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Help Build Your Child’s Self-Esteem

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Self-esteem is the way we feel about ourselves and is central to how we move through the world. If someone has high self-esteem, they feel confident and capable, and are more able to rise to a challenge and persevere. They can handle making mistakes, and do better overall in terms of school, work, and social interactions.

Those with low self-esteem feel negatively about themselves and their abilities. They may seem withdrawn, avoid challenges, and berate themselves if they feel they have fallen short. They do not stand up for themselves and may have more difficulty maintaining friendships and interacting with others.

Kids with low self-esteem may be moody or irritable. They may be hesitant to try something new, often predicting failure. If they make a mistake, they can be very self-critical, even calling themselves “stupid” or a “loser”. Self-harm (i.e. cutting of the skin) may occur as a way to deal with the negative feelings.

You can help build high self-esteem in your child by being loving, positive, and encouraging them to take on challenges. Don’t have them aim for perfection, an impossible goal, but instead celebrate when they try something hard or make progress towards a goal. Don’t give false high praise- -kids can often see through this which will make them feel less confident in their abilities.

Speak out about what makes them special and unique; avoid comparing them to others. As the parent, model good self-esteem, voicing self-confidence and your ability to tackle something challenging. Let your child hear that you are kind to yourself when you make a mistake and see that you still have self-respect.

Low self-esteem can be improved by getting out in nature (and off of phones and social media). Exercise, time with friends, and playing games can help your child feel more positively about themselves too. A volunteer activity (which you may do together depending upon their age) helps put the focus on others and how we can help instead of feeling negatively about ourselves. Your child may benefit from clubs or classes such as dance or karate that bring them together with peers they can relate to.

If your child is displaying signs of low self-esteem, talk with them about what you are noticing, and empathize with their feelings. Try to understand how the world seems to them even if what is concerning them may seem minor. If things do not improve over time, consider having your child speak with the school counselor or a therapist comfortable treating children.

By showing your child unconditional love, acknowledging their progress towards a goal, and encouraging them to challenge themselves, you can help boost your child’s self-esteem. Your child will be more confident and better able to handle what comes their way as a result.

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Dr. Elise Herman

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Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

When is it OK for Kids to Have a Smartphone?

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Seemingly everyone has a smartphone, and kids are drawn to these at a very early age. Parents do their best to supervise and set appropriate boundaries for their kids around phones, but may wonder when it is OK for their child to have their own phone. Making this decision can seem daunting, especially as younger and younger kids seem to have a phone in their pocket. According to Common Sense Media/Research, 43% of kids age 8 to 12 and 88% to 95% of teens up to age 18 have their own smartphone. If you are the parent of a 10-year-old, the begging may have already started. The general recommendation has been “Wait Until 8th (the end of 8th grade)”, but many kids get phones earlier.

Parents often see the benefit of staying in touch as a reason to give their child a phone. Other positives include use in an emergency and socializing. As kids get older, phones can help them stay connected to their friends and communicate about school work, sports, and other activities.

There is no perfect age for a child to have a phone. It may depend on the child’s maturity and sense of responsibility as well as family values. Is the child impulsive? Do they generally respect rules and limits? Are they generally honest? Are they good about following the rules regarding other tech, such as a Chrome book use at school? ATT and the American Academy of Pediatrics have partnered on an online ‘quiz’ to assess a child’s readiness (see resources, below).

The potential negatives of cell phones include less time spent with family, less physical activity, and sleep disturbance. Phones offer access to social media which can increase the risk of depression and anxiety. There is the possibility of kids oversharing, experiencing cyberbullying, and being victimized. Phone addiction is a concern for users of all ages.

On-line pornography poses significant risk to kids and teens. The average child is exposed to pornography by age 12 years. Pornography often portrays physical and verbal aggression and sexual violence, usually directed towards women, including women being choked, slapped and spit upon during sexual activity. It is horrific to note that free porn sites carry videos of child rape and assault. Early exposure to pornography is related to anxiety, depression, and difficulty forming healthy intimate relationships later on.

So how to navigate this complicated situation? Communication is key. Have open discussions with your child regarding the pros and cons of a smartphone. Take the “phone readiness quiz” and review the results with your child. Parental controls restricting the amount of usage as well as access to social media and inappropriate sites are vital. Discuss where and when the phone can be used (not at meals, not during family social time, not after bedtime, etc.) Your child should understand your concerns and the importance of respecting these limits when using other devices, for example, the phone of a friend who may not have the same restrictions.

