Identifying Children Who Succeed (Pedcast)


I was at the grocery store the other day and ran into the mother of two long time patients. One of her children just went off to college and her older child, is now starting law school, having graduated from an elite university last year. This mom was beaming and rightly so. She has what every parent wants, successful children who are making it in the adult world.I told her that I was not at all surprised by her children’s success since as their pediatrician, I could tell that they had all the ingredients of success. Pediatricians have an instinct and intuition about which children are likely to make the transition from dependency to independence successfully. In fact, I am in the process of finishing a book on the subject, my second book. Look for it to hit the shelves spring or summer 2018.  More on that in the near future but in today’s discussion, I thought I would tell you a few of the things that I notice in children that lead me to have confidence that they would thrive when they go off on their own. Stay tuned and take a listen.

Musical Introduction

Parenting matters

It seems obvious, but it is worth stating that the way children are parented has a lot to do with their ultimate personality, their resiliency, their ability to work hard toward a goal, their willingness to delay gratification, their ability to establish meaningful relationships, and their ability to have empathy and show understanding toward others. But what can parents do to foster all these great traits in their children? What parenting style will get children closer to being confident and independent when they go off on their own? Fortunately, the effect of different parenting styles on children has been fairly well studied. A psychologist named Dianna Baumrind, did groundbreaking studies on this subject decades ago. She characterized parents based on their level of emotional responsiveness to their children as well as their willingness to set high expectations for their children. She termed this parenting trait demandingness.

So here are Dr. Baumrind’s parenting styles boiled down to their essential features:

  1. Authoritative parenting style-Demanding but responsive to the child’s feelings.
  2. Authoritarian parenting style– Demanding but not responsive to the child’s feelings.
  3. Permissive parenting style-Not demanding of the child but responsive to their feelings.
  4. Neglectful parenting style– Not demanding of the child and not responsive to their feelings.

In general, parents who exhibited the combination of being demanding but at the same time warm and responsive to their child’s feelings, the authoritative parenting style, is associated with positive developmental outcomes (e.g., emotional stability, adaptive patterns of coping, life satisfaction); the authoritarian parenting style has been associated with poor academic achievement and depressive symptoms; and permissive parenting has been associated with poor self-control, low self-esteem, and aggression.”(24) My experience confirms what the research says. I love to see parents who are emotionally sensitive to their children’s feelings but at the same time, have high expectations for their kids and hold them responsible when they fall short. That’s the sweet spot for me and as a pediatrician who gets to know families very well over a long period of time, you get to see how families deal with the inevitable problems that come up along the parenting journey. Again, the combination of having high but appropriate expectations along with being emotionally engaged with their feelings seems to be the most productive parenting style. This is the parenting style that pediatricians like to see and was, in fact, the style that I sensed in this mom who I encountered at the grocery store.



What characteristics, personality traits, and behaviors do I like to see in children by the time they graduate from HS?

A child who can easily handle a conversation with their doctor without their parents in the room. To me, this shows a level of confidence that kids will need and predicts success. This child can think on their feet, carry on a conversation with an adult in a somewhat stressful condition.  This young man or woman will need all these skills fairly soon. It’s great to see them well on their way before they have graduated high school.

A child who shows interest beyond themselves-Asks how I am, did I have a nice summer etc. notices things around them and comments about the feelings of others (i.e. is your nurse having a bad day today or you guys seem very busy today). We moved from the me to the we. Always a good sign.

A child who engages in conversation when asked to and makes eye contact, asks pertinent questions, and participates when decisions need to be made regarding their health. Hey, we are starting to act and think like an adult, mature and responsible. Nice.

A child who has goals that are well thought out, challenging, and realistic, not “I’m going to community college and then transferring to MIT to become a nuclear engineer.” Or, I’m going to live at home and work at the Starbucks. Really?

A child who has a realistic notion of their own strengths and weaknesses.  I like to hear things like, “I’m going to XYZ college to study such and such, and something I am good at and think I can master. They have a strong program there and I have mentored with a friend of my parents who seems to enjoy his job.”  “I may change my mind but that is what I am thinking right now.” Beautiful.

What characteristics do I not like to see?

I think you can guess at many of these negatives since they are really the opposite of the traits I perceive as positive.

A child who spends their time texting while in the presence of adults at a health supervision visit. To me this shows very poor judgment on the part of the child and is disrespectful to those around them.

A child who speaks without engagement, only responding to questions with simple short answers, often without eye contact. Do they lack confidence? Are they not able to engage in a meaningful conversation or think on their feet? Have they not achieved the ability to be articulate in conversation?

A child who doesn’t judge risk well like a 16 year old young man who has had two concussions but insists that they are going to continue playing rugby, a serious contact sport that is played without a helmet or a 17 year old young woman who is having unprotected sex even though she understands the risks. To me both of these teens are using childish immature thinking that is likely to be replicated in all of their decision making when they are off on their own.

An attitude of defensiveness. I expect this from very young teens but not from 17 or 18 year olds. This child’s emotional maturity is lagging for some reason.

A child who has never had a job outside of helping their parents around the house. To me this says that this child’s parents expectations are probably low or that the child doesn’t have the motivation or skills to interview and maintain employment. Either of these deficiencies do not bode well for this child’s future.

A child who is disrespectful to their parents. Not just unhappy with their parents on particular day, but those that disobey, use bad language, or belittle their parents. Respect for adults, especially a child’s parents is both earned and demanded. Something went wrong if I don’t see this respect by the time a child is 18 years old.

My opinion

Parents who display the warm but demanding traits that I previously described, in a way, force their children to acquire social skills, achieve a high level of cognitive abilities, and demand a level of maturity that end up serving the child well as they move away from home. How is this magic achieved? Being having high expectations or what Dr. Baumrind called being demanding, forces children to learn through what I call the school of natural consequences. Think about what demanding parents expect from their kids: respect for adults, achievement at school, helpfulness at home, mastery of social skills, and a demonstration of a moderate amount of independence. All these expectations pull the child away from the “self”, forces them to engage with the world, as well as being sensitive to other people’s feelings. Parents do all these magical things by being emotionally supportive while at the same time setting high expectations for their kids. And here is what this pediatrician thinks; parents don’t serve their children well when they inflate their children’s abilities, overly praise their children, or habitually make excuses for their children’s failures– things pediatricians see all to often these days. No, I knew that this mom whose children I had known for decades were going to be successful. The kids and their parents had success written all over them. Their success was no surprise to me.


I hope you found that pedcast informative and useful. Portable, Practical, Pediatrics is my tagline and what I try and provide you with each episode If you enjoy learning and thinking about pediatrics with pedcasts, consider taking a moment to write a review on iTunes or my DocSmo Facebook page. This will help others find my blog. As always, thanks for joining me today. This is Doc Smo, broadcasting from studio 1E in Charlotte, hoping you think a while about your own parenting style. Until next time.

Thanks to Dr. Monica Miller for her editing comments in the production of this pedcast. Thanks Monica.