Preventing Teenagers From Running Away: 15 Tips For Parents

The teenage years can be a tumultuous time, and as many moms and dads know, it is also a time when teens begin to flex their mental muscles, testing boundaries, and turning to peers rather than parents for advice. Sometimes emotions and arguments can become so intense that things get out of hand and the teen runs away.

Reasons Teens Run Away—

It may be hard for a mother or father to understand why adolescent’s runaway, so here are a few reasons that may help you to understand:

1. The adolescent may feel like she has to escape and get away from home to avoid something bad from happening (e.g., maybe you have been fighting a lot and she feels she just can’t go through it again …or she may be afraid you will be mad at her for something she did wrong or rules she disobeyed …or she may feel like you won’t forgive her so she has to leave).

2. An adolescent may be afraid that something bad might happen if she doesn’t leave home (e.g., living with a step-parent that she fights with a lot, the step-parent may make her feel like everyone would be happier without her).

3. The adolescent may feel that you “don’t understand,” and she may runaway to be with others that will let her just “be herself” (whether it is right or wrong).

4. An adolescent may runway to meet someone you told her to stay away from.

5. Sometimes just plain being lonely and begging for attention will cause an adolescent to runaway.

Other reasons teens run away include:

• abuse (violence in the family)

• arrival of a new stepparent

• birth of a new baby in the family

• teenagerren or parents drinking alcohol or taking drugs

• death in the family

• failing or dropping out of school

• family financial worries

• parents separating or divorcing

• peer pressure

• problems at school

Periodic vs. Persistent Running Away—

It’s important to distinguish between teens who run away periodically, and those who are persistent runners. The reasons behind the actions are quite different, and it’s critical to know what they are:

• Periodic Running: When your teenager runs away after something has happened, it can be viewed as periodic running away. It’s not a consistent pattern, and your teenager is not using it as a problem-solving strategy all the time. It's also not something she uses to gain power. Rather, she might be trying to avoid some consequence, humiliation or embarrassment. Some teens leave home because they were caught cheating in school or because they became pregnant and were afraid of their parents’ disapproval.
• Persistent Running: A teenager who consistently uses running away to gain power in the family has a persistent problem. Know that persistent running away is just another form of power struggle, manipulation, or “acting out” (a very high risk “acting out”). She may threaten her parents by saying, “If you make me do that, I'll run away.” She knows parents worry, and for many, it’s one of their greatest fears. Some moms and dads may engage in bargaining and over-negotiating with their teenagers just to keep them from running away. But understand that teens who threaten to run away are using it for power. This not only gives them power over themselves, but power over their mother and/or father. When parents give in to threats of running away, their teen starts using it to train them (e.g., a mother will learn to stop sending her teen to her room if she threatens to run away each time it happens). A teen who persistently threatens to run away is not running away to solve one problem – she is running away because that is her main problem-solving skill – she’s trying to avoid any type of accountability.

Red Flags—

Even though you can never really know for sure what an adolescent may be thinking, there are signs that you can look for that can help alert you to possible problems:

• Does she avoid spending time with the rest of the family?
• Do you ever agree on anything, or does it seem you only argue and fuss all the time?
• Does your adolescent act strange, or have extremely emotional feelings that are out of control?
• Has your adolescent been hanging out with bad company (e.g., peers who drink alcohol, use drugs, or other adolescents that just go out to look for trouble)?
• Is your adolescent acting withdrawn and completely unsociable?

If you notice these signs, it would be wise to try and communicate with your adolescent, even if you have to get outside help to do so.

Prevention—

Unfortunately we can’t completely prevent adolescents from running away, but here are a few suggestions that may help:

1. Always approach something as a problem that needs to be solved, and reward your teen when he’s able to do it successfully. Be sure to say things like, “I liked the way you solved that problem. The teacher was mad at you, but you went up and apologized.” Praise your teenager when he does something positive.

2. Don’t scream and yell, or threaten your adolescent, this will only make him want to leave more.

3. Give a warning by saying, “Listen, if you run away, I can't stop you, but it's dangerous out there. I won't be able to protect you. So not only will you not solve your problems, you'll also be putting yourself at risk.”

