Disabilism and the Health Care Community

In honor of Blogging Against Disabilism Day (check out the other blogs participating today at Diary of a Goldfish), I think I had better make one thing clear:

I do not speak for "the disability community".

I am a parent of a child with a significant disability and a nurse who practices in the field of pediatric disability and special health care needs. My understanding of the issues of disabilism come from an attempt to understand my own attitudes every bit as much as from the attempt to understand the reactions of others to my child and my clients.

It is because I am a nurse that I have a fundamental misunderstanding of disability against which I must continually guard myself! This is because the health care fields persist in the view that disability is a medical condition and not a social construct. We use a continuum to measure a concept we think we understand, and at one end we put "normal" and at the other end we put "abnormal". And this thinking pervades health care; we use this same yardstick to measure everything.

Even the very fact that we think we know what we mean when we use the word "disabled" is, in itself, an example of prejudice. It's what leads people to identify themselves as part of a subgroup, because the majority group perceives a difference. Perception of difference leads to difference, in a sort of circular experience for all.

Yet the truth is that there is deep-seated, pervasive prejudice against perceived disabilities that affects us all, even those (or maybe, especially those) who are diagnosing it in other people. This is especially prevalent in neonatal areas when a child with a significant and obvious disabling condition is born and there comes an inevitable "quality of life" discussion with the family. Which is, in essence, a discussion of all the things the baby will not be able to do, all the ways in which that baby will never be like a non-disabled person and all the significant supports that child will need if he grows up.

It is hard for doctors and nurses to separate their own pre-judging of disability from the lives they are discussing. For one thing, the prejudice against significant disability is so deep it seems natural. It even seems sensible: "who would want to live that way?" is what I'm often asked. "He will never walk. He will never see!"

If that is not prejudice, what is?

Think about this: is it the condition that is so awful, or the lack of automatic inclusion in society? If we had a society in which it was easy to function despite a sensory or motor disability (we don't! this is fantasy here), why would it matter if one could not walk? If you can envision a place where every single area of every single man-made surface--and as much of the natural world as can be--is accessible to a wheelchair, for instance, and you still persist in thinking it is better to walk on your own two feet, then you need to think about that. That, dear reader, is disabilism. Or ablism, depending on your point of view!

Think about the fact, the very true and obvious fact, that there is nothing separating you or those you love from the experience of living life with a disability then a split second of fate or chance. And if you would not regard your own child as of less worth the minute after the car accident in which he loses a limb or some cognitive functioning then you would the minute before, then what is up with your prejudices against others in the same situation?

My little contribution to Blogging Against Disabilism Day is this: if you are a doctor or nurse taking care of people with disabilities, think hard--very hard--about how you regard disability. Come to start thinking of disability as a social construct (what is wrong with our social structures that make it difficult to be disabled) more than a diagnosis or condition (what is wrong with the person). This doesn't mean stop treating what can be treated, stop researching and questioning and providing good adaptive equipment and equitable access to your services. It does mean examining your conscience about your own knee-jerk reactions to obvious disability; thinking about why this bothers you and why you equate disability with less worth and how you can stop. And how we can begin to think about societies that make room for everyone, reduce barriers to accessibility, and even come to understand how our own perpetuation of the "disability as something bad" pre-judgment--which permeates health care--contributes to the problem.

mary

PS: I'd like to recommend some articles at the DREDF (Disability Rights, Education, and Defense Fund) site: Disability Rights Law and Policy: International and National Perspectives, edited by Mary Lou Breslin and Silvia Yee. In particular, Where Prejudice, Disability, and "Disabilism" Meet, by Silvia Yee.

Chernobyl: the legacy

This is a very disturbing portrayal of the human disaster wrought by the Cherynobyl fallout ten years ago.

There is no question that the radiation has damaged hundreds of thousands of people. And yet I am having a hard time with some of the portrayals and articles about the human victims, because the language used to describe the children implies, for instance, that the victims are "monsters" and that they "look like a whole other race". This video, for all the compassion you can hear in the narrator's voice, flatly states the Belarus people face degeneration as "people like these grow up to pass on their genes to the next generation" (to paraphrase).

