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Sleep Deprivation in Children and 5 Tips on How to Get Your Child to Sleep

Sleep is one of the most important activities in your child’s day but it is often overlooked as such. It is as essential as food, water, and child sleepingsafety and vital for adequate physical and cognitive development.

How much sleep does your child need? Often more than we typically expect, school-age children need 10-12 hours, with younger children needing the most, and adolescents needing 9-10 hours of sleep per night to function optimally. If your child is not getting this on a regular basis, they can become sleep-deprived. When this is prolonged, a number of problematic issues can arise, including problems focusing, mood dysregulation, and risk for falling behind in school.

How do you know if your child is sleep-deprived? Some of the signs include:

  • Excessive daytime sleepiness (e.g., falling asleep in the car, wanting to take naps)
  • Needing to drag your child out of bed in the morning
  • Waking up irritable and unrested
  • Problems falling asleep at night (more than 30 minutes)
  • Sudden change in emotions or behavior

Here are some tips to help your child sleep and for your entire family to get the rest they need:

  • Dim the lights: Our sleep cycle is regulated by light so try turning off or dimming lights around the house 30 minutes before bedtime.
  • Avoid the “second wind:” Tune into your child in order to find the time when they begin to slow down and become tired. If this opportunity passes, children may become more hyperactive and difficult to settle.
  • Routine is key. Keep it simple and short (less than 30 minutes)
  • Oftentimes children will need help settling down. When other strategies have not worked, you may want to talk to your pediatrician about Melatonin, an over-the-counter supplement.
  • And finally, make bedtime a time in which to look forward. Use it as an opportunity to unwind from the day and bond with your child.

If you suspect that your child may not be getting enough sleep, and your attempts to alter the problem have not helped, talk with your doctor or schedule an appointment with one of our behaviorally-trained social workers and experts.

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.

Brain Injury in Children

Traumatic brain injuries that occur in children are quite common and are often associated with significant cognitive, academic and brainsocial/emotional concerns. Studies have indicated that brain injuries occur in approximately 180 out of every 100,000 children.

Transportation-related injuries are the most common cause of brain injuries in children as well as adolescents. Studies have indicated that motor vehicle accidents and bicycle falls account for upwards of 80% of all brain injuries in children. The causal factor for brain injuries is varied based upon the age of the child. Specifically, infants and young children are more likely to sustain a brain injury through falls while older children are more likely to sustain a brain injury from a sports injury, bicycle accident or motor vehicle accident.

Traumatic brain injury is the leading cause of death amongst children and adolescents. Data has indicated that about 40-50% of deaths of children and adolescents are associated with brain injuries. The mortality rate associated with a brain injury is related to the severity of the injury. Children with mild brain injuries almost always survive the injury.

The majority of brain injuries are mild and mostchildren and adolescents will usually survive the injury; however, there is often a wide range of neurobehavioral and cognitive concerns associated with the injury. Issues with attentional regulation, slow speed of processing and concerns with executive functioning are often associated with a brain injury. In addition, \children and adolescents that experience brain injuries often exhibit concerns in regard to their social and emotional functioning.

It is often that these children require significant interventions and accommodations within both a clinic setting and academic setting. The specific interventions and accommodations that the child needs must be individually determined based upon the specific areas of strength and weakness that are observed. The interventions may often consist of pharmacological intervention, social work support, academic accommodations (as part of an Individual Education Plan) and supplemental environmental accommodations.

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.

Prematurity and Low Birth Weight

Prematurity and low birth weight are quite common and have been increasing in evidence. Research has indicated that infants that arepremature baby born with a low birth weight comprised approximately 8% of live births in the United States in 2005 (National Center for Health Statistics, 2006). Children that are born prematurely are on the rise and this is largely attributed to the advances in medicine and technology.

It is important to monitor several cognitive, academic and social-emotional factors of children that are born with a low birth weight and prematurity as these children are at risk for a wide variety of possible concerns.

More specifically, research has indicated that children that are born with low birth weight may be at risk for:

  • working memory and long term memory concerns
  • slower processing speed
  • attentional regulation
  • executive functioning
  • social/emotional concerns

Not every child with low birth weight or prematurity will exhibit the above concerns; however, it is always best to keep in mind that these concerns may be evident within the academic setting. A neuropsychological evaluation will help to establish a baseline of current functioning in order to monitor and track progress as well as to help determine if specific interventions and modification of the environment should be warranted.

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Are you Happy? How can you increase your happiness?

I’d like to think that I am generally a happy individual.  I greet people with a smile, share a laugh and look to the positives when happy familyconfronted with a challenge.  I too have fallen into the pitfall of thinking “I’ll be happy when…”.  This is dangerous thinking because once I have achieved filling in that blank, I am already thinking about the next thing or maybe that blank does not live up to my expectation of what I wanted to achieve. With that being said, how can I break this type of thinking and learn how to be happy in the present moment?  How can I increase my happiness now?

