Questions About Medication For Children

For many children, therapy or accommodations are not sufficient to support their needs.  It is often that these children will need child medicationpharmacological intervention to help improve their attentional regulation, impulse control, emotional regulation and/or behavioral self control. Parents should be honest with their pediatrician about medication as well as ask several questions about ensuring the best care.

Questions Parents Should Ask When Determining If Medication Is The Right Choice For Your Child:

  1. What are the side effects of the medication? All medications have side effects and it is important to be aware of what to possibly look out for.
  2. How long should the child be on medication?  It is important to ascertain if the medication is likely a temporarily solution or long-term.
  3. What therapies would be beneficial for the child to participate in while taking medication?  It is often that medication alone is not sufficient. Children will often benefit from specific therapies and interventions to help teach emotional and behavioral regulation.
  4. Who should I tell? My advice about medication is to always inform the academic staff as to when a child starts medication. Many times, the teacher would be able to have a greater watch over the child and monitor whether or not there are experiencing any negative side effects.

Medication is often warranted in a child’s treatment regime. It is always important for parents to ask good questions and work with a treatment team in order to ensure the best success of their child’s social and emotional development.

Nonverbal Learning Disability

The majority of learning disabilities that a child may have are language-based.  These include deficits with the child’s reading boy readingachievement as well as written expression.  Researchers have found that there is a small percentage of children that demonstrate adequate or above average verbal functioning; however, they have significant weakness with their nonverbal reasoning. Researchers and educational specialists have characterized this specific condition as a Nonverbal Learning Disability (NVLD).  Currently, the Diagnostic and Statistical Manual of Mental Disorders does not have a specific diagnosis for these children and, instead, these children are typically diagnosed with a learning disorder that is not otherwise specified.

Areas of Cognitive Weakness in Children with Nonverbal Learning Disabilities:

  • Visual-spatial awareness
  • Visual organization
  • Tactile and perceptual reasoning
  • Psychomotor functioning
  • Nonverbal problem solving skills
  • Difficulties with mathematics
  • Pragmatic (social) language
  • Social interactions

Areas of Strength in Children with Nonverbal Learning Disabilities:

  • Rote verbal memory
  • Phonemic awareness
  • Verbal reasoning
  • Reading

It is important to identify children that have speculated NVLD’s areas of strength and weakness in order to develop the most effective intervention plan.  It is often that intervention for these children is multi-faceted and can consist of:  social work support to help with socialization and interaction, speech-language therapy to help with pragmatic language functioning, academic tutoring to help with mathematics and executive functioning support and/or occupational therapy in order to help develop visual spatial functioning, tactile-perceptual reasoning and motor abilities.

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Strategies to Boost you Child’s Memory

There are two general types of memory strategies: Internal strategies refer to ways to retrieve information more easily by thinking child memoryabout something in a different way, whereas external strategies refer to ways to compensate utilizing mechanisms outside of your brain to help you remember information. Depending upon the situation, one strategy may be more beneficial than the other.

Try the following strategies with your child to encourage retrieving and storing memories:

Internal Strategies:

  1. Repetition: repeat information aloud or in your head
  2. Visualization: create a mental image of what you are trying to remember
  3. Association: link information to prior life experiences
  4. Chunking/Grouping: link similar items together by category. For example, link items on a grocery list by departments located in the store
  5. Acronyms: create a word or phrase comprised of the first letter of all the letters to be remembered. For example, “ROYGBIV” represents the order of the colors in a rainbow

External Strategies:

  1. Daily planner/Calendars
  2. Organization: keep important objects (e.g. backpacks, school supplies, technology) in the same location
  3. Stick with a schedule: encourage memory by completing routine activities in the same order every day
  4. Alarm clocks
  5. Voice memos
  6. Highlighters/colored pens

Family History and Kids with Special Needs

If you have a brother, nephew, uncle or some other member in your family with certain special needs, you will want to be cautious and family tree mindful that many neurodevelopmental conditions have a high genetic component. Recent studies have indicated that genetics account for 70 to 80 percent of the risk of having Attention Deficit Hyperactivity Disorder. A 2004 study indicated that there is considerable evidence that demonstrates that genetics play a major role in the risk of having an anxiety disorder. It is important to realize that the risk factors are high; however, they are not necessarily 100%.  This simply means that just because a parent or relative has a neurodevelopmental disorder, it does not mean that the child will exhibit the condition. What it does indicate is that the child is at a higher risk for the condition.

As a parent, it is important to realize that your child may be at risk for a condition if a relative has that same condition. Do not be alarmed; instead, be aware. Always pay attention to any concerns, seek out advice from your pediatrician, psychologist and/or developmental therapist.

There are numerous possible warning signs for the purpose of this blog;  however, below is what to be on the lookout for:

Anxiety:

• Does the child shy away from peers?
• Does the child have sleep onset  issues?
• Does the child engage in behaviors such as picking, biting nails, pacing, etc.?
• Are there fixed routines that the child engages in?

