guilt: the new willpower

Our last post discussed self control measured by resisting marshmallows. The NYTimes has an interesting article this week discussing how guilt can help with self control. It comes from the following experiment with toddlers:

Show a toy — a doll, say, or a model boat — to a toddler and explain that it it’s something special you’ve had since you were little. Ask the child to be “very careful” with it. Hand over the toy, which appears to be in fine condition, except that you’ve secretly rigged it to break spectacularly as soon as the child handles it.

When your precious toy falls apart, express regret by mildly saying, “Oh, my.” Then sit still and observe the child.

After a minute, they reassure the child and fix the toy so as not to permanently traumatize the little ones.

What’s interesting about this is how their behavior predicts future outcomes, much like the marshmallow test. The researchers are trying to isolate conscious self control from emotions that may cause the child to avoid breaking rules not because they decide not to, but because they can emotionally anticipate the consequences.

In Dr. Kochanska’s latest studies, published in the August issue of The Journal of Personality and Social Psychology, she and colleagues found that 2-year-olds who showed more chagrin during the broken-toy experiment went on to have fewer behavioral problems over the next five years. That was true even for the ones who scored low on tests measuring their ability to focus on tasks and suppress strong desires to act impulsively.

“If you have high guilt,” Dr. Kochanska said, “it’s such a rapid response system, and the sensation is so incredibly unpleasant, that effortful control doesn’t much matter.”

But self-control was critical to children in the studies who were low in guilt, because they still behaved well if they had high self-control.

They explicitly looked for parenting behaviors that led to having or not having guilt, and couldn’t find them. So it’s not clear what we as parents might do with this, except perhaps to note whether your child evinces guilt, and if not, work more on self-control to try and make up for the lack of a good emotional check on behaviors that might induce guilt (like hitting or taking toys or whatever). The researcher does have one piece of advice, on the difference between shame and guild:

“The key element is the difference between shame and guilt,” Dr. Tangney says. Shame, the feeling that you’re a bad person because of bad behavior, has repeatedly been found to be unhealthy, she says, whereas guilty feelings focused on the behavior itself can be productive. But it’s not enough, Dr. Tangney says, for parents just to follow the old admonition to criticize the sin, not the sinner. “Most young children,” Dr. Tangney said, “really don’t hear the distinction between ‘Johnny, you did a bad thing’ versus ‘Johnny, you’re a bad boy.’ They hear ‘bad kid.’ I think a more active, directive approach is needed.”

She recommends focusing not just on the bad deed, but more important, on how to make amends. “Both children and adults can be surprisingly clueless about whether and how to make things right,” Dr. Tangney said. “Little kids are overwhelmed by the spilled mess of milk on the floor. Parents can teach and support them to say ‘I’m sorry’ and to clean it up, maybe leaving the kitchen a little cleaner than it was before.”

I’m not sure I believe that strategies like that will help your child learn to feel benign guilt, but at least the kitchen will be cleaner.

seeing the future in a marshmallow

There’s a famous study called the Stanford Marshmallow Experiment. It was done in the 60’s on a group of 4 year olds, and then, 18 years later, researchers followed up on the children to see what happened with them. Here’s how it works.

Put the four year old in a room with a table. On the table is a marshmallow. Tell the child you’re going to leave for a while, and if the marshmallow is still there when you get back, they can have it and another one. If it’s gone, though, they don’t get a bonus marshmallow. Then watch through a one way mirror or a camera and see how long they can last. Here’s what they found.

Some children grabbed the available marshmallow within seconds of the experimenter leaving. Others waited up to twenty minutes for the experimenter to return. In a follow-up study (Shoda, Mischel, & Peake, 1990), children were tested at 18 years of age and comparisons were made between the third of the children who grabbed the marshmallow (the “impulsive”) and the third who delayed gratification in order to receive the enhanced reward (”impulse controlled”).

The third of the children who were most impulsive at four years of age scored an average of 524 verbal and 528 math. The impulse controlled students who scored 610 verbal and 652 math! This astounding 210 point total score difference on the SAT was predicted on the basis of a single observation at four years of age! The 210 point difference is as large as the average differences between that of economically advantaged versus disadvantaged children and is larger than the difference between children from families with graduate degrees versus children whose parents did not finish high school! At four years of age gobbling a marshmallow now v. waiting for two later is twice as good a predictor of later SAT scores than is IQ. Poor impulse control is also a better predictor of later delinquency than is IQ (Block, 1995).

