April is Alcohol Awareness Month, led by the National Council on Alcoholism and Drug Dependence, Inc. (NCADD). This month, the organization is highlighting the problem of underage drinking. So throughout the month of April Addiction.com will be sharing the latest statistics, information and guidance on how parents can help keep children and teens from drinking and also foster a healthy relationship with alcohol when they are old enough to legally drink.
Writer Madeleine Beckman started the series with a look at school-age children — those from about age 4 through 10. In this article, she reports on the questions and concerns of pre-teens and younger teenagers to help parents and older kids understand the risks of drinking too soon.
It’s natural to think of adolescence as the time when you really need to pay attention to whether or not your child is drinking — and that is important, of course — but in some ways, children ages 11 to 16 are in the most vulnerable age group, say experts. Besides being very curious, pre-teens and those in their earlier teenage years are wrestling with many influences — from hormones and academic pressure to pimples and first romantic relationships. A recent study at the National Center on Addiction and Substance Abuse cites low self-esteem, peer pressure and concerns about appearance, among other factors, as influences that can lead young people to drink as a way to self-medicate difficult feelings and stress. This, simply put, is an age at which kids are forming what may turn out to be lifelong opinions and experiences of alcohol. Fortunately, parents still have a significant impact now. According to the “GFK Roper Youth Report,” parents are the strongest influence by far on school-aged kids and younger teens when it comes to their decisions about whether to drink or not.
That’s why — as moms, dads, grandparents, aunts, uncles and guardians — it’s so important now to communicate with your child, grandchild, niece or nephew, even if it may seem like it’s too soon to start the conversation about drinking. “Research shows that the lowest incidence of alcohol use amongst children is in homes where parents praise their child and are present in their child’s life, including checking their homework,” says Patricia C. Schram, MD, a pediatrician and addiction specialist at Boston Children’s Hospital and Harvard University.
Simply put, your opinion about the appropriate use of alcohol is something your son or daughter needs to know (yes, even if it seems like they aren’t paying attention to much of what you say). To that end, being a good model yourself is crucial; this establishes a foundation for your child to understand both measured, appropriate alcohol use (if you drink at all) and the risks of drinking. One way of setting a good example is by making it difficult to access to alcohol in your home. This communicates to your child that alcohol is off-limits for those under age 21, and that there’s good reason for this law. “Talking about alcohol, its risks and responsible drinking requires an ongoing conversation,” says Dr. Schram. “Communication and trust between you and your child are key to prevention.” Schram, who grew up in Brazil, recalls that at home her parents typically had a glass of wine with dinner. “It’s part of our culture,” she explains, but if someone at a party, for instance, became drunk or behaved inappropriately “they were ostracized.”
These kinds of familial and cultural mores go a long way in making clear to your child what is acceptable behavior and what is not. Of course, younger kids are likelier to be more influenced by the example you set than will teenagers, but experts make clear that children throughout this age span do take in what they see and hear at home.
What Experts Recommend
“Role-playing can be a particularly useful tool to help your child learn how to respond to peers who may be drinking or pressuring your son or daughter to drink; one kid bullying another to drink is not uncommon,” explains Seth Brenner, LMSW, coordinator of adolescent treatment services at the Realization Center, in Brooklyn, New York. Brenner and his colleagues often use role-play with their young clients, he says; for instance, the counselors play the role of a bully and script out the situation so that if a kid finds him or herself pressured to drink, he or she has the verbal tools to respond while still saving face. Tools like these help a child’s confidence and self-esteem so that if a bully calls him a nerd or loser they know how to respond — perhaps by simply saying, “I don’t like the taste of alcohol,” or another answer that’s not defensive or that engages the bully. You can try some of these techniques with your child too; a counselor specializing in adolescents and/or addiction can provide you with more examples.
If, in talking to your pre-teen or teen you find out that they’re being pressured by a friend or group of friends to drink, Sharon Levy, MD, medical director of the Adolescent Substance Abuse Program, and assistant professor of pediatrics, at Harvard Medical School, suggests discussing with your child what makes a true friend. You might ask them, “What qualities do you think a real friend has — someone who really cares about you?” And then follow that up with, “Do you think a friend would push you to do something that’s not good for you, like drinking?”
When you do sit down to talk to your child about alcohol try to avoid conversations that are confrontational or judgmental. Start by asking what they’ve heard about drinking. What do they think about alcohol? Ask how they feel about alcohol use. “Let them talk,“ stresses Brenner.
Remember, if your child suspects you don’t trust them or will judge or yell at them, you risk losing their trust and shutting down communication. And these talks — and there should be more than one, continuing as your child gets older, too — aren’t something you should assume will happen at school. Parents and other relatives and adults your child looks up to have tremendous influence, and drinking, as well as problem drinking and alcoholism, are subjects that you should raise periodically with your son or daughter, especially when you suspect they have questions or will be in a situation where illegal drinking will happen.
It can be hard to strike a balance between being engaged with your child and alert to his or her behavior without hovering or seeming to police their every move. To complicate things, good behavior doesn’t mean there’s no risk. “Just because your child is going to band practice, on the soccer team or getting good grades doesn’t mean he or she is immune to using,” says Brenner, who can recount more than one tragic story of parents who had no idea their child was using – like the 16-year-old who had a stroke from alcohol and the 14-year-old hospitalized for alcohol use disorder.
“Talk, talk, talk at home,” emphasizes Evelyn Stephens, MD, a New York City-based psychiatrist with a private practice specializing in addiction in young people. “But don’t exaggerate the risks of alcohol use. Kids know, or will soon realize, that you’re not being honest.” Communication about alcohol includes sharing whether alcoholism runs in your family; a family history of addiction does raise risk. “Discuss alcoholism as you might discuss a family member or relative who has diabetes or cancer,” advises Dr. Stephens. “Don’t pretend the … behavior hasn’t happened.” Stephens says that young people of all ages are often disturbed to see bad behavior brought on by drinking, so it’s helpful for them if you bring up why Cousin Dan was acting unusually, and make clear that you were also upset by the behavior.
Keep in mind, too, that if you’re putting off discussing alcohol use, struggling to find a way of being direct and honest with your child or you find that your son or daughter won’t open up to you, it may be time to consult a therapist or counselor who specializes in working with children and adolescents. “A third, neutral party can be helpful,” notes Brenner.