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ADHD:

• Does the child have difficulty focusing on work?
• Does the child require a lot of redirection and repetition of information?
• Does the child make careless errors with work?
• Does the child always seem to be on-the-go?

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Autism Spectrum:

• Does the child struggle with initiating and sustaining appropriate eye contact?
• Are there language delays?
• Does the child avoid seeking out others for interaction?
• Does the child avoid engaging in nonverbal behaviors such as gesturing?

The information above should not be considered to be a diagnostic check sheet, but rather possible concerns that might require further assessment. Parents, if you know that there is a family history of a neurodevelopmental condition and you see any of the above signs or symptoms expressed in your child, it is then time to seek further guidance.

Phonics versus Phonemic Awareness ~ What’s the Difference?

Phonics involves seeing letters individually and connecting each one to a specific sound. Letters are broken down into consonants and Child Alphabetvowels. Vowels are broken down into long and short sounds and words are taught by beginning and ending sounds. The order in which letters are taught is in conjunction with typical child development.

What is Phonemic Awareness?

Phonemic Awareness involves the understanding that spoken words are made up of individual sounds; these are known as phonemes. A child who is phonemically aware is able to isolate sounds, manipulate sounds, blend and segment sounds orally and in written words. Essentially, it is the ability to hear the different sounds in speech. Students may not recognize the written letter that accompanies the sounds, but he or she will recognize it in speech. Therefore, phonological awareness comes before phonetic skills.

The following is a simple separation of these two important pre-reading skills:

Phonemic Awareness

  • Main focus is on sounds, or phonemes
  • Deals with spoken language
  • Primarily auditory
  • Students work with manipulating the sounds within words

Phonics

  • Main focus is on graphemes/letters and corresponding sounds
  • Deals with written language, or print
  • Both visual and auditory
  • Students work with reading and writing letters based on their sounds and spelling patterns

Phonics and Phonemic Awareness are similar; however, they serve two distinctive purposes. Proficient use of both skills is the first step in the journey of becoming literate. Despite the many studies and educational debates on teaching these reading skills and others, one thing has remained certain. The more a child is read to the better his or her reading skills will be.

When Should You Hold Your Child Back A Grade?

Many parents are often worried and cautious about their child’s transition from kindergarten to first grade. There are unanswered kindergarten kidsquestions and concerns that the child faces. Oftentimes it may prove beneficial for the child to repeat kindergarten and have another year to develop pre-academic and social skills.

Questions that need to be kept in mind when deciding about holding the child back or moving him or her forward include:

  1. How is your child doing with learning basic academic skills? Is he or she learning all letters, letter sounds, numbers, etc? Is this an area that would need further guidance and assistance?
  2. How is the child doing socially and emotionally? Is your child able to transition readily from the house to the school environment? Does your child have friends and engage in appropriate play with others? How does your child deal with changes in routine?
  3. When is your child’s birthday? If it is a late birthday, holding him or her back might not be that major since he or she will not be much older than the rest of the class.
  4. What are the kindergarten teacher’s thoughts? She has the best opportunity to provide insight about your child’s learning styles and social functioning in comparison to same age peers.
  5. What are your thoughts as parent? Always remember that at the end of the day, you are your child’s best advocate.

Holding a child back in kindergarten is not the worst thing to possibly happen. The child has another year to mature and develop. In addition, the child is able to receive additional intervention and services in order to catch up with peers and ensure that first grade will be the utmost success. Remember, pay now or pay later. If things are pointing to next year being tough and him or her not being ready, don’t rush. It’s great to be mature for your grade.

Is Your Child Just Disorganized, or Is It a Bigger Problem?

Do you find that your evenings and mornings are primarily spent helping your child track down missing work or lost items andmessy child generally trying to help them get organized enough to manage their school day and extra-curricular activities? Is assisting your child too much interfering with family time and leisure time? Is this causing your family and your child stress? This scene is common in many families with middle and high school children that should be starting to manage their own lives. These problems are often caused by a weakness in Executive Functioning Skills: the skills that allow us to manage ourselves and our time with the resources we have. These skills are critical when it comes to being successful in school, but these skills are not often not taught in the classroom.

 The following are the Executive Functioning skills:

  • Emotional Control:  The ability to regulate emotions in order to stay productive and complete a task
  • Initiation: The ability to start a task independently
  • Planning/Organization: The ability to plan and organize one’s time, assignments and activities effectively
  • Shift: The ability to move from one task to another
  • Working memory:  The ability to hold information in the mind for completing a task
  • Inhibitions:  Stopping impulses at the right time in order to stay focused and accomplish the task at hand

Executive functioning coaching addresses weaknesses in executive functioning skills. Executive functions develop throughout childhood and continue to develop into early adulthood. Often, executive functioning difficulties become apparent for the first time during adolescence (although they may reveal themselves earlier). Poor or underdeveloped executive functioning skills may result in several difficulties for children, including emotional difficulties, risk-taking behavior, compulsive behaviors and attention problems. All of these may ultimately cause many issues in the self-esteem and functioning of the child and family, both in and out of school.

