PANDAS disease (short for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) isn’t a true disease. Instead, it is a rare disorder that can occur in children following a strep throat infection. With PANDAS strep, the child’s body sets up an immune response to the invading streptococcus bacteria, but ends up attacking the child’s own tissues in addition to the strep bacteria. The result is inflammation within the brain, and the dramatic onset of OCD (obsessive-compulsive disorder), tics, intense anxiety and other debilitating symptoms.
The hallmark of PANDAS is that these new symptoms and disorders appear or worsen very suddenly. In fact, parents say they come “out of the blue” or that their child changes “overnight.” Keep in mind that children who have been previously diagnosed with OCD or tics will always have their good days and their bad days, so an upswing in symptoms does not necessarily mean the child has PANDAS disease just because they’ve had a throat infection. With PANDAS disease, however, the child’s tics or OCD would flare up dramatically and continue to stay elevated anywhere from several weeks to several months.
The National Institute of Mental Health (NIMH) reports that the diagnosis of PANDAS syndrome is strictly a clinical diagnosis. There are no lab tests that can diagnose the PANDAS disorder. Additionally, the diagnosis of PANDAS is controversial, so some clinicians either don’t understand it or may overlook the syndrome.
Currently, the only way to determine whether a child has PANDAS disease is to look at the clinical features of the illness, so health care providers use diagnostic criteria to make a PANDAS diagnosis.
If the symptoms have been present for more than a week, blood tests may be done to document a preceding streptococcal infection.
Additionally, the NIMH reports that children with PANDAS often experience one or more of the following symptoms in conjunction with their OCD and/or tics:
The risk factors for PANDAS syndrome are:
Treatment for PANDAS disorder is medication to treat the strep throat infection (*Tip: Sterilize or replace toothbrushes during and following the antibiotics treatment, to make sure that the child isn’t re-infected with strep.). Treatment also includes medications to control the neuropsychological symptoms and Cognitive Behavioral Therapy (CBT) to help with the child’s OCD or ADHD symptoms.
Research does not indicate long-term penicillin use to try to prevent recurrence of PANDAS disorder. Current information suggests the syndrome is caused by the antibodies produced by the child’s body in response to the streptococcus bacteria, not by the actual bacteria itself. Research also does not support the removal of the child’s tonsils strictly to prevent recurrence of PANDAS disease.
If you are concerned your child may have PANDAS syndrome after a strep throat infection, we can help. Our Children’s Center focuses specifically on offering a variety of clinical, therapeutic, educational and supportive services to children ages two through twenty two in a warm and welcoming environment.
To learn more, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.
The start of a new school year is just around the corner. While many children are happy about heading back to the classroom and seeing their friends again, for some kids, a new school year embodies fear and school anxiety. But, what if your child could go into their classroom in a non-threatening way, interact with a new teacher and classmates, and learn effective methods for coping with the anxiety-inducing situations they dread in school? With virtual reality therapy, they can do just that.
This innovative treatment is emerging as a high-tech solution that lets kids challenge their fears in a safe, realistic environment, but in a way that gives them control. VR therapy can be used across age groups and can be adjusted to the child’s developmental age as they mature.
Additionally, this therapy can be tailored to vary the complexity of school phobia scenarios. For example, one child might be apprehensive about taking exams, while another dreads interaction with their peers. Both can be helped with virtual reality therapy, which is a combination of cognitive behavioral therapy (CBT) and in-vivo exposure therapy, but with a state of the art twist.
For example, if your child has a high level of test anxiety, as studies indicate anywhere from 15% to 25% of students do, virtual reality therapy will allow them to mimic test taking in a non- or less stressful environment (just like in-vivo exposure does) in order to overcome their negative thought patterns (“I always fail tests.”) through cognitive behavioral therapy. In a test-taking scenario, the virtual reality simulated distractions and stresses of taking exams would be minimal to start with, and then slowly be increased as the child learns to process and adjust to them. At the end of the therapy, the child will be able to face an exam with reduced or minimal fear.
Because most kids relate so well to video games, virtual reality exposure therapy seamlessly integrates treatment with real-world interface. It helps children retrain their brain so they have a defense against problems like meeting a new peer or being bullied, which makes them feel more comfortable about situations at school. VR therapy has also been successful in teaching or improving social cognitive skills and emotion recognition in high-functioning autistic children.
When kids go through VR therapy, they first learn coping skills to help them stay calm under a stressful circumstance. Once they are comfortable with these strategies, they continue on to virtual reality therapy, where they view computer-generated environments and use an avatar to experience interactions with adults and other kids.
