Anxiety Disorders in Children

Increase Your Child’s Executive Functioning Skills

As we previously learned in our blog What Are Executive Functioning Skills?, executive functioning skills are what help all of us achieve goal-directed behaviors. They are the building blocks of successful planning, appropriate communication and relationships, and task-oriented behaviors. Executive Functioning

To help your child increase his/her executive functioning skills, we must look at the whole child. If there are other issues, those must be addressed with qualified professionals, supportive family members and school staff.

To help your child become a prepared, organized individual, increase his self-esteem and aid him in social situations, executive functioning skills are crucial.

It is never too late to offer and obtain help; and for your child to learn the skills needed to increase his abilities. As with any skill, it will take effort, practice, praise and patience.

Try these tips to help your child improve their executive functioning skills:

Pre-school and Elementary School

Helping your child increase executive functioning skills may involve adding more structure to his environment.

Aid your child with putting out clothes the night before school or having her backpack ready at the door. Show your child how to put away her toys and allow her to do it on her own.

Do homework shortly after she gets home and in the same spot each time, with minimal distractions. If she is having trouble with staying on task at school, then the school may offer (and you can advocate for) accommodations through an Individual Education Plan.

Demonstrate through your actions and encouragement that being prepared is a positive message that creates less stress for her and the entire family. Model being on time and planning ahead. Use a calendar to plan playdates and appointments, and encourage your child’s participation in basic planning skills (like setting the table for dinner, studying for a spelling quiz, or writing a card for an upcoming party).

Help her notice when it is her turn to talk, and how others feel if she interrupts. Ask her to think about others’ feelings and behaviors and how her actions or words may impact them.

Middle School and High School

As your child gets older, help him to develop skills aimed at organization and time management. Continue encouraging your child to prepare for school the night before. Sit in the same place to do homework every day. Try to begin assigned work when still fresh and not wait until late at night.

Use an assignment notebook. If needed, have the teacher sign it, check it and give it back to provide accountability. Offer positive reinforcement for fulfilling goals. Limit electronics and distractions. Use a timer to discourage procrastination. Give praise.

Enlist help from the school. If your child’s grades are extremely inconsistent, his work is disorganized and he continually forgets to bring/do homework assignments, it is likely time to speak to your child’s teacher, counselor or social worker.

Your child may need further accommodations at school. These may be resource time to finish homework, meetings with the counselor for encouragement, checking his backpack and locker, preferential seating in class, checking of his assignment notebook to ensure he is writing down his assignments and knows what is expected.

College Years and Beyond

The goal is for our children to be prepared to not just handle the world of work and daily living on their own, but to be happy and successful doing so. Using executive functioning skills such as time management, planning, and organization enables kids to be successful when they are on their own. Being prepared for a work presentation takes planning, time constraint considerations, and organization.

Increase confidence in your child and help him build positive relationships as he learns to navigate social interactions, anticipate possible outcomes and problem-solve to come up with potential consequences of his behavior.

Executive functioning skills will allow your child to cope with many of the stresses presented in his daily life.

Let’s help our children now to increase executive functioning skills that will allow them to be productive and successful in their future. Help them continue to blossom!

NSPT offers services in BucktownEvanstonDeerfieldLincolnwoodGlenviewLake BluffDes Plaines, and Hinsdale! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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How to Teach Play Skills to a Child With Autism

Play skills are one of the most important areas that children, especially those with Autism, need to learn. These skills provide opportunities for the child to entertain themselves in meaningful ways, interact with others, and learn important cognitive skills. A successful way to teach play skills to children with autism is to initially teach the specific play skill in a very structured manner. Play Skills

  • Break the play skill into small, discrete steps and teach one step at a time. As the child demonstrates success in learning one step, add the next step. (After the child can add eyes to Mr. Potato Head, then add ears, then arms, etc.)
  • Use modeling to teach the skill (e.g. the adult builds a tower of Legos as the child watches, then the child builds his own tower).
  • Always provide reinforcement (behavior specific praise “Nice job putting the piece in the puzzle”, immediately following the child’s demonstration of the skill.). As the child exhibits improved accuracy of the skill, reinforce successive approximations.
  • The child should have plenty of opportunities to rehearse the skill in a structured setting. Practice, practice, practice!
  • In the structured setting, have the learning opportunities be short and sweet, so the task does not become aversive to the child.
  • Fade the adult prompting and presence out gradually, so the child can gain more independence. Systematically fade the reinforcement so that it is provided after longer durations.
  • Remember to keep the activity fun and exciting. You want your child to WANT to play with the toys and games.