Research on Happiness:

More and more research is being done into the positive gains from happiness, optimism and positive emotions.  Research has shown that a happy brain proves to be a better functioning brain.  When we are focused on positive emotions, we tend to achieve more, are engaged in building deeper relationships and experience greater satisfaction with life.  Harvard researcher, educator and author, Shawn Achor, states that “people that work with a positive mindset, performance improves on nearly every level – productivity, creativity, and engagement”. (1)

The keys to happiness:

  • Getting more pleasure out of life (savoring sensory experiences)
  • Becoming more engaged in what you do
  • Finding ways of making your life feel more meaningful

The goal then is to spend part of every day engaging in positive exercises to increase happiness. Achor recommends spending 21 straight days engaging in any of the below exercises:

Tips to be more engaged and happy:

  • Gratitude journal- write three things that you are grateful for.
  • Write a positive message to someone in your social or professional network.
  • Exercise for 10 minutes each day.
  • Take two minutes of your time to describe in a journal the most meaningful experience in the past 24 hrs.

Others include:

  • Acts of altruism or kindness – can be random (let someone in line in front of you at a busy store or paying for the next person at a highway toll) or systematic (bring Sunday dinner to elderly neighbor).
  • Gratitude visit- write a letter expressing your gratitude towards a grandparent, mentor, friend, etc. Go visit that individual to read the letter to them.
  • Take 10-20 minutes a day to do something you truly enjoy. For me, this means making a fresh healthy juice to start my day.

As an experiment, I am currently engaged in increasing my happiness by writing a daily gratitude list, exercising 10 minutes a day and taking  10-20 minutes to make a healthy juice. At this point, I have already noticed a daily shift in my overall happiness.  Keep in mind that it is the simple and small steps that lead to big results.

1) Achor, S. (2012). Positive Intelligence. Harvard Business Review. January-February 2012. http://hbr.org/2012/01/positive-intelligence/ar/1

5 Tips to Help With Social Concerns Associated With ADHD

Children with Attention Deficit Hyperactivity Disorder (ADHD) often present concerns interacting with peers and maintaining ADHD boysappropriate social relationships.  These children often present appropriate social skill sets; however, issues with inattention and impulsiveness directly impact their ability to execute these skills on a regular basis.

Below are five strategies to help improve the social interaction of these children:

  1. Keep social situations limited to one or two peers as opposed to having them interact with a large group in which the child will likely become easily distracted.
  2. Try to modify the environment in which the social interaction is going to happen.  Situations in which there are many distractions will likely set the child up for an uncomfortable situation.
  3. If the parent or teacher is in close proximity of the interaction, attempt to actively intervene in situations in which the child is not engaging with peers appropriately.
  4. Before the social interaction occurs, remind the child  about the importance of taking turns, eye contact, personal space, etc.
  5. If the interaction occurred at a friend’s house, follow-up with the other parent afterwards and discuss the interaction.  Use the feedback as a means of providing insight to the child about what was positive about the interaction and what he or she will need to improve upon in the future.

Many children with attention and impulsive behaviors exhibit social interaction issues.  They have a difficult time regulating personal space and picking up nuances in social interactions.  Above are some basic tips that parents and teachers should implement in order to help improve their child’s social relations.  If the child continues to struggle with social interaction, it is recommended that he or she work with a behaviorally-trained social worker as an individual or in a group format to help develop the child’s social skills.

For more on ADHD, click here

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Executive Functioning Basics

Executive functions (EF) are a fancy way to explain our everyday problem-solving strategies. EF are self-regulated behaviors that we executive functioning girlneed in order to plan, execute and maintain activities.

Observable Executive Functioning behaviors include:

  • Initiation
  • Organization
  • Transitioning
  • Inhibition
  • Goal-setting
  • Monitoring own behavior
  • Planning
  • Sequencing information
  • Self-control

Complications in any one of these areas may create difficulties in a child’s school as well as life at home. It is not uncommon for many children to have issues in EF at some point. In fact, it is the “norm” and it is related to the child’s developing brain. EF skills begin to emerge at an early school age and continue to develop into the early 20’s. In some cases, altering the environment is all that is needed in order to help children that are weaker in these skills.

