All Posts Tagged: boca raton

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Technology, Screen Time, And Children’s Mental Health

It’s no secret that people are somewhat “addicted” to their screen time. Just look around you at any restaurant and you’ll see families and friends interacting more with their phones than with each other. The same hold true for almost anywhere you go: some people can’t even take their eyes off their screens when driving or walking, which has resulted in numerous accidents and deaths.

In a 2018 study done by the Pew Research Center, 54 percent of teens aged 13 – 17 said they were concerned about the amount of time they were spending online and on their phones. In fact, they were so alarmed about it that “Some 52% of U.S. teens report taking steps to cut back on their mobile phone use, and similar shares have tried to limit their use of social media (57%) or video games (58%),” according to the researchers.

Parents don’t do much better. The study reported that, “36% say they themselves spend too much time on their cellphone.”

Because of all the time spent watching screens, research is being done to find out the physical and emotional effects it might be causing for us.

What Does Too Much Screen Time Do To Your Brain?

Since phones and computers have only been easily accessible and affordable for people in the last thirty years or so, we don’t yet know the long term effects of screen time on the brains of kids or adults. But, we do know that, because children’s brains are still in the process of developing and growing, it seems likely that they would be affected by this technology.

The Adolescent Brain Cognitive Development (ABCD) study by the National Institutes of Health agrees. It has been following more than 11,000 kids, ages 9 and 10 years old, at 21 different areas throughout the United States. According to an article on Healthline, the initial results of the research show that:

  • MRI scans found significant differences in the brains of some children who reported using smartphones, tablets, and video games more than seven hours a day.
  • Children who reported more than two hours a day of screen time got lower scores on thinking and language tests.

The scary thing is that it will take many more years to discover whether these effects are the result of too much screen time or whether the differences were from something else.

So, does that mean adults are safe from the adverse effects of too much screen time? Actually, no.

Today’s adults have been estimated to spend more than 10 hours a day in front of screens (Harvard T. H. Chan School Of Public Health). Because the activity is sedentary, this exposure has been linked, in part, to higher obesity rates (which can lead to diabetes) and sleep problems.

Additionally, when asked, 15 percent of adults reported that they were more likely to lose focus at work due to checking their cellphone, which is double the number of teens who have trouble focusing in class for that same reason.

And, the Pew Research study indicates that more than half of teens (51 percent) say their parents are “often or sometimes” distracted by their own phones while in conversation with their child, leading to feelings of unimportance in the child.

What Are The Emotional Effects Of Too Much Screen Time?

For kids, anxiety, depression, and loneliness are often the result of too much screen time. A 2018 population-based study by Twenge and Campbell showed that after an hour of screen time per day, “…increasing screen time was generally linked to progressively lower psychological well-being.” The researchers also noted that, “High users of screens were also significantly more likely to have been diagnosed with anxiety or depression.”

But maybe screen time isn’t bad if kids are texting or gaming together? After all, they are interacting with each other and developing social relationships, right?

Again, the answer is ‘no’. According to a Psychology Today article by Victoria L. Dunckley M.D., “…many parents mistakenly believe that interactive screen-time—Internet or social media use, texting, emailing, and gaming—isn’t harmful, especially compared to passive screen time like watching TV. In fact, interactive screen time is more likely to cause sleep, mood, and cognitive issues, because it’s more likely to cause hyperarousal and compulsive use.”

In addition to the physical and psychological effects, too much social media time can lead to problems with social skills and their application, as well as a decrease in self-esteem – in both children and adults. Furthermore, kids can be bullied online while sitting right next to their parents and they can’t get away from it.

How To Limit Screen Time

For parents who are wondering how to limit their child’s screen time, the American Academy of Pediatrics set out updated media guidelines based on the latest research. They suggest:

  • Don’t use screen time as a way to calm your child down or as a babysitter.
  • For children under 18 months old, no screen time.
  • For children 18 to 24 months old, parents should choose only high-quality media and watch it with their child.
  • For children 2 to 5 years old, less than one hour per day of high-quality programming is recommended, with parents watching along.
  • No screens 1 hour before bedtime, and remove devices from bedrooms before bed.
  • Keep bedrooms, mealtimes, and parent–child play times screen free for children and parents. Parents can set a “do not disturb” option on their phones during these times.

