Claudia M. Gold, MD

Claudia M. Gold is a pediatrician who blogs at Child in Mind and is the author of Keeping Your Child in Mind.

Help parents reconnect with their natural authority

Physician

November 14, 2013

Authoritarian parenting, as in “my way or the highway,” and its opposite, permissive parenting with lack of limit setting, may be linked with difficulty with emotional regulation in children. In contrast, an “authoritative” parenting style is associated with an enhanced capacity for emotional regulation, flexible thinking and social competence. An authoritative parenting stance encompasses respect for and curiosity about a child, together with containment of intense feelings and limits on …

We need to move beyond the DSM paradigm

Claudia M. Gold, MD

Conditions

October 24, 2013

A paradigm is a way of thinking about things. For the past 60 or so years, our thinking about mental health and illness has been dominated by what can be referred to as the “DSM (Diagnostic and Statistical Manual of Mental Disorders) paradigm.” What this looks like in everyday practice is that when a child is referred to my behavioral pediatrics practice for say, anxiety, the questions that parents, referring …

Read more…

We need to move beyond the DSM paradigm

Miriam Carey: The lessons of motherhood and mental illness

Claudia M. Gold, MD

Conditions

October 10, 2013

We do not have medical records or diagnoses. The news is filled with speculation. What we do know is that Miriam Carey’s one-year-old daughter lost her mother, and that because the incident occurred in Washington, DC in front of the White House, it is shining a spotlight on the subject of mental health and motherhood. And the message should be simple. Diagnoses don’t matter. As part of our nation’s health …

Are ADHD drugs responsible for mental illness in college?

Claudia M. Gold, MD

Meds

September 4, 2013

Recently, I “launched” my oldest off to college. As anticipated, it was an intense emotional experience full of joy, sadness, and many things in between. (I have to tip my hat to Beverly Beckham for her piece I was the sun, the kids were my planets that was very helpful. However, I might have written that my child was the sun, a burst of light in our household, and the experience …

Sleep problems are behavior problems: We must know the family story

Claudia M. Gold, MD

Conditions

August 16, 2013

A study published in the Journal of Developmental and Behavioral Pediatrics showing a connection between hours of sleep and childhood behavior problems has received a lot of media attention. Children who slept less than 9.4 hours of sleep had more impulsivity, anger, tantrums and annoying behavior. The obvious conclusion-more sleep, better behavior. If only it were that simple.

If one takes the time to look closely, one will discover that what …

The co-location of mental health care services in pediatric practices

Claudia M. Gold, MD

Physician

April 7, 2013

Patricia Wen’s front page story, “Children’s Access to Mental Health Care is Growing,” in which she describes the “co-location” of mental health care services in pediatric practices, brought me back to the summer of 2011 when I attended a meeting of a working group of the Massachusetts Chapter of the American Academy of  Pediatrics (MCAAP.) The task of this working group, a subgroup of the MCAAP task force on mental …

Raising a child alone in a culture of quick fixes

Claudia M. Gold, MD

Physician

February 22, 2013

Sam burst into the office, a two-year-old wild bundle of energy. Squealing with delight — or was it distress; it was hard to tell — he ran from toy to toy not looking at me or his mother, Jane. He was unable to engage with anything. Jane had brought him to see me in my pediatric practice because, “he hits me, has explosive tantrums, and I can’t take him anywhere.” …

How can we as a society honor the dead children?

Claudia M. Gold, MD

Physician

December 16, 2012

For the families who lost children, their world as they knew it has effectively ended. Yet somehow the sun rises again and the next day is here. For the rest of us grieving along with these families, the only way to move forward is to take what President Obama called “meaningful action.” I interpret this to be action that is radical and significant enough that it will somehow give meaning …

Heal relationships without needing a devastating life event

Claudia M. Gold, MD

Physician

November 6, 2012

When I write from my clinical experience as a behavioral pediatrician, I am careful to change identifying information to protect the privacy of my patients. It is rather freeing, therefore, to write about characters in a novel. Left Neglected by Lisa Genova, who is also a neuroscientist (perhaps she took the story from some real cases) offers some important insights into this complex subject.

