Jean M Clinton B.Mus MD FRCP(C)
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Jean M Clinton B.Mus MD FRCP(C) McMaster University and Children’s Hospital www.offordcentre.com Hamilton Academy of Medicine Clinical Day Jan 30 2008. Kids Today.

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Jean M Clinton B.Mus MD FRCP(C)

McMaster University and Children’s Hospital

www.offordcentre.com

Hamilton Academy of Medicine Clinical Day Jan 30 2008


Kids today
Kids Today FRCP(C)

"The children now love luxury; they have bad manners, contempt for authority; they show disrespect for elders and love chatter in placeof exercise. Children are now tyrants, not the servants of their households. They no longer rise when elders enter the room. Theycontradict their parents, chatter before company, gobble up dainties at the table, cross their legs, and tyrannize their teachers."

PLATO


Adolescents: Why FRCP(C)DO they do the things they do?


Key messages
Key Messages FRCP(C)

‘‘UNDER CONSTRUCTION”

What we THINK, affects how we FEEL, affects how we ACT(TAFFY)

Teens need MORE of our time, not less.

The majority of adolescents do well YET


The paradox
The Paradox FRCP(C)

  • Measures of most abilities indicate that adolescence is the healthiest and most resilient period of the lifespan.

  • Strength, speed, reaction time, mental reasoning abilities, immune system all improve

  • Yet overall morbidity and mortality increases 200-300times from childhood to late adolescence. (Dr R DAHL)

  • Primary causes of death and disability related to

    Problems with control of behaviour and emotions


03 013
03-013 FRCP(C)

THE BRAIN FAIRY

The Hostage Brain

, Bruce S. McEwen and Harold M. Schmeck, Jr., 1994.


Key messages1
Key Messages FRCP(C)

‘UNDER CONSTRUCTION”

(MUC to some) which explains much of the challenge!!


Neurodevelopment Findings FRCP(C)

Keep in mind…..

  • The research on neuro- development is in the early stages.

  • Many key human studies on youth can not be conducted because of ethical considerations.


The brain bonsai
The Brain Bonsai FRCP(C)

Overproduction and Exuberance

Pruning



The Brain FRCP(C)


The frontal lobes aka ceo
The Frontal Lobes aka CEO FRCP(C)

“Executive Functions”

  • Governing emotions

  • Judgment

  • Planning

  • Organization

  • Problem Solving

  • Impulse Inhibition

  • Abstraction

  • Analysis/synthesis

  • Self-awareness*

  • Self-concept*

  • Identity

    and

  • Spirituality

*Self- “everything”

Williamsgroup, 2003: Please credit Protecting You/Protecting Me (PY/PM)


Areas under construction
AREAS UNDER CONSTRUCTION FRCP(C)

Prefrontal Cortex

  • Responsible for planning , strategies (cognitive flexibility).

  • Allows one to solve problems.

  • DEVELOPED frontal cortex allows one to regulate emotions, solve problems effectively and plan behaviour.


The problem
The Problem FRCP(C)

Frontal Lobe Development

Average age of first sexual encounter in Canada

Autonomy

drivers license

Dr Jim Stieben MEHRI



Limbic system for birth 21
Limbic System for Birth - 21 FRCP(C)

Years

Age

Dr Jim Stieben MEHRI



WHAT YOU SEE IS WHAT YOU GET! FRCP(C)

Fear

Contempt

Surprise

Anger

Disgust

Sadness

Happiness


Under construction
UNDER CONSTRUCTION FRCP(C)

Neurodevelopment likely contributes to:

1)Increased risk taking (particularly in groups)

(Decreased risk perception)

2)Increased propensity toward low effort - high excitement activities

(Reward sensitivity….need more bang for the buzz)

3)Increased interest in novel stimuli

4)Decreased capacity for good judgment & weighing consequences

(Self –regulation)


Age 24 FRCP(C)

emotion

motivation

physical coordination; sensory processing;

judgment

WINTER


Scenarios
SCENARIOS FRCP(C)

  • What we THINK….

  • Affects what we FEEL…

  • Affects how we ACT….


Focus on positive development asset building
Focus on Positive Development-Asset Building FRCP(C)

  • REDUCING RISK IS NOT SUFFICIENT TO HELP YOUTH SUCCESSFULLY NEGOTIATE ADOLESCENCE

  • Family and school connectedness

  • Community engagement

  • Positive Peer support

Saewyc and Tonkin Paediatric Child Health Jan 2008


Clinical tips
Clinical Tips FRCP(C)

  • Always spend time with adolescent alone

  • Their ACC picks up more than you emit…

    be genuine

  • Dialogue works better than interview.

  • Help parents know their HUGE importance

    and TAFFY

    (Think, Act ,Feel….not F You)

    UNDER CONSTRUCTION

Clinton


What s a family dr to do
What’s a Family Dr to do? FRCP(C)

  • Help parents understand what is going on.

  • Give them resources

  • TAFFY

  • Emphasize the importance of relationships/assets.

Clinton


Key messages2
Key Messages FRCP(C)

‘‘UNDER CONSTRUCTION”

What we THINK, affects how we FEEL, affects how we ACT(TAFFY)

Teens need MORE of our time, not less.

The majority of adolescents do well YET

Clinton


Books
Books FRCP(C)

  • The Primal Teen: What the new discoveries about the teenage brain tell us about our kids. Barbara Strauch New York Anchor Books 2003

  • “Why do they act that way.” A Survival Guide to the Adolescent Brain for you and Your Teen . David Walsh PhD New York Free Press 2004

  • Teen Brain, Teen Mind. What Parents Need to Know to Survive the Adolescent Years . Dr Ron Clavier Toronto Key Porter Books 2005



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