In addition, the conditions shown in this institution are inhumane in the extreme, yet the narrator describes the children being fed on the floor as "loved and cared for" at the same time he acknowledges that when they grow up they will simply be admitted to the main mental institution.

What happened is horrible. But the resulting congenital disorders do not remove anyone from the human race. These are human beings, not "disasters", not "monsters".

Well, while I examine my conscious to see why this kind of portrayal of legitimate horror-so illustrative of man's hubris and our unconcern for the consequences of our own misuse of our world-strikes cords of dismay in my mind, maybe some of my readers know what efforts are ongoing to try to help Belarus. What is a legitimate effort ongoing, and how I can support it; where to send my money or otherwise do my share. Sincerely. I can't go rescue all those kids literally, but I'm hoping there is something that I can do that will be more than a token response.

I should note that it is not possible to determine from this video just how many of these children have conditions that were the direct result of the Chernobyl fallout. The WHO Chernobyl report has data that indicates the rate of congenital problems has not substantially increased, so perhaps this should be kept in mind.

However, regardless of cause, this video's portrait of children in a floundering society is very disturbing and thought provoking.

mary

How did I miss Pediatric Grand Rounds?

Wow, things can slip right by you when you don't read a few blogs for a few days...all of a sudden there it is!! The new Pediatric Grand Rounds-Premier Edition-up at Unintelligent Design. Check out the pediatricians of the blogosphere in their specialty grand rounds.

And then of course one of the wonders of the medical blogosphere (don't you all feel there needs to be a better word than "blogosphere"? Please inform me if I have overlooked it, 'k?) Grand Rounds is up at Health Business Blog. Lots and lots of great links; I hope you find time to read some of them.

If this keeps up I'll be reading blogs six or eight hours a day. Will have to give up sleep and...other fun stuff. Use your imagination.

:-)

mary

Blogging Against Disabilism Day

The Goldfish over at Diary of a Goldfish has announced a Blogging Against Disabilism Day for May 1, 2006.

Thanks to becca at Comprehension Dawns for the notice.

mary

What I've Been Reading on the Web Lately

Inspired by The American Journal of Bioethics blog's "What we are reading today" entries, here's what has been interesting me the last week.

Comments welcome~~~very welcome. MORE than welcome. Please comment.

Enough groveling.

:-)

Secret Worlds: The Universe Within

"View the Milky Way at 10 million light years from the Earth. Then move through space towards the Earth in successive orders of magnitude until you reach a tall oak tree just outside the buildings of the National High Magnetic Field Laboratory in Tallahassee, Florida. After that, begin to move from the actual size of a leaf into a microscopic world that reveals leaf cell walls, the cell nucleus, chromatin, DNA and finally, into the subatomic universe of electrons and protons."

One could watch this over and over. One, er---cough---has watched it over and over.

:-)

The CBC Network (Center for Bioethics and Culture), one of whose stated mission goals is "to defend the dignity of humankind", has a speaking avatar who introduces the site the first time you click on. Do you find this as ironic and silly as I do? There is a voting link on the right hand side, if you want to vote about it. Of course, it just occurs to me as I type that this is increasing site traffic there. Maybe the silly talking avatar has a place...maybe Moteguardian could get one.

One ponders.

Interesting essay by Tom Connors at The Yale Journal for Humanities in Medicine entitled "On Esthetics & Disability". One of his points:

"What I have cited merely describes the reality of a person with a disability in modern culture. I can argue that it isn't always so, in times past we have been honored deprecated, sanctified and vilified. Every possible reaction has been manifest at one time or another, but never were we unidentified. By virtue of differences in intellectual capacity, behavior, or appearance we are always identified as separate and distinct -- as the other."

"Retiring on the Edge of Poverty in Rural America": on being poor, old--and female--in hidden pockets of America today. At the NPR website.

"Learning to Savor a Full Life, Love Life Included" from the NYT:

"There, for the first time, Ms. Graham, who is mentally retarded, and Mr. Ruvolo, who has Down syndrome, will be permitted to spend time together in private.