All that from a marshmallow. Amazing.

This has received some recent attention from a popular and fascinating New Yorker article, Don’t. It recaps the experiment and interviews some of the subjects — a typical well-written New Yorker column. One of the things it discusses is a method for learning how to resist the siren call of the marshmallow by the inventor of the experiment, Walter Mischel:

When he and his colleagues taught children a simple set of mental tricks—such as pretending that the candy is only a picture, surrounded by an imaginary frame—he dramatically improved their self-control. The kids who hadn’t been able to wait sixty seconds could now wait fifteen minutes. “All I’ve done is given them some tips from their mental user manual,” Mischel says. “Once you realize that will power is just a matter of learning how to control your attention and thoughts, you can really begin to increase it.”

What’s not at all clear is what learning to resist marshmallows means for the other outcomes. Could it really be that teaching kids a few tricks to temporarily resist a simple temptation will put them on a path to higher SAT scores and greater life success? Or is it that there are a set of related, correlated attributes which collectively explain the outcomes, of which delaying gratification is merely one.

There’s evidence both ways. It turns out kids as young as 19 months show differences in their ability to delay gratification, and those differences persist through the marshmallow test age and are nearly as predictive as the test of 4-year-olds. That suggests there’s a large genetic component. But there are also a set of people who were bad at delaying gratification at four but good at it at 40 (they retested some of the original group recently with a more subtle test for 40-year-olds) — how did they learn that skill?

Mischel is of the opinion, according to the New Yorker article, that learning techniques for delaying gratification really will improve life outcomes. He’s starting a study at a set of public charter schools for poor kids, KIPP. It’ll be interesting to see what he finds, and if the skills really do change lives.

In the meantime, what can we as parents do? Well, if you’re bored, you could give your child the marshmallow test. Or, you can work with your child on delayed gratification techniques, teaching them to distract themselves from temptation, or remove themselves from it if possible. Even if that’s not a magic switch that will turn them from underachievers to stars, it’s still a useful life skill.

In the meantime, here’s a video segment about it. Watching the kids struggle with the marshmallows is pretty entertaining.

duct tape, the perfect material

You were wondering, I can tell, if duct tape occlusion therapy is as effective as cryotherapy with liquid nitrogen in the treatment of the common wart. Or at least, you should have been, since the answer is evidently yes, duct tape works better than liquid nitrogen for getting rid of warts:

Of the 51 patients completing the study, 26 (51%) were treated with duct tape, and 25 (49%) were treated with cryotherapy. Twenty-two patients (85%) in the duct tape arm vs 15 patients (60%) enrolled in the cryotherapy arm had complete resolution of their warts (P = .05 by 2 analysis). The majority of warts that responded to either therapy did so within the first month of treatment.

How do you apply duct tape to warts, you ask?

The duct tape occlusion group had a small piece of duct tape applied to the study wart, which was left in place for 6 days. This tape was removed on the evening of the sixth day and then replaced the following morning for a maximum of 2 months or until wart resolution.

Awesome. Duct tape for the win. Though two months is a pretty long time, especially when you consider that two thirds of warts go away by themselves in two years.

For the record, a follow-up study of duct tape versus a placebo found the duct tape to be not significantly better, achieving “wart resolution” only slightly more than the placebo after 6 weeks. However, it was significantly better at reducing the size of warts after 6 weeks for the ones that were still there, so I think we can still go for the duct tape when a wart shows up.

too restrictive, or too much?

Too much sugar isn’t great for kids, we all know that. Bad eating habits can cause all kinds of problems both in childhood and afterwards — adults now believe obesity is the biggest problem for kids. But what should we do about it?

Annie at the tranquil parent has an idea: let the kids have as much candy as they want.

Have you ever met a parent who allows free access to sweets and desserts for their children? It isn’t likely – most parents feel it is important to restrict their child’s sugar intake in one way or another, with the goal of teaching smart, long-term feeding behaviors about food. 

