Sally is a two and a half year old with tight blond curls. She came to my Pediatric Developmental Clinic with her worried parents because of poor language and communication skills, along with unusual behaviors and interactions that concerned both her parents and her early intervention program.
Throughout the exam I noticed Sally watching toys from the corner of her eye and examining the perceptual qualities (like the color or shape) of objects but not their function. I noticed she got incredibly upset whenever I interfered with her lining up the toys. I noticed she made little eye contact with me or with her parents. I noticed she had no spontaneous meaningful words. I noticed her moods changed in an instant, often for no apparent reason.
As you've no doubt surmised, I diagnosed Sally to be on the Autism spectrum.
* * *
Autism can be a hard diagnosis to make and harder still to explain to parents in a way that is factual and without sugar-coating, but not devoid of hope and empathy. After a long tearful discussion, the Mom said: "I don't know what to do. I can't tell my family about this."
"Why not?" I asked, perplexed. "Most parents of autistic kids need and get a lot of support from their families."
"They'll blame me for it." was her stunning response. "Already they say it's my fault that Sally is the way she is. They say I coddle her and give in too easily to her tantrums. If only I were firm, they tell me, she'd be fine."
"But" I sputtered, "that's completely ignorant. She's autistic. Nobody thinks it's caused by bad parenting anymore. It's a neurological condition. And, anyway, you're great parents."
"Well, they don't think so," she said softly. "I'm not sure if they will ever forgive me for this."
I felt doubly bad for these parents. Not only had they just received very distressing news about their child, but they carried the fear of being blamed by their family for it. I was reminded of the bad old days, when children were considered born with a "blank slate" and autism was blamed on emotionally distant, "refrigerator" mothers.
* * *
When the book on which I collaborated with Dr. Spock came out (my 15 minutes of fame), I was dutifully sent on a promotional book tour. One part of it consisted of sitting in a bare radio studio, looking at a blank wall, wearing headphones. Every few minutes some radio station talk show host from Anywhere, USA would call in and pepper me with a few questions.
The very first question (oft repeated throughout the hellish day) by a loud-voiced talk show host (you know the type) was "So, tell us, Dr. Parker, what are some of the worst things parents are doing these days to their kids?" I suppose parent-bashing makes for good ratings.
Why else might "blame the parents" be such a popular cottage industry? Part of it is ignorance, plain and simple. Most parent-bashers have no idea of the forces shaping
children's development and behavior and harbor the archaic "blank slate" belief that all we become is due to effects of the environment, which has written on the blank slate with which we are born. If a child has any behavioral and/or developmental challenges, it must come from bad parenting.
These are the folks who often are parents and - by dint of luck and perhaps some skill - have not experienced any significant problems with their impeccably behaved, successful kids. Of course, they attribute 100% of this success to their marvelous parenting skills (nurture) and 0% to a lucky throw of the genetic dice (nature). They judgmentally wag their fingers: if only all parents were as good as me, all kids would do as well as mine.
These are the folks who, when I wrote about the difficult issues of
using psychoactive medications in children, contended that using meds in kids is a travesty, that the parents who use such medications (like
Ritalin) with their kids are those who just don't know how to parent, who can't tolerate any misbehavior in their lives and who, in their lazy selfishness, want to chemically restrain a normally unruly child. (By the way, I've never met such a parent).
These are the folks who tsk tsk tsk the beleaguered mom whose child is having a temper tantrum in the supermarket and reproach loudly, "Why can't you control your child?"
These are the folks who are, in short, self-righteous twits.
As my wise grandmother used to say (in a different language), "It's easy to beat on someone else's behind."
* * *
To be fair, my profession is no stranger to parent-bashing. Most pediatricians, alas, never took a course in developmental psychology in their lives (even worse, they don't think they need one). They become pediatricians and - poof! - they are considered experts in child development, which they most assuredly are not.
Rather, they are subject to the same "blank slate" prejudice as everyone else, so they don't recognize the child's contribution (such as a difficult temperament) to the problem. They often unsympathetically blame the parents for everything. They overgeneralize from their own limited personal family experiences (good or bad) and may be insensitive to problems they never personally experienced. And they overrate what did and did not work with their own kids.
All of this is magnified during pediatric training by being taught how magically effective (1-2-3 magic!) measures like time-out are (dream on). So, if a child continues to misbehave despite the wonderful advice we have given their parents, it must be that the parents are not doing their job. Rotten kid = rotten parent. Bash, bash, bash. End of discussion.
* * *
Most tragically, it is parents (like Sally's) who have kids with significant developmental and behavioral challenges that are the most likely to be criticized by an unholy trifecta: by the media and popular pundits because it makes for good, simple-minded talk radio and TV and book sales, by other parents who lack the imagination and empathy to understand what another parent is really going through, and by their own pediatricians who blame it all on their imperfect parenting skills.
I think the vast majority of parents love their kids passionately and are trying with all their might to do the right thing by them. And, all in all, most do a pretty darn good job of raising their kids and make the right decisions when there are challenges to be faced.
Parent-bashing is almost always unfair, misguided and, worst of all, cruel. Just remember that the next time you are tempted to cast the hairy eyeball on some poor mom whose child is out of control in a public place.
At the very least, you can remember there but for fortune... Better still, lend them a helpful hand and a sympathetic ear and a kind word.
译文:
抨击父母的把戏
萨莉今年两岁半了,有着一头金黄色的浓密的鬈发.一天,她被满面愁容的父母带进我的儿童发育门诊.她语言表达能力差,不善交流,同时,她的行为比较怪异,与人沟通的方式奇特.这与她的父母及过早地接受了介入教育都有关系.
