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corresponding and disturbing increase in the use of a fairly new, relatively unproven class of medication in kids whose difficulties, in many cases, are very poorly understood. In a nutshell, that’s one reason psychotropic medications are overprescribed: Not enough people are familiar with the cognitive factors that can set the stage for social, emotional, and behavioral challenges, and sometimes it’s just easier to give a kid a pill than to figure out what’s truly getting in his way.
    Can irritable or anxious kids be helped to better regulate their emotions and respond to life’s frustrations and anxieties more adaptively? Certainly. But not by putting a lot of effort into coming up with new and creative ways to punish them.
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IN FOCUS
Difficulty seeing the “grays”/concrete, literal, black-and-white thinking
Difficulty deviating from rules, routine
Difficulty handling unpredictability, ambiguity, uncertainty, novelty
Difficulty shifting from original idea or solution/difficulty adapting to changes in plan
Inflexible, inaccurate interpretations/cognitive distortions or biases
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    Young kids tend to be fairly rigid, black-and-white, literal, inflexible thinkers. They’re still making sense of the world and it’s easier to put two and two together if they don’t have to worry about exceptions to the rule or alternative ways of looking at things. As kids develop, they learn that, in fact, most things in life are “gray,” that there are exceptions to the rule and alternative ways of interpreting things. Sometimes we have a substitute teacher, a field trip needs to be rescheduled because of the weather, someone is sitting in our usual seat in the cafeteria, recess has to be indoors instead of outdoors.
    Unfortunately, for some kids, “gray” thinking doesn’t develop as readily. Though some of these kids are diagnosed with disorders such as nonverbal learning disability or Asperger’s disorder, it’s more useful to think of them as black-and-white thinkers living in a gray world. Predictably, these kids are most likely to exhibit challenging behavior when the world places demands on them for gray thinking.
    Many such kids are quite comfortable with factual information because it’s black-and-white but grow uncomfortable when life demands problem-solving because it’s gray.
     
          T EACHER : Class, what’s the highest mountain in North America? Andrew?
          A NDREW (black-and-white thinker): Mount McKinley!
          T EACHER : Excellent, Andrew. Now, I’d like you and Susie to do a presentation on Mount McKinley for the rest of the class. You guys can do it anyway you like, but you have to talk about it and agree on a plan. OK?
          A NDREW : OK.
           (2 minutes later)
          A NDREW : Mrs. Huggins, Susie won’t do it right!
          T EACHER : What do you mean, Andrew?
          A NDREW : When you do a presentation on mountains, first you have to show everyone a picture of the mountain you’re talking about. Susie says it doesn’t matter when you show the picture. She’s wrong!
     
    It sounds like Andrew has some pretty clear ideas about how to do a presentation on Mount McKinley, and is having difficulty moving off his original idea. Spoiled brat? No. Control freak? Wouldn’t be the best choice of words. Black-and-white thinker living in a gray world? Classic case.
    These kids love details (black-and-white) but aren’t so adept at handling ambiguity (gray) and often miss the “big picture” (gray). They love predictability (it’s black-and-white) but don’t do so well when things are unpredictable (gray). They love certainty (black-and-white) and routines (black-and-white) but don’t handle uncertainty (gray) or changes in plan (gray) very well.
     
          T EACHER : Class, we’re not going out for recess today at ten-fifteen because we have an assembly.
          A NDREW : What do you mean we’re not going out for recess at