As the parent, you should have your child’s password, be able to track their usage, and maintain the right to take the phone away if rules are not being followed. Having your child contribute to the purchase of the phone or service plan financially or by doing extra chores teaches responsibility.
As a trial, many families opt for a flip phone (calls and texts only) for a year to assess their child’s readiness. If connection to your child is most important, a smart watch, iPad, or tablet is a good way to start without the complications and potential risks of a smartphone.

Resources

Wait unitl 8th: https://www.waituntil8th.org Parents can join together, pledging to avoid phones for kids in elementary and middle school.

Phone Ready Quiz: https://www.healthychildren.org/English/Pages/PhoneReadyQuiz.aspx

more about The contributor

Dr. Elise Herman

Blog Posts
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Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

How to Help Your Child Make Friends

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Contributor Dr. Elise Herman

As kids head back to school, it is easy to focus on the academics, but the social side of school, including friendships, is very important to a child’s development and overall success. You can help your child with the skills of making friends, keeping friends, and being a good friend, all vital to building social connections at school and beyond.

As the parent, you can be a good role model. Be friendly and social when you are out and about (and put away the phone, of course). Make conversation and express curiosity when interacting with others. At home, encourage conversation at the dinner table, taking turns asking and answering questions (again, no phones around). Having family game night or doing chores together teaches kids how to interact within a group. Let your child know that bragging and teasing will push other kids away.

Some kids need help reading others’ facial expressions; this is a skill that you can teach your child and practice at home. Active listening makes the other person feel heard and can be achieved with eye contact and verbal affirmations such as “uh-huh”, “yes”, and “tell me more”. Kids should also take turns speaking and let someone finish before jumping in and interrupting.  Role playing with your child for greetings, introductions, and conversation can help them feel more confident in social situations.

Bonding over a common interest or activity happens naturally, so encourage participation in clubs, sports, and other groups.  Arranging a playdate at a park or some other ‘neutral’ location is a great way for kids to build relationships. If there is a fellow student your child has mentioned positively, you may be able to reach out to their parent at school drop-off or a school event and discuss a get-together.

Help your child work on emotional regulation so interactions with other kids are positive and without anger or tantrums. Communicating calmly about feelings and stepping away briefly if upset are helpful strategies. Remind your kiddo to ‘let little things go’ and avoid being petty. Explain that annoying behaviors such as poking, imitating, and not respecting personal space can be very off-putting.

It is said that the best way to have a friend is to be one. Ask your child what they would want in a friend—and have them brainstorm how they can be that special person for someone else. Be positive about their efforts to master the important social skills needed to create friendships; this comes easier to some kids more than others. If your child is really struggling in this area, you may want to speak with your child’s health care provider or counselor.

more about The contributor

Dr. Elise Herman

Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Helping Your Shy Child

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Contributor Dr. Elise Herman

By nature, some kids are more outgoing than others. Many children are shy and reserved when younger but become less so as they grow up. Being shy, however, just characterizes a child’s approach to the world (especially new situations) and does not have to be seen as a negative. There are felt to be some benefits of this personality trait as these children tend to be more observant and less impulsive. Shy kids may be slower to warm up and more cautious about jumping into a new social situation but given time and the opportunity to be involved when they feel ready, do fine socially.

You can help your child if they fall into the ’shy’ category:

  • Don’t allow people to label your child as ‘shy’ which can make them feel negatively about themselves. You can say something like, “He just sometime needs a little time to observe and warm up”. You can suggest your child give a little wave or smile if they are not ready to talk to someone.
  • Accept your child’s shyness and acknowledge their feelings, but don’t be overprotective. Gently encourage them to try challenging situations such as answering a question in class, ordering an item at a restaurant, or saying ‘hi’ to a child they see on the playground.
  • Create opportunities to practice social skills especially in low-risk settings such as going on playdates, casually getting together at a park with another family, etc.
  • Roleplay certain situations such as meeting new adults and approaching kids at school. It is fine to be near your child if they ‘need’ you, for example when meeting other kids at a playground, but try to let them speak for themselves. If they seem comfortable, you can move away while reassuring your child that you will be nearby.
  • Participation in group activities can build social skills and confidence. Small groups or classes such as scouts, dance, sports, or music give your child a chance to get to know a group that they will see regularly and so become increasingly comfortable.

It is important to separate common shyness from social anxiety disorder, which is more severe, long-term, and interferes with everyday life to a greater degree. Those with this issue worry excessively about social interactions and seek to avoid social situations when possible. This can negatively impact school, friendships, and overall emotional well-being. Talk to your child’s healthcare provider if you think your child may have social anxiety disorder as counseling and other treatments can be very helpful.