The pair were coached in dating, romance and physical intimacy by a social service agency at the cutting edge of a new movement to promote healthy sexuality for the seven million Americans with mental retardation and related disabilities.

In what experts say is the latest frontier in disability rights, a small but growing number of psychologists, educators and researchers are promoting social opportunities and teaching the skills to enjoy them."

Read the whole article, especially the appalling statistics for the percentage of people with mental retardation who have experienced sexual abuse by their 18th birthday.

The National Nurse. A move is afoot to establish a federal office: There is a bill before the US Congress seeking to amend the Public Health Service Act and establish an office of The National Nurse:

"[W]ithin the Office of Public Health and Science an office to be known as the Office of the National Nurse, which shall be headed by an individual serving in a position to be known as the National Nurse. The Secretary shall appoint a registered nurse to serve in such position. The Secretary shall carry out this section acting through the National Nurse."

Wonder what the hours are?

:-)

Finally, I have been spending hours reading nursing blogs found on the left hand side of the page at Mediblogopathy, even though I'm not listed there yet, either! It really comes home to you how diverse nursing is, how interesting nursing can be. How many very talented writers we have among us (and some who are pretty bad!).

I'm inspired to increase my own list of links.

Maybe tomorrow.

What have you all been reading lately?

mary

Attention diagnosticians: why are you using the term FLK?

OK little rant coming. Click away now or be forewarned.

Why are we seeing this persistent acronym which stands for "funny looking kid" in medical records? As a diagnosis?

FLK is an informal term used when the clinician feels the child has mild or soft signs of a possible genetic syndrome. In other words, when he has mild dysmorphic features.

Why not say "mild dysmorphic features" to begin with?

Now, it's bad enough when this term is thrown around in general conversation between clinicians. I know what you mean, and you know I know what you mean. It's like shorthand, or abbreviation. It's not the most disrespectful of terms, but it's one you would not really and truly like to let a parent overhear you using, is it? So, bad enough to use it in everyday conversation.

But it is not a diagnosis. And it is not a proper description of a sign or symptom, either.

If you mean "the child has mild dysmorphic features possibly indicating a genetically based syndrome"...say that.

Do not---do not---write FLK as a diagnosis or as part of your evaluation of systems. Which I have seen twice---TWICE---this week alone in medical records. Tell me this is not being taught in medical school. Tell me there is not a professor running around telling you to use that term in written diagnostic terminology.

For heaven's sake, people. Why am I having this conversation?

mary (goes off to get a cold iced tea and consider the state of modern pediatrics)

Some goodbyes are forever

Sometimes people get the impression that nurses (and others whose work brings them in frequent contact with illness or trauma) get hardened to death, or immune to the sadness it brings. And I just don't think that's true. A nurse can get used to the possibility of death. When prepared, a nurse can assist a patient or family during the dying process, support the grief of the loved ones, and respectfully care for the body of the deceased person.

But not without grief, seen or unseen.

I no longer work in clinical care areas as a clinician; my work as a case manager requires different nursing skills. I'm not the one who starts the IV or inserts the foley. I'm the one standing by with the parents and siblings while the clinicians work. I'm the one who sees them at home, goes with them to the doctor visits, and visits their child at school. I'm invited along on their journey through the complicated and confusing American healthcare system, and I come to know some of them very, very well.

So it's not without grief and a sorrow too potent to explain that I tell you I lost a little client today. She died suddenly, at home: Mom said she just stopped breathing. This was one little feisty baby, let me tell you. When I shut my eyes, I can see her laughing. She has just learned to say, "bah-bah-bah". She liked to blow raspberries. When she smiled, her eyes crinkled shut. When they told me she had died, I just put my head on my desk and cried. Hard.

Who knows why some die early and some live long lives? Not me; I don't know the answers to any big questions like that, and especially not today. I only know I'll miss this baby; this particular, charming, feisty, amusing little complicated human being. I'll carry on; this is not my own child and my grief is nothing compared to a parent's grief. I maintain perspective because I have many more clients and because I also have my own family to love and worry about. Life goes on.

