard for everyone who is a parent to find that time and that energy to just wait, and not jump in and start to give advice and start to react when your child is talking about things, and just find a way to listen and let them speak at their own pace,” he says.

Peters says that although kids may initially be uncommunicative and withdrawn, most of them do want to open up and talk and get advice and guidance from grown-ups. Establishing a predictable routine that can build trust is very important, he adds.

“Parents have to do the best they can in terms of taking the time to listen to their kids and have an opportunity to let them free-form, to let them talk about what’s important to them and not jump in,” he says. “To give them a chance to express things in their way.”

Diagnosing and Treating ADHD

One of the most well-known behavioral conditions affecting children and adolescents is Attention Deficit Hyperactivity Disorder, or ADHD. Peters says ADHD is a biological condition that has neurological underpinnings and shows a strong degree of genetic inheritance. ADHD can significantly hinder a child’s ability to participate in school, especially in completing multi-step tasks, and it can also affect behavior in social situations.

“The core symptoms are things like hyperactivity, being driven, feeling that you have to move constantly, impairments in your focus, attention, and concentration,” Peters says. Typically, ADHD presents in young children, and it can extend through adolescence and into adulthood, although Peters says symptoms of ADHD are somewhat different in adults.

Cases of ADHD are more prevalent among the U.S. population than in other countries, which could be because psychiatrists here are better equipped to analyze children for symptoms, but also could be attributed to the demands of modern American society. Peters cautions that ADHD should only be diagnosed once other potential causes for a child’s behavior traits are ruled, out and he says that there is a danger of applying an ADHD diagnosis too readily when a child is hard to control.

“I think that ADHD represents a natural variant of the human condition – kids that need to explore, kids that need to wander, that need to have their eyes in all corners of the room instead of being able to pay attention easily to what’s in front of them,” he says. “And modern society is somewhat forced that performance aspect of being able to attend to something right in front of you for prolonged periods of time as a desirable trait, whereas maybe in prehistory that wasn’t the case.”

Treatment of most child behavioral disorders usually involves a combination of family-based remedies, one-on-one therapy, and medications, Peters says. For ADHD, medication is the main treatment modality, since most people respond well to the drugs. But Peters says that kids with ADHD still need to be educated on how to recognize their symptoms and, with the aid of medication, control them.

“It’s a very treatable condition, it’s a condition that’s very responsive to medication, which is not necessarily true of all child psychiatric disorders,” he says. “But ADHD is one where, if you can get the medications right, it can make a big difference.”

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