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mental illness in children

The Rise of Mental Illness in Children

 

 

The Journal of Pediatrics published a recent article that childhood developmental conditions including ADHD and Autism are increasing at a rate of 16% from 2001 to 2011 (Read a review of this article on the CNN blog, The Chart, here). Although this might sound astounding and like this should be an area of concern, the researchers have posited that this actually might be a positive.

In all likelihood, these rates were probably the same. What we have now is an increased awareness of a variety of developmental disabilities as well as increased acceptance of such conditions. Having increased acceptance is extremely positive in that now we are able to provide support and services to help these children that otherwise would not be available.

Here are some tips for parents for children who might have a neurodevelopmental condition like ADHD or Autism:

  1. Seek out a good, comprehensive evaluation in order to first help identify the specific condition that the child might present with.
  2. Identify your treatment team. Your team will consist of multiple individuals including teachers, therapists, administration, and special education teachers. Make sure the team is all on the same page and aware of the specifics that the child presents with.
  3. Seek out resources and information to help support you and your family. There are multiple, empirically supported organizations that provide parents and family members with not only support but also resources to help the child out.

Although the rates of a variety of neurodevelopmental conditions are on the rise, it is likely that these conditions have always been as prevalent as they are today. The social stigma associated with the conditions is no longer as strong, and these children are now able to receive specific services and interventions that would be beneficial for them.




set up a routine for homework success

Set-Up a Routine for Homework Happiness

 

 

 

Children with attentional problems or issues with executive functioning often have difficulties with homework completion. Several issues associated with executive functioning lead to concerns with the ability to complete daily work including the following:

  • Initiation on work
  • Organization concerns
  • Time management
  • Difficulty transitioning

When is the best time for my child to do homework?

Oftentimes children will want to have a break from school work when they come home. They want to play for a while before doing work. I would actually recommend that the child immediately start homework when he gets home. Research has indicated that children with attentional problems and poor executive functioning have difficulty transitioning between tasks. The child is still in the school mindset when he arrives home. Having the child take a break and then later transition back to homework likely will prove difficult. Instead, I would recommend that the child have a light snack and then immediately start the work.

How should I structure the homework space?

Organization, or lack thereof, is a hallmark feature of poor executive functioning. With that in mind, I would highly recommend that the homework environment in which the child is working be as organized and structured as possible. Have a specific desk or table where work is to be done. Keep the table as clean as possible with a minimal amount of distractions in the room. Oftentimes, having the child complete homework in his room proves to be a disaster. There are too many distractions that keep the child’s interest away from the homework assignment. It may prove best to select a quiet room away from family members with the fewest distractions possible.  Click here to watch a Pediatric TV Episode on setting up a homework station.

How do I work on time management with my child?

Parents often state that the child has no idea about time management or how long tasks should last. I often recommend that parents have the child provide an estimate of how long he perceives a task should last. Time the child and then provide the difference as to how long he thought the work would last and how long it actually lasted. Then the next day, have the child again provide an estimate as to how long the task will last. If the child is way off with the estimate, pull out the data from the night before and ask if he wants to revise his estimate. Keep this going until the child starts to develop an actual idea of how long tasks should last.

These are just a few tips to keep homework as structured as possible. Help the child start homework right away as it will help with initiation on tasks as well as ensuring a smooth transition between demands. Keep the room and desk as organized as possible to limit distractions and off-task behaviors. Provide some guidance with time management by helping identify how long tasks and assignments should last.

Read here for 8 more tips to ease homework time stress!





prep your child's teacher to help your child with ADHD

How to Prep Your Child’s Teacher to Work with an ADHD Diagnosis

To start the school year out right for your child with and ADHD (or other) diagnosis, it is important to establish a close collaboration between you, your child’s teacher, any professionals of the treatment team, and your child!  Here is how you can prepare your child’s teacher to best understand your child’s needs to get off to a great start this academic year.

10 tips to prepare your child’s teacher to best help your child with an ADHD diagnosis:

1. Request to set up a meeting at the start of school year.

2. Get an idea of what your child’s teacher knows about ADHD and his general attitude towards ADHD. Some teachers may be more or less informed about ADHD, as research and diagnostic criteria has changed quite a bit over the years.
3. Inform the teacher of your child’s ADHD diagnosis (or other diagnosis), if he is on any medication or if you chose an alternative treatment method.

