All Posts Tagged: The Children’s Center for Psychiatry

Toxic Stress and Child Development

Social Skills Training can help children and young adults connect with other.Stress surrounds us on a daily basis. From traffic delays to work projects, worries about finances or health, and news reports of world events, the demands of our everyday lives produce both positive and negative stress. Stressors (which are the things that cause your stress) can be physical, emotional, theoretical, or environmental. Even positive events like weddings and job promotions cause stress.

Whether negative or positive, one thing is certain – stress raises the body’s anxiety levels. When we’re under stress, the “fight or flight” response kicks in. It raises your heart rate and your blood pressure. It sometimes causes you to lose sleep or feel like you can’t breathe. While this response generally subsides after the stressor is removed, a prolonged or permanent stress response can develop in someone who is under frequent or constant stress. This is called toxic stress and it can affect children just the same as adults.

Effects of Stress on Kids

The incidence of diabetes, obesity, heart problems, cancer and other diseases increases when a child lives with toxic stress. Additionally, a child’s chances of smoking, depression, substance abuse and dependence, teen pregnancy and/or sexually transmitted disease, suicide and domestic violence escalates. So does their tendency to be more violent or to become a victim of violence.

Studies done by the Centers for Disease Control and Prevention (CDC) show that when a child is subjected to frequent or continual stress from thing like neglect, abuse, dysfunctional families or domestic abuse – and they lack adequate support from adults – their brain architecture is actually altered and their organ systems become weakened. As a result, kids who live with stress risk lifelong social and health problems.

Of the 17,000 people participating in the CDC study, two thirds reported an Adverse Childhood Experiences (ACE) score of 1 or higher. Of these, 87% had more than one ACE. By measuring and scoring ten types of trauma ranging from neglect or bullying to childhood sexual abuse and even divorce, researchers could assess the chronic disease risk for the study’s mostly white, middle class participants. Their results showed that the problem of toxic stress isn’t limited to children of certain ethnic groups or those who face poverty – children from all walks of life can have high ACE scores which will affect their entire lives.

If you would like to find out your ACE score and what it might mean for you, go here.

Signs of stress

Children who are exposed to toxic stress exhibit:

  • Poorly developed executive functioning skills
  • Lack of self-reflection and self-regulation
  • Reduced impulse control
  • Maladaptive coping skills
  • Poor stress management

Research on children who face continued toxic stress shows they are more likely to have:

  • Trouble learning in school
  • Difficulty trusting adults, forming healthy relationships and will have an increased chance of divorce as an adult
  • Higher incidence of unhealthy behaviors such as engaging in sexual experimentation and unsafe sexual practices, participating in high-risk sports, smoking, substance abuse and alcohol abuse
  • Higher incidence of depressive disorders, post-traumatic stress disorder (PTSD), behavioral disorders, and even psychosis
  • Poor health outcomes such as heart disease, obesity, diabetes, cancer, and have a higher suicide risk

Help for Toxic Stress

The key to preventing and reducing toxic stress in kids is awareness. Now that we know about the effects of ACEs, many states have conducted their own research. Some cities formed task forces, while others are working with pediatricians, schools, daycare centers and the justice system to set up screening programs that can turn lives around.

Protecting children from toxic stress involves a multi-faceted approach that targets both the caretaker and the child in order to strengthen family stability. Treatment includes intervention and implementation of methods that reduce stressors and reinforce the child or caregiver’s response to stress.

As more programs are formed, researchers have found that children can benefit even when the solutions are solely focused on their caregiver and aren’t aimed at the child. This is most likely because the caregiver’s altered interaction with the child makes the child feel safer. Parenting classes, family-based programs, access to social resources for parents, peer support and telephone support are beneficial. Cognitive behavioral therapy and relaxation methods like yoga and mindfulness are also helpful. Additionally, community-based programs like Head Start have been shown to be effective.

Do you have Questions?

For more information about toxic stress and its effects on child development, 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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Tips to Improve Your Child’s Executive Functioning Skills

Children's Center Now OpenThe first time you hear the term “executive functioning”, you may think it refers to the leaders of a worldwide conglomerate, but nothing could be further from the truth. Executive functioning is actually a life skill we learn in childhood. It forms the basis of the actions we perform every day. From taking a bath and getting dressed, to getting ready for school or doing homework, executive functioning helps us plan things, organize our lives, control our emotions, and learn from our mistakes. It lets us evaluate information, come up with a solution, and carry it out.