But don't let anyone tell you nurses don't grieve.

mary

When the patient's mom has mental retardation

One of the challenges I face as a case manager for children with special needs is mothers who have cognitive disabilities.

But something that doesn't occur to most other primary care givers is this:

You have those moms in your practice, too.

There isn't one kind of face or one set of symptoms by which you can recognize cognitive impairment in a caregiver. Most of us are used to thinking about impairments as something we assess in a patient; it is harder to get our minds around to recognizing it when it is subtly present in a caregiver.

Here are some hints for those of you who suspect there may be an underlying cognitive disability in a parent:

~~Repeatedly disregards written information
~~Cannot repeat instructions
~~Has difficulty generalizing information
~~Has difficulty prioritizing
~~Reads but does not comprehend material and/or cannot remember what is read
~~Always forgets appointments
~~Never learns how to negotiate her insurance requirements
~~Has difficulty recognizing her child's developmental milestones and anticipating them
~~Is not feeding her child properly

I find many primary and specialty practices who have seen the mothers who come to my attention-frequently seen them for many visits-and who have labeled these moms as "problem moms", and have never realized they, in fact, have mild mental retardation. They come to my attention as "non-compliant", which they are. But not intentionally.

Once I was called repeatedly to come see a mother whose child had a disability and mom was not taking her to needed appointments. I spoke to mom on the phone a couple times, and always when it came time to visit, she "forgot" or "had to work". Finally, I caught up with her at her child's bedside. The child had been admitted as "failure to thrive" and the hospital staff were on the point of reporting mom to CPS.

So I came in, introduced myself, and after about two minutes realized the problem.

Mom had mental retardation.

How did I know this, when it had been oblivious to other professionals? Because of familiarity with this population, largely, but also simply because I know there are moms with mental retardation out there slipping through the cracks and so I keep it in mind.

Because part of my assessment includes a family and social history I asked about two things that often get useful information: 1) do you get SSI? If so, what disability do you have? and 2) Tell me about your school days. Were you in any special classes for reading or other things?

This mom had found her own job, and was so proud of this! She was so proud of it, in fact, that she did not ever miss her scheduled days. Not ever. Even if the baby had another appointment. She could not prioritize this, because she had not been instructed in this directly. This may seem like something you shouldn't have to do: you shouldn't have to tell a mom how to prioritize these things. But you do.

She could parrot back the nursing staff's instructions on how to feed her baby, but five minutes later, could not repeat what was said (I know. I stayed and assessed this). She could read the instructions, but not follow them.

Before beginning to work with this mom on how to prioritize appointments and work schedules, etc, I asked the nurses to make one simple adjustment in home instructions. After making sure she had a VCR at home, I asked the nurses to videotape mom feeding her baby while the nurse gave instructions. Mom took this home, and watched it as she fed, until what was being done became second nature.

I wish I could tell you this story had a happy ending, but I can't. Mom disappeared from my follow-up; moved and left no address and I never found her again.

Hopefully, she showed up somewhere.

But maybe you might recognize one or two of the moms in your own practices from her description, and think about how to adapt your teaching or anticipatory guidance, how to make sure she knows how to feed and give meds, and how to refer her to your local resources when there are any available.

It is not a crime to have mild cognitive disability and be a mom. It is just hard to do it without significant help.

mary

This blog is apparently not about the nursing experience

Huh.

Well, maybe it's not. Maybe it's really about health care continuums, and community care alternatives. About safety nets and access to care and the unmet needs of the uninsured. About what it looks like to case manage complex kids in America today.

Which I thought was "the nursing experience". At least, it's "the nursing experience" from my shoes.

My blog (which I'll admit is pretty new) has been declined by a "nursing blogs" blog; nicely, with a compliment about my writing, but reminding me that they are really looking for blogs that pertain to "the nursing experience".

Apparently the only "nursing experience" is acute inpatient hospital based. Or somehow excludes the kind of case management they pay an RN like me to do.