4. Find out what the culture of the classroom is like:

  • Structure: Is the daily schedule posted?  Does the teacher request frequent “brain breaks” during the day?
  • How does she describe her teaching style?
  • Rules & Expectations: Are there visual reminders posted around the room? What is the reward system? Incentives? Token System?  Nature of the homework assignments? Seating arrangements?
  • Can your child sit facing the front and close to the teacher?

5. Discuss the best way to contact one another (i.e. via phone or email).
6. Discuss if any notes home or behavioral report cards are necessary or how often?
7. Pass along any recommendations to your child’s teacher that she can implement that you have found helpful  for your child.

Examples:

  • “Jake does well when given one command at a time versus following multiple steps at once.”
  • “At home, we have found that having Jessica repeat back directions or rules, helps her to be more accountable.”
  •  “We use the token system at home and Sam seems to do well with it when we are consistent.”

8. Be supportive and open.

  • Assist the teacher in any way by being supportive and open to suggestions he or she may have.
  • Let the teacher know you want to work as team to make it a successful year for everyone.

9. Offer Praise and appreciation: A positive attitude with your child’s teacher creates a stronger relationship with all involved!

10. Request to set up a follow-up meeting to check-in : This could be half-way through the school year or sooner depending on the needs of your child.

Click here to read about self-regulating strategies to help children with ADHD.

ADHD in boys and girls

ADHD in Girls v. Boys

 

 

 

 

Although there are many features of ADHD that may overlap between genders, studies have shown there to be characteristics that differ among boys and girls. Neither of these characteristics are exclusive to the gender, but these are generally the characteristics seen in girls and boys with an ADHD diagnosis:

 ADHD Features in GIRLS:

  • Tend to show more symptoms of inattentiveness vs. hyperactivity
  • Are more likely to be diagnosed later in their academic career
  • Some adult women are not diagnosed until their child goes through the process and is diagnosed themselves!
  • Have a higher likelihood of being under-identified and under-treated
  • Display more symptoms of inattention, daydreaming, and memory problems
  • May be initially misdiagnosed
  • Tend to go under the radar during early school years
  • Tend to be slower learners and less motivated
  • Are at-risk for self-esteem issues, mood issues, and substance abuse
  • Adolescent-aged girls have lower self-efficacy and coping skills
  • Have a higher tendency to internalize problems
  • Are easily overwhelmed
  • Have difficulty with time management

 ADHD Features in BOYS:

  • Have a 2:1 ratio diagnosis of boys to girls
  • Are more likely to be detected and diagnosed early on in the school–age years
  • Show more symptoms of hyperactivity and behavioral problems
  • Have higher rates of impulsivity
  • Have Higher incidents of externalizing problems associated with ADHD symptoms (i.e. aggression, trouble getting along with peers)
  • Have trouble sitting still or disruptive in the classroom
Girl Day dreaming

Self-Regulation Strategies For Kids With ADHD

Symptoms related to ADHD can manifest differently from child to child. Redirecting hyperactive, impulsive, and/or inattentive behaviors can be achieved through following these strategies:

Engagement In Whole Body Listening

Educate your child that listening does not just include opening your ears to the sound of words, but that it in fact means that the entire body is calm, engaged, and focused. The child’s body should be directed toward the speaker or the task at hand, with feet still on the floor, hands still in their lap or on the desk, eyes looking at the task or person speaking, ears listening to the spoken content, and with their brain focused on the current material.

If your child is too hyperactive and is having trouble regaining whole body listening, encourage them to engage in muscle relaxation activities such as squeezing hands/fists/body into a ball tightly for 10 seconds and then releasing. They can do these reps about 5 times or until they are able to extinguish the extra energy causing them to become hyperactive.

On-topic vs. Off-topic Thinking

Help your child gain awareness about what their brain is processing. Chances are, if your child is thinking about Minecraft, a fun science experiment that he did in school, or what he will have for dinner that night, he is NOT listening to what you are saying. If your child appears inattentive, ask them what they are thinking about. If they reply in alignment with the message you have presented, they are using “on-topic” thinking which fosters enhanced focus/attention. If they reply that they were thinking about unrelated material, educate them that this is “off-topic” and they can shelve this idea until after their work is over or after the directive is completed.Girl Day dreaming

Stop-Sign Technique

Help your child reverse their acting and thinking processes. Impulsivity occurs at times when we are absently thinking and as a result, behave quickly. When we react before we think, we do not think about the potential ramifications of our actions and therefore can make poor choices. If you notice your child acting quickly and in the process of engaging in a non-preferred or unexpected behavior, shout out “stop” and/or hold your hand out to signal stop. Have your child cease whatever they were engaging in and have them evaluate the potential consequences if they continue doing what they are doing. Having the child assess the outcome of their action will help them reconfigure more compliant behaviors. You can help your child problem-solve in this process and model for them the appropriate steps for formulating the best choices through thinking before acting.