4. Have a system where you check in with your teenager frequently. Just stop and ask, “How's it going?” …or “Is your day going O.K.?” You can say this two or three times in one day; go by their room and knock on the door. That way you're constantly giving her interest and affection. You’re saying in a roundabout way, “I'm interested in you, I care.”

5. If you don’t agree with your teenager, at least listen to her side, then calmly give your side. If things start to get out of control, take a break

6. If you feel your teenager may runaway, you can seek professional help with counseling.

7. If you think your teenager is at risk of running away or you know that her friends have done so, you want to sit down and have a talk. You could say, “If you become upset and run away, don't hesitate to come back and we'll talk about it.” If your teenager says, “Talk about what?” …say, “Talk about how to solve the problem differently.”

8. If your teen is very upset about something, you could say, “So what's so bad about this that you can't handle it?” After she tells you, you might say, “You've handled situations like this before. I’m sure you can do it again.” As a parent, you're not “giving in,” rather you're trying to persuade your teenager that she is O.K.

9. It's also good for moms and dads to say, “It's okay to make mistakes around here.” Make it clear to your teen that “the way we handle mistakes in our home is by facing up to them and dealing with them.”

10. Teach your teens “problem solving” skills. Ask them, “What can you do differently about this problem? What are some ways we can deal with this problem?”

11. Try not to interrupt your adolescent when she does come to you to talk …sometimes it helps the most to just listen. Show your adolescent respect and keep communication open by listening to what she has to say. Explain how much you love her, and that you will always be there for her.

12. When you talk to your teenager, don't ask her how she's feeling – ask her what's going on. All teens want to argue about how they're feeling—or they want to deny that they’re feeling anything at all. Often parents get stuck there. So instead of, “Why are you so upset?” try asking, “What’s going on? What happened that made you want to leave?”

13. When your teen threatens to run away, respond by saying, “Running away is not going to solve your problems. You're going to have to take responsibility for this. And if you do run away, you're still going to have to face this problem when you come home.” Then tell her what will solve her problems.

14. Don’t get tossed into panic-mode that your teenager will run away and you will never – ever – see her again. Most homeless teens return home soon after they leave. The keys seem to be (a) maintaining relationships with pro-social or mainstream peers (non-runaways), (b) staying in school, and (c) the support of parents – especially a teenager's mother. All of these factors influence teenagers to return home. More than two-thirds of newly homeless teens leave the streets, resolve their family differences, and go home.

15. Most important of all, though, is early intervention before family relationships deteriorate and negative peer influences take hold.

==> My Out-of-Control Teen: Help for Parents with Defiant Teens

When Teenagers Get Arrested: 12 Tips for Parents

There are some  areas where seemingly small transgressions can easily become huge legal problems for a teenager. About 15 percent of all adolescent males get arrested, and 24 percent of all minority adolescent males get arrested.

When kids enter the teen years, they will naturally begin to rebel. Some adolescents choose to change their hair color or get a tattoo, but others become more rebellious. This struggle for independence can lead to trouble for the adolescent. This trouble can then lead to an arrest. If this happens with your youngster, follow these steps to learn to deal with the adolescent getting arrested:

1. Be sure your adolescents knows their legal rights. They do not have to talk to a police officer without a lawyer present. They do not have to submit to a search without a warrant. They do not have to answer questions.

2. Determine if your adolescent is alright. Is he in jail? Is he in a safe jail? Some communities have safe jails, other communities have unsafe jails. If it is safe, you might want to leave your adolescent in jail for the night. If he is unsafe, get him out as soon as possible.

3. If it is a minor issue, do not hire your youngster a lawyer. Let your adolescent know that you will find him a lawyer, but he will have to arrange with the lawyer how the lawyer will get paid.

4. Don't yell at - or question - your adolescent. This problem is your adolescent's problem, not yours. Let your adolescent take responsibility for his own mistake, not you. The more the parent yells, the more the parent takes responsibility for the adolescent's behavior. The less the parent yells, the more the adolescent realizes this is between him and the law.

5. If your adolescent is a cooperative, cheerful adolescent, never in trouble, and protests that he is innocent, he might be.

