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PANDAS Disease Following a Strep Throat Infection

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.

PANDAS Symptoms

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.

NIMH’s diagnostic criteria for PANDAS:

  • Presence of obsessive-compulsive disorder and/or a tic disorder
  • Pediatric onset of symptoms (age 3 years to puberty)
  • Episodic course of symptom severity (see information below)
  • Association with group A Beta-hemolytic streptococcal infection (a positive throat culture for strep or history of scarlet fever)
  • Association with neurological abnormalities (physical hyperactivity, or unusual, jerky movements that are not in the child’s control)
  • Very abrupt onset or worsening of symptoms

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:

  • ADHD symptoms (hyperactivity, inattention, fidgety)
  • Separation anxiety (child is “clingy” and has difficulty separating from his/her caregivers; for example, the child may not want to be in a different room in the house from his or her parents)
  • Mood changes, such as irritability, sadness, emotional lability (tendency to laugh or cry unexpectedly at what might seem the wrong moment)
  • Trouble sleeping, night-time bed-wetting, day-time frequent urination or both
  • Changes in motor skills (e.g. changes in handwriting)
  • Joint pains

PANDAS Disease Risk Factors

The risk factors for PANDAS syndrome are:

  • A family history of rheumatic fever
  • The child’s mother has a personal history of an autoimmune disease
  • The child has a history of recurrent group A streptococcal infections
  • PANDAS is more common in males
  • It is more common in prepubescent children

PANDAS Syndrome Treatment

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.

Have Questions about 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.

 

 

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How Does Virtual Reality Therapy Help School Anxiety?

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.

What Happens During Virtual Reality Therapy?

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.

Did You Know?

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.

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Sexual Abuse by Teachers is on the Rise

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):

  • Of children in 8th through 11th grade, about 3.5 million students (nearly 7%) surveyed reported having had physical sexual contact from an adult (most often a teacher or coach). The type of physical contact ranged from unwanted touching of their body, all the way up to sexual intercourse.
  • This statistic increases to about 4.5 million children (10%) when it takes other types of sexual misconduct into consideration, such as being shown pornography or being subjected to sexually explicit language or exhibitionism.
  • Very often, other teachers “thought there might be something going on”, but were afraid to report a fellow educator if they were wrong. They didn’t want to be responsible for “ruining a person’s life,” although that is exactly what they are doing to the child if they don’t speak up, thus allowing the abuse to continue.

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.

  • The Department of Justice notes that about 15% of children in the 12 – 17 age group who own a cell phone have received nude, semi-nude, or sexually suggestive images of someone they know via text.
  • 11% of teenagers and young adults say they have shared naked pictures of themselves online or via text message. Of those, 26% are trusting enough to think the person to whom they sent the nude pictures wouldn’t share them with anyone else.
  • About 26% of teenagers and young adults say they have participated in sexting.

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 general:

  • Unexplained nightmares or sleep problems
  • Refusal to eat, loss of appetite, or trouble swallowing
  • Sudden mood swings, insecurity, or withdrawal
  • A new or unusual fear of a certain person or place
  • Exhibits knowledge of adult sexual behaviors and language
  • Draws, writes, dreams, or talks about frightening images or sexual acts
  • Thinks of themselves or their body as “bad” or “dirty”
  • Not wanting to be hugged or touched

In teens or adolescents:

  • Running away from home
  • Drug or alcohol abuse or may be sexually promiscuous
  • Either stops caring about bodily appearance or compulsively eats or diets obsessively
  • Anxiety or depression
  • Attempting suicide

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.

  • Don’t overreact and don’t criticize or blame the child
  • Don’t demand details
  • Don’t downplay their disclosure because you’re trying to minimize their feelings (or yours)
  • Do listen calmly and keep in mind that children seldom lie about sexual abuse
  • Do assure the child it is not their fault
  • If necessary, seek appropriate medical care for the child
  • Notify local law enforcement, as well as the appropriate child services organizations. You can call ChildHelp: 1-800-4-A-CHILD (1-800-422-4453) or RAINN, the national sexual assault hotline: 1-800-656-HOPE (4673).

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.

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Sleep Away Camp and Separation Anxiety – Tips from a South Florida Child Psychologist

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.