But what if the opposite was true? What if giving your children unlimited access to sweets and desserts would set them up for lasting healthy relationships with these foods? As a pediatric dietitian, I am not necessarily condoning this approach, but just asking you to consider it. And I’ll be testing this theory with my own 2.5-year-old daughter in my own home – but more on that in a minute.

I like the idea in concept, though it does seem a little dangerous to me. In week 1, as you might expect, her little girl ate a ton of chocolate and candy. Too soon to tell if it will remove the allure of sweets over time.

On the research front, it sounds like Annie’s idea is a good one. A recent study suggests that parental restriction of food is associated with weight gain and lower self control for girls. They assessed the kids for 10 years starting at age 5, and found:

Girls with lower inhibitory control at age 7 had higher concurrent BMIs, greater weight gain, higher BMIs at all subsequent time points, and were 1.95 times more likely to be overweight at age 15. Girls who perceived higher parental restriction exhibited the strongest inverse relation between inhibitory control and weight status. CONCLUSION: Variability in inhibitory control could help identify individuals who are predisposed to obesity risk; the current findings also highlight the importance of parenting practices as potentially modifiable factors that exacerbate or attenuate this risk.

What’s not clear is which way the causality goes. Suppose you notice that your daughter has low self control and eats too much: your response might be to further restrict food, producing the same correlation. I can’t find an actual copy of the study to see if or how they tried to control for that.

If the study’s conclusions are right, though, Annie’s experiment is the right idea. Of course, totally free access might be too much… but we definitely have reason to believe that too much restriction is bad.

getting it wrong: science in the press

Dan made a great observation to our last post:

What’s especially frustrating about media coverage like this is that even when the journalist gets it right, the story may be hyped in a way that obscures the truth. For example, if the story you quoted was on TV news, there would be promos all day saying “Is TV killing our kids? Tune in at 6 for the shocking story that may make you think twice about owning a television!” Then a large fraction of the audience absorbs the implied message without actually hearing the story.

Here’s an example from last week, not really parenting related, but it gets at some of the issues in absorbing medical/science info from news articles. The Times UK wrote up a piece of research, which they titled as Women Are Getting More Beautiful:

FOR the female half of the population, it may bring a satisfied smile. Scientists have found that evolution is driving women to become ever more beautiful, while men remain as aesthetically unappealing as their caveman ancestors.

The researchers have found beautiful women have more children than their plainer counterparts and that a higher proportion of those children are female. Those daughters, once adult, also tend to be attractive and so repeat the pattern.

Other places picked up the story, and further emphasized that women are getting more attractive over time, but men are not, with titles like, “Women more beautiful but men remain Neanderthal, study finds.”

Here’s the crazy thing. None of the reporters who wrote those articles or the derivative ones even bothered to talk to the original author! His name is Markus Jokela, and he wrote a post about their mistakes:

Having your study publicized by the media is nice. Having your study misrepresented and misinterpreted in the process is not. The media coverage of my paper on physical attractiveness and having children had a bad start and even worse follow-up. The origin of the problem: Times Online news article sexing up the finding a bit too much (I wasn’t interviewed for this article at all and heard about it only after it had been published). Then things got worse with other journalists copying & slightly modifying the Times Online piece. Naturally, things were further muddled by the If-I-were-a-movie-critic-I-would-rate-movies-without-seeing-them-and-just-by-relying-on-discussions-overheard-in-a-pub columnists, the I-haven’t-read-the-paper-but-here’s-my-take-on-it-anyway bloggers and the ever so alert This-research-is-nonsense-I-want-my-tax-money-back-even-if-the-research-was-not-funded-by-my-tax-money readers.

He goes on to list the inaccuracies, like that attractiveness mattered for men too, though not as much; that the point was to see if attractiveness mattered for fertility, not the evolutionary implications of same; that anyway the effect is small enough you couldn’t see the impact for generations; and that he never made the claim that more attractive women had daughters more often, despite that being reported in multiple places.

So in summary, the author had a small study that found that if you are more attractive, you have slightly more children (though interestingly not for the very top cohort of women), and that the effect is bigger for women than for men. That turned into a claim that women are evolving to become more beautiful, while men are staying the same — a pretty different claim!