6. Listen intently to the adolescent when he tries to explain the arrest. Moms and dads have a tendency in times of crisis to turn off their listening skills. This is a mistake, and you will miss an opportunity to really listen to your youngster. The mother or father should make note of the body language of the adolescent. If the adolescent is truly remorseful, his body language will be withdrawn and sullen. If the body language is relaxed and nonchalant it, may signal that the adolescent is still having issues realizing that he has a problem.

7. Realize that this is not about you. Too many times moms and dads ignore the cry for help from the adolescent and make the arrest about themselves. This creates a feeling of neglect in the adolescent. They will feel that the parents care more about their reputation than what is going on with their youngster. This increases the chances the adolescent will act out again.

8. Relax. Finally someone else is yelling at your adolescent: a police officer or a judge. Not a parent. This is a good learning experience for a rebellious adolescent.

9. Show the adolescent that you still love and accept him, but that there will be consequences for his actions. This will obviously depend on the severity of the crime but responsibility and love should be your focus after the arrest.

10. Stay away from blaming any other adolescents involved in the arrest. Too many times moms and dads will search for others to blame for their kid's behavior. It is a major mistake to shift the blame to another youngster and not focus on why your youngster chose to do this. The adolescent will also try to blame others for the arrest and you need to make sure he and you take responsibility for the arrest.

11. Help your adolescent stay out of trouble in the future. Find out what went wrong, and allow him to learn from this mistake. This is a “learning opportunity” – not a “failure” on the child’s - or parents’ - part.

12. Try to understand the root cause of the arrest. The root cause is not the criminal offense that resulted in the arrest. It is the underlying emotion the adolescent felt that made him commit the offense. For instance, many adolescents will shoplift in order to fill their emotional needs through the danger and material satisfaction of the crime. Moms and dads often focus on the surface of the crime, totally missing the underlying cause.

A Message To Your Teenager—

In some U.S. states, any adolescent who has attained the age of seventeen years who commits a crime will be charged immediately in adult court – and they will face the adult penalties. Kids of lower ages may be "waived" into adult court depending upon the nature of the offense, the age of the youngster, and the youngster's record. Adolescent behavior that in years past might have been shrugged off as "boys being boys" is now considered to be criminal behavior.

1. Alcohol— In Wisconsin it is against the law for an individual who has not attained the age of twenty-one years to consume alcoholic beverages except in the immediate presence of a parent or guardian. In other words, it is legal for a parent or a guardian to allow a youngster who is not yet twenty-one years old to consume alcohol- as long as the drinking is in the immediate presence of the parent.

When you are not in the presence of your parent or guardian you may not possess or consume alcoholic beverages. As a practical matter, if a police officer finds an adolescent in public with alcohol on his or her breath, even though no alcoholic beverages present, there is going to be a problem. This is primarily because many police officers do not understand that it is legal for an adolescent to drink alcohol in the presence of their moms and dads. The more experienced police officers, though, will first question the adolescent about where he was when he consumed the alcohol. If the answer is anything other than "at home with my moms and dads" a ticket is going to be issued. The penalty for under-aged consumption or possession of alcohol is a forfeiture of money and/or a suspension of driver's license. Repeat offenders will certainly lose their driver's licenses.

2. Cars— Moms and dads may not be able to keep their children away from every party, but they should make every effort to avoid putting their child into a situation where he/she could easily face a serious felony charge. Allowing an adolescent to have his/her own car, to be used at any time, is a recipe for disaster. Lawyers joke that they will never let their adolescents drive with friends. They know that there could be a car-load of young people, all of whom went to the same party, all whom drank the same amount of beer, and all whom chanted for the driver to "go a hundred miles an hour." But when that car hits the tree killing or injuring the occupants, it will be the driver who is charged with a felony and sent to prison while the passengers are all wrapped in the cloak of victim-hood.

There are no adolescent car accidents anymore. There are homicides and recklessly causing injury charges. There are prison sentences and lawsuits. Additionally, it is a fact that the police would be unable to make approximately one-third of the arrests they currently make if it were not for cars. The police may pull over an automobile on a public roadway for almost any reason. If it is a slow night, any cop will tell you that all they need to do is to find a car-load of adolescents and pull them over. It will usually yield some under-aged drinking tickets and a bag of pot or two.