As you can see in this Today Show video, the teens have the freedom to pause or review and repeat their avatar’s interaction with others inside the setting until they feel confident about the situation. A therapist listens in on the virtual reality session and offers feedback and coaching to help the child navigate the difficulties that have created their school refusal.
Studies have shown that virtual reality therapy actually “rewires” the brain so that the areas relating to sociability and attention are heightened. This leads to increased awareness and understanding of social cues, enhanced perception of the give and take in conversations, and more control when faced with real-life school issues. In studies done after kids have gone through virtual reality exposure therapy, scans have shown that the regions in the brain associated with social skills and those sections that exchange information during social interactions are heightened.
This interactive and visually stimulating approach to treating school anxiety delivers a dynamic platform that can simulate an unlimited number of phobia situations. By targeting a child’s specific fears, it provides meaningful close-to-life scenarios with immediate feedback, which greatly enhances the child’s ability to cope under stress.
Our Children’s Center focuses specifically on offering a variety of clinical, therapeutic, educational and supportive services to children ages two through twenty two in a warm and welcoming environment.
For more information about how our child psychologist team can use virtual reality therapy for your child’s school refusal, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.
Lately, it seems like it has become common to see news stories involving the arrest of teachers who are being charged with sexual abuse and misconduct involving their students, some of whom are as young as 11 years old. Schools are expected to be a safe environment for children, but these arrests make people realize kids aren’t as safe as we’d like them to be when we send them off to school.
Stop Educator Sexual Abuse Misconduct & Exploitation (SESAME) is an organization that describes itself as a national voice for prevention of abuse by educators and other school employees. It has compiled alarming statistics on the incidences of sexual abuse in schools nationwide, reporting that just under 500 educators were arrested in 2015 (2016 statistics were unavailable as of this writing):
Reasons for the Increase in Sexual Misconduct
So, why are we suddenly seeing a rise in the number of cases of sexual misconduct and teacher/student relationships? It may be partially due to more transparency as schools seek to report what they formerly kept hidden and tried to deal with on their own. More than likely, however, the upward trend is due to the use of social media and cell phones.
The Washington Post ran a story in 2015 that related how about 80% of children age 12 – 17 had a cell phone and 94% had a Facebook account that year. In 2014, The Post says about 35% of the educators convicted or accused of sexual misconduct had used social media to gain access to their victims or to continue the teacher – student relationship.
Today’s technology makes it easy for predators to discreetly prey on children. Students usually have their phones with them at all times, which allows the perpetrator free and unmonitored access to the child. Even children without cell phones can be targeted through their laptop, tablet, or personal computer.
Signs of Sexual Abuse by Teachers
If you are concerned your child might be being sexually abused, there are warning signs you can look for. Keep in mind that the presence of one sign doesn’t necessarily mean your child is in danger, but seeing several signs should alert you to the need to ask questions.
In teens or adolescents:
What to do if You Suspect Sexual Misconduct by an Educator
If your child tells you about being abused or if you suspect it, your reaction is very important.
A Child Psychologist at our Children’s Center Can Help
Child victims of sexual misconduct often experience anxiety and/or depression, as well as feelings of guilt and symptoms of posttraumatic stress disorder (PTSD). For this reason, consider making an appointment for your child to speak with a mental health professional who is experienced in dealing with child sexual abuse victims.
Psychotherapy can help them find a safe place to share their feelings and allows them to talk through things they might not want to tell a parent or family member. It will help the child learn coping strategies so they can deal with the emotions surrounding their exploitation. Therapy will also teach them how to better manage the stress of the situation.
For more information about how our child psychologist can help, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.
Summer is here and sleep away camp is just around the corner for many children. Some kids look forward to seeing friends from last year and are eager to take a break from their parents and siblings. Others dream about the adventures to come. Still more think about the new friends they’ll make and the independence they’ll get to experience. But the idea of being away from home can also bring up anxiety in children, as well as homesickness and depression. With that in mind, our child psychologist has some tips to help hold off or reduce your child’s summer camp separation anxiety.
It’s a good idea to listen to your child’s concerns before they ever leave home – whether they are heading off for sleep away camp or not. It’s not unusual for a child to go through day camp separation anxiety when they attend a local summer program, even if they will be home every night.
Children with separation anxiety might have physical symptoms, such as:
Additionally, your child’s summer program separation anxiety might show up in the form of:
Our child psychologist recommends the following steps to help reduce or eliminate depression and homesickness in kids who are attending day camps or leaving home for a sleep away camp:
Keep in mind, your child’s separation anxiety may still continue no matter what you do. In these cases, it is best to seek the help of a child psychologist. These professionals can help your child identify and change their anxious thoughts. Through role-playing and modeling of positive behaviors, your child will learn coping strategies to lessen their fearful response to their approaching sleep away camp experience.