These strategies can be interactive and process-oriented between child and parent in the hope that the child can then internalize these strategies and autonomously utilize them. Don’t be afraid to help redirect your child, but also encourage them to utilize these skills independently.






Child having trouble reading

Learning Disabilities or ADHD: Which Is It?

My child is disorganized, has trouble during homework time and following directions, and doesn’t seem to be reading like other kids his age…Is it ADHD or maybe a learning issue?

ADHD and learning disabilities often co-occur. In fact, about 1/3 of children with ADHD also have an additional learning disability. Sometimes parents might wonder if the ADHD is causing the learning disability or if the learning disability causing the inattention. The fact is that they are two discrete disorders with their own set of symptoms. It is true that some of the symptoms may be common to both disorders including:

–          Poor executive functioning
–          Lack of organizational skills
–          Inefficient use of strategies (mnemonic tricks, imagery, rhymes)
–          Behavior problems
–          Low self-esteem

Learning and attention problems are on a continuum ranging from mild to severe.  With the various overlapping symptoms and the fact that behaviors, that may be a result of a learning disorder, can look like ADHD, it can be difficult to distinguish between the two. Although they are both neurologically based, they are assessed and treated differently. A learning disorder (i.e. dyslexia, reading, writing, math) can affect the way that information is stored and relayed back causing a breakdown in information and learning.

Intervention for learning disorders may include the following:

–          Academic skills tutoring
–          Development of compensatory strategies
–          Self-advocacy skills
–          Implementation of an Individualized Education Plan (IEP) or other school accommodations

Although ADHD can interfere with a child’s ability for learning, it is often treated with the following:

–          Behavioral modifications
–          Family counseling and parent training
–          Modifications to the learning environment
–          Implementation of medication
–          Classroom accommodations
–          Executive functioning tutoring

Whether your child struggles with a learning disability, ADHD or both, parent support and education are important to help your child succeed. CHADD.org  is a great website that offers resources such as training and classes that help with parenting and discipline concerns.

Tips to Help Your Child with Word Retrieval

Parents may notice that their child may take longer to respond, may have difficulty picking the right word or may use filler words like “um” or “uh” more often than expected. All of these are signs of word finding difficulties, or trouble retrieving a desired word. These children are not having difficulties with vocabulary, they know the words, they simply can’t always access them in a desired moment. Difficulties with word finding or word retrieval is commonly associated with ADHD, reading disorders, and specific language disorders. If left untreated, word finding difficulties can impact a child’s success in school, notably in both oral and written communication.

So my child has word finding difficulties – now what?

A licensed speech-language pathologist can help! Direct therapy can target these difficulties and create strategies to help both at home and at school.  Parents can also work with their children at home by incorporating these tips into their everyday communications:

Wait: your child knows what he wants to say, he may just need a little more time. Allowing your child to work through these difficulties, retrieve the desired word, and participate in a conversation will help not only his self-esteem, but will also encourage strategy use.

Describe it: encourage your child to describe an object or experience if he is struggling. As adults, we all have all said, “It’s on the tip of my tongue” and have used this strategy. Support your child by having him describe the following:

  • Color (it can be brown)
  • Shape (it’s round)
  • Size (it fits in my hand)
  • Feel (soft or crunchy)
  • Parts (might have chocolate chips, raisins, or sprinkles)
  • Where we find it (at the grocery store)
  • Who uses it (we all do)
  • When do we use it (after dinner)
  • What do we do with it (eat it)

These strategies can be helpful for children who are not having word finding difficulties, too! Describing things will encourage language development and growth and will allow children to expand their repertoire!



Signs of a Sensory Issue and Who Can Help

Everyone (children and adults both) have sensory issues and concerns.  As adults, we often learn to avoid noxious sensory inputs that we find to be bothersome.  Oftentimes, children are unable to avoid the sensory concerns that they find to be bothersome.  These sensory concerns can at times have a significant impact on a child’s social, emotional, and academic functioning.  Parents and educators are often unsure of when to actually seek help or what help to seek.

