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Saturday, February 14, 2015

Responding to the Teen Brain

From MGH/Aspire

By Christina Lazdowsky, CPNP‐PC, MSN, RN
February 11, 2015

For parents of pre-teens and teens on the spectrum.

Why does my child get annoyed at the simplest request? Why does he roll his eyes at practically every comment I make? How do you respond to your teen's behavior? Here are some tips to help you and your teen get through these wonderful but complicated years. A journey into the teen's brain will also help.


All parents worry about their children entering the pre‐teen and teenage years. Teenagedom as we all know is a passageway into adulthood and comes with new responsibilities, biological changes, emotional transformations, as well as social and academic challenges. It is also a time when our children can seem moody and unpredictable.

It is normal for parents to ask themselves whether they are doing everything possible to help their children succeed, or are being too hard or too easy on them, or are letting their children develop, grow and explore the way they should. When you have a child with a diagnosis these same questions exist, though with additional layers of complexity. In either case, we can find some answers by taking a small journey into the teen brain.

Not Just Hormones

During the pre‐teen and early teenage years, your child's changing emotions and behaviors are not just due to hormonal changes. While their hormones do play a role, a more important factor is their brain development: their continued but staggered brain development. The frontal lobe is not yet fully developed.

This is the portion of the brain responsible for decision making, impulse control, mood regulation, and attention along with many other functions. Full function of the frontal lobe is not completely developed until an individual is well into their twenties!

The sub‐cortex, on the other hand, develops much earlier than the frontal lobe and signals the brain much faster. The sub‐cortex is responsible for instinctual responses and emotional reactivity. It has a very important function which affects our safety and security: it controls our “fight or flight response.”

Because in adolescence the frontal lobe is not yet fully developed, the sub‐cortex takes the lead. This is why pre‐teens and teens seem to be reactive, slightly (or very) impulsive, and don't seem to think about the long‐term consequences of their actions.

So here, we come to some understanding of teen behavior: The teen’s instinctual and emotional reactivity which are controlled by the sub‐cortex, develop much faster, and travel more quickly to the brain than their impulse control and mood regulation functions which are controlled by the frontal lobe.

The Erratic and Impulsive Teen: Where Did I Go Wrong?

Teens, we just learned, tend to be guided by the reactive and impulsive functions of the sub‐cortex. Here is how it can play out: Let’s say you ask your teenager to take a 5 minute break from the hours he has spent texting and help you bring groceries in from the car. The teen brain will first receive this information in the sub‐cortex, and may experience your question as one that requires a fight or flight response. Remember, the reasoning part of their brain has not yet been fully developed.

This is why your teen may storm off or roll his eyes or get annoyed at you or scream at the top of his lungs. Don’t be so hard on yourself, you did nothing wrong. When the frontal lobe is fully developed, these thought processes can more easily override the sub‐cortex's instinctual response.

These over‐reactions may be even more intense and passionate with a teen on the spectrum, though not all are necessarily bad.

Let’s take, for example, a teen on the spectrum who is brilliant in math. In math class, the teacher may ask a rhetorical question, that is, she does not want a verbal answer, yet this teen may just not be able to help himself. He may be so overjoyed about math that he absolutely has to blurt out the answer, and loudly.

How Can You Help Your Teen During These Years?

You don’t need to experience deep emotional trauma to help your teen. You will be relieved to learn that when adolescents are able to slow down, and have supportive adults around to help them think through their reactions, they are able to access the frontal lobe. This will results in “smarter” or more thoughtful responses. Here are some ways you can support them:

Prepare ahead of time. Present potentially difficult or stressful scenarios, discuss the different decisions your teen can make, and explore what outcomes may occur based on those decisions. Discuss how each seemingly small decision or reaction can have a big impact on people around them, as well as on themselves. These conversations will also help to keep lines of communication open between you and your child.

Encourage self-awareness. Independence is such an important part of adolescent growth, but for parents, allowing their teen to be more independent can be a little scary, especially since teens can exhibit such erratic or impulsive behaviors.

To help both of you get through this inevitable stage, encourage self‐awareness. Using a goal based on an independent living skill as an example, ask her to list some things that are hard for her and some things that come easily.

For instance, a goal might be to go into town on the train with a friend. You might talk about what strengths and skills she may have or need for executing this goal.

Be sure you and your teen are not on the same page regarding her strengths and weaknesses, then set up an activity for her to demonstrate the skill, or lack thereof. You can go on a short expedition on the train, for instance, where you can be around for safety reasons but not for anything else: not getting their train ticket, not showing them what to do with the ticket, not telling them when their predesignated stop has been reached, and not how to walk to their destination from the train. Then, respectfully debrief the experience together.

Independence comes with responsibility, which comes with consequences. Make sure your teen knows what this means, and understands how this impacts her. Provide clear examples of the consequences of the decisions she may make.

Create opportnities for success. Any parent understands the importance of building a child’s self‐confidence. This effort can be exhausting if the child has a diagnosis. The pre‐teen and teen years bring with them more advanced school work assignments and new levels of social complexity than they have ever been used to. These new expectations can leave a teen’s confidence battered.

You can help build their self‐esteem by finding outlets where they can succeed, have fun in environments, and where they are allowed to be who they are. Plus your teen can use his or her special interests to meet others with similar interests.

Another way to increase self‐confidence is to continue working on self‐awareness. Help your child to become familiar with his or her stressors and triggers, as well as how their body feels when they become stressed or anxious. Improving awareness of these signals will improve your child’s ability to self-regulate and control their behaviors when they are upset, leading to feelings of self‐control and confidence.

While the thought of your child entering adolescence may seem like you are about to fall into a parental abyss, it is also a wonderful time to support your child’s unique personality. By encouraging open communication and helping them to develop positive decision making skills, you can support your child's increasing independence and reasoning skills in a positive manner.

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Aspire’s Adventure Camp Trail Blazers summer program focuses on the emerging skills of pre‐teens and early teens. For more information visit: www.mghaspire.org.

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Christina Lazdowsky, CPNP‐PC, MSN, RN is Aspire's assistant program manager of child cervices. A Certified Pediatric Nurse Practitioner with almost 10 years of experience working with children and teens with autism spectrum diagnoses, she began working for Aspire as a group leader in the summer of 2006. Christina supports development and implementation of both child school‐year and summer programs with a focus on self‐regulation, stress management and self‐awareness.

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