Well, I'm not going to quibble. I'm aware of this implicit bias because people sometimes ask me what I used to do "when" I was a nurse. Even other nurses ask me that. It can get irritating after awhile, but there you go. Once you're out from beside the bed, not only doesn't the public understand you are still a nurse doing nursing for a living, your own peers don't believe it either.

Of course, I do get off topic and post about my personal life. Or about what is interesting to me in the world of health care policy. You know, like...blogging. What bloggers do. What blogs were intended for, I thought. Maybe the decliners thought I verged off topic too much for a blog featuring "the nursing experience".

:-)

Anyway I thought I'd ask some of my readers to respond and tell me:

What is "the nursing experience"?

Looking forward to comments, whether you are a nurse or not.

mary (you know, the case manager who signs "RN" after her name and before her title)

NYT: "Siblings of Disabled Have Their Own Troubles"

Some words of wisdom here in this short article from the NY Times, about the siblings of children with disabilities:

"These brothers and sisters will likely have the longest-lasting relationships of anyone, relationships easily in excess of 65 years," Mr. Meyer said. "They should be remembered at every turn."

It's not easy to know what to do all the time, when you are parenting. Add a child with special needs to the sibling mix in your house, and the chances of not meeting everyone's needs goes up pretty quickly. This article points out that much of the support in the (broadly speaking) disability community comes to parents and to people with disabilities themselves. There is a lot less attention to the emotional and support needs of siblings.

When Emily was born, my middle child was only 3 and a half. I made mistakes. I know: all moms make mistakes. But I wish I could go back and rethink some things.

Since she was so sick at birth, we had so many appointments with all kinds of people. We had so much new stuff to learn. But she had open heart surgery at 2 months of age, and then things settled down a bit.

We started going to an Early Intervention program weekly, meeting other parents and kids with Down syndrome. It was wonderful for my soul to meet so many other moms (and a few dads) and see so many beautiful children. I loved that weekly visit, and looked forward to it each week. It was the major source of comfort and support in my life, at that time.

But siblings were not allowed. And one day, I had to take my middle child with me, because I could not arrange babysitting.

And she was so sweet. So good. She couldn't come in. But outside the door of the Infant Program was a little playground with a slide and swings, and a bench. It was literally right outside the door, and I could see her every moment.

What I saw through the door: a curly headed four year old girl playing patiently alone on the swings and on the slide, and sitting on the bench talking to herself, swinging her legs back and forth. Occasionally she'd get up to peer through the glass of the door inside. She'd see me and wave, and go back. Go back outside the circle.

Here's what I should have done: I should have cancelled my Infant Program visit that week and stayed home. I should have heard the call of motherhood a little clearer that day.

Well, she assures me she has no lasting traumatic emotional impact of her solitary day on the swings outside the glass door. Truth be told, I don't think she remembers it.

I pray to God she doesn't remember it.

It is hard to raise children with complex needs; hard to not get confused, hard to keep your mind on what truly matters. But I think we need to focus on the siblings, too. They often get shunted to the side, out of necessity---but also, out of focus. Our focus, as parents.

Just a little story from this mom.

mary

The gift of risk

Dream Mom has a wonderful post up today called "The Hole". I think it describes perfectly the value of allowing risk into the lives of children with complex needs.

No, I'm not talking about letting them push their wheelchairs out into rush hour traffic! I mean the ordinary risk of everyday life, such as the possibility of dirty shirts from playing down in the dirt.

We who love and care for children who require from us lots of delegated responsibility, particularly children with significant cognitive disability who require help with ordinary decision-making or self-care, tend to want to wrap them up in protective layers to keep them from harm. And that's fine most of the time. It keeps them safe and protected.

But we sometimes forget that we also have to let them have some element of risk, some decision-making, some experiences, or we are depriving them at the same time we protect them. We are taking away something in our effort to maintain safety, and that is the ordinary place of play and new sensory experiences in a child's life. That's how children learn about the world, even children with complex disorders and problems with cognitive functions.

Allowing risk is not something most moms like me necessarily want to do! In our vigilance to protect, with the fierce love of our children and an understanding of their vulnerability, we often have trouble letting go in even ordinary situations.