Once the child masters the skill in the structured environment by independently completing the play tasks for extended periods of time, he or she can then begin to practice and develop the skill in more natural settings. Bring the toys and games into other rooms of the house, to school, and eventually have peers present, so the child can use the skills learned in a social setting.

NSPT offers services in BucktownEvanstonDeerfieldLincolnwoodGlenviewLake BluffDes PlainesHinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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What Are Executive Function Skills?

Many of us have heard executive functioning used in terms of our children at school and at home. But what does it mean? Executive Function Blog

Executive Function – a Definition

Executive functions are necessary for goal-directed behavior. When we use the phrase “executive functioning skills,” we are describing a set of cognitive skills that control and regulate other behaviors and abilities. Our thought processes influence attention, memory and motor skills. (minddisorders.com).

Executive functioning skills help us to learn and retrieve information, plan, organize, manage our time, and see potential outcomes and act accordingly. When these processes work without difficulty, our brains do these tasks automatically, often without our awareness.

High Executive Function

In children and adults, those with high executive function skills are able to:

  • Initiate and stop actions
  • Make changes in behavior
  • Plan for the future
  • Manage time wisely
  • Anticipate possible consequences
  • Use problem-solving strategies
  • Use senses to gather information

For instance, the ability to initiate and stop actions may include working on a project for school or studying for an allotted time. Monitoring ones changes in behavior includes being able to act appropriately in a given situation and alter that behavior as needed. Planning for the future and managing time may include not procrastinating due to understanding the consequences of doing so.

Low Executive Function

When one is deficient in executive function skills, it may be difficult to plan and carry out tasks. The person may seem unable to sustain attention and feel overwhelmed by situations others find easier to navigate.

People with deficits in this area may also have comorbid diagnoses (meaning they go together). These include, but are not limited to: Attention Deficit Hyper-Activity Disorder, Autism, depression and obsessive-compulsive disorder. Executive functioning deficits may run in families (learningdisabilities.about.com).

So, a child with executive functioning deficits may be able to pay attention to a lesson, until something new is introduced that requires a shift in their attention or that divides their focus. Children lacking in executive functioning skills also may have issues with verbal fluency.

Additionally, a child (or adult) with low executive function may have social problems. Executive functioning skills allow us to anticipate how others might feel if we do or say something. Those with low executive function may have difficulty interacting with others. Because they sometimes do not think things through before saying them, people with executive functioning deficits may blurt out inappropriate or hurtful comments, leading others to avoid them.

Working with your child, a therapist, and creating structure at home and accommodation plans at school are all ways to provide help for your child.

Increasing executive functioning skills will enable her to become a more organized, less stressed and less frustrated individual as she grows into a world of ever-increasing pressures.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, and Hinsdale! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

Why School Speech-Language Screens are Important

A school speech-language screening allows a speech-language pathologist to observe the child’s language understanding and use, production of speech sounds, vocal and nasal quality, and social language skills. The screening typically follows a checklist that a speech-language pathologist administers in approximately 15-20 minutes. 

Most screening tools yield a “pass” or “did not pass”. If a child did not pass the screening, then a comprehensive full speech-language evaluation is recommended. Following this process, an intervention plan is created and proposed if needed.

A hearing screening is equally important and recommended upon entering kindergarten. The screening is typically a hand raising game an audiologist administers in approximately 10 minutes. If a child did not pass the screening, a comprehensive full hearing test is typically recommended. Normal hearing in children is important for normal language development.  If a child has hearing problems, it can cause problems with their ability to learn, speak or understand language.

Speech and language skills are used in every part of learning and communicating with other children in school. In kindergarten, children learn the routine and structure of a typical school day and need to be able to follow directions, understand ideas learned in class, communicate well with their peers and teachers, practice early literacy skills and use appropriate social skills within the classroom and during play.

