Vulnerable Child Syndrome

If you listen to the cultural commentary about parenting, it can seem like modern parents are to blame for everything from screen addiction to the obesity epidemic to the youth mental health crisis. Today's parents are accused of being "helicopter parents" or even "snowplow parents" who constantly worry about and intervene in their kids' lives. Parents are accused of treating their children as fragile and vulnerable and shielding them from taking the risks that would allow them to become independent, confident adults. Recent headlines such as  " How Millennials Ruined Summer Camp "  and  " Parents Cause Teens To Be Anxious and Depressed by Making This One Common Mistake "  reflect a broader narrative that overprotective and overinvolved parents are to blame. The message is clear: parents are too protective, too involved, and too anxious—and it's harming kids.

Yet, how could parents not see children as fragile and vulnerable in the world that we live in? Never in history have parents been so aware of what could potentially go wrong with their children. From the moment of conception, parents are inundated with information about possible risks to their children's health and development. We have to complete countless screenings during pregnancy and early childhood which often result in false positives, the 24/7 news cycle informs us of every scary event that could ever happen to a child, social media tells us that everything we do is harming our children, and a quick Google search turns a mild symptom into a list of terrifying diagnoses. How could we not see our children as vulnerable when everything is telling us that they are?

This increased risk awareness is meant to help children and families and, in many ways, it does. Yet, it is also important to ask the question of whether this constant influx of information might psychologically impact us as parents and how we treat our children. Whereas previous generations of parents may have been blissfully unaware of everything that could go wrong, parents now are acutely aware of  every possibility . At the same time,  the data  actually show that childhood is safer than ever. So what happens when parents see children as more vulnerable and fragile than they really are? A long history of research on a condition once called  Vulnerable Child Syndrome may provide some insight. 

Vulnerable Child Syndrome

In 1964, two pediatricians,  Dr. Maurice Green and Dr. Albert Solnit , noticed a phenomenon in which parents of children who had fully recovered from medical conditions such as prematurity or pneumonia continued to see their child as vulnerable or fragile. They referred to this as  Vulnerable Child Syndrome . These children were completely healthy but their previous condition made their parents view them as more vulnerable. Dr. Green and Dr. Solnit found that the parents who saw their children as more vulnerable tended to be overprotective and overly controlling and their children showed increased separation anxiety, behavioral problems, and difficulty with self-regulation.

As the concept evolved, researchers began to use the term  parental perception of child vulnerability (PPCV)  to refer to this concept, rightly noting that the issue is really not the vulnerability of the child but the parent's perception. Researchers found that this perception is common among parents with premature or low-birthweight children, childhood cancer survivors, and any child with a chronic illness. It can also emerge from relatively minor conditions and complications such as jaundice, feeding difficulties, colic, or croup, or from complications during conception, pregnancy and delivery such as fertility issues, a history of pregnancy loss, or a high-risk pregnancy or delivery.

More recent research has revealed that parents may see their child as more vulnerable even when they  aren't  at increased risk. For example,  parents whose children receive false positive results  in routine screenings are more likely to continue to see their child as vulnerable long after further tests confirm that there is no cause for concern. This experience can be quite common. The newborn hearing screen, for instance, flags up to 10% of newborns (typically due to fluid in the ears following birth) yet only  0.2% of children have permanent hearing loss . Research finds that  many parents remain worried  about their children even after further tests indicate that the child's hearing is totally normal.  Screenings identifying a child as a carrier  for a genetic disorder may also contribute to parents seeing their child as more vulnerable even when the child is completely healthy and unaffected by their carrier status.

How Does Vulnerable Child Syndrome Impact Parenting and Development?

The purpose of all of the screenings, warnings, and increased awareness is to help us to protect our children from potential harm but  we need to consider whether all of these well-intentioned advances are negatively impacting how we parent and ultimately impeding our children's development. 

Researchers  believe that seeing your child as more vulnerable may make you more overprotective and controlling as a parent— limiting your child's ability to take the risks necessary to develop independent skills. For example,  research  finds that 40% of parents who were told that their child had an innocent heart murmur restricted their child's activity even though this was never recommended by doctors.  Another study  found that mothers of babies with jaundice were less likely to leave their infants with another caregiver and more likely to bring them to the doctor or emergency room even after the jaundice had been fully resolved 

While these actions come from a place of care, they may limit a child's ability to explore or learn from mistakes and may signal to a child that they are at risk or not as capable as other children. As a result, their development may be impacted.   One study found that mothers who saw their children as more vulnerable were more likely to have children with worse language skills and fewer independent skills months later.  Research  also finds that when parents see their child as more vulnerable, their children show less advanced social emotional development. They are also  more likely to have mental health and developmental problems . 

But What If Your Child Really Is More Vulnerable?