The story revolves around Sarah, a 37-year-old mother of three …

ADHD: Not all complex problems have simple answers

Claudia M. Gold, MD

Conditions

October 9, 2012

I’ve been thinking about the phrase, “the fallacy of simple answers,” in preparation for writing about a new book I was asked to review, Pills are Not For Preschoolers. Author Marilyn Wedge gives a clear and compelling argument for the use of family therapy in treatment of behaviorally symptomatic children. Unlike the title suggests, the book is not primarily about preschoolers, but offers multiple examples of her successful work …

Being home with an infant: Take care of your mental health

Claudia M. Gold, MD

Physician

September 3, 2012

I am a devoted fan of Zumba, specifically as it is taught by my wonderful teacher, who has a dedicated following. She has been out for the past month, home with a newborn and two year old. Last week, she came with her baby to try to take the class, now being taught by a substitute, also a regular member of her class.

“I need this for my mental heath, ” …

Eliminate the guilt in parenting

Claudia M. Gold, MD

Conditions

July 24, 2012

In my behavioral pediatrics practice, it is not uncommon for parents to go to great lengths to put up a good front. They feel terrible shame about moments of out-of-control behavior, and also fear that I will blame them for their child’s troubles. They focus primarily on “what to do” about their child’s difficult behavior. However with time, and the realization that I am interested in understanding, not shaming or …

Read more…

Eliminate the guilt in parenting

Repeated experiences of shaming are not good for a young child

Claudia M. Gold, MD

Physician

January 24, 2012

The little boy, who looked to be about two, darted away in a fit of giggles. His young mother, who seemed thoroughly worn out and exasperated, ran after him, grabbed him by the arm and said in a harsh whisper, “You must stand here!”

We were on line waiting to board a Southwest Airlines flight. For those of you not familiar with the Southwest system, there are no assigned seats. Rather, …

When parents respond to the meaning of a child’s behavior

Claudia M. Gold, MD

Patient

September 1, 2011

It was a peaceful Saturday morning at Fuel, a local coffee shop in Great Barrington. People sat quietly murmuring with friends over coffee and muffins, or intently working at their laptops. I was doing the final edits for my forthcoming book Keeping Your Child in Mind, when I looked up to see a small boy of about two years tottering down the narrow aisle holding a plate with an …

Baby monitors abuse the vulnerability of parents for profit

Claudia M. Gold, MD

Physician

June 9, 2011

Recently I was interviewed by a reporter about the effects of the newest baby monitors on parent-child relationships. A teddy bear with a camera in its nose hooks up to a TV, allowing parents to watch their baby’s every move.

One product called an exmobaby is actually worn against the baby’s skin and measures heart rate and respirations. A CEO of …

How can research capture the complexity of tiny moments?

Claudia M. Gold, MD

Patient

March 24, 2011

Recently, as I listened to leading researchers grapple with the question of how to design a feasible study of intervention for postpartum depression, I held in my mind an image of a particular moment in my office.

I was sitting on the floor with 10 month old Madison and her mother Nancy, who was struggling with postpartum depression. Nancy spoke of the strain Madison’s refusal to take a bottle and her …

Maternity leave and infant brain development

Claudia M. Gold, MD

Patient

January 19, 2011

It is not until about eight weeks of age that an infant has a fully developed capacity for mutual gaze.

Then a baby looks directly into his mother’s eyes, while she, in turn, reflects back this loving gaze, cooing softly in response to her baby’s earliest communication. When a mother looks at a baby in a way that communicates with him, not with words but with feelings, “I understand you,” he …

Routine use of sleep medication for children

Claudia M. Gold, MD

Meds

November 21, 2010

A recent study published in the journal Sleep Medicine revealed that most child psychiatrists prescribe medication for sleep at least once a month, despite the fact that no sleep medications are approved for use in children. The study was funded by Sanofi-Aventis, makers of Ambien.

Managing sleep is one of the greatest challenges of being a parent. It represents the first major separation and can be fraught with complex ambivalent feelings. …

Children who are difficult may not be simply toxic

Claudia M. Gold, MD

Conditions

October 2, 2010

As a pediatrician I have listened to many parents speak of their child in very negative terms. Dr. Richard Friedman, in his New York Times article entitled Accepting That Good Parents May Plant Bad Seeds shares his patient’s description of her “rude and defiant” teenage son. Like the parents in his piece, the parents of my patients have other children with whom they have had no such difficulty. …

Too many young children are medicated with powerful drugs

Claudia M. Gold, MD

Meds

August 28, 2010

Recently while cleaning out my office in anticipation of my new job, I discovered that I had unknowingly been witness to to an historic moment in child psychiatry. I found a binder from a course I had taken in June of 2001 sponsored by Harvard Medical School on Major Psychiatric Illnesses in Children and Adolescents.

Though I did not remember until I looked at my scrawled notes in the margins, on …