Question: At what age should children stop bathing with parents of the opposite sex?
My daughter wants her children to be comfortable with their bodies and not to feel ashamed of any bodily functions. However, I have always believed that there should be an age when children are taught that privacy should be provided when requested.
For safety and convenience, our daughter sometimes bathes with her 6- and 4-year-old sons. Do you consider this a problem? When I mention my concern, she thinks I'm being old-fashioned. — No Name
Answer: Children will let parents know by their behavior when they are ready for privacy. At the age when children begin to feel uncomfortable or silly about the differences between their bodies and their parents' bodies, it is certainly time to stop family baths.
A parent can tell that siblings are ready to stop bathing with each other, or with parents, when the children lose interest in the plastic ducks and boats, the pouring and splashing, and instead become preoccupied with talking about, looking at, even poking at body parts.
Children do need information about the differences between girls' and boys' bodies, between child and adult bodies. But children can also be quite overwhelmed by these differences — uncomfortable that they are not like the other gender, daunted by how unattainably bigger grown-up bodies seem.
This is the time to say in a matter-of-fact way: "That part of your body is special and only for you to touch." You should also answer questions that children have about their bodies, simply and honestly.
This is also the time to plan separate baths. Children can still think and ask about these important questions without the ongoing exposure that may be too much for them as they face these issues.
This shift can be done in a way that is respectful of the children's new needs, without giving them negative or guilty feelings about their bodies or their curiosity.
In our culture, children seem to become increasingly modest as they grow and often begin to feel the need for privacy some time between the ages of 4 and 6. Parents need to look for the signs children give that they are ready for more privacy — and respect them.
Question: My 9-year-old granddaughter has had problems in school, so her parents had her evaluated. She seems to have ADHD and is taking Metadate.
Her schoolwork seemed to improve for the first two weeks after starting the medication — yet she will still bring home a paper with a mark of 100 and the next day get a mark of 60. She seems to be attentive but evidently has trouble following instructions.
I'm wondering if there is a way to correct her problem without medication. I'm concerned about the long-term effect. — W.C., San Angelo, Texas
Answer: You will need the help of your grandchild's pediatrician and/or psychiatrist to look into the possibility that a medication may not be helping. A psychologist can also contribute ideas about other kinds of treatment when these are appropriate.
When a treatment is ineffective, it often is important to ask, as you are, whether the treatment is the right one and whether the diagnosis is accurate. Sometimes, there is more than one problem and the treatment is addressing only part of the whole picture.
The professional who evaluates your grandchild may want to look for more evidence that ADHD (Attention Deficit Hyperactivity Disorder) is a reasonable diagnosis. ADHD is often associated with learning disabilities and depression and is sometimes misdiagnosed when the culprit is really anxiety.
A recent study showed that appropriate medication alone for ADHD (when it is correctly diagnosed) is as effective as medication together with other treatments.
But there are a number of simple ways to try to help: cutting down on distracting noises and activities, seating the child in the front of the classroom so that it is easier for her to focus, paying attention to whether she takes in information better when she hears it or when she sees it in writing, scheduling times during class for her to get up and do something, such as passing out papers, so that she gets the physical activity she needs.
All these approaches can help a child with ADHD. Of course, if ADHD is not the diagnosis, or if there are other problems — such as depression, anxiety or a learning disability — there are other ways to help.
In next week's column, we will offer more information about understanding and diagnosing ADHD.
Questions or comments should be addressed to Dr. T. Berry Brazelton and Dr. Joshua Sparrow, care of The New York Times Syndication Sales Corp., 122 E. 42nd St., New York, NY 10168. Questions may also be sent by e-mail to: n=ytsyn-families@nytimes.com. Questions of general interest will be answered in this column. Drs. Brazelton and Sparrow regret that unpublished letters cannot be answered individually.