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Jean M Clinton B.Mus MD FRCP(C) McMaster University and Children’s Hospital www.offordcentre.com

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

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  1. 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

  2. Kids Today "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

  3. Adolescents: Why DO they do the things they do?

  4. Key Messages ‘‘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

  5. The Paradox • 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

  6. 03-013 THE BRAIN FAIRY The Hostage Brain , Bruce S. McEwen and Harold M. Schmeck, Jr., 1994.

  7. Key Messages ‘UNDER CONSTRUCTION” (MUC to some) which explains much of the challenge!!

  8. Neurodevelopment Findings 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.

  9. The Brain Bonsai Overproduction and Exuberance Pruning

  10. 7-10 % up to 50 % loss of Grey matter GIEDD

  11. The Brain

  12. The Frontal Lobes aka CEO “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)

  13. AREAS UNDER CONSTRUCTION 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.

  14. The Problem Frontal Lobe Development Average age of first sexual encounter in Canada Autonomy drivers license Dr Jim Stieben MEHRI

  15. Anterior Cingulate Cortex

  16. Limbic System for Birth - 21 Years Age Dr Jim Stieben MEHRI

  17. ACC The “Oops Centre”

  18. WHAT YOU SEE IS WHAT YOU GET! Fear Contempt Surprise Anger Disgust Sadness Happiness

  19. UNDER CONSTRUCTION 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)

  20. Age 24 emotion motivation physical coordination; sensory processing; judgment WINTER

  21. SCENARIOS • What we THINK…. • Affects what we FEEL… • Affects how we ACT….

  22. Focus on Positive Development-Asset Building • 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

  23. Clinical Tips • 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

  24. What’s a Family Dr to do? • Help parents understand what is going on. • Give them resources • TAFFY • Emphasize the importance of relationships/assets. Clinton

  25. Key Messages ‘‘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

  26. Books • 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

  27. Slides will be available at www.offordcentre.com

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