If you are not old enough to drink, you may not drive a motor vehicle with any amount of alcohol in your system. This even includes any alcohol consumed in the presence of your mom or dad. The moral of story is for adolescents to walk to where they are going (and I fully realize that this is advice that will be accepted by exactly no one).

3. Drugs— Of the children who wind up in legal trouble because of drugs, it is usually alcohol and cannabis. It is so obvious that possessing or selling heroin, crack, cocaine, LSD, or ecstasy is such a serious legal matter that it is truly beyond the scope of this article. If you are caught with these drugs, you will most-likely find yourself obtaining your GED in prison.

4. Cannabis (marijuana)— It is a misdemeanor, punishable by up to six months in jail, for an individual to possess cannabis. One may be found to have "possessed" cannabis even if the police officer does not find it in one's pocket. I’ve heard many teenagers complain that they should not be charged with possession of cannabis because the cop found the weed under the passenger seat and "I was sitting behind the driver in the back." Under the law, an individual "possesses" all items that are known to them to be present in an area that is under the person's "dominion and control" (i.e., in an area where the person could go get the item if one so desired). So the fact that is was "dude's weed" and he threw it under the seat is not much of a defense.

It is a felony to deliver cannabis to another person. The law does not require there to be a "sale" in order to charge a felony. All that is required is that the defendant transferred possession of the cannabis from themselves to another person. Therefore, one commits a felony by simply passing the bowl to a friend. Such behavior is not usually charged as a felony; however, the point is that it could be charged as a felony by a zealous prosecutor.

You may have heard of people getting a "ticket" for possessing cannabis. Most municipalities have ordinances prohibiting the possession of cannabis. One cannot be put in jail for a municipal ordinance violation. If a small amount of cannabis is found and if the defendant has no prior record, the police officer may decide to issue a ticket rather than to refer the matter to the district attorney for criminal charges. You do not have a right, though, to be given a ticket. This is in the police officer's discretion. Therefore, if you find yourself in this situation, it will normally be to your advantage to be as courteous and as cooperative with the police officer as you can.

There are two significant consequences of being convicted of a "state charge" of cannabis possession as opposed to a municipal ordinance violation. First, a municipal ordinance violation for possession will not disqualify you for federal financial aid for college, whereas a state charge will disqualify you. Second, a second state conviction for possession of cannabis is a felony. However, a municipal ordinance violation for possession of cannabis does not count as a first offense.

5. Sex— It is remarkable how few moms and dads understand the truly life-shattering consequences of adolescent sexual behavior. It is a fairly common occurrence for a sixteen year-old sophomore boy to be dating a freshman girl who may be as young as fourteen. This is an absolute legal mine-field for the boy and his mom or dad. Whether it seems fair or not, the truth of the matter is that in the case of adolescents having sexual intercourse or sexual contact, it is the boy who will be charged and the girl who will be considered the "victim". The penalties for a boy having sexual contact with a fourteen year-old girl can ruin a young man's life permanently.

The statutory definitions of "sexual intercourse" and "sexual contact" include activity beyond the normal meanings of the phrases. It includes almost any intentional touching of another's sex organ for the purpose of sexual gratification. What moms and dads called "petting" in their day can very easily be a serious felony in this day.

Any person who has sexual intercourse or sexual contact with an individual who has not attained the age of sixteen years is guilty of a Class C felony. The maximum penalty for such a crime is a fine not to exceed $100,000 or imprisonment not to exceed 40 years. This is an offense that will put the boy on the sex offender registry for life. Even when the girl turns sixteen there are still problems. It is a Class A misdemeanor to have sexual intercourse with an individual who has attained the age of sixteen years, but who has not attained the age of eighteen years. The penalty for a Class A misdemeanor is up to nine months in jail and/or a $10,000 fine. It is absolutely critical that moms and dads talk to their adolescents about the legal problems that sex between adolescents will cause. This, of this, of course, is not to mention the family problems of pregnancy, paternity actions, and child support.