在对萨莉进行行为测试的过程中我发现：她总是用余光注视着玩具，只关注物体的知觉特征（比如颜色，形状），对功能不感兴趣；在她摆放玩具的时候只要被我打断就会非常不高兴，而且说话时很少用眼睛看着我或者她父母．我还注意到她随口说的话没有什么意义而言，经常会突然喜怒无常．
毫无疑问，你会猜测她患上了自闭症．是的，这就是我对萨莉的诊断结果．
一般情况下我们不会轻易作出自闭症的结论，比这更难的是如何对孩子的父母以实情相告，而不是拐弯抹角，但这种病也不是完全没有治愈的希望．萨莉的妈妈鼻涕一把眼泪一把的和我谈了好久，最后她说：＂我不知如何是好，反正不能把孩子的真实情况告诉家里．＂
＂为什么呢？＂我疑惑的问到．＂很多自闭症儿童的父母需要全家人的鼓励，也得到了很多支持．＂
她的回答让我震惊．＂全家人都会责备我的，他们把萨莉的问题全都归在我一个人身上，认为是我把孩子惯坏了，对她的任性不加以管教，如果当初我严着点她就不会成现在这个样子．＂
＂但是，＂我因着急而近乎语无伦次的解释道：＂他们的想法完全是无知的，现在已经没有人认为自闭症与父母欠妥的抚养方式有关了，纯属神经系统的问题．再说，你们是了不起的父母．＂
她轻声说道：＂他们可不这么认为，我不知道他们能不能原谅我．＂
我为这样的一些父母感到难过，一方面他们要接受这个令人痛苦的事实，另一方面惟恐遭到家人的谴责．我不禁回想起过去那些糟糕的岁月，孩子一出生就是一块＂璞石＂，如果患了孤独症其母亲就会遭到大家的唾弃．
我和斯伯克博士合著的书出版的时候，本着负责的态度，我参与了巡回售书活动．其中的一个环节是让我做在空徒四壁的广播演播室内，戴上耳机，盯着墙看．每隔几分钟就会有美国各地的广播台脱口秀节目主持人打进电话，接二连三的向我发问．
第一个问题（也是在那个可怕的一天中经常重复的问题）是由一个大嗓门的主持人（你应该知道这类主持人）提出的，＂帕克博士，告诉我们这些日子以来父母对孩子们都有什么最过分的一些做法？
＂
为什么那些容易＂抨击父母＂的人大都从事家庭手工业？部分原因就是他们的无知，苍白，头脑简单．他们中大部分并不清楚如何孩子指导孩子的发展及行为方式，他们信奉老一套的＂璞石＂理念，即我们成为什么样的人完全是环境因素在起作用，仿佛我们一出生着个理论就刻在石头上面．如果孩子的行为或发育出现问题，肯定是父母的错．
而这些人通常也为人父母，靠着运气或一些所谓的技巧，在孩子的成长过程中没有经历任何较大问题，孩子无可挑剔，走向了成功．当然，他们会说这完全得益于他们的养育之道，和遗传（先天）没有任何关系．他们对别人指手画脚:全天下的父母都能象我这样,他们的孩子也差不了.
当我在书中提到对孩子的精神进行治疗这个问题时,这些父母一致认为对孩子用药是变态行为,那些让孩子服药的父母都是不知如何为人父母的人,因为在生活中不能忍受孩子的不规矩行为而一心想用化学药物约束难管的孩子.(顺便提一句,我从未遇到过这样的父母)
如果一个孩子在超市里哭闹,这些人就会围攻孩子的母亲,啧啧的唏嘘不已,"不能管管你的孩子吗?"
一句话,他们是伪善的.
我那明智的祖母说过一句话(以一种完全不同的观点),"在别人身后打击人再简单不过了"
公平的讲,我的职业决定了我对这种现象并不陌生.阿拉斯加的儿科医生从来就没有上过儿童心理发育这门课(比这更糟的是,他们认为没有任何必要),他们竟然也成了医生.呸!_他们还被公认为儿童发育方面的专家,他们大部分人不配这个称呼.
而且,和所有人一样,医生们也倾向于"璞石"偏见,所以他们意识不到是孩子本身出现了问题(比如顽固的任性).他们通常把孩子的父母批评一通,毫无同情之心.他们从自身有限的家庭成长经历出发,以偏概全,或许对自己从未有过的经历觉察不到.同时,也高估了对自己孩子的那些有用没用的教育.
在儿童训练期,医生教给父母一些具有神奇效果的措施(1-2-3,芝麻开门!),就象体育比赛中的暂停信号一样管用(做梦),这时候父母的作用被放大了.所以,如果孩子持续出现行为异常,而父母没有听从我们的良好建议,那么父母肯定没有尽到责任.孩子无可救药等于父母同样如此,那么抨击吧,抨击吧,讨论完毕.
可悲的是,正是象萨莉父母的那些可怜的人最容易受到可怕的三方面的谴责:首先是媒体和当红的专家学者,因为他们的批判能带来好的脱口秀广播节目及电视节目,相关书籍的销量也会增加.然后是同为父母的人,他们缺乏想象力和同情心,无法理解别人正在过什么样的日子.还有就是他们找的那些儿科医生,他们因为不正确的教导方式而斥责孩子父母.
我想绝大多数父母都深爱着自己的孩子,竭尽所能的为孩子做有利的事情.总之,大部分人在抚养孩子上都做的相当不错,在面临一些考验的时候能够作出正确的决定.
抨击父母几乎在任何时候都是不公平的甚至残忍的,这是一个误区.下次你在公共场合再看到失控的孩子而忍不住怒气冲冲的瞪着他可怜的母亲的时候,一定要记住这一点.
最后强调一下,一定记住要向她们伸出援助之手,听他们的倾诉,说一句善意的话.