Screenings can be a great tool to determine if a child warrants a full speech-language or hearing evaluation. A screening alone is not diagnostically reliable and should only be used as a tool to decide if an evaluation is necessary.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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How to Get Your Kid to Sleep in Their Own Bed

Bedtime can be a stressful time of the day for both children and their parents. Getting your child to sleep in their own bed at night can be quite the challenge. Figuring out what works best for you and your child can be exhausting and may require a trial-and-error process. Sleep Blog

If you are searching for ideas to help your child sleep in their own bed at night, you may be interested in exploring some of the options below:

Bedtime routine

  • A bedtime routine is extremely important if you are having a difficult time getting your child to stay in their own bed. It may be helpful to have them take a warm bath, put on their pajamas, brush their teeth and pick out a book, as well as a stuffed animal to sleep with before getting into bed. Establishing a before-bed routine will reduce your child’s stress levels and assist with falling asleep, staying asleep throughout the night and waking up feeling refreshed. Many children benefit from a visual schedule, so that they can follow a step-by-step picture sequence of their routine.
  • During the hour or so before bed, make sure your child engages in calming activities. Activities that are alerting or stressful for your child can make the transition into bedtime more difficult. Examples of calming activities may include guided meditation, listening to calming music, yoga, drawing or reading a book.
  • Keep in mind that consistency is key! It is important to establish a routine and stick with it, even if you may not be noticing immediate results.

Gradual transition

  • Be sure to give your child ample warning time before bedtime approaches. Moreover, do not suddenly tell your child that it is time for bed while they are in the middle of their favorite activity. It is beneficial to give them a reminder that bedtime is approaching, roughly an hour before they should be asleep, with consistent warnings until it is time to go to sleep. If your child has not yet mastered the concept of time, using a timer can assist with this.

Bedtime fading

  • Another option is a concept called “bedtime fading.” This is putting your child to sleep somewhat later than their usual bedtime, so that they are more tired and fall asleep faster. After doing this for a few days, you can gradually shorten the time down closer to their actual bedtime. For example, if bedtime is typically 8 p.m., put your child to bed at 8:30 for a few days. Then 8:15 and so forth, until you get back down to 8. This allows them to gradually learn to fall asleep alone, especially if they prefer to have a parent with them in the room in order to fall asleep.
  • Your child may also benefit from keeping their bedroom door open. A child may feel better falling asleep on their own if the door is open at least halfway. If they do not stay in their bed, the door gets closed. You can also try using a nightlight to increase their level of comfort while they are trying to fall asleep.
  • Gradually moving yourself out of the room may also be beneficial. Explain to your child that you will stay on the floor next to them until they fall asleep. The following night on a chair nearby, etc. After a few days, the goal will be to phase yourself out of their room.

Reward system

  • A reward system works well for many children, especially during bedtime. If your child lays in their own bed without coming out, they can earn a breakfast treat or pick a prize out of a bin of options such as stickers or toys of your choice. You can even place that reward on a shelf in their room, so they know it is there for them in the morning. If your child comes out of bed throughout the night, they do not receive a reward; however, can try again the next night. It is best not to bring too much attention to the fact that they were unable to achieve the reward and focus more on earning it for the following day.

Re-direction

  • The first time your child gets up from their bed, take them by their hand, walk them back to bed and calmly state that it is bedtime and they need to go to sleep. The second time, do the same thing but just say the word “bedtime.” If it happens again, say nothing and silently walk your child back to bed. The less talking, the better, as to bring less attention to the situation.

Praise your child

  • Saying your final “goodnight” should be brief. You may want to discuss how your child’s day went and what will take place tomorrow. Praising your child for something he or she did during the day that you were proud of them for will help them to fall asleep on a positive note.

NSPT offers services in BucktownEvanstonDeerfieldLincolnwoodGlenviewLake BluffDes PlainesHinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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Back to School with ADHD

Executive functioning skills are daily requirements for everyone, especially for school-age children who are required to be organized, pay attention, plan, and manage their time. Children with attention-deficit/hyperactive disorder (ADHD) often struggle with executive functioning tasks that can negatively impact their attitude towards school, academic achievement and performance, and overall emotional well-being. 