Some kids learn executive functioning with ease, but for others, it can be difficult to choose appropriate actions, develop time-management skills, or anticipate the consequences of their actions. Kids who have poor executive functioning often need constant guidance for simple tasks, such as packing their backpacks for school. They may forget to turn in the homework they worked on so diligently the evening before or have difficulty making decisions because they get bogged down in the mental strain of weighing pros and cons. Fortunately, there are ways to help these children acquire organizational skills. Apps, like our Giant Leap app, are great learning tools for, among other things, teaching behavior strategies and generating lists to help kids start and complete tasks.

Learning Tools for Executive Functioning

Executive functioning learning tools help children overcome struggles with organization and follow-through.

Some keys to building executive functioning abilities are:

  • Checklists – Checklists make tasks easier for a child with executive dysfunction. Often, these kids don’t follow through because they can’t visualize the steps required to complete a task, but a checklist lays it all out in front of them. You can make a checklist for anything. If your child consistently misses the bus, for example, you can make a checklist of the things he/she needs to do before leaving the house. This eliminates their need to ponder what they’ve just done and trying to decide what they must do next. Instead, when they follow a checklist, they know they have to move from brushing their teeth to putting on their clothes, then onto putting on their jacket, and picking up their back pack. Laying things out the night before can also help eliminate morning drama.
  • Planners – Teach your child to write things down. No one can remember everything, and noting tasks in a planner or on a checklist ensures they won’t forget to do it.
  • Rationale – Remember when your child was about two years old and constantly asked, “Why?” In the same way, children who have trouble with executive functioning do better when they understand the reason behind what they need to do. Without a rationale, they may feel like planning or following a chart is a waste of time.
  • Figure out how your child learns best. Are they visual learners? Then charts and apps are great for them. Are they tactile learners? Counting necessary steps on their fingers might be better for these types. Do they learn more easily when they hear something? Try laying out the steps for something like a homework routine in story form or in a song.
  • Make it a routine – this is especially good for older children. Set a time to start the task and a time limit in which to finish it. Practice breaking down tasks with your child so they develop an awareness of how long something takes, which allows them to better plan their time. For instance, a child might need thirty minutes to write a book report, but not think about the fact they need three days to read the book. Learning to think through each step of a task also builds organization skills and helps the child anticipate that Step A comes before Step B, etc. In the book report example, a child might think about the task of selecting a book and the task of writing the report. If they have executive dysfunction, they may completely forget they have to read the book or turn in the report.

Apps Turn Daily Routines into Fun Activities

For children who can’t read (and even those who can), the colorful images on an app can make all the difference. Eye-catching charts and graphics give the child something to focus on. They also make it easier for these kids to understand the bigger picture – for example, by showing when a task needs to be completed or by listing action steps that need to be taken.

Once parents set up their child’s chart, these visual aids help the child see the tasks they need to complete. Additionally, engaging images capture kid’s attention, making it more likely that these visual reminders will instill the routine in the child’s mind.

Some apps, like our Giant Leap app, are customizable. This flexibility allows parents to generate personalized charts with the specific behaviors their child needs to learn. Giant Leap gives children executive functioning issues an easy way to stay organized and can support their unique needs. Additionally, Giant Leap permits parents to update their child’s charts in real time within the app and allows them to print each chart out for daily or weekly use.

Apps encourage consistency and make daily routines easier to set and follow. When a child completes the tasks on their chart, they not only begin to acquire executive functions, they also gain self-confidence. Successfully learning organization skills translates to self-reliant, responsible in kids and gives them the tools they need for future success.

Learn More about Giant Leap and Executive Functioning

For information about how our Giant Leap app can help your child improve their executive functioning skills, 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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SMART Goals Method Teaches Kids About Goal Setting

We’ve gotten through the first month of a new year and many of us have already abandoned our New Year’s resolutions. As adults, we have good intentions about goal setting for things we want to work on or change throughout the year. Stating a goal is easy, however, while actually seeing it through can be much tougher. Goal setting and accomplishing objectives can be even more challenging for kids because they have a much harder time envisioning the future outcome, which makes it difficult for them to keep their eye on the prize. But, what if there was a way to help children learn how to set specific goals and teach them how to attain them? This is where working on SMART goals can help.

SMART is an acronym that stands for:

  • Specific
  • Measurable
  • Attainable, Achievable
  • Realistic and Relevant
  • Time-Limited and Trackable

For kids (and some parents), goal setting through the SMART goals method teaches an important life skill that simplifies an ambition and breaks it down into actionable steps, making it more likely to be achieved. The great thing about SMART goals is that this method can be used for any type of goal setting, ranging from something like aiming to read a certain amount of books as a child, to more difficult tasks like paying off debt as an adult – and everything in between.

