How To Scaffold Empathy For Kids: Practice Makes Proficient

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Key points

  • Empathy is a teachable skill. Based on repeated practice, synaptic plasticity is key to teaching empathy.
  • What we do or do not practice will shape the neuroarchitecture of our brains as we respond to things in our environment.
  • Parents can scaffold difficult social concepts by breaking situations into small chunks and providing tools to make learning easier.

I perched on the edge of an undersized plastic chair across from my daughter’s teacher at our first elementary parent/teacher conference of the year. “Your daughter listens well and is so well behaved, but her reading level is not exactly where it needs to be, and she’s having trouble with some math skills. But she is very sweet and kind, and that’s so important too—you can’t teach those things, but don’t worry, we can teach her the math and reading.

It’s the Oreo cookie approach to giving parents bad news—They sneak the negative in as white filling surrounded by thin wafers of good. But as a neuroscientist, I was stunned by the complete inaccuracy of the last statement.Of course, you can teach those things. You can teach empathy, teach kindness, and respect. These are not innate talents or solely genetic gifts. They are teachable skills.

We understand how learning works for things like 2+2=4 pretty well. Teachers typically use active participation and frequent practice spaced out over a period of time to teach classroom content. But there aren’t special neuroscience rules to help learn empathy, creativity, or countless other life skills–they follow the exact brain mechanisms as learning math facts.

There are spines on the edges of neurons that mediate synaptic connections between neurons and govern how we learn. In kids, the spines are super dynamic. They appear or retract based on experience and how frequently they are used. If you keep using a pathway, the spines are more likely to stick around. This results in the reshaping of synapses and long-term learning.

That school conference was a moment of profound insight into the bare-bones social skills my daughter was (not) learning at school, and it explained a lot about why her perfect classroom presence was completely train-wrecked when she got home from school.

I knew the social landscape of this classroom was terrible. A girl in my daughter’s class plays a game called “bus,” where the other girls line up to take rides on her back at recess. The girl is the bus, and she carries passengers around. It looks benign to the teachers who stand and monitor play at recess. But in this game, the girl charges for rides. Usually, the fare is an imaginary five cents, but my daughter gets charged $100 to take her ride every time. Why? Because the girl said, my 20th percentile weight daughter is just too heavy.

I knew complaints were flowing in about the class social situation—It wasn’t just the “bus” game. Another parent, fed up with her daughter being picked on, made T-shirts that said the girl was a bully and tried to pass them out at school. This is the real reason I was at the parent/teacher conference. Yet, when I brought it up, I quickly detected a relatively new teacher overwhelmed with classroom dynamics who was grateful for an “easy,” compliant kid. I saw a classroom in which my daughter was figuring out how to react to bad social situations on her own and failing.

It’s here that parents need to think carefully about the qualities we want our children to possess and then consistently and purposefully create opportunities for our kids to practice those skills. Deliberate parenting will make children who live deliberate lives. In my daughter’s classroom, I could see that math was being practiced—there were even memorized arithmetic songs.

But they were not teaching kindness, conflict resolution, or even problem solving, which are the things I prioritize as a parent—the building blocks of empathy. The school is not just relying on parents to teach empathy at home. They are actually assuming that kids either come in with these skills, or they don’t get them. If, in turn, parents think kids are getting social skills at school, then all our kids drop through a crevice.

My daughter saw two choices with the bully in her class: Confront her or tell on her. Unable to do either, she felt completely stuck when the girl price gouged her on the playground. With repeated practice, she is learning to stand there and internalize it.

Those are not the synapses I want firing in her, so I taught my daughter how to practice empathy. It’s not just the queen bee who needs to be taught empathy. Cognitive empathy is a powerful skill, and it’s the underdog that needs powerful skills.

First, I asked my daughter to explain the girl’s actions as if she were her best friend. “I guess she feels like she doesn’t want to be alone on the playground, so she’s in charge, and if she’s in charge, she can decide which friends to have.”

Next, my daughter became a detective, looking for body language to find motivation and predict patterns in the girl’s behavior. Even at age seven, becoming a social sleuth enabled her to understand the situation better. This gave her back a measure of personal control, and eventually, the power to speak up for herself, instead of standing there, glued to the asphalt, feeling terrible.

Then, we learned conflict resolution skills the same way as math, using active participation and frequent practice spaced out over time. I became the girl, and in our living room, I rudely charged my daughter $100 a ride until her reactions to it were second nature.

We came up with a system so she could be heard in these situations: STAFF:

  • Say how you feel.
  • Tell them it’s not okay.
  • Ask for what you want to have happened.
  • Find a friend.

She wasn’t frozen—she knew what to say, and it rolled off her tongue. There was a scaffolding to cling to. We used these social skill pathways repeatedly—on our terms—until spines had formed between newly used neurons, the pathways were solidified, and learning had happened.

Since neuronal connections that have been used are more likely to fire the next time, it’s second nature for her now. If we expect our children to be socially independent and to do it well, they need tools to do it with.

Neuroscience tells us that practice defines us as people, that the pathways we choose define our nature. Activity influences the brain’s architecture, and this neural plasticity is constantly occurring, even when they are still watching TV, eating dinner, or choosing which birthday present to open first. These spines are actively growing and shrinking, and the experiences are actually turning on and off genes that support this process.

