All posts by Dr. Andrew Rosen

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Help for School Refusal

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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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Problems with Sleep: Treatment Approaches for Kids and Teens

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Problems with Sleep: Treatment Approaches for Kids and Teens

About the Webinar:

Dr. Joseph Brand recently held two webinars with the Anxiety and Depression Association of America (ADAA). These webinars provide an overview of common sleep problems experienced by kids and teens, including insomnia, separation anxiety, circadian rhythm problems, and other issues.

Watch Part 1
Watch Part 2
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Sensory Processing Disorder (SPD) – Boy Patted Down by TSA

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

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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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Where Will They Be in 10 Years? Exploring Residential and Therapeutic Options For Adolescents & Young Adults

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About the Presentation:

Clinicians are often unaware of the range of residential options that exist nationally for their most challenging young clients. We will demystify the antiquated, often misunderstood assumptions about residential treatment programs. We’ll provide a deeper understanding of the options clinicians can propose to their adolescent and young adult patients who need a more intensive milieu.

When:

Tuesday, March 21, 2017
9:00 am – 12:00 pm

Where:

Center for Treatment of Anxiety and Mood Disorders
4600 Linton Blvd, Ste 320
Delray Beach, FL 33445

Register Here

About the Presenters:

Marcy Dorfman, LCSW
Therapeutic Educational Consultant 

Marcy is a Licensed Clinical Social Worker and Therapeutic Educational Consultant. Having treated families clinically, both in agencies and in twenty years of private practice, she recognized the need to work with a Therapeutic Educational Consultant for her own son, then 14, because he was not progressing in outpatient therapy to the extent he needed to reach his full potential. Now working to assist and guide families through the vast array of available options, she travels throughout the country to pinpoint the finest schools and programs based on their programming, staff, and clinical reputation. She shares her invaluable knowledge with parents who are in need of expert advice and direction.

 

 

About Josh Watson, LCSW
Chief Marketing Officer, Aspiro Adventure Therapy 

Josh completed graduate studies at the University of Georgia and is currently a Licensed Clinical Social Worker in Utah and North Carolina. He is a co-founder and Chief Marketing Officer for Aspiro, a Wilderness Adventure Therapy program based in Sandy, Utah. Josh has spent over 15 years of his professional career in the research, development and implementation of effective treatment strategies for both adolescent and young adult populations presenting with mixed emotional, behavioral, and learning challenges. Since the conception of Aspiro in 2005, Josh and the Aspiro Group have successfully developed five additional partner programs in Utah, North Carolina and Costa Rica that each serve different client profiles.

 

Andrew Taylor, CSUDC
Founder & Executive Director, Pure Life by Aspiro

A native of Utah, Andrew grew up in the outdoors and spent his college summers as a river guide on the Upper Colorado River. After graduating from the University of Utah with a degree in Organizational Communication, Andrew went to Costa Rica in search of white water. During his time in Costa Rica, he fell in love with the Costa Rican people and the wide range of adventure activities the country has to offer. Andrew has been running adventure trips in Costa Rica since 2004. He’s rafted and kayaked in rivers all over the world, including Costa Rica, New Zealand, and Venezuela. He has been inspired and fulfilled by his work with individuals suffering from drug and alcohol addictions at Cirque Lodge, one of the top substance abuse programs in the nation.

 

Register Here

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Vaccines and Autism – Is There a Connection?

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The Centers for Disease Control (CDC) reports that autism, classified as a developmental disability, is on the rise in the United States and around the world. Currently, about 1 child out of every 68 will be diagnosed with Autism Spectrum Disorder (ASD). Obviously, when there is an increase in a disorder or disability, people begin to look for reasons for that change. Because signs of ASD can be seen as early as the age of two, the focus has been on potential factors a child may experience early in life that could contribute to an autism diagnosis. From birth, children receive many and varied immunizations, so fears have been raised of a possible connection between these vaccines and autism.

In particular, there have been concerns about the measles, mumps, and rubella (MMR) vaccine and thimerosal, a mercury-based preservative that had been used in MMR and other inoculations. Since 2003, nine studies have been conducted into the relationship between thimerosal and ASD, however the Institute of Medicine has determined there is no link between the vaccine and the development of autism.

In reaction to fears over whether thimerosal in vaccines and autism were related, between 1999 and 2001, the preservative was either removed from vaccines or reduced to negligible amounts. Today, this preservative is only found in some flu vaccines and is limited to use in multi-dose vials. If you are still worried, you can request your child receive a thimerosal-free vaccine.