If executive functioning weaknesses are suspected, a neuropsychologist will be able to diagnose specific areas that need to be improved. A directed, executive functioning coaching program designed to address these challenges will result in a marked improvement in the current and future functioning of the child. North Shore Pediatric Therapy offers both individual executive functioning coaching programs and intensive workshop experiences to teach these vital skills. Contact us to schedule your appointment today.

*Cooper-Kahn, Joyce, Dietzel, Laurie. Late, Lost and Unprepared: A Parent’s Guide to Helping Children with Executive Functioning: Woodbine House Inc: 2008.
Rush University Executive Functioning Curriculum Training
https://www.aboutkidshealth.com.ca/En/News/Series/Executive Function/Pages/Executive Function

Risk Factors Associated with Prematurity and Low Birth Weight

As previously described in a prior blog, prematurity and low birth weight are commonly found in 2-8% of live births in the United States.  There pregnant ladyare numerous neuropsychological and cognitive concerns that were reported in the previous blog.  There are many risk factors that parents need to be aware of that can be a contributing factor in premature delivery.

Medical risk factors that are associated with low birth weight are:

  • Previous preterm delivery
  • Family history of infertility
  • Multiple gestation
  • Placental abnormalities
  • Uterine abnormalities/infection
  • Preeclampsia

Cultural risk factors associated with low birth weight include:

  • Preterm birth more than 2x as common in African Americans
  • Higher in single mothers
  • Higher in low socioeconomic status families

Because of the possible long term concerns with low birth weight, it is important to be preemptive and knowledgeable about medical and cultural factors that might contribute to the condition.

What is Cognitive Behavioral Therapy (CBT)?

Cognitive Behavioral Therapy (CBT) is an empirically supported psychotherapy approach that focuses on altering an individual’s negative cbt tHERAPYthoughts, beliefs and emotions.  The therapeutic technique stems from a combination of behavioral therapy (in which the focus is to develop behavioral regulation strategies in order to increase the frequency of positive behaviors while extinguishing negative behaviors) and cognitive therapy (in which the entire focus of therapy is on an individual’s thinking and mental beliefs).  Research has indicated that CBT is an appropriate and effective intervention for a variety of conditions, including anxiety, depression/mood concerns, tic disorders and eating disorders.

History of Cognitive Behavior Therapy:

Aaron Beck, MD, whom is considered to be the founder of CBT, created the therapy in the 1960’s after conducting extensive research on the limitations of psychodynamic therapy. Dr. Beck developed this strategy as a means for patients to be able to develop appropriate solutions for a variety of obstacles that they may face.

What is the Focus of Cognitive Behavior Therapy:

The focus of CBT is on the therapist being a guide in order to help the patient identify an appropriate response to specific situations.  The premise of the therapy is that the way someone thinks may lead to the way that person feels, which ultimately leads to how the person will act.  The point of change is not on the individual’s actions or feelings, but rather on how the individual thinks about a specific situation.  Essentially, the therapist works with the individual to help identify that there are multiple ways to think about a situation. As a result, this would lead to multiple ways to think and finally act on the situation.

Warning Signs of a Learning Disability

Prevalence rates of Learning Disabilities have an average range of 2-10%. While we aware of the negative impact that learning learning disability girldisabilities may have on achievement, when identified early, your child can be given the opportunity to meet their potential.

Below are 7 signs that may suggest that further evaluation may be needed:

  1. Uneven delays in development that persist to school age
  2. Inconsistency in your child’s performance and retaining of information
  3. Your child seems to need extra time to process information, learn concepts and complete work.
  4. You notice an increasing, strong dislike for school
  5. Your child routinely avoids academic tasks
  6. There is a sudden drop in achievement or a consistent pattern of under-achievement
  7. You recognize a change from your child’s typical behavior or mood presentation (e.g. opposition, anger, sadness, anxiety, inattention or negative self-statements)

It is important to know that children with learning disabilities are not lazy. The opposite is more often the case; they are highly motivated and want to learn.

What can you do if you suspect learning difficulties?

  • Bring your concerns to your child’s teacher. Develop a plan that will implement interventions and monitor your child’s response.
  • If problems persist, request that an evaluation to be conducted. This evaluation can be done through the school, but it may take several months to complete. Parents may wish to seek a private evaluation for faster results.
  • Closely monitor the progress your child is making with any strategies that are put into place.
  • A final and very important point is to provide opportunities for your child to be successful everyday. This will help them feel a sense of mastery and achievement that all children require.

1.Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. (2000). American Psychiatric Association: Washington, D.C.