Eventually, the neuronal pathways we use most become more likely to fire as our “default” setting. In essence, we practice being ourselves until we become who we are. Viewed through this lens, every moment is a critical period to teach critical skills important to us—skills like creativity, self-control, social awareness, and compassion.

Several proven social learning curricula target empathy, social learning, and conflict resolution skills in the classroom that have gotten great results that last for years, including roots of empathy (K-8), positive action (K-12), and responsive classroom (K-5). Still, you don’t have to wait for the teachers to do it. The window for explosive synaptic formation doesn’t close when children hit elementary school or even high school.

Social connections are being formed even more so in tween and high school kids, continuing into adulthood. Your child’s critical period for development is now. There’s no bad age to start working on these skills, and there’s no one correct way to do it, as long as you’re consistently practicing and folding it into your everyday life.

Find a way that works for your family, and if you’re consciously empathetic in spirit, then it will seep into your child.

By: Erin Clabough, Ph.D.

Erin is a neurobiologist, author, mother, and professor interested in understanding neurodevelopment in children.

Reviewed by Vanessa Lancaster

Source: How to Scaffold Empathy for Kids: Practice Makes Proficient | Psychology Today

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The Role of Empathy In Improving Patient Care and Decreasing Medical Liability

Studies reveal that more than half of all practicing physicians demonstrate signs of burnout. Contemporary physicians face tremendous pressures due to a confluence of factors, including balancing heavy patient loads within constrained schedules, the increasing complexity of patient health problems, and increasingly burdensome COVID-related documentation requirements.

These circumstances—and more—challenge physician empathy, and even to some extent dampen it even further. Multiple research studies document a decline in empathy that appears to begin in the third year of medical school and persists during residency.  The pandemic has exacerbated this deterioration. In the past, empathy rebounded after the rigors of training were over, but today, empathy needs to be refreshed to help both patients and providers. Physicians who lose sight of the meaning, purpose, and rewards of their roles in patients’ lives suffer more from burnout than those who remain connected to their purpose.

The role of empathy training

In response to patients’ pleas for more empathic care and national media headlines calling for more compassion in medicine, which have been growing since about 2005, empathy training courses grounded in the neuroscience of emotions and emotional intelligence can be helpful. In fact, recent neuroscience research on the brain’s plasticity in up-regulating and down-regulating empathy provided evidence that empathy could be taught.

The research team in the Empathy and Relational Science program at Massachusetts General conducted a study of the effectiveness of the three, 60-minute empathy training courses in physicians. Researchers found statistically significant improvement in patient perception of physician empathy on a validated and reliable empathy rating scale called the “CARE measure.” Another study by the same team show that empathic physician behaviors resulted in higher ratings of both physician warmth and competence.

One of the most frequently asked questions about empathy training is, “Doesn’t this just add even more time to a busy doctor’s day?” Actually, it does not. Empathic care does not have to take more time. Courses on empathy training help health care professionals detect subtle emotional cues and nuances that indicate patient concerns so they can be addressed right away.

In addition, when physicians convey empathy, they put patients at ease, increasing trust in the provider-patient relationship. This creates a dynamic that ensures that small problems are addressed before they become bigger problems. Multiple studies have demonstrated that better medical outcomes are also correlated with strong empathy and relational skills.

Empathy training offers many benefits 

Courses based on empathy research and principles provide training for each of the following predictors of risk of increasing medical professional liability claims:

  1. Physicians’ uncaring attitudes, attitudes of superiority, or callousness
  2.  Communication failures including not listening, interrupting, or not being clear about availability or backup coverage
  3. Disparagement of previous care
  4. Failure to learn and manage patient expectations

Physicians can learn how to perceive patient emotions, manage difficult interactions, and communicate bad news. Empathy education teaches how to respond with empathy and compassion even in challenging situations, including informed consent conversations and inter-team conflicts.

In addition to greater patient satisfaction, doctors also discover the personal satisfaction that connecting with their patients in a more meaningful way provides.  “After empathy training, I feel that I like my work again, and instead of resenting all the demands, I’m remembering why I chose this profession in the first place,” a physician reported.

Interviews and research around empathy-based practices reveal that greater empathy not only improves patient satisfaction, but also helps to reduce physician burnout and improve physician job satisfaction. By using empathy-based skills, physicians, nurses, and other providers become more attuned to the needs of patients and their families. With this greater perception and shifts in attitudes, communication between providers and patients improves.

More empathic conversations will enable patients to trust their care to physicians who are confident in their skills without demeaning prior care they may have received. Patients will appreciate physicians who explain things clearly, ask about and understand their expectations, and form alignment about what is desired, likely, and possible.

Empathy-based training brings rewards

Through empathy-based training, physicians and other health care providers learn the skills to have honest informed consent discussions without causing undo fear, while also preparing patients for all possible outcomes. Empathic skills make for better physicians, better communications, and better conversations for all outcomes.

With a strong alliance, a reduction in medical professional liability claims is the result of increased trust, better understanding and expectations of all possible outcomes, and knowledge that physicians deeply care about their patients, because, when it comes to health care, empathy matters.

Helen Riess is a psychiatrist and author of The Empathy Effect: Seven Neuroscience-Based Keys for Transforming the Way We Live, Love, Work, and Connect Across Differences. This article originally appeared in Inside Medical Liability.

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