Lastly, a 2013 study by the CDC determined there is no link between vaccines and autism. It looked at the number of antigens that help the body’s immune system fight disease and found no difference between children with ASD and children without the disorder.

Then, What Causes Autism?

There are many categories of disability along the autism spectrum and, at this time, specialists haven’t found any one specific reason for the development of autism. The CDC is conducting research to find out if the disorder has environmental, biological, or genetic causes.

We do know there are factors that can indicate a more likely chance of a child developing autism. These components are:

  • Children with autistic siblings are more likely to develop the disability.
  • Children born to older parents are more likely to be at risk.
  • It is thought that the critical developmental time for ASD is in utero, or in the period during or immediately after birth.
  • The prescription medicines valproic acid and thalidomide have been linked to a higher ASD risk in the infant, when these medications were taken during the pregnancy.
  • ASD occurs more often in people who have certain chromosomal or genetic conditions (for example: Fragile X Syndrome).

Early Signs of Autism

Autism can affect either gender, but occurs about 4.5 times more often in males than in females. It is found in every cultural, socioeconomic, and racial background, although it is more prevalent in white children than in African-American or Hispanic children.

People with ASD may have problems communicating or interacting with others, or may have difficulty focusing or learning. Additionally, early signs of Autism Spectrum Disorder may include:

  • Avoiding eye contact
  • Lack of interest in objects or in relating to people
  • Becoming upset if routines change
  • Unusual reactions to stimuli, such as smells, tastes, textures, or sounds
  • Repeating words or phrases or repeating actions over and over
  • Preferring to spend time by themselves

Diagnosis, Evaluation, and ASD Treatment

The earlier a child is diagnosed and begins treatment, the better their chances of reaching their full potential. ASD treatment and early intervention can begin as soon as 3 months of age. Although there is no cure for ASD, early intercession can reduce the severity of a child’s developmental delays and can teach them important skills.

If you are concerned about your child and the way they interact with you or others, the way they learn, or the way they speak or act, the first step is to call your child’s pediatrician and share your worries. Your child’s doctor can help answer your questions and, if alarmed, should refer you to specialists for further evaluation. Psychologists, psychiatrists, pediatric neurologists, and/or developmental pediatricians have been specially trained to assess and diagnose Autism Spectrum Disorder.

If you need a free assessment, you can contact your state’s early intervention programs. To find out more about your particular state’s Child Find evaluation, visit the Early Childhood Technical Assistance Center.

Our Children’s Center Can Help

If you have questions about the early signs of autism, treatment and intervention, or other autism-related concerns, 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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New Mothers & Babies Workshop

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New Mothers Workshop

New Mothers & Babies Workshop

Saturday, April 1st 1:00 pm – 2:00 pm

Click here to register.

Adjusting to a being a New Mom? Join Boca Pediatric Group and Dr. KC Charette, Clinical Psychologist from The Center for Treatment of Anxiety & Mood Disorders for a free 1-hour workshop on adjusting to having a new baby. Join us to learn about the adjustment process and to meet other new moms. Babies welcome too, of course!

Click here for more information.

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Treatment for School Refusal and Separation Anxiety

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The summer is waning – it’s almost time for autumn to roll around again, which means school will be starting soon. While most children look forward to this time so they can see their friends and enjoy various school activities, this can be a period of major anxiety for some school-aged children. These kids are extremely unwilling to leave home or be away from major attachment figures such as parents, grandparents, or older siblings. The beginning of the new school year is often seen as a threat to them, resulting in elevated anxiety levels and possible school-related disorders, such as separation anxiety disorder and school refusal.

In some cases the separation anxiety and school refusal follow an infection or illness or can come after an emotional trauma such as a move to another neighborhood or the death of a loved one. The anxiety generally occurs after the child has spent an extended time with their parent or loved one, perhaps over summer break or a long vacation.

Anxiety Definition

A teen or child is said to be suffering from a separation anxiety disorder if they show excessive anxiety related to the separation from a parent or caregiver or from their home, or if they exhibit an inappropriate anxiety about this separation as related to their age or stage of development. School refusal and separation anxiety are not the same: school refusal is not an “actual” diagnosis, instead it is a result of the child or teen having a separation anxiety disorder, panic disorder, post traumatic stress disorder, or social phobia, among other diagnoses.

Separation Anxiety Physical Symptoms

Children with separation anxiety have symptoms which can include:

  • Excessive worry about potential harm befalling oneself or one’s caregiver
  • Demonstrating clingy behavior
  • Avoiding activities that may result in separation from parents
  • Fearing to be alone in a room or needing to see a parent at all times
  • Difficulty going to sleep, fear of the dark, and/or nightmares
  • Trembling
  • Headaches
  • Stomachaches and/or nausea
  • Vomiting

A child who exhibits three or more of these symptoms for more than four weeks is likely to be suffering from a separation anxiety disorder.