Common experiences of children with ADHD include:

  • Difficulty remembering to submit or complete assignments
  • Forgetting instructions
  • Poor organizational skills and planning
  • Avoidance of difficult or time consuming tasks
  • Emotional dysregulation

It is imperative that preparations are made to provide skills and systems that will assist children with ADHD to have a successful school year and to enjoy learning.

Some steps to prepare your child with ADHD for the school year include:

  1. Create structure at home, teach and practice executive functioning skills.
  2. Encourage your child to make a to-do list for each day and check off items at the end of the day (parents can also create a list of their own and model this behavior for their child).
  3. Create a system that helps with organization of room and or study area, so items and books can be easily stored and located.
  4. Teach and model accountability by checking in at the beginning and end of the day.
  5. Allow appropriate natural consequences and implement logical consequences for behaviors.
  6. Allow your child to advocate for themselves at home, so that they will be confident to advocate at school.
  7. Work with your child to teach responsibility and develop skills.
  8. Play games that reinforce executive functioning skills (i.e. Jenga, Max, Distraction, AnimaLogic, and No Stress Chess).
  9. Maintain daily routine during days off and weekends.
  10. Get a neuropsychological assessment, so that school-based accommodations can be put in place.

Overall, ensure that your child is learning to manage their time, is building good habits, and is completing tasks.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, and Hinsdale! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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Hand Flapping: When to Worry

Many people correlate hand flapping with only Autism, however this is not the case. All children could exhibit a hand flapping behavior when they are in a heightened emotional state including when anxious, excited, and/or upset.  Many believe that children with Autism will engage in hand flapping as a self-stimulatory activity, which can be accompanied by other stimming behaviors like rocking and/or spinning. Blog-Hand Flapping-Main-Landscape

Children with autism are often extremely sensitive to specific sensations and sounds that may not effect someone who is not on the spectrum. Environments in which there are multiple sounds, loud noises, and crowds can cause distress for some individuals with and even without autism. Hand flapping is seen as a way to escape the over stimulating sensory input present in the environment.

Other times when hand flapping can be observed in children (both verbal and non-verbal) is when they are trying to express or communicate to others around them. It is viewed as them trying to express that they are: happy, excited, anxious, or angry. In cases like these, families and professionals often feel that hand flapping should not be a concern, stopped, or corrected.

Hand flapping would be something to worry about when and if it impacts a child’s functional daily living ability, for example if it impacts their ability to navigate their environment safely.

NSPT offers services in the Chicagoland Area! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

My Toddler Isn’t Talking Yet! Will He Catch Up?

Parents often worry when their child reaches 18 months or 2 years of age and does not talk much or at all. Some children exhibit late language emergence, also known as late talking or a languageBlog-Late-Talking-Main-Landscape delay. Approximately 10-20% of 2-year-old children exhibit late language emergence. A late-talking toddler is typically defined as a 24 month old who is using fewer than 50 words and no two-word combinations. While research shows that late talkers catch up to peers by elementary school, approximately one in five late talkers will continue to have a language impairment at age 7. For some children, the late emergence of language may indicate a persistent language disorder, also called a specific language impairment. For other children, late language emergence may indicate a related disorder such as a cognitive impairment, a sensory impairment, or an autism spectrum disorder. Many parents wonder if their late-talking toddler will catch up naturally or whether speech-language therapy is recommended.

The following signs may indicate that a child will not naturally “catch up” in language and therefore may require therapeutic intervention:

  1. Language production: The child has a small vocabulary and a less diverse vocabulary than peers. A child who uses fewer verbs and uses primarily general verbs, such as make, go, get, and do is at risk for a persistent language disorder.
  2. Language comprehension: The child has deficits in understanding language. The child may be unable to follow simple directions or show difficulty identifying objects labeled by adults.
  3. Speech sound production: The child exhibits few vocalizations. The child has limited and inaccurate consonant sounds and makes errors when producing vowel sounds. The child has a limited number of syllable structures (e.g., the child uses words with two sounds, such as go, up, and bye instead of words with three to four sounds, such as down, come, puppy, black, or spin).
  4. Imitation: The child does not spontaneously imitate words. The child may rely on direct modeling and/or prompting to imitate (e.g., an adult must prompt with, “Say ‘dog,’ Mary” instead of a child spontaneously imitating “dog” when a parent says “There’s a dog”).
  5. Play: The child’s play consists mostly of manipulating or grouping toys. The child uses little combination or symbolic play, such as using two different items in one play scheme or pretending that one item represents another.
  6. Gestures: The child uses very few communicative gestures, especially symbolic gestures. The child may use pointing, reaching, and giving gestures more than symbolic gestures such as waving or flapping the arms to represent a bird.
  7. Social skills: The child has a reduced rate of communication, rarely initiates conversations, interacts with adults more than peers, and is reluctant to participate in conversations with peers.

