Research Alert
Catching Eating Disorders Before They Start
Eating disorders are typically associated with teenagers and young adults, but a recent study by researchers at Newcastle University suggests that the risk factors for such conditions can manifest as early as age 7 and be prevalent by age 9. The study highlights the need for closer attention to the early warning signs of potential dietary problems, according to the authors. These include early eating-disorder symptoms, depression, and low body satisfaction.
The research was conducted over a six-year period, based on questionnaires given to more than 500 children in Northern England when they were ages 7, 9, and 12. The study found that, for both boys and girls, eating-disorder symptoms exhibited at age 9 were significantly predictive of greater symptoms at age 12. (Symptoms include binge eating, self-induced vomiting, rigid dieting, and anxiety about weight.) In addition, for boys, dietary restraint at age 7 was associated with eating-disorder symptoms at age 12.
Girls with depressive symptoms at age 12 were more likely to have concurrent eating-disorder symptoms. For both boys and girls, body dissatisfaction at age 12 was also associated with higher symptoms. The incidence of "full-syndrome" eating disorders rises from ages 10 to 13, according to the study. A release on the findings notes that the most common age for hospitalization for an eating disorder is age 15.
"Our findings strongly suggest the importance of early interventions (before the age of 9 years) to address children's eating disorder symptoms," the study says.
Information on the study, "Risk Factors for Eating Disorders at 12 Years of Age."
School Tools
A Child's Mind
A teacher might be the first adult to see signs of a child's mental health problem, and a teacher's response can make a huge difference. Yet how can educators know exactly which behaviors reflect a mental health issue that warrants a response? Resources from the Child Mind Institute's website can help educators understand more about diagnosable mental conditions as well as problems like severe shyness or executive-functioning issues that can impede learning. The Institute's guides for teachers and families include information about common problems like anxiety and less frequently seen diagnoses like selective mutism and obsessive-compulsive disorder. The site provides classroom strategies (such as approaches to try for situations like "helping kids who are too hard on themselves"), interviews with experts, and videos of kids with mental health challenges telling their stories.
Screen Grab
The Hard—and Hopeful—Truth About Trauma
You've probably heard about Adverse Childhood Experiences (ACEs) and how having more traumatic experiences as a child puts a person at greater risk of developing serious physical and mental health problems as an adult. In a moving TED talk, pediatrician Nadine Burke Harris shares findings from the study that brought ACEs—and the need to provide treatment for children with high ACE scores—to public attention. Although the statistics that Harris shares about the increased health risks for adults with history of trauma are daunting, she maintains this public health crisis is "treatable and beatable" with screenings and early mental health treatment.
Snapshot
A Mindful Moment
First graders at Summit Cove Elementary School in Dillon, Colorado, participated in breathing exercises in May 2017. Jen Leslie, the school's special education teacher, brought mindfulness studies to the district's nine schools.
Turn and Talk
Q&A
with Fred Bemak professor of counseling and development in George Mason University's College of Education and Human Development and founder, Counselors Without Borders
How does Counselors Without Borders help children affected by trauma?
Counselors Without Borders is an organization I wish didn't exist. We mobilize when there is a need, and unfortunately there is a lot of need. I take teams of professional counselors and graduate students to provide training, consultation, and counseling following traumatic events, such as Hurricane Katrina, the Haiti earthquake, and the San Diego wildfires. We are currently working out details to visit a few school systems in Texas after Hurricane Harvey.
We work with diverse populations who typically do not have access to services that other people do. For example, after the San Diego wildfires, I worked with the public schools to train staff that work with migrant populations and American Indian schools about how to handle trauma and mental health issues with students and families.
What is your advice for schools about how to help students in the aftermath of a traumatic event?
The first thing I tell staff is, "Heal yourself." You cannot support the mental health needs of your students without addressing the fact that your own home is destroyed, your life is chaotic, your pet has died, or whatever the situation. The assumption always is that the teachers and school personnel are fine. Well, they're not.