==> My Out-of-Control Teen: Help for Parents with Delinquent Teenagers

Helping Your Child to Deal with Cyber-Bullies

Bullies have been around forever, but technology has given them a whole new platform for their actions. As grown-ups, we're becoming more aware that the "sticks and stones" adage no longer holds true; virtual name-calling can have real-world effects on the well being of children and adolescents.

It's not always easy to know how and when to step in as a mother or father. For starters, our children tend to use technology differently than we do. Many spend a lot of time on social networking sites, send text messages and instant messages (IMs) by the hundreds, and are likely to roll their eyes at the mention of email — that's "so old-school" to them. Their knowledge and habits can be intimidating, but they still need us as moms and dads.

Fortunately, our growing awareness of cyber-bullying has helped us learn a lot more about how to prevent it. Here are some suggestions on what to do if online bullying has become part of your youngster's life:

Cyber-bullying is the use of technology to harass, threaten, embarrass, or target another person. By definition, it occurs among young people. When an adult is involved, it may meet the definition of cyber-harassment or cyber-stalking, a crime that can have legal consequences and involve jail time.

Sometimes cyber-bullying can be clear-cut (e.g., leaving overtly cruel cell phone text messages or mean notes posted to Web sites). Other acts are less obvious, such as impersonating a victim online or posting personal information or videos designed to hurt or embarrass another youngster.

Cyber-bullying also can happen accidentally. The impersonal nature of text messages, IMs, and emails make it very hard to detect the sender's tone — one teen's joke or sense of humor could be another's devastating insult. Nevertheless, a repeated pattern of emails, text messages, and online posts is rarely accidental.

A poll from the national organization Fight Crime: Invest in Children found that 1 in 3 adolescents and 1 in 6 pre-adolescents have been the victims of cyber-bullying. As more and more youths have access to computers and cell phones, the incidence of cyber-bullying is likely to rise.

No longer limited to schoolyards or street corners, modern-day bullying can happen at home as well as at school — essentially 24 hours a day. And, for children who are being cyber-bullied, it can feel like there's no escape.

Severe cyber-bullying can leave victims at greater risk for anxiety, depression, and other stress-related disorders. In very rare cases, some children have turned to suicide.

The punishment for cyber-bullies can include being suspended from school or kicked off of sports teams. Certain types of cyber-bullying also may violate school codes or even anti-discrimination or sexual harassment laws.

Many children and adolescents who are cyber-bullied are reluctant to tell a teacher or parent, often because they feel ashamed of the social stigma, or because they fear their computer privileges will be taken away at home.

The signs that a youngster is being cyber-bullied vary, but a few things to look for are:

• avoidance of school or group gatherings
• changes in mood, behavior, sleep, or appetite
• signs of emotional distress during or after using the Internet
• slipping grades and "acting out" in anger at home
• withdrawal from friends and activities

If you discover that your youngster is being cyber-bullied, be sure to discuss how it feels. Offer assurance that it's not your youngster's fault. Talking to educators or school administrators also may help.

Many schools, school districts, and after-school clubs have established protocols for responding to cyber-bullying; these vary by district and state. But before reporting the problem, let your youngster know that you plan to do so, as he or she could have concerns about "tattling" and might prefer that the problem be handled at home.

Other measures to try:

• Limit access to technology. Although it's hurtful, many children who are bullied can't resist the temptation to check Web sites or phones to see if there are new messages. Keep the computer in a public place in the house (no laptops in kid's bedrooms, for example) and limit the use of cell phones and games. Some companies allow you to turn off text messaging services during certain hours, which can give bullied children a break.

• Know your children's online world. Check their postings and the sites children visit, and be aware of how they spend their time online. Talk to them about the importance of privacy and why it's a bad idea to share personal information online, even with friends. Encourage them to safeguard passwords.

• Block the bully. Most devices have settings that allow you to electronically block emails, IMs, or text messages from specific people.

If your youngster agrees, you may also arrange for mediation with a therapist or counselor at school who can work with your youngster and/or the bully.