For adults who are trying to limit their own screen time:

  • As with the suggestions for kids: Keep screens out of the bedroom and stash them somewhere else during mealtimes and parent–child play times.
  • Use phone apps to alert you when it’s time to stop using the phone.
  • Turn off the majority of your notifications.
  • Delete your social media apps.
  • Stop using your phone as an alarm clock because it’s too easy to get caught up in checking for updates from friends, scanning texts, and reading emails if you pick up the phone to turn off the alarm.

We Can Help Break The Screen Time Cycle

If you are concerned about your teen or ‘tween’s screen time amount – or your own – we can help you take steps to “disconnect.” 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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Mental Health Risks Of Marijuana

As more states legalize the possession and use of marijuana, we are beginning to get a clearer picture of the effects it can have on mental health. While more research is needed, we know there has been an upswing in suicides and mental health disorders in the states that have legalized the drug. So, what are the mental health risks of marijuana use?

Long Term Side Effects Of Marijuana Use

The short term effects of marijuana use have been known for years. They include:

  • Altered judgement
  • Weakened motor skills
  • Impairment of short term memory, along with an associated difficulty in learning and retaining information.

However, with long term use or with heavy use of cannabinoids, people are developing more serious mental side effects. This is particularly if the drug was initially used early in adolescence.

A 2016 study by Volkow, et al, found:

  • Addiction (in about 9% of users overall, 17% of those who begin use in adolescence, and 25 to 50% of those who are daily users)
  • Altered brain development
  • Cognitive impairment, with lower IQ among those who were frequent users during adolescence
  • Increased risk of chronic psychosis disorders (including schizophrenia) in persons with a predisposition to such disorders
  • Diminished life satisfaction
  • Symptoms of chronic bronchitis (*we are now seeing this in the current vaping crisis, which has been linked to the use of THC pods)

This is especially concerning because the study also reported that, “Currently, marijuana is the most commonly used “illicit” drug in the United States, with about 12% of people 12 years of age or older reporting use in the past year and particularly high rates of use among young people.”

Marijuana And Psychosis: Are They Linked?

Today’s marijuana is not the same strength as what people were familiar with in the past – cannabis is now much stronger. A review of the negative health effects of pot in the Western Journal of Emergency Medicine reported that, “Current commercialized cannabis is near 20% tetrahydrocannabinol (THC), the primary psychoactive constituent of cannabis, while in the 1980s concentration was <2%. This 10-fold increase in potency does not include other formulations such as oils, waxes, and dabs, which can reach 80–90% THC.” And, as the potency of marijuana increases, so do the rates of mental health disorders and psychosis.

Age at first use of the drug also makes a big difference in developing mental health issues. A 5-year study by Di Forti, et al, that was published in The Lancet in 2019 compiled data from across 11 sites in Europe and in Brazil and discovered that the occurrence of first-episode psychosis increased exponentially in those who used marijuana daily or in high potency form.

Although the study authors reported that “Use of high-potency cannabis (THC ≥10%) modestly increased the odds of a psychotic disorder compared with never use… those who had started using high-potency cannabis by age 15 years showed a doubling of risk.” And, they said that, “daily use of high-potency cannabis carried more than a four-times increase in the risk of psychotic disorder.”

Cannabinoid Induced Psychosis

USAToday recently published an article highlighting the debate over cannabinoid induced psychosis. In it, they detailed the downward spiral of a young man who had once been a star high school athlete. After months of vaping a highly potent form of THC, he showed up at work on his day off, disoriented and speaking incoherently. Upon hospitalization, doctors diagnosed him with “cannabis use disorder” and “psychotic disorder, unspecified.”

If the young man stays off pot for a year and has no further psychotic symptoms or episodes during that time, he will join the growing number of pot smokers who have been identified as suffering from cannabinoid induced psychosis. The diagnosis takes a year to confirm in order to ensure the psychotic episode did not stem from another reason.