But don’t fret if you have a shy child—things will get easier! Accepting your child for who they are and supporting them as they work on social skills will help them gain the confidence they need as they grow.

more about The contributor

Dr. Elise Herman

Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Avoiding Picky Eating in Kids

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Contributor Dr. Elise Herman

Most parents are familiar with the ‘picky eater’- the child who is suspicious of new foods, has strong favorites, and may refuse to eat what the rest of the family is eating. Picky eating is very common in young children, but usually improves by age 5 years. This behavior occurs in part to exert some control over mealtime (and parents) in a way that is often attention-getting.

Regarding feeding your child, it is a parent’s job to offer healthy foods and decide the time and place for eating; it is the child’s job to decide what to eat and how much. Remember that children will eat when they are hungry, and with enough opportunities (it may take 15 ‘exposures’ to something new), will accept and eat most foods. Pressuring a child to eat creates conflict and can make mealtime stressful actually resulting in the child eating less. It is OK if your child occasionally misses a meal because they refuse to eat what is served.

There are things parents can do to minimize “picky eating” and encourage good eating habits that last a lifetime:

  • Offer a variety of foods including vegetables as soon as your child starts solids in infancy.
  • Have set mealtimes and decide how long meals will last; most kids can sit at the table for about 15 minutes for breakfast and lunch, and 20-30 minutes for dinner.
  • Sit down for meals and do not allow kids to come and go from the table; if they are ‘done’, the plate and any uneaten food is removed.
  • The kitchen is ‘open’ for planned meal or snack time and otherwise is ‘closed’; no other eating or drinking (except for water) as it may decrease the appetite for the next meal. Kids need 3 healthy balanced meals and 1-2 small snacks daily.
  • Get your child involved–gardening, preparing food/ helping with cooking (keep this age appropriate), planning the meal, or setting the table.
  • No separate meals; you are not running a restaurant! You can have a ‘boring’ option available (for example, plain bread) occasionally, but ignore whining or tantrums about food.
  • Give new foods in very small amounts so it is not intimidating.
  • Do not offer crackers, cookies, chips, etc. to get your child to eat ‘something’; if they are truly hungry, they will eat some of what is served.
  • Do not use dessert as a bribe to eat a meal.
  • Model healthy eating habits and keep discussion of eating neutral; no elaborate praise if they eat ‘well’ and no criticism if they refuse to try a new food. Keep conversation light and upbeat so mealtimes are positive.

If you have concerns about your child’s ability to eat or swallow normally, or if you worry they may not be getting enough nutrition, talk to your child’s health care provider.

Resources

more about The contributor

Dr. Elise Herman

Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

The Benefits of Awe-Inspiring Experiences for Kids

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Contributor Dr. Elise Herman

We have all known the sensation of wonder and amazement when we experience something “awesome” like a spectacular rainbow. It turns out that ‘awe’- the overwhelming feeling of respect and amazement, often created by something vast and mysterious- is an important emotion with lots of benefits. Sources of awe might be nature, art, music, spirituality, or a demonstration of courage.

Experiencing awe has been well studied in kids and adults and has been shown to increase creativity and curiosity, which fuel learning. Awe increases positive feelings, decreases negative feelings, and helps with emotional regulation and the ability to handle stress. Awe inspiring moments give children stronger feelings of connection and cooperation, especially if shared with others. Family bonds are strengthened by family members witnessing something ‘awesome’ together.  Prosocial behavior (behavior that benefits others) has been shown to be more likely after experiencing awe.

In the face of something vast like a starry sky or beautiful ocean, we may feel more humble, understanding how small we really are in the world. This feeling of humility can put our own issues and struggles in perspective and encourage us to think beyond ourselves. This is particularly important now given social media use with its constant attention on us as individuals and how we appear to others.

When nature is the source of wonder, kids tend to feel more comfortable and confident in the outdoors. Nature-inspired awe also can decrease PTSD and overall stress. Feeling awe after doing something brave or challenging can increase a child’s resiliency and ‘grit’.  

The benefits of awe have a biologic basis.  Research shows that feelings of awe decrease cytokines, chemicals in the body which are related to inflammation, illness, and depression. Awe can also cause the release of oxytocin, a hormone associated with love and empathy.