For more information about how a child psychologist can help with your child’s separation anxiety at sleep away camp, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.
As a parent, are you aware that Netflix recently launched a new teen drama series based on the young adult novel, 13 Reasons Why, by Jay Asher? In the series, the main character, Hannah Murphy, commits suicide after experiencing a lethal combination of bullying by her peers, an incidence of stalking by a classmate, and the petty cruelty that can make life in high school a hell on Earth. The teen records a series of cassette tapes (these are her 13 reasons) which detail her motives for choosing suicide. On the day of her death, she mails the tapes to the thirteen classmates who influenced her suicide, in the hope they will listen to them and understand how their actions can affect others. While the Netflix series may open the door to frank discussion on several topics between the teens who watch it and their parents (suicide, bullying, stalking, rape, sex, and depression are addressed in the drama), there is concern that the show amounts to suicidal ideation by over-glamorizing suicide. And, because the drama is popular with teens, there are fears that it will increase the risk of vulnerable adolescents taking their own lives.
Furthermore, much younger children have access to this show, as well as to additional overwhelmingly adult-themed programs on Netflix and other online and streaming services. Because of the content of some shows like 13 Reasons Why, it is critical that caretakers use parental controls to block and prevent their children’s access to programming that is above the child’s content level.
Across the country, many school districts have sent warnings to parents about the hit series, especially now that the drama has been renewed for a second season. In Colorado, where seven teens in one small locality have committed suicide since the beginning of the 2016-2017 school year, the Douglas County School District temporarily removed all copies of 13 Reasons Why from its library shelves until it had a chance to review the content of the Jay Asher book.
Did they go too far? While we know that suicide is the second leading cause of death in teens, do we really know that books, movies, or television shows increase the risk of a certain behavior in impressionable teens? Is it possible that media coverage can spread “behavioral contagion,” which is defined as the situation in which the same behavior spreads quickly and spontaneously through a group?
The answer is unquestionably “yes,” according to Madelyn S. Gould, Ph.D., a psychiatrist at Columbia University. She states, “The magnitude of the increase [in the number of suicides] is proportional to the amount, duration, and prominence of media coverage. We know from a number of studies that the celebrity status of a suicide victim increases the impact of the suicide.”
In her abstract on the subject, Dr. Gould cites a study relating to suicidal ideation (Martin, G. 1996. The influence of television in a normal adolescent population. Arch. Suicide Res. 2: 103–117.) in which “students reporting frequent exposure to television suicide reported more suicide attempts.” This means that the glorification of a person’s death can present a compelling case for choosing death to a person who is already actively considering it. Add to that the feeling of being alone in their pain and the rapid sharing of condemnation and bullying via social media and, like Hannah in 13 Reasons Why, it’s possible a depressed teen might be pushed over the edge.
Just as with an adult, adolescents who are considering teen suicide generally show unmistakable warning signs. In fact, four out of five teens who attempt to take their life give signals about their intent before their attempt.
These suicide warning signs can be:
Your teen needs to know you care about them and are taking them seriously. If your adolescent or teen exhibits some of these behaviors and you are concerned, either ask your child directly or have someone they trust ask them if they are considering suicide. It is okay to say the word “suicide” – simply using the word will not increase the chances of them acting on the idea.
If they are considering suicide, show empathy for their feelings and refrain from judging them. Enlist the aid of a mental health professional such as those at our Children’s Center, your child’s pediatrician, or a suicide crisis hotline. The crisis hotline is especially critical if your child is in imminent danger of attempting suicide.
Never leave your child alone if they are threatening suicide. If you believe your child is in immediate danger, call 911 or the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) in the United States.
If your child is showing signs of teen depression, don’t wait! Contact the experts at our child-focused Children’s Center for help. To reach the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida, call us today at (561) 223-6568.
With the relaxing of possession laws in states like Colorado and Washington, and the legalization of medical marijuana in other states, parents have begun worrying more than ever about the availability of cannabis (also known as weed, pot, grass, marijuana) and whether their child might be smoking weed.
First the good news: while we know that teens are smoking pot, according to data from the Substance Abuse and Mental Health Services Administration (SAMHSA), marijuana use has actually decreased slightly. Approximately 7.1 % of teens were smoking pot as of 2013, which is down from ten years earlier (in 2003), when about 8.2% of teens were using the drug.
Now the bad news: as of 2013, this same study reported that the first use of any illicit drug was marijuana, by just over 70% of participants. In fact, nearly 50% of teens and adolescents say that it would be fairly easy for them to obtain cannabis.