We have trouble letting them get down in the dirt to play.

How well I remember the first time I let Emily go into the McDonald's play area and go up into the tubes by herself. I know: those of you who haven't raised a child with significant and global developmental delays are probably scratching your heads about this big "event". But those of you raising kids like mine are smiling with a tear or two.

Of course, she would not come down for love, money, or french fries, and I had to send a young McDonald's counter person up there to get her down. And finally (the truth comes out!) get him to "assist" her down by, well~~~by pushing her down the slide.

She was thrilled with the whole darn thing.

Risk. Choice. Decisions. These are things our kids need.

Dream mom: I'm sorry he ate the dirt. But I'm not sorry he played in it!!

mary

Massachusetts mandates health insurance for all citizens

BOSTON (AP) — Lawmakers overwhelmingly approved a bill Tuesday that would make Massachusetts the first state to require that all its citizens have some form of health insurance.

The plan — approved just 24 hours after the final details were released — would use a combination of financial incentives and penalties to dramatically expand access to health care over the next three years and extend coverage to the state's estimated 500,000 uninsured.

If all goes as planned, poor people will be offered free or heavily subsidized coverage; those who can afford insurance but refuse to get it will face increasing tax penalties until they obtain coverage; and those already insured will see a modest drop in their premiums.

The measure does not call for new taxes but would require businesses that do not offer insurance to pay a $295 annual fee per employee.



*****************
Well, very interesting and I mean that without sarcasm. I hope other states are watching this and seriously considering it. The combination of business mandates and personal responsibility to be insured or face financial penalties is unique.

mary

Tag! I'm it!

I've been tagged by Kim at Emergiblog (after some shameless handraising by yours truly--true, true). So, if I understand the rules correctly, I have to provide answers to the following questions, then tag four more lucky bloggers. Here goes:

4 Jobs I Have Had In My Life:

--Counter girl at "Roy Rogers", complete with red hat and cowboy tie. I had to say, "Howdy pardner, may I serve you?" and "Happy trails!" (at least, when the boss was within hearing distance). And you wonder what motivated me to go to nursing school!

--Nursing assistant.

--Registered Nurse.

--Mom. (Mom counts!!! "Because I say so, that's why").

4 Movies I Could Watch Over and Over:

--Fellowship of the Ring.

--The Two Towers.

--The Return of the King.

--um.....are there any other movies?

4 Websites I Visit Regularly:

--Arts & Letters Daily. So far, the best web site for all kinds of artsy/lettery things, different articles by scholars and critics, different viewpoints, different subjects. OK, it's published by the Chronicle of Higher Education but they let regular old ordinary people like me read it, too. And for free, I might add.

--Short Sharp Science. A great blog from a great magazine, full of all the sorts of short sharp science-related reporting that New Scientist is known for.

--Kevin, M.D. I don't know how Dr. Kevin has time to blog all these things, but I admit to reading his blog daily. Often twice a day. I can't always tell what his platform is; I think that's a good thing. Dr. Kevin, please: do not increase your patient load, and risk your blog, OK?

--TheOneRing.net Reading Room. All right, look. A girl has to have a hobby. Mine is talking about Tolkien. If you are in any way interested in JRR Tolkien and enjoy talking about him and all sorts of related and interesting tangents, this is by far the best discussion board available. There are more highly knowledgeable contributors and worthwhile posts on this board than any other place on the web (or off the web, for that matter). A virtual Bird and Baby. I say no more.

4 of my Favorite Foods:

--really ripe mangoes

--homemade macaroni and cheese

--steamed Chesapeake Bay blue crabs, heavy on the Old Bay spicing

--my mom's chocolate cake

4 Places I Would Rather Be Right Now:

--Sitting on a porch somewhere in the Blue Ridge mountains of Virginia.

--In a pub in western Ireland.

--Somewhere the ocean is blue, warm, and placid.

--Middle Earth.

4 Most Wonderful Places I Have Been:

--The Blue Ridge mountains of Virginia.

--Miami Beach.

--The desert of New Mexico at sunset.

--Home.