Symptoms of Separation Anxiety in Children

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:

  • Stomach aches, upset stomach, vomiting, or nausea
  • Trembling
  • Feeling faint or lightheaded and dizzy
  • Having headaches
  • Difficulty sleeping, having nightmares, or being afraid of the dark

Additionally, your child’s summer program separation anxiety might show up in the form of:

  • Being very reluctant to go to the camp
  • Crying or being overly clingy or whiny
  • Worrying excessively about possible harm coming to them or to you (or to another family member) while they are away at their summer program
  • Needing to keep a parent or caregiver in their sight at all times
  • Acting distressed when they can’t be with their caregiver or parent
  • Becoming physically ill if they are separated from their loved ones
  • Avoiding activities or refusing to participate in events that will take them away from their parents or caregivers even briefly
  • Being afraid to be in a room by themselves

How to Help with Summer Camp Homesickness

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:

  • Let your child know that it’s okay to be worried, particularly if this is the first time they will be going to an overnight camp. Also let them know that about 90 percent of summer camp children feel anxiety and homesickness on at least one day of camp.
  • Help your child practice being away from home by letting them spend a night or two with a friend or a relative before they leave for their summer program.
  • Talk positively about the new friends they will make and the fun adventures they’ll have. Also – and this should go without saying – do not tell your child about any negative summer camp experiences you might have had! There’s no need to add to their anxiety.
  • Help your child choose something comforting to take with them to camp. For example, they can pack a family picture or a favorite book or toy to give them a familiar “anchor” to home.
  • Remind them of the successful outcomes they’ve had and the fun things they’ve enjoyed when they’ve been fearful of new experiences in the past.
  • Give your child lots of extra attention in the days before they leave for their summer program or day camp.
  • Send your child to camp with stamped and pre-addressed envelopes and paper so they can write to you. You might even go as far as printing out a calendar for your child so they can mark off days and see how fast the time is going.
  • Discuss your child’s fears with the camp administrators so they are aware of your child’s concerns and so you know what their plan is for dealing with homesick children.
  • It’s best NOT to reassure your child that you’ll come get them if they are too upset. Most kids get over their anxiety after a day or two once they get into the routine of the summer camp.
  • When you drop them off for camp, don’t drag out your good-byes. Make it brief and leave before your child gets too worked up about your departure.

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.

Connect with a Child Psychologist at our Children’s Center

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.

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Suicidal Ideation – Does the 13 Reasons Why Series Influence Teen Suicide?

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.

Does Suicidal Ideation Raise Suicide Risk?

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.

Suicide Warning Signs

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:

  • Feeling down or depressed for more than a week or two
  • Sharing feelings of worthlessness, self-contempt, or of being hopeless and unsure of ever being happy again
  • Making jokes about dying or about suicide
  • Giving away possessions they formerly cared about deeply, such as favorite clothes or  mementos
  • Losing interest in activities or relationships they used to enjoy
  • Talking a lot about the suicide of someone important
  • Isolating themselves
  • May have insomnia or may over-sleep, may be lethargic
  • May exhibit extreme mood swings or have violent outbursts of grief or anger
  • May have had a significant recent loss (for example: they may have lost a close family member, been diagnosed with an serious illness, may have lost their freedom or security in some way)
  • Indulging in high-risk behavior, especially if this is not characteristic of the person
  • An increase in drug or alcohol use

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.

Teen Depression? Our Children’s Center Can Help

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.

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Smoking Weed: Marijuana Facts for Teens

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.

Cannabis Effects on Children, Adolescents, and Teens

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:

  • Impairment of athletic performance due to cannabis’ effects on coordination and timing
  • Potential for addiction
  • Learning and memory problems
  • Increased heart rate
  • Aggravation of asthma and other respiratory illnesses
  • Developmental delays; trouble learning something new or focusing on difficult tasks
  • Coordination problems
  • Failure in school
  • Possible panic or psychosis when using the drug
  • Worsening of psychotic symptoms in people who already have schizophrenia
  • Altered judgement, increase in risky behaviors
  • Potential to abuse harder drugs, such as heroin

Marijuana Facts

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

Smoking Weed: Second-hand Smoke Impacts Children

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.

Safe Storage of Cannabis

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:

  • Store the drug (as well as any vitamins or medicines) away in a place that is high up and out of reach of your child.
  • Think about getting a lock box to store your medications and drugs. Be sure to keep the key in a different place, away from the box.
  • Never leave the drug or any medications out, even if you will be using them again soon. Keeping potentially harmful substances out of the reach of kids helps keep them safe.
  • Talk to your guests and to the parents of children whose homes your own kids may visit about keeping their marijuana hidden and locked away.
  • Be prepared to contact the Poison Help Center at (800) 222-1222 if you think a child may have ingested cannabis products.