The following risk factors exist for long-term language disorders:

  1. Males
  2. Otitis media (middle ear infection) that is untreated and prolonged
  3. Family history of persistent language/learning disabilities
  4. Parent characteristics including less maternal education, lower socioeconomic status, use of a more directive instead of responsive interactive style, high parental concern, and less frequent parent responses to child’s language productions

For children displaying any of the above signs or risk factors, a comprehensive speech-language evaluation is recommended.

References:

  • Paul, R. (2007). Language Disorders from Infancy through Adolescence: Assessment & Intervention. Elsevier Health Sciences.
  • http://www.asha.org/Practice-Portal/Clinical-Topics/Late-Language-Emergence/

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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Why is Mindset Important for Child Development?

Kids thrive on pleasing their parents, so when your child does something well you want to praise them! Have you ever said “you are so smart” or “you are so talented” at a sport? It’s not that simple, as the way you praise them can impact their confidence and drive. Blog-Mindset-Main-Landscape

As an example, our son picked up a baseball bat at 2 ½ years old and was able to hit a pitched ball (no tee!) that same day. I was an extremely proud dad, especially since all the other parents at the park were clearly impressed. We enthusiastically complimented his natural talent and he seemed so proud. When we signed him up for a t-ball team his enthusiasm faded and we noticed he was less interested in trying to learn the game. We wondered why he was not excited to play.

My wife and I noticed some patterns at home and school. He would only attempt tasks that he felt confident or had already possessed a level of skill. As it turns out, what we were doing when we were praising his natural ability was feeding into his ‘fixed mindset’. With a fixed mindset, Carol Dweck writes in her book Mindset, people believe their basic qualities, like their intelligence or athleticism, are fixed traits and don’t change over time. They believe their talent alone creates success—without effort.

So how do we make sure that we are praising our kids ‘the right way’ to be sure they give their full effort? One idea is to encourage them to have a ‘growth mindset’ – where people believe their skills and abilities can be developed over time through hard work.

When our son took up hockey and was learning to skate we saw this as an opportunity to try out a growth mindset. We were determined to focus on praising his effort since we knew learning to skate would be potentially frustrating for a kid who is naturally athletic. We talked with him beforehand about how hard it would be, that he would fall a lot, but getting back up and trying again was most important and after each session we were enthusiastic about his effort.

And guess what? It worked! Towards the end of the 8 week session he even started coming off the ice bragging to us about how hard he worked. Even though he was not the fastest or best skater on the ice he was proud of his own resilience and what HE accomplished. As parents, we too were bursting with pride for him!

I strongly encourage you to ask yourself how you can start incorporating this type of growth mindset approach with your own children. Learn to recognize how you praise your children and ask questions such as “What did you try that was difficult or challenging today?” I bet you’ll be surprised how quickly you will see a positive impact. Good luck and let us know how it goes!

FIXED MINDSET (Intelligence is static) → Leads to a desire to look smart and therefore a tendency to…→ (Challenges) avoid challenges → (Obstacles) …get defensive or give up easily → (Effort) …see effort as fruitless or worse → (Criticism)…ignore useful negative feedback → (Success of Others) …feel threatened by the success of others → AS A RESULT, they may plateau early and achieve less than their full potential.

GROWTH MINDSET (Intelligence can be developed) → Leads to a desire to learn and therefore a tendency to…→ (Challenges) embrace challenges → (Obstacles) …persist in the face of setbacks → (Effort) …see effort as the path to mastery → (Criticism)…learn from criticism →(Success of Others) …find lessons and inspiration in the success of others → AS A RESULT, they reach ever-higher levels of achievement.

References:

Dweck, C. S. (2006) Mindset: The new psychology of success. New York: Random House.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!