Dr Colleen Kraft On Raising Children Who Are Mentally & Emotionally Healthy

Make routines important. Time to be together and interact with your child, enough time to sleep, and time to play are foundational in building your child’s mental health.

Our children are facing challenges that didn’t exist just a short while ago. They are growing up with social media, constantly being connected, and the hurried pace of life today, as well as the pandemic, and the often frightening news. In short, our children are facing unprecedented mental health challenges. Anxiety, depression, and even suicide are on the rise. As parents and educators, what can we do to raise children who are mentally healthy? In this interview series, we are talking to authors, parenting experts and mental health professionals who can share their expertise and advice on Raising Children Who Are Mentally Healthy. As a part of this series, I had the distinct pleasure of interviewing Dr Colleen Kraft.

Colleen A. Kraft, MD, MBA, FAAP is Professor of Pediatrics at the Keck School of Medicine/University of Southern California and Children’s Hospital Los Angeles. She is the 2018 Past President of the American Academy of Pediatrics. Dr. Kraft received her undergraduate degree at Virginia Tech and her M.D. from Virginia Commonwealth University, and her MBA from the University of Cincinnati. She completed her residency in Pediatrics at Virginia Commonwealth University.

Dr. Kraft is known for her work in integrating care for children with developmental disabilities and behavioral health conditions into primary care pediatrics.

Thank you so much for joining us in this interview series! Before we dive in, our readers would love to hear a little about you. Inspire us with your backstory!

I was fortunate to be a member of the very first class of Head Start in 1965. My parents were Irish Catholic, and had 6 children — the first four of us were born during the first four years they were married. We lived outside Akron, Ohio where my father worked for Goodyear and my mother, whose education finished with secretarial school, made sure her children would have access to education. Head Start was a new program, a summer program designed to give poor kids an opportunity to do well once we started school. Because our mother always read to us, I began to “read” to my younger siblings and eventually became a very early decoder of words. When my Head Start teacher realized that I, as a 5-year-old in her class, could read, she told me that I was “smart enough to be a doctor when I grew up”! So that set my career trajectory.

What are some lessons you would share with your younger self if you had the opportunity?

We live in a society so focused upon achievement, and I was always one to go above and beyond what I needed to do to be successful. I would tell my younger self to slow down, take time, find the grace in play and interacting with people you care about. It is the social-emotional connections we make and solidify in life that are foundational to our creativity and sense of belonging. And it is these connections that fundamentally build our physical and mental health.

None of us are able to experience success without support along the way. Is there a particular person for whom you are grateful because of the support he/ she gave you to get where you are today? Can you share that story and why you are grateful for that person?

My three children, Daniel, Julie, and Tim Kraft have taught me everything I know about that important social-emotional connection: how to just spend time and enjoy the life we have, and how to navigate life’s challenges. The things that make us happy are the simple activities, routines, inside jokes, and shared experiences. They are the best people I will ever know.

Are you working on any exciting new projects now? How do you think it might help people?

I am fortunate to work with young pediatric trainees at the Children’s Hospital Los Angeles as co-director of IMPACT, which stands for Improving Medicine, Pediatricians and Communities Together. This program recognizes that child health is much more dependent upon factors that exist outside the clinical setting, like housing, food security, quality education, and resources to help families build and optimize the health of their children. So our residents, as part of their education, work with a community organization to improve the day-to-day environment where children live and play.

I am also fortunate to be consulting with companies who are using innovative technology to help address health disparities. One company is Cognoa, a pediatric behavioral health company; their landmark autism diagnostic, CanvasDx, can easily and reliably take data from parents, clinicians, and videos of a child to accurately define that child’s developmental strengths and challenges. CanvasDx can recognize and diagnose the core components of Autism in as little as two days. So many children wait months for a developmental evaluation and CanvasDx can simplify this process. Thanks to this diagnostic, a clinician can work with a family to start therapy months earlier that what was possible even five years ago. It’s exciting to use a diagnostic that could change the landscape of how children are evaluated after developmental concerns are identified. My vision of early diagnosis and therapy for these kids aligns with Cognoa.

Ok, thank you. Let’s talk about raising emotionally and mentally healthy children. In the Western world, humans typically have their physical needs met. But what has led to the tremendous downgrade in emotional and mental health that we are seeing today, especially for children? What is lacking in the mental health arena? Why are so many of our children struggling today?

Remember how I mentioned that all health, including mental health, is built upon a strong social-emotional foundation? It is the supports for families of our youngest children that need to be a priority in our country if we are ever going to reverse the trend of emotional and mental health problems in children. Families are stressed; in most families, both parents are employed. Quality childcare is difficult to find, and absolutely unaffordable for most families. Healthy food is more expensive than junk food, and screens often are used as babysitters in place of important parent-child interactions. We know that investment in early childhood reverses this trend; one dollar invested in quality early education returns seven dollars in creating healthy adolescents and adults. They are more likely to finish high school and college, be successfully employed, have fewer mental health problems, and even have lower incidence of diabetes, hypertension, and high cholesterol!

How does technology play into the equation of mental and emotional well-being? What about social media?

Technology is often used in place of quality adult-child interactions. It’s easy to turn on a video, and children like screens. This is not putting blame on parents; so many families of young children have time and financial stresses, and media is an easy fix in that moment. What is interesting is that research notes that teens who spend 30 minutes daily on social media actually have better mental health outcomes; this amount of time can help kids connect with other who are like them, have similar interests, and may work on a creative project together. But the research is clear that more than 2 hours per day on social media is detrimental to a child’s health. There is a much higher incidence of anxiety, depression, body dysmorphism, and suicidal ideation in teens who spend more than 2 hours on social media.