Let Our Children’s Center Help

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.

 

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Maternity Leave – Tips for Going Back to Work after Baby

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.

Easing Back into your Job After Maternity Leave

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.

  • Research and arrange for childcare. If you have a babysitter instead of a daycare center, also set up a back-up plan in case the babysitter is ever sick.
  • If you plan to breastfeed, talk to your boss to arrange a schedule and set aside a private area for pumping.
  • Establish and practice your morning routine a couple of times, at least a week or two before going back to work. Actually wake up at the time you’ll need to get up for work, then eat, dress, and get your baby ready to go. Build in some “glitch time” for occasions like when the baby spits up just as you’re ready to leave or for the day you can’t find your keys.
  • Decide on temporary compromises you can make when going back to work after baby. Maybe you can go to sleep earlier, eat prepared meals once or twice a week instead of cooking, or let that load of laundry go until the weekend when you’re more rested.
  • Ask for help. Working moms are essentially doing two jobs: their actual employment job and the work of being a mother. It is not a sign of weakness to ask your spouse, family, or friends for help while you go through this transition.
  • Avoid venting at work about the stress you may be feeling at home. That way, your boss doesn’t get the idea that you can’t handle the pressure and start worrying that you’ll quit.
  • Be kind to yourself. Get in some exercise time to reduce stress (even a little goes a long way), get plenty of rest, and try to spend 15-30 minutes every couple of days just doing something for yourself.

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.

Concerns? We Can Help

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.

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Help for School Refusal

For some children, going to school can be emotionally traumatic. Their school anxiety may stem from such things as their dread of encountering a particular child or teacher, their worry about not doing well in school, or the fear of failing a test or “looking stupid.” While many of these worries are a normal part of growing up, they may also be triggered by stressful events like moving, changing schools, or being bullied.

Just about every child goes through a day here and there when they don’t want to go to school,  but the Anxiety and Depression Association of America notes that about 2-5% of children regularly experience school refusal due to severe stress or emotional concerns. School refusal is not the same as truancy: truant children skip school, then go out to play. They aren’t afraid of going to school and they try to hide their absence from school from their parents.

On the other hand, children experiencing a school refusal disorder will stay home (where it is safe), are fearful of going to school, and will try to talk their parents into letting them stay home. Often, the children with school avoidance also suffer from mood and anxiety disorders, such as post-traumatic stress disorder (PTSD), social anxiety, depression, or panic disorders.

Symptoms of School Refusal

School refusal is most common in children ages five, six, ten, and eleven, according to the American Academy of Family Physicians. The pattern of rejecting school isn’t the same for every child. Some kids will go off to school without a problem, but become more anxious as they get closer to the building. Some children have no trouble until a holiday comes up, then they become depressed or anxious when the time comes to go back to school. Others will go to school willingly, but frequently ask to visit the school nurse. Still others are chronically tardy, skip a certain class most days, or simply decline to go to school.

Frequently allowing your child to stay home from school keeps them from learning and advancing with their peers. Additionally, a child’s symptoms may increase or they may suffer from additional symptoms the longer they stay out of school.

Just as school refusal patterns aren’t the same for each child, the symptoms of school anxiety can be different, as well. Your child may experience some of these signs of school refusal:

  • Sleep issues
  • Temper tantrums, defiance
  • Crying or exhibiting fearfulness
  • Panic symptoms
  • Threats to harm themselves if they have to go to school
  • Headaches, stomach aches
  • Nausea, vomiting, diarrhea
  • Heart palpitations
  • Separation anxiety

School Anxiety Treatment

School refusal is best treated as a collaborative effort. The first objective is to get the child back into the classroom because the longer they stay out of school, the harder it can be to go back.

With that goal in mind, the child’s physician should do a thorough exam to be sure any physical complaints, such as headaches and abdominal pain, don’t stem from a medical condition. Once medical concerns have been ruled out, your child’s teacher will be asked to evaluate for behavioral issues and things like problems with report cards and tests, or the possibility of the child being bullied.

Armed with this information, a child psychologist or other mental health professional will evaluate your child to look for any emotional or psychiatric difficulties. These results, combined with the medical and school evaluations will help them develop the most effective plan of treatment.