There are relatively simple ways to encourage more awe, terrific for both our kids and ourselves:

  • Slow down and take time to notice the little things such as birds in flight, changing leaves, or a butterfly
  • Have more unstructured time, less rushed time and put away the phones and devices
  • Expose your child to art (such as galleries and museums), dance, and music; there are many local opportunities for this
  • Look for science activities that inspire wonder, such as going to a planetarium or a science museum
  • Get out in nature more, taking the time to comment on and express curiosity about what you see and hear
  • Notice and discuss courageous and kind behavior
  • Read books about brave and pioneering individuals
  • Create experiences at unusual times such as an early walk at sunrise or stargazing late at night (yes, after bedtime!); these can be very impactful
  • Consider doing journaling or artwork about awe-inspiring experiences
  • Although in-person is best, watching nature documentaries can also create feelings of awe
  • Express awe yourself- get excited about wondrous things and share those feelings with your child

more about The contributor

Dr. Elise Herman

Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Social Media & Teens

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Contributor Dr. Elise Herman

Parents of teens know that this is a tough time for their kids, and many experts point to smartphones and social media as contributing to the worsening mental health of young people. Recent research has shown that social media is not just related to depression, anxiety, and loneliness, but can cause these issues. It should be noted that no one should be on social media until age 13 (it is against the rules as well as potentially harmful), and the later a teen starts with it, the better.

When phones and social media became common around 2012, kids began spending less time with friends just ’hanging out’, which is felt to contribute to feelings of isolation. So what are kids doing instead of hanging out with their peers? They are, of course, on their phones. 95% of all American teens have smartphones and they are on their phones over 7 hours a day (excluding for academics or homework). It is well known that all that phone and social media time is interfering with sleep, and inadequate sleep is tied to anxiety and depression in teens.

The negative effects of social media include bullying, kids comparing themselves to other people’s “perfect lives”, and a sense of FOMO (Fear of Missing Out). There may also be exposure to violent or sexual content. Instagram and other social media can promote body image issues in teen girls who may already be struggling with self-esteem. Social media (including TikTok, Instagram, Snapchat, and YouTube) is engineered to be addictive, and 2/3 of teens age 13-17 years use it, 16% admitting to using social media “almost constantly”.

There are some clear positives of social media, however. Most teens say it can make them feel more connected to peers, and those with a disability or feeling marginalized may find support on a social media platform. It can provide an outlet for creativity, and most would agree on its potential for being entertaining.

Given that there are some positives, and most teens are very plugged in to their social media, what can parents do to help their kids regulate their usage? Although banning social media outright seems tempting, this is unlikely to be successful. Knowing that just decreasing the amount of social media can help kids with body image, depression, anxiety and self-esteem, it is better to make a mutually agreed upon plan with your teen to limit it.

This plan should have scheduled downtime daily without the phone and social media, including mealtimes and the hour before bed (and ideally no phones in the bedroom). Social media should be allowed only after homework is done; this can be implemented via parental controls if needed. Setting a daily time limit for social media apps is easily done on the phone; ideally your teen should do this and look at it as helpful reminder although parental controls are again an option. Encourage taking a longer break for activities like camping, traveling, and special times with friends or family. It is good to see how much more engaged we are when we don’t have our phones and social media to distract us.

Discuss with your child what on social media makes them feel better or worse; if something makes them feel worse, they should avoid it (good advice for us adults, too). Sympathize with your teen if you have a love/hate relationship with your social media and that limiting this may be difficult for you, too. Handling social media can be something you do together as a family. The American Academy of Pediatric has a new version of their free Family Media plan which can guide parents in media usage individualized for each family member (see Resources, below).

Parents should be familiar with social media platforms and know which ones their child is using. Encourage frequent conversations with your teen about relationships, social media, and emotional well-being so it will be easier for them to come to you if they have concerns. If social media is affecting your teen’s mental health, it is time to take a break and consider talking to your child’s healthcare provider and/ or a counselor.

Resources

more about The contributor

Dr. Elise Herman

Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Bringing Music into Your Child’s Life

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Contributor Dr. Elise Herman

Children seem to love music right from the start, which makes sense since babies in the womb can hear sound beginning around the fourth to the fifth month of pregnancy. Research has shown the many positives of music for kids, so making music part of your child’s life will reap benefits over their lifetime. Music involvement includes listening to music, playing an instrument, singing, and dancing.

Music exposure for young children increases brain development, according to research done at the University of California at Santa Cruz in 2016. This was particularly noted in the areas of language and reading skills. Other research has shown that participation in music classes can increase IQ and standardized test scores along with achievement in English and mathematics. Involvement with music improves patience and listening skills and, therefore, school readiness for young children. Experiencing music and dance of different cultures expands a child’s world view and appreciation of other people.