This person is not alone. For their story, USAToday also “interviewed a dozen parents whose children suffered psychotic episodes – some of which led to schizophrenia – related to their marijuana use. Several of the children died by suicide. “

The USAToday article went on to say that, “In May, more than 40 Massachusetts doctors, psychiatrists, pediatricians and other public health professionals urged the state to add psychiatric risk warnings to marijuana packaging and to prohibit most advertising.”

Be Cautious Before Using Marijuana

In addition to concerns about marijuana use and the associated mental health risks are the recent vaping illnesses and deaths that dominated the news this summer. THC-containing vaping products and e-cigarettes have been implicated in almost all the cases. The Centers for Disease Control and Prevention (CDC) is recommending that people “should not use THC-containing e-cigarette, or vaping, products, particularly from informal sources like friends, family, or in-person or online sellers.”

At this point, it is obvious that more research and time are needed to understand how marijuana affects the brain. Clearly, though, the drug isn’t as innocent as some people believe.

We Can Help

Talk with a compassionate child psychologist at the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us or call us today for more information at (561) 223-6568.

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How Does Online Bullying Affect A Child’s Mental Health?

Sadly, bullying is more common than we like to think. Kids belittle and pick on each other for many reasons. In the past, adults often wrote off bullying as “kids being kids”, but we have learned that being subjected to this type of abuse can be devastating for the targeted child. And, now that computers and social media are commonplace, a bully’s harassment doesn’t have to be done in person – kids can be besieged by cyberbullying, too. So, how does online bullying affect a child’s mental health?

Cyberbullying can cause a child to have more physical problems (sleep disturbances, headaches, stomachaches) and issues with self-esteem. A child who is bullied is less able to learn and adjust in school and more likely to have “depression, anxiety, sleep difficulties, lower academic achievement, and dropping out of school” as reported by the Centers for Disease Control and Prevention (CDC). In extreme cases of online bullying, children have even been so traumatized that they have taken their own lives.

In addition, bullying also affects the child who is carrying out the harassment, resulting in a higher risk of substance abuse, problems in school, and violence in their teen years and in adulthood.

Cyberbullying Definition

According to the U. S. government website, StopBullying.gov, “Cyberbullying is bullying that takes place over digital devices like cell phones, computers, and tablets. Cyberbullying can occur through SMS, Text, and apps, or online in social media, forums, or gaming where people can view, participate in, or share content. Cyberbullying includes sending, posting, or sharing negative, harmful, false, or mean content about someone else. It can include sharing personal or private information about someone else causing embarrassment or humiliation. Some cyberbullying crosses the line into unlawful or criminal behavior.”

Does Cyberbullying Cause Depression?

An article on VeryWellMind about cyberbullying and depression in kids notes that, “Victims of cyberbullying can experience symptoms of depression including sadness, loneliness, insecurity, poor self-esteem, academic decline, feelings of not belonging, and suicidal thoughts and behavior.”

Because online bullying can be done 24/7, kids cannot escape it in the same way they might be able to avoid harassment in person. This can add to the victim’s depression and feelings of helplessness.

What Is The Main Cause Of Cyberbullying?

A 2012 study by Low and Espelage, the authors noted that there are “…relations between bullying behavior and more conflictual and harsh parenting styles…as well as low parental monitoring.” They report that, “it can be hypothesized that family conflict and ineffective monitoring would heighten bullying perpetration indirectly via (a) risk behaviors such as alcohol and drug use (AOD) and (b) impairments in social competency and self-regulation, manifested in hostility, depressive symptoms, and reduced empathy.”

In cyber space, people feel anonymous, so they often say or do things they might not ordinarily. Kids can post something about someone or put up demeaning photos of another person without feeling much responsibility for their actions. Plus, because the trauma is done online, they don’t actually see how their attacks hurt the targeted child, so they don’t feel the same guilt that they might if they bullied in person.