SMART Goals Examples

A goal is an outcome that will make a difference when you achieve it. Measurable goals can’t be too ambitious that they’re out of reach, but they also shouldn’t be so simple that it’s not challenging to attain it. The goal should be realistic, but should require attention and effort to achieve it. That’s one of the reasons goals need to be trackable and time-limited, and why measurable action steps need to be step up. That way, you can keep track of progress and make adjustments to the steps as necessary.

Breaking down each step, here are some SMART goals examples:

  • Specific – Don’t say, “I want to get better grades in school.” Do frame the desire for better grades in the form of something such as, “I will get all B’s and higher on my report card.” Stating the specific goal in concrete terms helps it become measurable.
  • Measurable – How will you know when you’ve achieved your goal? In the case of getting better grades, you’ll know if you’ve succeeded when the next grading period ends and you can see the results of your efforts.
  • Attainable (Achievable) – It’s probably unlikely that a student could go from mid-level grades to making straight A’s in one grading period, so they would want to set a goal they know they have a good chance of hitting. Don’t say, “I will make all straight A’s on my next report card.” Instead, do say, “I will raise all my grades by one letter by the end of the next grading period.
  • Realistic and Relevant – Again, it’s going to be tough (and, therefore, self-defeating) to try to go from C-grades to straight A’s all at once. Raising grades by one level is realistic, however, setting this goal won’t matter unless it’s relevant to the child. Is the goal something they are excited about attaining?
  • Time-limited and Trackable – Using the goal of raising grades on a report card, a time-limited goal would be to set the goal of achieving the result by the end of the next grading period or maybe the end of the school year. This goal is trackable if the child (and you) have a way of keeping tabs on their grades. Talk to the teachers to see if they’d be willing to give the child progress reports to help keep them motivated. Another way to track results is by keeping a chart of grades from papers, tests, and projects, so your child can get an idea of their progress. Keep the age of the child in mind – preschoolers have much shorter attention span. Their goals need to have a shorter time period.

The biggest barrier to attaining goals is that they are often too lofty and hard to achieve. By using the SMART goals method of goal setting, you can break your goals down into detailed, manageable chunks and set up action plans and benchmarks that will keep you focused on the end result.

Our Giant Leap App Helps with SMART Goals

Our Giant Leap app contains customizable charts that give your child a visual reminder of their SMART goals. Eye-catching charts and graphics give kids something to focus on and makes it easier for them to understand the bigger picture – for example, by listing actions that need to be taken. In addition, the app’s colorful images engage and hold children’s attention, which is particularly important for young children who can’t read. For added convenience, Giant Leap lets parents update their child’s charts in real time within the app and allows them print charts out for daily or weekly use, if needed.

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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Is Medical Marijuana Use Linked to an Increase Anxiety and Depression?

As of this blog post, 30 states, the District of Columbia, Guam and Puerto Rico have all approved the broad use of medical marijuana. In addition, several other states allow limited medical use and 8 states (plus the District of Columbia) allow recreational use of pot. Even though the use of marijuana is becoming more acceptable, the Drug Enforcement Administration (DEA) still classifies pot and weed (marijuana) as a Schedule I substance, meaning it is likely to be abused and it completely lacks medical value. Because of this classification, there hasn’t been much research into the efficacy of the drug for medical conditions. In particular, we lack long-term studies that would tell us whether it is safe and/or effective when used over a long period of time.

What we do know is that, in our clinical practice – and in those of colleagues in other practices – we have seen an increase in the number of incidents of anxiety, depression, panic attacks and even psychotic reactions since marijuana use has become more mainstream.

Did you know that:

  • THC, the primary chemical in marijuana, is believed to stimulate areas of the brain responsible for feelings of fear.
  • A 2015 study found that university-aged young adults are more likely to have a higher risk of developing depression from heavy marijuana use.
  • Numerous research studies show that marijuana is an addictive substance. The more you use it, the more you need to use in order to get the same “high.”
  • Frequent or heavy use in adolescence can be a predictor of depression or anxiety later on in life – especially for girls.
  • According to available scientific literature, people who use weed have higher levels of depression and depressive symptoms than those who do not use cannabis.
  • Scientific evidence suggests cannabis use can trigger the onset of schizophrenia and other psychoses in those already at risk of developing it.
  • Even if using cannabis seems to alleviate symptoms in the short-term for some users, it can lead to delay in getting appropriate treatment.