Treatment for School Refusal and Separation Anxiety

When treating a child with separation anxiety and school refusal, therapists try to help the child learn to identify and change their anxious thoughts. They teach coping mechanisms that will help the child respond less fearfully to the situations that produce their anxiety. This can be done through role-playing or by modeling the appropriate behavior for the child to see. Medication is sometimes appropriate in severe cases of separation anxiety. Additionally, the therapist encourages child to use positive self-talk and parents help with this therapy by actively reinforcing positive behaviors and rewarding their child’s successes.

Have Questions? Need Help?

To get more information and help for child anxiety, separation anxiety and school refusal, please contact The Children’s Center for Psychiatry, Psychology, & Related Services in Delray Beach, Florida at 561-223-6568.

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Now Open: The Children’s Center for Psychiatry, Psychology and Related Services

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We are pleased to announce the opening of our new Children’s Center for Psychiatry, Psychology, and Related Services. This full-service center offers a range of clinical, therapeutic, educational, and supportive services to children ages two through 22.

Families in the South Florida area now have access to a multi-disciplinary staff practicing in a single, convenient location. The center provides a warm, welcoming environment where families can receive supportive and educational programming.

The Children’s Center Services

These are just some of the services offered to children and their families at the new center:

  • Psychiatry — Psychiatric evaluation and psychopharmacology
  • Individual and Group Psychological services — Psychotherapy, play therapy and cognitive-behavior therapy
  • Psychological and Neuropsychological Screening and Assessment
  • Speech/Language Assessments and Therapy
  • Educational and Gifted Testing
  • Occupational Therapy
  • Behavior Management
  • Parenting Support/Management
  • Transitional/Vocational Support
  • Sibling Support
  • Reading, Writing, Science, and History Tutoring
  • SAT/ACT Tutoring
  • Learning Disability Testing
  • Reading, Math, and Writing Testing
  • Psychological Testing

Diagnoses Treated

Our staff provides treatment for these diagnoses:

  • Anxiety and Related Disorders of Childhood and Adolescence
  • Mood Disorders of Childhood and Adolescence
  • Behavior Disorders
  • ADD/ADHD
  • Autism Spectrum Disorder
  • Eating Disorders
  • Developmental Disorders
  • Learning Disorders
  • Communication Disorders

Learn More About The Children’s Center

The Children’s Center’s skilled and experienced staff includes a child and adolescent psychiatrist, clinical child psychologists, a school psychologist, speech therapist, occupational therapist, nutritionist, behaviorist, and academic advisor.

To learn more about how the center’s services may help your child and family, please call us at (561) 223-6568 or complete our contact form.

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Children’s Mental Health – Psychiatric Help for Children

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While we tend to think of childhood as a carefree time of life, the fact is that many children suffer from mental conditions and disorders, just the same as adults. Among other things, children’s mental health concerns can include emotional, behavioral, and mental disorders such as eating disorders, learning and developmental disabilities, Attention Deficit Hyperactive Disorder (ADHA), and autism. And, similar to adults, children can be impacted by conditions like anxiety, depression, Obsessive Compulsive Disorder (OCD) and Post-traumatic Stress Disorder (PTSD). Additionally, as children grow and mature into young adults, they can develop other problems associated with adolescence, such as underage drinking and substance abuse.

Left untreated, any of these conditions or disorders can result in difficulties with making friends, and behavior issues in school and at home. What is most troubling, however, is that research has shown that a majority of adult mental disorders start early in life. This makes it critical that children’s mental health conditions be caught promptly and treated appropriately.

Symptoms of Child Psychological Disorders

Child psychological disorders and conditions can affect any ethnic group, and income level, and those living in any region of the country. In fact, the Centers for Disease Control (CDC) cites a study from a National Research Council and Institute for Medicine report that estimates about 1 in 5 children across the United States will experience a mental disorder in any given year.

Symptoms often change as a child grows and matures, so the signs of a problem may be difficult to spot in the early stages. Often, parents are the first to recognize that there is an issue with their children’s emotions or behavior, however problems may also be brought to your attention by your child’s educators or another adult who knows your child well. Some general signs to look for include:

  • Marked decline in school performance
  • Strong worries or anxiety that causes problems at home or at school
  • Random, frequent physical aches and pains, such as headaches or an upset stomach
  • Difficulty sleeping, nightmares
  • Marked changes in eating habits
  • Feeling hopeless
  • Having low or no energy
  • Aggressive behavior, disobedience, and/or confrontations with or defiance of authority figures
  • Temper tantrums or outbursts of anger
  • Thoughts of suicide or thoughts of harming themselves or others

Psychiatric Help for Children

  • Please get immediate assistance if you think your child may be in danger of harming themselves or someone else.  Call a crisis line or the National Suicide Prevention Line at 1.800.273.TALK (8255).