4 Books I Could Read Over and Over:

--The Lord of the Rings

--O Pioneers!

--Bleak House

--To Kill a Mockingbird

4 Songs I Could Listen To Everyday:

--She Belongs to Me (Dylan)

--And It Stoned Me (Van Morrison)

--Boulder to Birmingham (Emmylou Harris)

--Long Ride Home (Patti Griffin)

4 Reasons I Blog:

--Because I have experiential knowledge in my field to share.

--Because I like to write.

--Because blogging is more personal than "listserving" or "message boarding".

--Because there are lots of other bloggers I read and I want to feel part of the extended "health care professionals" family while expressing my unique viewpoint.

4 People To Tag:

--Keith at Digital Doorway

--I'm hoping to follow Kim's lead and ask for volunteers! C'mon, it's fun. Raise that hand where I can see it!

Little Girls Gone

A news release on a study appearing in the April issue of Pediatrics, the peer-reviewed, scientific journal of the American Academy of Pediatrics (AAP).

For Release: April 3, 2006, 12:01 am (ET)

CHICAGO - A new study establishes a strong connection between young adolescents' media diet and increased sexual intercourse.

The study, "Sexy Media Matters: Exposure to Sexual Content in Music, Movies, Television, and Magazines, Predicts Black and White Adolescents Sexual Behavior," found that white 12-14 year-olds who had a heavier sexual media diet were more than two times likely to have intercourse when 14-16 years old than those adolescents who had a lighter sexual media diet.

This relationship was not as significant for black teens, which seemed to be more influenced than their white peers by their parents' expectations and their friends' sexual behavior than by what they hear or see in the media.

But while one of the strongest risk factors for early sexual intercourse for both black and white teens was the perception that his or her peers were having sex, the study says that one of the strongest protective factors against early sexual behavior was clear parental communication about sex.

***************

I've worked for many years with lots and lots of young moms, some as young as 14 or 15. One as young as 13.

Many-very many-as young as 17.

I've been in their houses, to their social gatherings, to the places they hang. Seen the TVs that show all day long images of breathtaking depravity and violence from MTV and HBO, while toddlers climb on couches nearby and babies sleep in the chaos. Heard the violent, hate-filled, misogynist lyrics of the songs that play in the cars or boomboxes around which the children gather. Been to a city-sponsored "health" fair where a DJ blasted popular music from immense loudspeakers and the lyrics were about "do me, come on baby, do it hard" accompanied by passionate "uh, uh, uhs"....and the little ones were running around getting faces painted and eating healthy snacks from the WIC table. Stood in line at the grocery stores surrounded by images of women's breasts, butts and thighs--all the famous people who look like (let's face it) prostitutes, glorifying the look and promising: "look like me, strut like me, wear hardly any clothes, sing suggestive lyrics, simulate sex while you dance, moan, and rub up against the male dancers, and if not famous, you can at least be a real woman like me".

But it's not women who are buying this crap. It's little girls, our little girls, our lost generation of young teens succumbing to this horror.

I'm not a very large fan of censorship by government decree. I'm aware that each new generation acts in ways that scandalize the older generation. But it's really gone past the point of toleration. It's past time for a backlash against this kind of media, which harms our girls (and boys), giving them false understanding of human sexuality and pushing them beyond their years into risky behaviors before they have mature thoughts. Before they even are old enough to have mature thoughts. During the years they are learning how to think and negotiate life, they are learning to take all this glorified prostitution as somehow glamorous, somehow "real" and valuable.

Those of us working with children, especially those of us who are home-visitors, need to speak up, correct, role model, and advise moms to turn it down, turn it off, and don't buy it. How much younger can moms be moms than 13? Do we want to know the answer to that?

mary

(PS: Judging by the interesting Google searches that are referring people to this post, some web surfers are going to be MIGHTY MIGHTY disappointed! )

They had to do a study to tell us new moms are exhausted?

I don't know why I find this so amusing.

At five weeks postpartum, a majority of new moms were fatigued, had breast discomfort and a decreased desire for sex, the study found.

Well, yeah.

:-)

mary