Feb 27, 2016

Temperament in Children: The Key in Which Their Song is Written

David Rettew is an Associate Professor of Psychiatry and Pediatrics at the University of Vermont College of Medicine. He is the Training Director of the UVM Child & Adolescent Psychiatry Fellowship and the Director of the Pediatric Psychiatry Clinic at the UVM Medical Center. Dr. Rettew has over 100 published journal articles, chapters, and scientific abstracts on a variety of child mental health topics, including a recent book entitled Child Temperament: New Thinking About the Boundary Between Traits and Illness. He also writes a blog for Psychology Today called the “ABCs of Child Psychiatry.” Follow him on Twitter or Facebook at @PediPsych.

Understanding Temperament

We all know that children differ according to their temperament, and parents often marvel at how temperamentally different their kids can be. Some are quick to feel anxious or mad while others seem unflappable. Some want to be surrounded by as much noise and excitement and people as possible, while others prefer quiet and solitude.  Some kids ride the wave of their emotions while others can keep them in check. 

Where do these traits come from and what, if anything, should we do about them?

One analogy that I like for temperament is in music. If you think of a piece of music such as a song or symphony, you can think of temperament as the key (F major, A minor) in which the music is written.

Studies of twins tell us that around 50-60% of the influence on child temperament comes from our genes, depending on the trait. That may sound like a lot, but it leaves plenty of room for other influences, such as the environment. 

Nature, Nurture or Both?

In the old days, we used to argue about nature versus nurture in determining behavior. That argument is now largely over, as we understand more and more that not only are both influences important but that genes and the environment can mutually impact each other. 

As an example of this, geneticists have a term called an evocative gene-environment correlation. In the world of child development, this term means that the environmental events that a child experiences aren’t just random acts that occur out of nowhere but are often instead associated with genetically influenced behavior. To use a local metaphor to explain this idea: kids, just like high mountains, have the ability to create their own weather. If you think of a child who is born with a temperament-based tendency to be happy and affectionate, it is easy to imagine that the world tends to react to those traits in very positive ways. But what about the child who is prone to get irritable or very easily feels anxious? For those children, the environment around them might cause more irritability or more anxiety. When that happens, the snowball begins to roll downhill and this is one way that small personality tendencies can develop into full-blown disorders.

So what can we do to support children?

In the past we often simply blamed parents or even the children themselves. A better strategy, however, might be to use this knowledge of how all these factors work together to see if we can get that snowball rolling in a different direction. In working with parents, the word I often like to use when talking about the response to children with more challenging temperaments is override. When your little mountain is provoking you into having a thunderstorm, those feelings you have may be completely normal and completely understandable, but they are probably going to make things worse. What we need to be able to do instead is recognize that an override situation is here and then take a very deliberate step in a different direction. 

Easier said than done, right? 

To be sure. But with practice, we can get better at it. 

I also recognize that this advice is the exact opposite of what many parents have been told in the past. The main message from past experts such as Dr. Spock was that we should parent in a way that feels natural. This still is good advice in my opinion, but I also think that there are many times and many moments when as parents we have to do the thing that feels the least natural to us, if we want to move our kids onto a different track. 

Two famous temperament researchers, Stella Chess and Alexander Thomas, proposed almost 50 years ago that temperamental traits by themselves are neither good nor bad. Rather, what determined whether or not traits were adaptive was the degree to which the trait and the environment were a good fit.  This important “Goodness of Fit” theory remains with us today. And in many ways, the process of trying to improve a child’s fit with the environment can boil down to two things: changing the child to fit the environment, or changing the environment to fit the child, or some combination of the two. Parenting is always hard work, and even more challenging when it comes to kids with temperaments that do not fit their environments.

Kids don’t come with instruction manuals, but that may be alright. 

Unlike some plastic toy that has to be put together in a specific way, with kids there is no single final product that needs to be assembled. Returning to the analogy of temperament as similar to the key of a piece of music, remember that even though the music’s key is an important part of the song, there are endless possibilities for what that music can sound like.

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