Getting psychiatric help for children, in the form of early diagnosis and receiving the correct treatment, is essential for your child’s well being, both now and throughout their life.

If your child’s problems persist across a variety of settings (for example: home, school, and with peers), some of the steps to get help include:

  • Talk to your child about how they are feeling. Find out if they would like to discuss a problem with you or another adult. Actively listen to their responses and concerns.
  • Talk to your child’s pediatrician, school counselor or school nurse, or a mental health professional if you see behaviors or problems in your child or teen that worry you.
  • Seek evaluation from a specialist who deals with children’s mental health concerns.
  • Ask the specialist if they have experience with treating the problem or behavior you see in your child.
  • Don’t delay in seeking help – early treatment generally gives better results.

Children can be treated in a variety of settings that range from one-on-one (or with a parent) sessions with a mental health professional to a group setting with a therapist and the child’s peers. Talk therapy can help change behaviors and may be used in combination with other treatments. Cognitive Behavioral Therapy (CBT) has been shown to be very effective in helping children learn coping strategies so they can change unhealthy behavior patterns and distorted thinking. Additionally, medications may be recommended for disorders such as ADHD or may be given for other types of severe or difficult cases.

Need More Information on Children’s Mental Health?

If you have questions or need more information about psychiatric help for children, we can help. For more information, contact The Children’s Center for Psychiatry, Psychology, & Related Services in Delray Beach, Florida or call us today at 561-223-6568.

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person typing on a laptop

Child and Teenage Internet Addiction: Anxiety, ADHD, Social Phobias, and Depression on the Rise

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In today’s world, around 85 percent of children and adolescents have some type of game console, cell phone, computer, or tablet.  Often, these kids use these devices in their bedrooms away from the family living area, and studies have found that nearly twenty percent of children use the internet without being monitored by their parents. Because kids aren’t being watched and are spending so much time in cyberspace, today’s children and adolescents are at a much higher risk of developing anxiety, depression, impulsiveness, abuse drugs, and develop antisocial tendencies.

Often, these children and adolescents are exposed to pornography or engage in activities that are psychologically harmful. Many teens participate in “sexting” or sharing intimate photos of themselves among close friends. This can lead to humiliation, anxiety, and depression when these private photos are shared online. Additionally, unmonitored children and teens can be exposed to cyber-bullying or become the unwitting target of pedophiles.

In addition to the distress children are experiencing due to the ease with which they can find pornography, violent videos, and information about drugs and alcohol, we are finding that kids who spend a lot of time in virtual worlds are also becoming antisocial. They often lose track of time, want to eat in front of the computer, and have difficulty turning off their mobile phone, computer, or tablet because they have become addicted to it. Adolescents who experience teenage internet addiction have more psychological problems, and addiction is more likely in those who are depressed, have anger issues, ADHD, or a social phobia because computer addiction has been shown to disrupt nerve pathway “wiring” in the brain. In fact, studies have shown that teens who are addicted to the internet are about 2.5 times more likely to have more anger issues and higher incidences of ADHD. They develop more social phobias because they can retreat into a different “personality” through their avatars, thereby avoiding conventional social interaction at a time when they are usually defining themselves socially.

As a parent, what can you do to help your child avoid teenage internet addiction?

  • Be supportive and involved with your children’s lives. Even though kids will tell you they don’t want to talk about their day or about their disappointments and problems, children inherently want and depend on their parent’s attention and encouragement.
  • Limit your child’s use of the device by locking it up or removing it, if necessary.
  • Cut back on your own internet use. If parents are ignoring their children in favor of online time, children can do as they please and don’t have a good example to follow.
  • To fight child or teenage computer addiction, put the computer in a public place in your home, not in your child’s bedroom. Also, be sure your kids use their cell phones and tablets in a family area.  Remember the good old days, when families had one phone line and kids had to talk to their friends in earshot of everyone in the house?  The computer should be used in the same way today.
  • Seek therapy for teenage computer addiction or anxiety with a psychologist, psychiatrist, or other mental health professional (parents should also take this action if they notice any other compulsive or dangerous behaviors.)

For more information and help for children’s and teenage internet addiction, and other childhood anxiety disorders, contact Dr. Andrew Rosen at 561-223-6568 or today.

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