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Perri Klass, MD, writes in the NY Times that she as a pediatrician doesn’t call children “rude” or even describe them that way in her medical records.
But she does make judgements, she says, and so do all pediatricians.
Finding “Miss Manners’ Guide to Rearing Perfect Children,” by Judith Martin very useful, she called her to ask why Martin feels so strongly that manners are at the heart of the whole parental enterprise.
Martin said, “Every infant is born adorable but selfish and the center of the universe.” It’s the parent’s job to teach that “there are other people, and other people have feelings.”
The conversations that every pediatrician has, over and over, about ‘limit setting’ and ‘consistently praising good behavior’ are conversations about manners.
And when you are in the exam room with a child who seems to have none, you begin to wonder what is going on at home and at school, and questions of family dysfunction or neurodevelopmental problems begin to cross your mind.
Dr Barbara Howard, an assistant professor of pediatrics at Johns Hopkins School of Medicine and an expert on behavior and development, tells Klass that a child’s manners are a perfectly appropriate topic to raise at a pediatric visit.
It has a huge impact on people’s lives — why shouldn’t you bring it up? Do they look you in the eye? If you stick your hand out do they shake it? How do they interact with the parents; do they interrupt, do they ask for things, do they open Mommy’s purse and take things out?
She suggests that the whole “manners” concept might seem a little out of date; cast it as “social skills.” These days, “social skills” are a very hot topic. They are necessary for success in school; they affect how you do on the playground, in the classroom, in the workplace.
Social skills are a profound set of challenges that complicate the lives of families living with children on the autism spectrum. Such children have great difficulty learning social codes, deciphering subtle body language or tone of voice, and catching on to the rules of the game.
Therapy for these children can include systematic training in social skills. Sometimes the training uses scripts for common human interactions.
“You Can Teach This Stuff”
One message that comes through is that “you can teach this stuff,” says Howard, “and we maybe aren’t teaching it as well as we should to children who are developing normally.”
Of course, one of the long-term consequences of being a rude child is that you become a rude adult. Perhaps even a rude doctor. There are bullies on the playground and bullies in the workplace.
It’s always disconcerting, writes Klass, to see an adult with 20years or more of professional practice under their belts, who still sees the world only in terms of his own wants, needs and emotions. I want that so give it to me; I am angry so I need to hit; I am wounded so I must howl.
Klass likes Miss Manners’s approach because it lets a parent respect a child’s intellectual and emotional privacy — I’m not telling you to like your teacher; I’m telling you to treat her with courtesy. I’m not telling you that you can’t hate Tommy; I’m telling you that you can’t hit Tommy.
Your feelings, little one, are your own private business; your behavior, on the other hand, is public.
It is a counterintuitive lesson, and the first big one, that there are other people out there whose feelings must be considered. And it affects a child’s most basic moral development.
For a child, just as for adults, manners represent a strategy for getting along in life; they also offer a chance of successful intellectual engagement with the business of being human.
As a pediatrician, I worry about the trajectories of children’s growth and development: measuring a baby’s head size, weighing a toddler, asking about the language skills of a preschooler. Manners are another side of the journey every child makes from helplessness to autonomy.
And a child who learns to manage a little courtesy, even under the pressure of a visit to the doctor, is a child who is operating well in the world, a child with a positive prognosis.
source: Perri Klass’s article in the Science Times on 1/13/09. www.nytimes.com
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