Psychologist’s work centers on children, parenting

Parenting is tough. But, is it tougher than it used to be? Is there better information out there for parents… or just more information that can become overwhelming?

Robert Pressman, Ph.D., ABPP, director of research for the New England Center of Pediatric Psychology, has worked with families and children for several decades. He has seen changes in the way children are raised and in the communities surrounding them.

Over the years, he has developed unique clinical methods to better reach clients, done extensive research into parenting styles and identified a non-neurologically-based condition he calls “Faux ADHD” that shows a type of behavior that may be more affected by sleep habits and routines.

Pressman spoke with New England Psychologist’s Catherine Robertson Souter about the challenges faced by parents in today’s technology-driven world and what he sees as the biggest concerns for raising healthy, successful children.

Q:  You have worked with children for most of your career. How did you get involved in this field?

A:  It all started when I was about 5 years old and I was being evaluated for kindergarten. The name of the psychologist was Dr. Miller. He gave me the Stanford-Binet and I had the greatest time. I wanted to be like him. The only time I swayed from that was when I announced to my mother that I wanted to be a garbage collector because I loved the big trucks but she did not encourage me.

It started for me in earnest in 1970s when I did primarily family work. My board certification is in family and marital therapy. I found I did a pretty good job as a family therapist and working with children and a real lousy job as a marriage therapist and so I gave that part of it up.

Our practice has changed over time also. In recent years, we have started to see some Spanish speakers, not by any great effort, it just happened. That really grew and now our practice is about 80 percent or more Spanish-speaking and virtually 100 percent underserved population.

Q:  You introduced some new treatment modalities like “dual micro group psychotherapy.” Can you tell us about that?

A:  It is the most exciting thing that we have done in our clinic besides the research. “Micro” because we have only three-four children in it and “dual” because at the same time it is a parent group.

Some 20 years ago, a colleague introduced me to this technique; “If you are having parents bring their children to a group, why have them sitting around in a waiting room? Why not put it to good use?” We have found it to be a really successful format.

We do limit it to four children and have two therapists but it is not just children sitting around talking. There is equipment involved like a foosball table and board games. It is far superior than seeing an adult sitting with a child and having them talk. I have never found that to be effective especially with older children. They get bored and they leave therapy.

Q:  You have also identified a condition you call ‘Faux ADHD.” What is that?

A:  In 2011, the center ran a study with children who had all the symptoms of ADHD, and particularly hyperactivity, but treatment was not working with them. The features that were really prevalent across this group were poor routines in the home and co-sleeping with parents.

Q:  How does co-sleeping affect ADHD?

A:  This was not a causal study but there is a relationship; we found that children who were sleeping with their parents, and who had no set bed time, had ADHD symptoms up to 10 times the rate of children who were not.

I’ll give you my philosophy on it. There are micro stages of independence and one is children sleeping alone and learning to comfort themselves and feeling a certain degree of independence.

How does that lead to having a hyperactive day? I think it has to do with self-regulation. What we found in these homes is that there are much broader issues around not knowing how to set limits and have a regular routine.

With children who are not responding to traditional treatment, that is when we look at bedtimes. Once we get the child to sleep independently it’s easier to do other things like regular dinner times, showers, homework, restricting the amount of videos – all the things that fill up a child’s life and that can have an impact on behavior in a negative way if not handled properly.

Q:  Do you believe that parents have more issues to deal with today? Too much technology, for instance?

A:  That is part of it, but what we know now is that the language of parents has also changed with parents trying to relate as friends rather than as a parent. Many parents have two or three jobs now so we have more kids maybe going to after school programs as a substitute for parenting.

Plus, we now have even fewer community resources available for families with a lot of these after school programs just gone so we have children who are alone and not having interactions. These are all big differences in terms of how we are structuring things for kids.

Q:  You did a major study comparing parenting styles and other factors around raising children. What were the major findings?

A:  Yes. The Learning Habits Study was released in 2014 and published in The American Journal of Family Therapy. We looked at a number of variables with 21,000 parent respondents from cities throughout the U.S. We looked at family routines and how that related to grades and emotional health.

The finding that drew the most interest was when we compared the effects of screen time on grades, the amount of sleep a child had, social skills and emotional balance. What we found was that 28 percent of the kids consumed from six to eight hours of media every day. That blew me away.  

We found that the only absolute safe level was 15 minutes. Grades start to decline at 45 minutes of exposure and then one half grade point is lost between two to four hours and at more than four hours grades dropped a full grade point.

We also found other than screen time, along with household chores and parenting styles, related to another variable that we named Grit. Grit has three parts: the belief you can attain your goal, passion about your goal and the ability to recognize the cost of attaining the goal and doing it anyway.

Q:  On the flip side, parents have more information and more advice from experts like you than our parents did. Does that help today’s parents to be better parents?

A:  I have been musing about that question. Yeah, we have a lot more information but the problem is that we have an overload of information and it is hard to sort it out. You get one opinion and then another. There is so much information out there. For instance, we just talked about a number of things here but there are whole topics we didn’t even begin to touch.

How to sort through all this as a parent, I don’t know. That is where Google comes in handy I suppose.