Clearly the research shows that parents may see their child as vulnerable even when they are completely healthy, but what if your child truly does face increased risk due to a medical, psychological, or developmental condition? Even in these situations, it can help to see your child realistically rather than as more vulnerable than they actually are.  Research  suggests that when parents of children with chronic illnesses perceive them as especially vulnerable, the illness is more likely to negatively affect the child's quality of life. Seeing your child as more vulnerable than they really are is also linked to  increased stress as a parent , which is notable given that parents of children with chronic illnesses are already at risk for increased stress. 

Overall Translation

There is a growing movement to allow children more freedom to play unsupervised and explore their world without adult intervention. This may sound great in theory but it is hard not to feel some anxiety when you consider your own child taking these risks. Given the increased monitoring of pregnancy and infancy and the increased awareness of everything that can go wrong (which overall is a positive thing!), it is hard for all of us parents not to see our children as vulnerable in some way. Maybe your child was measuring small at a prenatal appointment or maybe you are worried about a tongue tie because you heard about it on Instagram or maybe your child didn't reach a particular developmental milestone that an influencer's baby reached at 9 months— any of these relatively minor experiences may change how you view your child and how you parent.  So how do we prevent vulnerable child syndrome?

1. Empower your child: One potential downside of seeing your child as vulnerable is that you think they constantly need your "protection" so instead of allowing them to learn how to face uncomfortable situations and regulate their own emotions in these situations, you are more likely to step in when they are uncomfortable. Make a conscious effort to reverse this trend by teaching your child coping skills and empowering them to know that they are capable of doing hard things and regulating their emotions when they do. My  new book, What To Do When It's Time to Calm Down , aims to help parents and their kids learn research-backed coping skills and feel empowered that they are capable of managing their own emotions.  Research  finds that parents who see their child as more vulnerable are more likely to show dysfunctional coping strategies themselves, so let's break this cycle for our kids by teaching them strategies that work!

2. Limit reassurance loops: When we are worried about our children, we can get caught in something called a  "reassurance loop."  For example, if you are worried that something will happen to your child at night, you might check their video monitor every time the worry comes up. This checking behavior may give you temporary relief from anxiety and reassurance but you may ultimately feel more anxious since you haven't learned how to tolerate uncertainty. The urge to check the monitor was also rewarded by the temporary reassurance so you are likely to feel the urge to check the monitor more and more frequently which in turn increases your anxiety, which then further increases your checking behavior— ultimately forming a vicious cycle that can be difficult to stop. 

3. Challenge thoughts about your child's vulnerability with actual evidence.  Research  has found that cognitive behavioral therapy (translation: therapy that addresses the underlying thought patterns) may help parents who see their child as vulnerable. You can challenge your thoughts by: 

   1. Educating yourself on the real risks of what you are worrying about. For example, it may help your anxiety to know that the chance of a child being kidnapped by a stranger is extremely low (about  ~1 in 740,000 per year in the United States).

   2. Asking yourself whether you are making decisions based on your own fears or on your child's actual safety. 

   3. Creating a mantra for yourself such as "My child is safe, capable, and resilient."

2. Put yourself through gradual exposure therapy to reduce your anxiety: If you are overly anxious about risks to your child and you think your anxiety might be impacting your child, come up with a plan to gradually expose yourself to risk. For example, if you feel too nervous to let your school-age child play outside unsupervised (assuming you live in an environment in which this is safe), come up with a plan to work up to this goal. First, your child may play for 10 minutes in a different room without you checking on them, and then 15 minutes, and then 20 minutes. Then, you would build up to gradually more time outside without checking or watching them.  Research  finds that this type of gradual exposure to anxiety-producing events is very effective at reducing anxiety. 

3. Stay curious about your child's thoughts and feelings:  Research  finds that seeing your child as vulnerable may actually be linked to positive outcomes when it leads parents to show interest and understanding of their children's emotions and thoughts. In other words, if worrying prompts parents to figure out what is really going on with their children, it may actually be helpful. In other words, there is nothing wrong with being a concerned parent but try to channel that concern into understanding what is going on in your child's brain. By being concerned enough to ask and listen, the parent gains insight into the child's inner experience and can help them work through it. For example, if your child is refusing to go to school, rather than jumping to the conclusion that something is wrong with the child or with the school, you could calmly discuss the child's thoughts and feelings about school and find out the real underlying cause of the behavior and thus help the child to find a solution. 

4. Get more confident in your own parenting: Research  finds that seeing your child as vulnerable is linked to more positive outcomes when you are more confident in your parenting. You can gain confidence as a parent by having a trusted advisor such as a pediatrician, therapist, or experienced friend who can guide and encourage you in your parenting skills. It can also help to make a conscious effort to focus on your parenting wins rather than your parenting fails and aim for progress and not perfection.

5. Be careful about what media that you consume: Reflect on whether there are shows, websites, or social media sources that increase your anxiety about your children. For example,  research  finds that watching local news is related to increased fear and concern about crime. It could be your local news or it could be the social media account that tells you that you're doing everything wrong— cut it out of your life if it isn't helping!