A “Collapse of Parenting” Needs to Be Assessed Carefully
I first heard about this book on a National Public Radio broadcast from nearby Philadelphia during which Dr. Sax was interviewed about his fourth book on parenting. Leonard Sax, MD, PhD, is an experienced family practice physician who is also trained in psychology. The Collapse of Parenting: How We Hurt Our Kids When We Treat Them Like Grown-Ups is his latest book that offers advice for parents to raise healthier children and teenagers.
Despite more money being spent on parenting, Sax claims there are worse results for children, citing examples of increases in children’s diagnoses of mental illness and obesity, and decreases in resilience. He blames a widespread transfer of authority from parents to kids, that is, giving children the reins for making daily and life decisions. As a physician, he frames a diagnosis and offers a simple prescription of 3 inexpensive things parents can do to raise a healthy child:
- Teach Humility
- Enjoy
- Focus on the Meaning of Life
Before believing all that you read about this diagnosis and prescription, you may need to do some research to verify whether Sax’s claims are based on solid research evidence. In the book’s introduction, the author explains that the major sources for his book are his 27 years of encounters with children and parents during healthcare visits, and conversations with families and teachers during his travels around the world.
These experiences may be valuable to share, but some have questioned the book’s lack of scientific evidence to back up his personal views on parenting and child behavior. For example, one review in Slate Magazine challenged the book’s comments on how children learn healthy eating habits:
“It’s too bad Sax didn’t consult the research on how kids develop good eating habits, because he would have discovered he’s got this all backward, too. Starting in the 1980s, researchers found evidence to suggest that commanding kids to eat foods like vegetables, and making dessert contingent upon finishing them, makes them dislike the vegetables even more and consider dessert foods more desirable; it may also interrupt the development of satiety cues, so they have problems regulating caloric intake.”
[Melinda Wenner Moyer, January, 2016, There’s Has Been No Collapse of Parenting, Slate Magazine]
When speaking of resilience, while Sax acknowledges that a strong parent-child relationship is key, he neglected to cite the powerful research from the Center for the Developing Child that demonstrates the impact of early nurturing relationships and other protective factors on building young brains and adaptive capacities to cope with adversity. He also could have cited Paul Tough’s research-laden book on character development, How Children Succeed: Grit, Curiosity and the Hidden Power of Character or Angela Duckworth’s award-winning research on children‘s development of grit and self-control that contribute to school success.
Given Sax’s focus on parenting throughout four books, he clearly believes that parenting is important. Physicians readily rely on the results of physical exams and diagnostic assessments when diagnosing and treating patients. I wonder if he uses any parenting assessments, like KIPS, in his clinical work? A few physicians use parenting questionnaires. However, as we’ve discussed previously, self-report instruments provide information on parents knowledge and attitudes, but do not strongly correlate with what parents actually do. What parents actually do is what matters to children. The only reliable way to assess actual behavior is through observation. I know of no physician who uses a validated tool to observe patients’ parenting behavior with their children in his or her routine practice. I agree with the recent call in JAMA Pediatrics for pediatricians to incorporate parenting supports within their primary care practices as part of preventive care for families. These supports should be guided by quality assessments, just as any other routine health service. As we have discussed in our blog many times, parenting is important. Yet unlike other important aspects of child development, it is rarely objectively assessed.
I believe it is essential for child/family practitioners of all sorts (e.g., health, education and social service) to integrate parenting assessment into their practice. First, observe the strengths and needs of parents and children as they interact, then use this objective information when coaching families. The coaching can help to build solid foundations for their children in learning respect and care for others, while allowing children to practice self-regulation and problem solving in daily situations. This takes a fine balancing act that requires parents to continually nurture, reflect and coach children about daily opportunities, choices, limits, and consequences experienced at home, in school and in the wider community. Raising healthy children is not simply a matter, as Dr. Sax suggests, of reasserting parental authority.