Questions to think about your child’s ability to deal with sensory input include the following:

  1. Does he have trouble with bright lights?  (has to have sun glasses at all times outside)
  2. Does he hate being touched?  (avoids hugs and contact from others)
  3. Does she seek out constant contact from others? (always wants to be hugged)
  4. Does he talk too loudly or too softly?

If you answer yes to any of these questions, it may prove beneficial to have your child evaluated.  Pediatric Occupational Therapists are often well trained in the assessment and intervention of sensory concerns.  They can  often work with the child to develop tolerance to the avoidant stimuli while also providing accommodations within his or her environment that help the child.

It is important to always keep in mind that there may be other medical or psychological concerns evident.  If you suspect that there may be something in addition to sensory concerns, have a consultation with the occupational therapist in order to determine if additional assessments or interventions are needed.

Additionally, don’t rule out ADHD and many other very associated issues.  You can learn more by visiting a pediatric neuropsychologist who can pinpoint the best treatment strategy.

Click here to download your Sensory Processing Disorder Red Flag Checklist.

Are You a Parent with ADHD?

How many times have you caught yourself going from starting dinner, to doing laundry and helping with homework, to find that dinner is burned and the laundry is in a wet pile? This is one of the many scenarios a parent with ADHD may struggle with on a daily basis. Parenting is one of the toughest jobs out there, and parenting with ADHD can be even tougher. ADHD can present itself differently from childhood to adulthood. You may be a situation where you were diagnosed as a child and are learning to cope with the symptoms as an adult. OR, maybe you are an adult who was never diagnosed as a child (but should have been).  Red on to understand how ADHD symptoms may manifest in adults.

Do Any of These Scenarios Sound Familiar?

  • I often miss deadlines at work
  • I lose things easily
  • I have a hard time completing house work
  • I have trouble managing my bills
  • I get easily distracted and, at times, tune people out when they are talking to me
  • I start a few different projects (i.e. laundry, dishes, vacuuming) without finishing them
  • I tend to get bored easily
  • I procrastinate when needing to complete a task
  • I act impulsively sometimes (i.e. shopping, eating) without thinking of the consequences
  • I am quick to yell when I am frustrated
  • I am accident prone
  • My work space is messy
  • I prefer to do things my way rather than follow rules
  • ADHD runs in my family or my child has ADHD

We can all probably relate to a few these! This doesn’t necessarily mean you have ADHD, but if there are several symptoms that tend to disrupt your functioning on a daily or weekly basis, you may want to reach out for support. You can talk to your primary care physician or find a mental health professional for treatment and to help you learn some strategies to better manage your symptoms.

How ADHD Impacts Your Child’s Social Skills and Friendships

ADHD is a neurobiological disorder that can affect your child’s ability to regulate his behavior and observe, understand, and respond to his or her social environment.

Does your child…

  • Often have problems getting along with other children (i.e. sharing, cooperating, keeping promises)?
  • Struggle to make and keep friends?
  • Tend to play with kids younger than him?
  • Become upset, aggressive, or frustrated easily when they lose a game or things don’t go their way?
  • Have difficulty following directions and rules?

Peer relationship issues tend to be a common problem area in children with ADHD. Children with ADHD tend to act in a way that provokes negative reactions from peers, and can become a target for teasing.  The hallmark symptoms of ADHD, such as hyperactivity and impulsivity, can be the main culprits to blame! These children tend to live in the NOW… meaning what they can achieve right now is what is important! The consequences, like losing friends and being left out the next time, are overlooked. Social skills (i.e. sharing, keeping promises, expressing interest in another person) have NO IMMEDIATE GRATIFICATION. These kiddos then have difficulty understanding the concept of building friendships based on these learned skills.

What can you do to help?

  • Practice social skills at home and when you observe your child playing with other children.
  • Avoid activities that require complex rules for success and a lot of passive time (i.e. choosing an infield vs. outfield position in T-Ball). They can become bored and distracted easily.
  • Keep groups small.
  • Discourage play with aggressive peers.
  • Experts have found more positive social interactions when there is less competition – this causes emotional over arousal, increased disorganized behavior, and frustration.
  • Make sure you are modeling appropriate social behavior at home.
  • Encourage friendships – invite kids over to your house and keep the play structured and supervised
  • Work with your child’s teacher and involve her in the process.
  • Enroll in social skills training class or contact a professional if more help is needed.

Sources:
Taking Charge of ADHD, Revised Edition: The Complete, Authoritative Guide for Parents  By Russell A. Barkley