Other advice I give schools is to try to normalize routines as much as possible. Kids feel safe and secure when routines get put back in place and when things like extracurricular activities are reinstituted. Also it is important to not shut the conversation down. If there is a suicide or a death or some other traumatic event with students, that's the buzz. You'll have every student talking about it in the halls, and yet a teacher might say, "Let's get to work. We have math to do."
Students need to openly discuss what's going on and express their fears and concerns. And teachers need training on how to facilitate that. Use external resources. Tap into your local mental health departments or university personnel who have expertise in these areas and can support the difficult life circumstances that interfere with the work in the school.
What other factors do teachers need to be aware of when dealing with students affected by trauma?
Traumatic events affect students in different ways, but teachers need to be especially attuned to students who may not be able to get the services that others can. For example, I know that some shelters set up for victims of the recent hurricanes would not permit undocumented youth and families. We can't speak and provide support in the same way to someone who is undocumented as we can to someone who is documented and who has access to resources. Staff in schools need to be attuned to students with special issues and understand how that contributes to their stress and mental health concerns.
Editor's note: This interview has been edited for space and clarity.
Numbers of Note
Parents' Expectations for Mental Health Support
Parents' confidence in a school's ability to identify and assist students with mental health issues is low, a September 2017 U.S. national poll showed.
38% of parents are very confident that their child's school can assist a student suspected of having a mental health issue.
14% of middle and high school parents say their child's school screens students for mental health problems.
49% of high school parents believe school counselors would most likely assist students with mental health issues.
38% of elementary school parents thought the school nurse would likely handle the situation.
Source: C.S. Mott Children's Hospital at the University of Michigan. (2017, September 18). Handling Child Health Needs During the School Day. Retrieved from https://mottpoll.org
Relevant Read
Unbroken Brain: A Revolutionary Way of Understanding Addiction by Maia Szalavitz (Picador, 2016)
If you find yourself struggling to understand the complexities of addiction, especially among young people during the current opioid crisis, this book will push you to think beyond conventional wisdom. Instead of viewing addiction as a medical disease or moral ill, Szalavitz regards addiction as a learning disorder with neurodevelopmental roots, akin to autism or dyslexia. She outlines the four features of such disorders: They start early in life as a result of variations in brain wiring; they aren't necessarily associated with global deficits; they follow precise sequences of environmental influences; and well-timed interventions can change their outcomes.
Drawing on her own struggles with addiction, Szalavitz describes how learned maladaptive behaviors unfolded in her life—from her difficulties in managing a sensory-intense world as a child, to the peer rejection she faced in middle school, to her escape into drugs during the crucial adolescent years that shape the brain and determine lifelong psychological coping skills.
Many of Szalavitz's arguments are controversial. She pushes back against the myth of the addictive personality and questions the 12-step program's moralistic groundings as well as its requirement for addicts to "hit bottom." Instead, she believes that new learning is possible at any stage of addiction. She argues that few people learn new, positive behaviors from punishment (after all, addicts continue to use despite negative consequences). Instead, she advocates for harm-reduction initiatives that minimize the negative effects of drug use and education-based programs in schools that teach adolescents cognitive skills to help them cope with vulnerabilities. "The problem isn't the existence of activities and substances that offer escape," she writes. "It's the need for relief and the learned pattern of seeking it that matters" (p. 72).
Page Turner
Some schools are just beginning to plan and execute protocols for opioid use; others are already responding to a crisis, but all secondary schools will eventually in some way face this public health crisis.
—Justine W. Welsh, Nancy Rappaport, and Valeria Tretyak
EL Study Guide: Helping Students Thrive
What are the signs of mental health issues, such as depression, anxiety, self-injury, and addiction, in young people? How can educators play a stronger role in identifying and responding to such issues? How can schools, families, and communities work together to help students get treatment and thrive? Explore these and other essential questions from this issue in our EL Study Guide, designed for use in professional learning communities or personal reflection.