Classroom accommodations for Executive Functioning:

  • Use a visual schedule on the wall or the child’s desk to reduce difficulties with transitions
  • Break-up assignments into smaller tasks in order to help with initiation and organization of tasks
  • Develop time lines for longer-term assignments
  • Utilize check lists as well as planners in order to stay organized and set appropriate goals
  • Perform a weekly clean-up of the child’s desk and locker to keep belongings organized
  • Provide specific feedback when the child demonstrates positive use of a skill

Home accommodations for Executive Functioning:

  • A visual or written schedule can be just as effective and necessary in the home environment
  • Set and enforce routines around daily activities (e.g., getting ready in the morning, homework, bedtime, etc.)
  • Weekly organizing of book bag and work area
  • Teach goal-setting behaviors by developing a plan to work towards a desired goal (e.g., special activity, material possession, etc.)
  • Model self-calming strategies and have the child practice these strategies
  • Develop independence in daily activities by labeling drawers and encourage independent follow through
  • Provide specific positive feedback for demonstration and effort

For an Executive Functioning checklist and more on EF, click here!

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ADHD Parenting Tips

Do you feel as if your child has a difficult time with paying attention and staying organized? Does your child struggle to plan ahead, adhd girlcontrol impulses or complete tasks? Life can be challenging and, at times, frustrating with a child that has ADHD. Some of the keys to positively handling situations such as these are to develop compassion for your child as well as use consistent strategies. Below are some tips to assist you and your family.

6 Tips For Parents of Children With ADHD:

Tip #1: Stay positive and healthy yourself

A positive attitude can go a long way towards modeling healthy behaviors for your child. Focus on taking care of yourself, whether that is through exercising, taking time for an enjoyable activity, reading, enjoying a personal hobby or even taking a relaxing walk with a pet while you focus on breathing. Your state of mind greatly impacts the richness in your interaction with your child. When you are in a positive state, you are also more open and engaged with the child.

Tip #2: Establish structure and stick to it

Discover ways to incorporate a routine and try to simplify your child’s tasks. Consistency is very important so the child knows what to expect and when to expect tasks. Do your best to stay neat and organized in order to better assist the child in modeling healthy behaviors.

Tip #3: Set clear expectations and rules

Communicate clear guidelines and rules so that the child understands what is to be expected of them. It can be helpful to break down the expectations in simple statements or steps as well as write them down for the child to remember and reference.

Tip #4: Encourage movement and sleep

Encourage the child to exercise and become involved in activities that interest them. Make sure that your child is getting an appropriate amount of sleep as insufficient sleep can increase the inattentiveness and may lead to over-stimulation. Other tips include decreasing television time, creating a time before the child goes to bed to “wind down” by engaging in quieter activities. One of my favorite activities is reading a child’s favorite bedtime story or having the child read the story to me.

Tip #5: Help your child eat right

Help your child eat a balanced diet that includes fresh foods, fruits and vegetables. Children with ADHD are more prone to skip meals or eat unbalanced meals. Assist your child with eating healthy so that their bodies are receiving the proper nutrients for an activity. One way in which you can assist him/her with this is to get the child involved in meal planning and decisions for daily/weekly meals.

Tip #6: Teach your child how to make friends

Children with attention or hyperactivity difficulties sometimes have a difficult time making and keeping friends. Work with your child in order to improve their social skills by role-playing and choosing playmates carefully who also have similar language or physical skills.

To learn more about ADHD click here

 

Reference: www.helpguide.org/mental/adhd_add_parenting_strategies.htm, Authors: Melinda Smith, M.A., and Jeanne Segal, Ph.D

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What is a Neuropsychologist?

Pediatric neuropsychologists are clinical psychologists who have extensive training in neurodevelopmental conditions.  We focus on learning disabled boythe assessment and diagnosis of such conditions and strive to develop the most effective interventions for a child within both home and school environments.

What types of testing do Neuropsychologists perform?

We conduct very extensive testing.  The focus of the testing is specific and is based upon concerns that parents have presented to us.  We evaluate children for a host of neurodevelopmental conditions, including Attention Deficit Hyperactivity Disorder, Learning Disorders, Autism, Social/Emotional concerns, response to medication, medical issues, etc.

Testing involves the collection of information from a variety of sources, including the parents, teachers, outside therapists, pediatrician/psychiatrist/neurologist as well as quantitative testing, in which the child would participate in a full day evaluation.  The reason why this information is gathered from so many sources is to ensure that the data we receive is consistent throughout all areas of the child’s life. It will also help to identify where the child may be struggling the most.

What happens after a Neuropsychologist performs the testing?

Once the testing is complete, the neuropsychologist will spend time integrating all the information and determine which specific areas of strength and weakness are identified.  With this information, we are able to help work with the family, outside therapists and academic team in order to create the most appropriate accommodations and interventions possible.

It is vital to realize that the neuropsychological evaluation should be an on-going phenomena.  We often request that the children return for brief follow-up evaluations every three to six months in order to track progress from therapy and help to identify whether or not there are changes to be made with the current accommodations and interventions.

Click here to find out how a Neuropsychologist can help your family or to schedule a consultation.

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