==> My Out-of-Control Teen: Help for Parents

Expulsion from School: What Parents Can Do

Expulsion from school is used to punish children, alert moms and dads, and protect other children and school staff. Unintended consequences of these practices require more attention from health care professionals. Expulsion may exacerbate academic deterioration, and when children are provided with no immediate educational alternative, child alienation, delinquency, crime, and substance abuse may ensue. Social, emotional, and mental health support for children at all times in all schools can decrease the need for expulsion and should be strongly advocated by the health care community. This policy statement, however, highlights aspects of expulsion that jeopardize kid’s health and safety.

Recommendations are targeted at doctors, who can help schools address the root causes of behaviors that lead to expulsion and can advocate for alternative disciplinary policies. Doctors can also share responsibility with schools to provide children with health and social resources.

Expulsion from school is a method used by school administrators to decrease violence, discourage drug abuse, and curtail criminal activities on campus. Expulsion is also used to deal with difficult and challenging behaviors, including truancy.

Between 79% and 94% of schools have policies known as "zero tolerance"—the term given to a school or district policy that mandates predetermined consequences for various child offenses, and almost 90% of Americans support these policies. Despite widespread public support for schools’ zero tolerance disciplinary policies, the American Bar Association (ABA) voted in 2001 to recommend ending them. The ABA argues that it is wrong to mandate automatic expulsion or referral to juvenile court without taking into consideration the specifics of each case. It is understandably important for legal professionals to challenge a "one-punishment-fits-all" approach. It is equally important for doctors and related health care professionals to address potential physical health, mental health, and safety concerns that arise from expulsion from school.

Advocacy from the health care sector can be divided into 3 major categories:

First and foremost, health care professionals need to advocate that the educational system provide, through its own system and through community partnerships, an environment and a range of resources that support children and that decrease the likelihood that children will engage in behaviors requiring disciplinary action. These recommendations are covered in the American Academy of Pediatrics policy statement "The Role of the Pediatrician in Youth Violence Prevention in Clinical Practice and at the Community Level." In addition, "Mental Health in Schools: An Overview," developed by the University of California Los Angeles Center for Mental Health in Schools, provides good references. A number of other published documents also exist on this subject, many of which are informative and comprehensive.

The second category of health, mental health, and safety concerns is related to the lack of professional support and adult supervision often associated with expulsion.

The third, discontinuity in education is an important concern, not least because educational success is so strongly linked to health and safety. Forty-nine percent of children in schools disciplined under a zero-tolerance clause are given out-of-school suspensions that last 5 days or more. Thirty-one percent are expelled, and 20% are transferred to an alternative school or program but often have out-of-school suspension periods up to 4 days in duration. Seventy-eight percent of schools in large urban school districts consider out-of-school or at-home suspension an acceptable disciplinary action.

REASONS SCHOOLS EXPEL CHILDREN—

Real and perceived immediate threats to a child’s own safety or to the safety of others are some underlying reasons for out-of-school suspension. The Gun-Free Schools Act (Pub L No. 103-882) of 1994 requires schools to expel, for a period of not less than 1 year, children who have brought a weapon to school. However, this act also specifies that schools are allowed to provide educational services in alternative settings. Threat to safety logically should only apply to those children who have already caused serious injury or damage to school property or are at high risk of causing such injuries (e.g., possession of a gun or explosive). However, studies of expulsion patterns suggest that danger of assault is not a major reason for children having been excluded from any school program. In 1997, of the 3.1 million children suspended from school, most were involved in nonviolent and noncriminal acts. Only approximately 10% of the expulsions or suspensions were for possession of weapons. In the small towns of states such as Oregon and South Carolina, children are expelled at 5 to 6 times the rates of children in cities such as Chicago and San Francisco, yet it is unlikely that crime rates in small towns are 5 times the rates in these large metropolitan areas.

Excluding a child from attending school is sometimes imposed as a disciplinary tactic, intended primarily to punish the offender and secondarily to deter other children. School administrators have reported that removing a youngster from school provides a cooling-off period for the offending child as well as for frustrated educators and administrators. At-home suspensions are also sometimes seen as warnings for moms and dads who may have not previously taken their youngster’s misbehavior seriously and who may have considered problem behaviors to be purely the school’s responsibility. Other school disciplinarians readily admit to using expulsion as tools to eliminate troublesome children from the educational system. In some states, no alternative educational setting is provided to suspended children. For example, in 1996–1997 in Massachusetts, 37% of expelled youth did not receive alternative education in another school or a special education program. In 75% of those cases, alternative education was not provided because the school district chose not to do so.