If you’re really interested, here’s the original paper.

kids, tv, and hypertension

The media loves stories about why TV is bad for you. Here’s the latest one, as covered by Time: Watching TV: Even Worse for Kids Than You Think.

Researchers in the U.S. and Spain collaborated on the study of 111 children ages 3 to 8 and found that of all the forms of inactivity they examined, television-viewing was the worst. It was linked to significantly higher blood pressure in children – the more TV kids watched, the higher their blood pressure – and the effect held true regardless of whether a child was heavy or at a healthy weight. What’s more, other sedentary behaviors, like using a computer, were not associated with similar blood-pressure hikes, according to the study, which was published in the Archives of Pediatric and Adolescent Medicine.

This is a classic press report about an interesting study. The authors measured how much kids exercised with pedometers, had their parents report the kids’ activities, and noticed that TV watching (but not computer use) was associated with high blood pressure. Unfortunately, it’s really hard to know from this how bad TV is, or even if it causes high blood pressure at all!

To its credit, the article does acknowledge that there may be some other explanations than the causal one:

For instance, beyond the complete inactivity involved with TV-viewing – which alone raises the risk of high blood pressure – children may be compounding their sloth by eating junk food. “A full bag of chips or a plate of hot dogs can disappear a lot more quickly while watching TV than they might at any other occasion,” says Ludwig. And the types of foods that children are likely to be eating in front of the tube, like salty snacks, can push up blood pressure readings.

So maybe the problem isn’t really TV, it’s junk food! That makes lots of sense, since we already know that eating bad food can increase weight and blood pressure. So is TV watching OK if you eat carrots and celery? Maybe keeping junk food out of the house is a better solution than worrying about TV watching.

This kind of correlational study isn’t really very useful unless you are very sure the authors did a tremendous job of controlling for all the possible causes of the symptom (in this case hypertension), and even then causality is really hard to establish.

In the article, it sure sounded like TV was to blame for the high blood pressure they found. In practice, as always, it’s hard to know what to do based on this one study. For instance, you could have your child replace TV with computer use, which was found to have no link to hypertension. Would that actually work? Really hard to tell.

This study is perhaps a useful piece of the puzzle, but not enough to make you throw out the TV set just yet.

Why we’re here

There is a lot of advice out there for parents. You can read dozens of books, magazine articles, columns, and blogs that will tell you what and how to feed your kids, what to teach them, and most of all, all the things you should buy. Nothing’s too good for your little one!

But… where does all this advice come from? In most cases, the advice giver can tell you about their immense levels of experience. And as in many things, experience matters. You can learn a lot by doing, and parenting is like that too. Just see the terror and uncertainty that brand new parents feel, only to relax into it once they learn the ropes.

But experience can also be a tricky thing. The history of medicine is full of examples of a scientist investigating a common practice and discovering it was wrong. The American Academy of Pediatrics just changed their advice about when to introduce peanuts to a child’s diet from age two to age one because new evidence shows that waiting to introduce nuts actually increases the risk of a peanut allergy. The advice pediatricians were giving was not only incorrect but harmful. The current regime of waiting past the first year is still likely wrong, too, actually. The advice hasn’t kept up with the evidence.

The evidence based medicine community understands this — it’s not at all controversial in the medical field to examine ideas and treatments, and to look over the best research before giving advice. But somehow that seems to be missing in the parenting advice field. I rarely see well-founded advice for parents that references studies and research.

Part of the reason for that is that it’s very hard to read research and have any idea what to do about it. Real medical research is full of caveats, and most of it isn’t actually focused on parenting decisions. Further, if your real access to the research is based on media reports, you’re in even worse shape: reports in the media nearly always exaggerate or even grossly misrepresent the actual research.

The purpose of this blog is to try and, in a small way, fill that gap. We’ll talk about what medical research can tell us about raising children. We’ll look at studies and advice in the news, and see which make sense and which have problems. And we’ll be comfortable, if not happy, with the fact that most of the time, there are no hard and fast answers, and sometimes you just have to try things and see what works.

But where there’s evidence, we’ll explore it and try to figure out how to apply it. Welcome to Evidence Based Parenting.