Music has been shown to decrease stress hormones and anxiety, so much so that it is used in hospitals before surgeries and in dental offices. It increases positive emotions and encourages self-regulation and a sense of calm– obviously beneficial for children of all ages. Playing an instrument and dancing help develop motor skills and encourage self-expression and creativity. Being part of a music or dance class teaches kids how to participate in a group and work with others; kids learn valuable social skills in these settings.

It is never too early to bring music into your child’s life. Sing to your unborn child and continue this from infancy onward. Talent doesn’t matter, so don’t avoid this if you are not a gifted singer (few of us are). Sing lullabies to your infant, and attach certain songs to activates for your toddler, such as songs for cleaning up, nap time, and bedtime. Nursery rhymes and clapping along are delightful to young children. Preschoolers love silly songs and lots of repetition (think “The Wheels on the Bus”). Quiet background music (at times) is a great way to expose your child to music of different types.

Keep simple musical instruments in your child’s play area, like a tambourine and shakers. You can also make your own ‘instruments’, such as using a wooden spoon to beat pots and pans and putting beans in a childproof small plastic container for a shaker.

Older kids enjoy music classes in school and benefit from music and dance lessons outside of school as well. Watching dance videos with your child and trying to learn dances together is a fun musical activity. Going to concerts and dance performances connects kids with others and encourages attention and listening skills.

So, start early by filling your child’s life with music and dance of all types. Have fun, and let it awaken the child within you, too. Look online to find lots of local opportunities for music and dance, both for classes and live events. We are also fortunate to have the outstanding music department at Central Washington University, which offers many concerts which are family-friendly.

more about The contributor

Dr. Elise Herman

Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Parenting Your Teenager

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Contributor Dr. Elise Herman

As kids get older, the joys and challenges of parenting change. Teenagers can be wonderful people—enthusiastic, very involved with friends, and with passionate opinions and feelings. However, they can also be impulsive, take risks and feel invulnerable, creating a setup for poor decisions. In addition, teens are working on independence, which can mean pushing back against authority (i.e., us parents). It is all-natural but can create some tension in the household.

Many parenting goals now are the same as when your child was younger, such as encouraging a healthy lifestyle. This includes good nutrition, family meals, getting outside regularly, and adequate sleep. Teens generally need 8-10 hours of sleep nightly but often want to stay up late and then sleep in or have difficulty getting up for school. “Sleeping in” on the weekends should be no more than 1-2 hours later than usual, and naps should be avoided. There should be no caffeine later in the day (this includes pop). Phones or other devices should not be used within an hour of bedtime; ideally, phones are out of the bedroom at night to limit temptation. If you feel this won’t work, parental controls can also be used to manage data access.

Safety is a big topic for teens— so many new things are happening! Driving, dating, possible alcohol and drug use, mental health concerns. Find moments to chat with your teen about some of these issues in shorter conversations, possibly when the two of you are in the car or making a meal. If something is in the news, such as cyberbullying, use that as a start to a discussion (not a lecture). Acknowledge that things are more complicated and high-pressured for them than when you were a teen and that you would like to know more about their world.

Encouraging autonomy means having clear, consistent rules and expectations (ideally agreed upon by your teen) for driving, dating, curfew, etc., gradually giving them more freedom. Acknowledging their successes helps build confidence and will make you comfortable giving them more responsibility. Consequences for poor behavior should be “firm and fair” and be understood by your child beforehand. Give your child a more significant voice on decisions such as meals, activities, and family plans; weekly brief family meetings are a great time to let your teen know their input is valued.

Teens are really in training for adulthood, and you need to give them life skills to succeed. Having chores, learning to set a budget, and being able to cook and clean are crucial. A part-time job encourages responsibility and teaches your teen to balance work, school, and other activities. Learning to drive can be challenging and perhaps worrisome to parents, but it is necessary to become independent. Teens should know how to do essential home repairs, change a tire and deal with small emergencies (such as power outages or grease fires in the kitchen). Teach them essential money management, such as using a credit card responsibly and spending wisely within their means. Learning to regulate emotions is also a necessary part of growing up. Model this by trying to remain calm, talking about your feelings, or taking a break from an uncomfortable situation.

The teen years can be challenging for you and your child as they strive for more independence. Mistakes may be made, but let them know you are there to support them. Don’t be afraid to tell them you love them, even if it sometimes feels awkward. They may not always act like it, but adolescents still want to know they are loved unconditionally, so even a brief hug or high five is reassuring when life may feel stressful and confusing.

Resources

more about The contributor

Dr. Elise Herman

Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.