School refusal can be addressed through several types of psychological therapy. For example, exposure therapy can ease your child back into school by allowing them (with cooperation from the school) to attend school part of the day and gradually increasing the time they spend there.

Cognitive behavior therapy can teach the child how to change their destructive behavior patterns. This therapy helps them develop coping techniques, and challenge their negative thoughts through strategies like role playing, relaxation techniques, and guided imagery. Operant behavior techniques can also be used to reward the child for attending or staying in school.

If your child’s school anxiety is new, often working with the teacher to identify and eliminate triggers can be enough to reverse it. However, if the school refusal has become significant, the therapies discussed above offer excellent outcomes for getting your child back into the classroom.

Our Children’s Center Can Help

For more information about how a child psychologist can help with your child’s school avoidance, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568

Resources:

American Academy of Family Physicians: http://www.aafp.org/afp/2003/1015/p1555.html

Anxiety and Depression Association of America: https://www.adaa.org/living-with-anxiety/children/school-refusal

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Sensory Processing Disorder (SPD) – Boy Patted Down by TSA

Recently, an angry mother took a disturbing video in which a TSA agent in the Dallas airport pats down her special needs boy who has Sensory Processing Disorder (SPD). Furious, she posted the video online, where it has been watched well over five million times as of this writing. The boy was patted down by TSA despite the mother’s request for an alternate screening method due to her son’s SPD.

Until this video surfaced, many people had never heard of Sensory Processing Disorder. It is a relatively uncommon disorder that is diagnosed in about 2.5% of children. Another estimated 10 – 20% of children do not have the disorder, but will suffer from some of the symptoms of SPD.

What is Sensory Processing Disorder?

Sensory Processing Disorder is a neurological disorder that interferes with how a person processes the information they receive from their senses of smell, sight, touch, hearing, taste, and even from their sense of movement or their perception of body position. People with SPD perceive the same things as other people, however their brains process the information differently which may cause them discomfort, confusion, or distress.

Sensory skills are used for social interaction, attention and focus, and motor skills. Everyone has preferences – they dislike a certain odor or perhaps they can’t concentrate when sounds are present. But, people with Sensory Processing Disorder fall on the extreme end of the spectrum. For these people, SPD disrupts their emotional and physical development and can affect their behavior and the way they learn. Children with SPD often have challenges performing routine tasks because their senses may overwhelm them or may cause them to respond inappropriately.

A great example of a child who may have SPD is one who will only eat two or three foods and flatly refuse to eat anything else. While you may think they are simply picky eaters, their food aversion may possibly come from the fact that they don’t taste food the same way you do – it may be extremely bitter or your child may be repelled by the texture of the food.

In the past, SPD was known as Sensory Integration Dysfunction and the names are often used interchangeably. Right now, researchers aren’t sure what causes SPD, although some studies indicate it may have a genetic component.

SPD Symptoms

Sensory Processing Disorder comes with a variety of indicators that are unique to each person who has the condition. Some people may have just a couple of SPD symptoms and others may experience a wide range of them. Additionally, it is not unusual for a child to experience symptoms one day and not the next. An extensive list of SPD indicators can be found on the Star Institute for Sensory Processing Disorder website.

Help for Sensory Processing Disorder

The brain is constantly evaluating information and sometimes certain stimuli will disrupt normal brain function. Overloading yourself or depriving yourself of sensory stimulation can change how you perceive things on a day to day basis. Keep in mind that just because a child has some of the symptoms of SPD, it doesn’t mean they actually have the disorder.

Rather, if you have concerns, being aware of the symptoms of SPD can be a way to open a dialogue with your child’s pediatrician, an occupational therapist, or your child’s mental health professional. There are many ways to help people who have challenges with SPD, but these methods vary with the person’s symptoms and the degree in which they suffer from the condition.

Some ways in which people with Sensory Processing Disorder have been helped are through:

  • Dietary changes
  • Listening programs designed to help people who have auditory challenges
  • Vision therapy
  • Sensory therapy in which certain activities are repeated daily until the person has learned to self-regulate their sensory perceptions
  • Desensitization therapy

Our Children’s Center Can Help

If you have questions or concerns about Sensory Processing Disorder and how your child responds to stimuli, the professionals at our child-focused department, The Children’s Center, can help. For more information, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

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