Many school districts have developed alternative programs for children who are expelled or suspended. Unfortunately, in many of these circumstances, children are required to stay at home during an interim period ranging from days to months until arrangements can be made or a position becomes available in an alternative setting.

RISKS FACTORS FOR EXPELLED CHILDREN—

Kids who are suspended are often from a population that is the least likely to have supervision at home. According to the 2000 US census, kids growing up in homes near or below the poverty level are more likely to be expelled. Kids with single parents are between 2 and 4 times as likely to be suspended or expelled from school as are kids with both moms and dads at home, even when controlling for other social and demographic factors. There may also be racial bias for application of school disciplinary actions, with African American youth suspended at nearly 2 times the rate of white children in some regions.

Kids who use illicit substances, commit crimes, disobey rules, and threaten violence often are victims of abuse, are depressed, or are mentally ill. As such, kids most likely to be suspended or expelled are those most in need of adult supervision and professional help. In one study, 15% of kids who have never been abused but had witnessed domestic violence were suspended from school in the previous year. This was attributed to heightened aggression and delinquency from living in a violent home environment. For children with major home-life stresses, academic suspension in turn provides yet another life stress that, when compounded with what is already occurring in their lives, may predispose them to even higher risks of behavioral problems.

Despite high rates of depression and numerous life stresses that are associated with school-based problem behaviors, children are not routinely referred to a medical or mental health provider on expulsion or suspension. The only exceptions are children requiring rehabilitation or drug testing when the cause of disciplinary action was related to substance abuse. Without the services of trained professionals (e.g., doctors, mental health professionals, and school counselors) and without a parent at home during the day, children with out-of-school suspensions and expulsions are far more likely to commit crimes. A Centers for Diseases Control and Prevention study found that when youth are not in school, they are more likely to become involved in a physical fight and to carry a weapon. Out-of-school adolescents are also more likely to smoke; use alcohol, marijuana, and cocaine; and engage in sexual intercourse. Suicidal ideation and behavior may be expected to occur more often at these times of isolation among susceptible youth. The lack of professional assistance at the time of exclusion from school, a time when a child most needs it, increases the risk of permanent school drop-out.

ALTERNATIVES—

Many school districts have been innovative with alternatives to expulsion. Children are immediately transferred to supervised suspension classrooms run by the district until they are moved to an alternative setting or readmitted to their regular school site. In some districts, moms and dads are required to accompany children to school for a portion of the school day. Some districts have children provide community service on school grounds during nonschool hours.

Although far from perfect, the statute for disciplinary action taken against children who are served by the Individuals With Disabilities Education Act (Pub L No. 101-476 [1990]; i.e., those who qualify for special education) presents a promising model for managing all young offenders in the educational setting. The law requires that children with disabilities, even if expelled, continue to receive educational services. The school must perform a pre-expulsion assessment and demonstrate that it has made reasonable efforts to minimize the risk of harm in a child’s educational placement. These children’ individualized education programs are often specifically modified to address and prevent recurrence of inappropriate behavior.

RECOMMENDATIONS FOR SCHOOLS—

1. A full assessment for social, medical, and mental health problems by a pediatrician (or other providers of care for kids and youth) is recommended for all school-referred children who have been suspended or expelled. The evaluation should be designed to ascertain factors that may underlie the child’s behaviors and health risks and to provide a recommendation on how a youngster may better adapt to his or her school environment. A full history should be derived from the child, family members, and school staff members once consent to exchange information is attained. Management options to consider include appropriate referrals to drug rehabilitation programs, social agencies, mental health professionals, and other specialists who may assist with underlying problems. Doctors should routinely consider including school staff members as partners in the management of kids and youth with school behavior problems, providing that privacy issues are respected as outlined in Health Insurance Portability and Accountability Act of 1996 (HIPAA [Pub L No. 104-191]) regulations.