Recreational Marijuana vs. Medical Marijuana

Whether it’s used recreationally or medicinally, both forms of pot are the same product. The medical version contains cannabinoids just like recreational marijuana. Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the main chemicals found in the medical form.

Although medical marijuana is used for many conditions (among them: multiple sclerosis (MS), seizure disorders, cancer and glaucoma), its effectiveness hasn’t been proven. “The greatest amount of evidence for the therapeutic effects of cannabis relate to its ability to reduce chronic pain, nausea and vomiting due to chemotherapy, and spasticity[tight or stiff muscles] from MS,” says Marcel Bonn-Miller, PhD, a substance abuse specialist at the University of Pennsylvania Perelman School of Medicine.

Mental Illness and Psychoactive Substances

As we’ve said, right now there aren’t many studies out there on the relationship between marijuana use and mental illnesses, such as anxiety, depression and bipolar disorder. However, there was a study done in 2017 which examined marijuana use in conjunction with the depression and anxiety symptoms in 307 psychiatry outpatients who had depression (Bahorik et al., 2017). The results of this study showed that “marijuana use worsened depression and anxiety symptoms; marijuana use led to poorer mental health functioning.” In addition, the research found that medical marijuana was associated with inferior physical health functioning.

A big part of the problem with using marijuana either medically or recreationally is that there is no way to regulate the amount of THC you’re getting in the product, because the Food and Drug Administration (FDA) doesn’t oversee it. This means that both the ingredients and the strength of them can vary quite a lot. “We did a study last year [in 2016] in which we purchased labeled edible products, like brownies and lollipops, in California and Washington. Then we sent them to the lab,” Bonn-Miller says. “Few of the products contained anywhere near what they said they did. That’s a problem.”

Another area of concern is that, as we know from regulated psychiatric medications, one dose may affect you differently than it affects your sibling or a friend. People are unique – each person’s reaction to a medication will vary, which is why psychiatric medications are monitored by the prescribing doctor so that the dosage can be adjusted for your specific needs.

Be Careful with Marijuana Use

In summary, if you choose to use marijuana either recreationally or medically, be careful. Talk to the physician who authorized it, or speak with a mental health professional if you find yourself experiencing the symptoms of depression or anxiety, or if you have panic attacks that begin or worsen while you are using marijuana. Additionally, be sure your doctor knows your psychiatric history before they authorize medical marijuana for you, especially if you have been diagnosed with anxiety, depression, experience panic attacks or have bipolar disorder or psychosis.

Do You Have Questions?

We can answer your questions about marijuana use and how it affects anxiety, depression, or other conditions. The mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida are here to help. For more information, contact us or call us today at 561-496-1094.

Reference:  Bahorik, Amber L.; Leibowitz, Amy; Sterling, Stacy A.; Travis, Adam; Weisner, Constance; Satre, Derek D. (2017). Patterns of marijuana use among psychiatry patients with depression and its impact on recovery. Journal of Affective Disorders, 213, 168-171).

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Virtual Reality Apps Are Helping Children With Anxiety

Sometimes it isn’t easy to go through childhood. There’s a big, scary world out there and new activities or experiences can often bring up anxiety in children. But, what if there was a way for your child to experience a new scenario in a safe, nurturing way so they could reduce their anxiety before taking part in the activity? Enter virtual reality apps. The growing field of virtual reality therapy is combining cognitive behavioral therapy (CBT) and in-vivo exposure therapy in a fun way – on a powerful and engaging game-like platform that children can easily relate to.

How Can VR Apps Help My Child?

The Children’s Center’s innovative Giant Leap app is great example of a high-tech solution that gives kids control over their fears. Giant Leap and other VR apps can be used in a variety of scenarios, such as:

  • Helping to reduce school anxiety
  • Addressing the child’s concerns before a visit to the doctor
  • Calming their separation anxiety when staying home with a babysitter

For example, one child might be apprehensive about classroom interaction in school, while another may worry about an upcoming medical procedure, such as getting an MRI. Both kids could conquer their fears by watching exposure stories on the app, which will show them what to expect from the upcoming experience.

VR apps can also be used to manage behaviors and teach your child emotional regulation techniques. Featuring customizable avatars that can be configured to match your child’s hair color, style, and skin tone (and can even use a photo of your child), these entertaining virtual reality apps encourage independence and motivate kids through stories, videos, and flexible charts and reward systems.