For these at-risk kids, the following marijuana facts for teens may change their minds about smoking pot.
Cannabis effects on the developing brain and body:
First of all, you may be wondering is marijuana addictive? The short answer is “yes”. Generally speaking, about 1 out of every 11 cannabis users will become addicted, but that number increases to 1 out of every 6 people for those who begin using marijuana in their teens. In addition, daily use increases the rate of addiction to between 25% and 50% of cannabis abusers.
We also know that exposure to cannabis affects the brain. The brain receptors for the drug are located in the areas regulating memory, coordination, and learning, which is especially troubling for teens and adolescents since brain development continues into a person’s early twenties.
Failing in school is another one of the sad facts about weed. Because of marijuana’s effect on the brain, teens and adolescents who use pot are more likely to have lower grades in school, to drop out, and may even have a lower IQ as a result of smoking grass. And, their IQ might not improve even if they stop smoking weed as an adult.
Athletic performance can also be impaired because of cannabis’ effects on movement and coordination. In addition, skills like timing the kick for a soccer goal or swinging a bat in baseball can be compromised
For some reason, there is a misconception that second-hand pot smoke is not as dangerous to children as cigarette smoke. As more and more states are legalizing the use of cannabis, however, new studies are showing that it impacts children far more than people realize. Just as with tobacco smoke, the vapors released by smoking weed can increase the symptoms of a respiratory illness, aggravate asthma, and make children more likely to catch viruses. Also, it has been shown that a “contact high” can result from exposure to cannabis, which means a child who inhales the smoke from an adult may have problems with memory, have lower attention levels, and decreased motivation.
Additionally, marijuana metabolites can be detected in children who have been exposed to the second-hand smoke of their parents, siblings, and caregivers. THC (delta-9-tetrahydrocannabinol), the psychoactive component of cannabis, has also been found in breast milk. This raises the possibility of decreased motor development in the infant of a mother who uses grass.
Now that some states legally allow adults over the age of 21 to possess a certain amount of marijuana, there has been an increase in accidental ingestion by children. For this reason, if you are using cannabis, always be sure to:
If your child is smoking weed, contact the professionals at our child-focused department to learn more about the Children’s Center’s parenting support services. To reach the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida, call us today at (561) 223-6568.
Going back to work after maternity leave is one of the hardest things for a new mother to do. You carried your bundle of joy for nine months and had time off from your job to bond with your child. It can be difficult to turn them over to strangers at a day care center and be separated from your child for an eight-hour period or longer when you’re used to taking care of their every need. And, even if you know the babysitter – maybe it’s your mother-in-law, a friend, or a trusted neighbor – new parents will still go through an adjustment period when maternity leave ends and mom return to their job.
The end of maternity leave means new routines and more work to do. Now you not only have to get yourself up and out to work, you need to get another person ready to go as well. There are clothes and toys, diapers, and possibly special foods or medicines to prepare and pack for the work day. The household chores still need to be done, not to mention tasks like grocery shopping, laundry, or trips to the pediatrician. Deciding which parent will take care of which tasks after the end of maternity leave can be a job all by itself.
Additionally, some new mothers go through postpartum depression. Returning to work can add to their symptoms of crying, mood swings, loss of appetite, the inability to bond with their baby, and the guilt that accompanies this type of depression. If your postpartum depression symptoms don’t lessen after two weeks or if they are getting worse, be sure to call your doctor. Postpartum depression can be successfully treated with psychotherapy, medications, or a combination of the two.
Many working moms experience feel guilty when they leave their child with someone else. They may also feel inadequate for not being a “superwoman” capable of handling the stresses of a new baby, new routines, and a new “normal.”
Surprisingly, there are few resources that address the anxiety and emotions that going back to work after maternity leave can bring up for a new parent. This period has been called the “fifth trimester,” a term trademarked by Lauren Smith Brody, a former Glamour magazine executive editor. She struggled with returning to work and ultimately wrote a book that helps new parents manage their expectations. She describes the shift from maternity leave to working mom as “a monumental transition.”
One of the best ways to help ease this maternity leave transition is to set things in place before the baby comes.
It can be challenging to be a new mother going back to work after baby. Working moms must find the balance that allows them to hold a job and still maintain their pre-baby life, along with preserving their sanity.
Remember that the transition after maternity leave takes time. If you are finding this transition more difficult than you thought, give yourself an adjustment period. If you still can’t handle it after this interval passes, it might be time to try working with your boss to discuss other options (example: working from home a couple of days per week) that can allow you to have a realistic balance.
If you have concerns about going back to work after maternity leave or if you are worried you may have postpartum depression, contact the therapists at the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.