2. As part of the school’s or district’s written policy on disciplinary action, schools should routinely refer a child to his or her primary health care professional for an assessment if there is a disciplinary action or a child is at risk of such action. Assistance with obtaining a medical home should occur in circumstances in which a child facing disciplinary action does not yet have one.

3. Matters related to safety and supervision should be explored with moms and dads whenever their youngster is barred from attending school. This includes but is not limited to screening moms and dads by history for presence of household guns.

4. Out-of-school placement for expulsion should be limited to the most egregious circumstances. For in-home expulsion, the school must be able to demonstrate how attendance at a school site, even in an alternative setting with a low ratio of highly trained staff to children, would be inadequate to prevent a child from causing harm to himself or herself or to others.

5. Doctors are encouraged to provide input to, or participate as members of, school- or district-based multidisciplinary child support teams that can provide disciplined children with a comprehensive assessment and intervention strategies. Schools should help support the participation of doctors on multidisciplinary teams by arranging for participation at times and in formats (e.g., telephone) that are conducive to practicing healthcare professionals, by financially supporting time for school physicians, or through other logistic considerations.

6. Doctors should advocate for practices and policies at the level of the local school, the school district, and the state department of education to protect the safety and promote the health and mental health of kids and youth who have committed serious school offenses.

7. Doctors should advocate to the local school district on behalf of the youngster so that he or she is reintroduced into a supportive and supervised school environment.

8. Schools need to establish relationships with various health and social agencies in their communities so children with disciplinary problems who require assistance are readily referred and communication lines between these agencies and schools are established.

9. Children and their families should be encouraged by school staff members to access health care and social services, which can be accomplished if these important topics are included in health education and life skills curricula. It is also recommended that health care professionals provide information to kids, youth, and families on access to health care and social services.

==> My Out-of-Control Teen: Help for Parents

Child Forgets To Take Medication At School

Question

My son just turned 14 two days ago, and was diagnosed with Aspergers, ADHD and ODD last November. He is supposed to take medicine twice per day (once at home, once at school) to help him focus and to control anxiety. The problem is that he doesn't take his medicine unless someone reminds him-ever. He and I have tried putting the medicine where he will see it every morning at home …and that has helped some, but at school no one reminds him, so he does not take his medicine there. I have two questions: 1) is it reasonable to expect him to take full responsibility for taking this medicine, and 2) if so, how can I help him to do that? Thank you!

Answer

Re: 1) Is it reasonable to expect him to take full responsibility for taking this medicine, and 2) if so, how can I help him to do that?

Reasonable? Yes.

Is it likely he will meet that expectation consistently? Probably not.

Plan A—

There are now a much larger choice among medications that can be used to treat ADHD. Many of the newer ones have the advantage that they only need to be given once a day and can last for up to 12 hours. In addition to not having to take a lunch time dose, the sustained release forms of these medications have the benefit that the medication is often still working after school, as your child is trying to do his homework.

The long acting stimulants generally have a duration of 8-12 hours and can be used just once a day. They are especially useful for children who are unable or unwilling to take a dose at school. Here is an up-to-date list of the current ones:

• Adderall XR

• Concerta

• Daytrana

• Focalin XR

• Metadate CD

• Ritalin LA

• Vyvanse

The prices of these medications seem to be based more on the number of pills in the prescription, rather than on the total number of milligrams. So, instead of taking one 10mg pill twice a day (60 pills), it is usually less expensive to get a prescription for, and take, one-half of a 20mg pill twice a day (30 pills). Based on the average wholesale price for some of the ones listed above, doing this could save you about 15-30% a month, respectively. The savings based on the retail pharmacy price usually seem to be even greater, often up to 50% a prescription.

Plan B—

Alternatively, you might consider recruiting the assistance of a staff member at your son’s school (e.g., school nurse) to give him his afternoon medication. Initially, the nurse could find him in class to give him his meds …then after a couple weeks, he can be instructed to stop by the nurse’s office for his afternoon dose.

Good luck,

Mark

==> My Out-of-Control Teen: Help for Parents