How Effective Are Virtual Reality Apps?

Studies are showing that virtual reality apps amplify the areas of the brain that are related to attention and control. The result is that children:

  • Strengthen their daily living skills
  • Learn emotional regulation techniques
  • Report having more control when faced with real-life issues

Animated stories like the ones provided on the Giant Leap app gradually expose the child, via their avatar, to the scenario they are worried about (for example: visiting the dentist). Kids work through one scene at a time, at their own pace, until they are ready to move forward to the next one on their own. These meaningful, close-to-life scenarios offer immediate feedback, which greatly enhances the child’s ability to cope under stress.

Furthermore, positive behavior can be learned and reinforced through virtual reality apps and tailored to each child’s individual needs. Flexible programs allow parents to customize the app to their child’s specific activities and situations while encouraging routines and building life skills. By motivating and rewarding appropriate behavior, children learn to function independently, and gain powerful tools that lead to future success.

Learn More About Our Giant Leap App

For more information about how virtual reality apps like our Giant Leap app can help with child anxiety treatment, 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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Autistic Children Find Help through Virtual Reality Therapy

Children with autism and Asperger’s often have phobias that limit their interaction with others. One child may be fearful of any social gathering, another of going shopping, while someone else may be afraid heights or be terrified to be in a crowd of people. These phobias can be so difficult for the child to experience, that often family members will go out of their way to avoid a situation they know will trigger the child’s fears. Additionally, children with Asperger’s syndrome and autism spectrum disorders often have trouble with safety boundaries that others take for granted, such as needing to stay within their own yard or being able to cross a street without harm. But, studies are showing that the new field of virtual reality therapy can help autistic children learn to manage everyday situations, allowing them to live a more normal life.

How Does Virtual Reality Therapy Work?

Virtual reality therapy (VR therapy) is a computer-based simulation of the world around us. It is multi-sensory, providing both visual and auditory environments that can be configured to mimic a setting. By going through VR therapy, an autistic child can challenge and overcome their fears in a safe setting and in a way that gives them control.

With virtual reality therapy, a simulated environment allows the child to use an avatar to interact with others. Reminiscent of a video game, the children move their avatar through the program while a therapist views the session and provides coaching and feedback to the child. The kids have the ability to pause, repeat, or review their avatar’s interaction inside the setting until they feel confident about the situation.

How Can VR Therapy Help Autistic Children?

Among other applications, virtual reality therapy is being used to teach or enhance social cognition skills and emotion recognition to help children with autism become more comfortable in social settings. Social interaction is often a source of discomfort for autistic children because the syndrome keeps them from picking up on the subtle social signals most people take for granted. In fact, Daniel Smith, the senior director of discovery science at Autism Speaks has said, “Virtual reality and avatar-based programs may be especially promising for people with autism who are uncomfortable in social interactions where subtle social cues are important.”

Studies have proven that virtual reality therapy can actually rewire the regions of the brain that relate to social skills. VR therapy also amplifies those areas that relate to attention and information exchange. The result is an increased understanding and awareness of social signals and a higher perception of the back and forth exchanges that is the foundation of conversation.

In addition to teaching social skills for circumstances such as attending school, sitting for a job interview, going to the mall, or going on a date, VR therapy has helped teens and children overcome more physical situations involving things like a fear of heights, phobias surrounding crowds, and traveling on a school bus. Because the virtual simulations can be configured to show real-world settings, they can be adapted to conform to each child’s specific fears.

For example: for a child who is afraid of heights, VR therapy can create a situation in which the child – via their avatar – experiences riding an escalator or crossing a bridge. The scenario introduces the child to the situation slowly and increases the stimulus as they learn to desensitize their fear and build up their tolerance.  The child is given encouragement and feedback by a child psychologist and has full control of the scene, so they can turn back or go to an earlier (less frightening) version whenever they need to.

After working through these phobias, the children are able to transfer their new skills to real-life situations – something that is usually difficult for autistic children because they focus on details instead of intangible perspectives. By targeting a child’s specific fears, virtual reality therapy provides real world scenarios with immediate feedback, which greatly enhances the child’s ability to cope under stress.

Need More Information about Autism and Virtual Reality Therapy?

Our warm and welcoming Children’s Center offers a wide range of clinical, therapeutic, educational and supportive services specifically for children ages two through twenty two.

For more information about how our skilled professional can use virtual reality therapy to help with your child’s autism, 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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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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