Much of what “de-stresses” us is in-person connection and interactions, activity and exercise, time in nature, playing with pets, and the healthy “serve and return” close connections between those we care about. Kids and adolescents miss out when there is too much time on screens.

Obviously, this is a huge issue, and it seems to be growing. What are some small, practical tips, or tweaks, that parents and educators can easily implement to help their children who are struggling?

Children and adolescents thrive on routine. So build this into your day-to-day life. Time for walks, or “dance parties” or coloring or painting or cooking, even one night per week, becomes a highlight in your child’s life. Routines help kids know what to expect from us, and what we should expect from them.

When kids are using media, try to have some interactive time with them. For a young child, the taking turns on a game, the reaction you have when you score a point or lose your place will create laughter and a sense of bonding. Watching a movie with your teen, even one with questionable content, can lead to important discussions about values, decisions, and actions.

Screens need to be off 1–2 hours before bedtime. When it starts to get dark, your body makes melatonin, which helps with calming and sleep. So, if you or your child are on a screen, it defeats the purpose of melatonin and you will both find it hard to sleep. And we know that sleep is so important in brain growth and mental health.

Exercise and activity round out the development of our brains and bodies. Some kids spend so much time on homework and academic endeavors that their bodies suffer because they are not moving. Walks, bike rides, exercise that your child sees as fun is just as important as studying; no time for activity other than homework is a risk for mental health problems.

In your professional opinion, what are certain triggers or signs that the state of a child’s mental and emotional health is not at its best? What is the best way to be proactive and address these signs from the get-go?

There are a number of reasons why children act out, including:

• They are not getting enough sleep
• They are not getting enough physical activity
• They may have a developmental concern. For example, many kids with autism do not have intellectual disability, and the major presenting feature is difficult behavior, tantrums with transitions, and getting in trouble with other kids in school.
• A child doesn’t seem to have joy with doing things that were fun. One major sign of depression in adolescents is dropping out of favorite activities or sports teams.

There is still far too much stigma and blame around developmental and behavioral disorders, which is harming our children. If you notice difficulty with your child’s behavior, you are not alone. Many clinicians are caring for these kids, and a discussion with your health care clinician can result in the right evaluation and subsequent care for your child.

Many families have two fears — one is that they somehow caused their child’s problem, and the other is that there is nothing that can be done about it. Both are wrong! We know that as a child’s brain grows, they can develop problems too, and there are many paths to take for the right evaluation and treatment.

Do you think we can do a better job of educating our children about their emotional and mental health? What would that look like?

Absolutely! We can start with interacting with our children and by calling out and talking about feelings and what you do with them. When you’re happy, you dance; when you’re sad you give mom a hug; when you’re angry you find your calm down activity. Giving feelings a name and talking about them gives kids the language and recognitions that all feelings are normal, and there are things you can do to deal with and/or express any feeling. There are now books and educational resources that kids can view to help them understand all feelings but particularly the ones that make them sad or angry.

If you as a parent have concerns about your child’s development or behavior, contact your health care clinician. When kids see their doctor because they are sad, just like they see their doctor when their ear hurts, it normalizes mental health concerns and teaches them that they can seek help

Can you share with our readers your “5 things parents can do to raise children who are emotionally and mentally healthy”?

1. Make routines important. Time to be together and interact with your child, enough time to sleep, and time to play are foundational in building your child’s mental health.
2. Understand what is normal and typical for child development at different ages. You can feel reassured a child is having tantrums at 15 months of age or toilet training issues at age 3. But also understand if a child does not seem to be developing beyond some of the typical age behavioral challenges that you may have cause for concern.
3. Play the “Feelings Game” with your child. Teach your child what happy, frustrated, irritable, calm, scared, angry, etc look and feel like. This way they will know what to say when they feel this way.
4. If you think your child may have a developmental concern — they aren’t talking or communicating or behaving in a typical way — seek help early. Your health care clinician has many resources and may even use a diagnostic like CanvasDx to help better understand your child’s concerns and set them on the path to receiving appropriate care.
5. Recognize that relationships, nurturing, and reassuring, are the foundation of healthy brains and behavior, and that your interaction with your child is most important.

Do you have any favorite books, podcasts, or resources you recommend to our audience reading this interview?

• Big Little Feelings is a great website and social media presence.
• Child Mind Institute https://childmind.org/positiveparenting/.
• Podcast: Autism Parenting Secrets.

There are lots more but these are great to start with!

You are a person of great influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

I would start with supporting our families with the youngest children. It would look like this:

• A health care “bill of rights” that supported every pregnant woman with care that is evidence based, addressing all complications of pregnancy, transcending political discussions.
• Support in the early postpartum period with doulas, lactation consultants, parental leave policies, and connections to help in those first few sleepless months with newborns.
• Universal mental health care for mothers and fathers with young children.
• Affordable, high-quality childcare.
• Education and well-paying employment opportunities for parents who want to work in early education, perhaps even where their own children attend.
• Resources and support for adoption of new technology that can provide early diagnosis and intervention for kids with development and behavior concerns.
• School-based connection to mindfulness and mental health resources, normalizing that solutions can be learned just as a child is learning letters and numbers!

What is the best way for our readers to continue to follow your work online?

I’m often interviewed about many topics which land in news videos, blogs, and social media. Just look for me!

You can also find me on LinkedIn here.

This was very inspiring. Thank you so much for the time you spent on this. We wish you only continued success.