How To Prevent Online Bullying

StopBullying.gov lists the following warning signs that could indicate that your child is either being cyberbullied or is bullying someone else:

  • Noticeable increases or decreases in device use, including texting.
  • A child exhibits emotional responses (laughter, anger, upset) to what is happening on their device.
  • A child hides their screen or device when others are near, and avoids discussion about what they are doing on their device.
  • Social media accounts are shut down or new ones appear.
  • A child starts to avoid social situations, even those that were enjoyed in the past.
  • A child becomes withdrawn or depressed, or loses interest in people and activities.

For Parents

To prevent or stop online bullying, if you notice changes in your child’s behavior, try to:

  • Determine if it happens after they have been online.
  • Talk to your child about what might be going on. Ask who is doing the bullying and what they are doing. Is there anyone else involved?
  • Document the bullying by noting the time and social media platform or email. Also, take a screenshot of the content or the post(s) for proof.
  • If a classmate is bullying your child online, report it to the school. You should also report it to the social media platform or app. If your child has been threatened with physical harm, report it to the police.
  • If it isn’t your child who is being bullied, reach out to the person who is the target, if at all possible. Tell them you are concerned and offer your support.
  • It can sometimes be helpful to post positive comments to try to shift the dialog away from the negative, however this should be done with caution. You don’t want your comments to further inflame the bully.

For Teens And Adolescents

  • Don’t respond to comments or try to get back at the bully. They are looking to get a response from you because that gives them power.
  • Know that it isn’t your fault you were targeted and you don’t deserve to be treated that way.
  • Take screenshots of the bullying posts or content whenever possible and save them in case the intimidation gets worse. This way, you have proof of what has been happening.
  • If you are being threatened with physical violence, tell the police and your parents, as well as the school authorities.
  • Talk to your parents, school counselor, or a trusted relative or other adult. They can help you take the steps you need to stop the abusive behavior.
  • Block the person from your apps, social media, email, etc. Never tell others your passwords (even your best friend!) and protect your phone with a password or fingerprint.
  • If your friend is being bullied, don’t just stand by and do nothing or the bully will be empowered. Instead, stand up for your friend.
  • Never pass along negative content or messages – even if the person being bullied is not your friend.

Help For Depression And Anxiety After Online Bullying

Cyberbullying can cause depression, anxiety, PTSD and other concerns for the child who is targeted. We can help your teen or adolescent handle their emotions and the way they manage online bullies. Talk with a compassionate child psychologist at the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us or call us today for more information at (561) 223-6568.

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What Type Of School Is Best For My Child?

When you are a parent, you always want what’s best for your child. This leads to seemingly millions of dilemmas over the course of the child’s life and one of the biggest is trying to figure out what type of school is best for them.

Nowadays, parents have many different choices in education for their children. One child may do well in a traditional public school, while another might excel if they are in a gifted program or in one that offers academics geared more towards the child’s interests, such as a STEM school. But, how do you know which is the right environment for your child’s specific needs?

What Are The Different Types Of Schools?

There are several types of schools, each featuring a certain learning structure. Parents must decide between public schools and private, as well as charter, choice, gifted, cluster, magnet, lab schools, and homeschooling. So, obviously, the first step in choosing a school is to understand what each type of school setting will offer children.

Public schools are located within a community and district. They generally must admit all students who live within the district. These schools get their operating money from local, state, and federal funding.

Most public schools are within or near neighborhoods. Sending your child to a public school makes it easy for them to get there and they usually will attend classes alongside friends from their area.

Some public schools are more specialized. For example, they might focus on certain subjects or be designed to help struggling students stay in school. An example is an alternative high school, which typically offers classes in a trade, such as hair styling or electrical work, to encourage teens to finish their education while getting early training in a career.

Charter schools are public schools with more autonomy than a traditional public school. They are run independently from the restrictions of a public school, so they can provide an intensive focus on a particular curriculum. One charter school might be geared toward college prep while another incorporates STEM components (science, technology, engineering and math) into each class.

Charter schools are held accountable to and operate under a contract (the “charter”) they have entered into with a charter school authorizer. These authorizers might be a university or college, a nonprofit organization, or may be part of a government agency.

Magnet schools (cluster schools) are also public schools. As with charter schools, magnet schools give students an education in a particular subject concentration (a cluster) of STEM subjects, languages, or the arts. Students who excel in science might want to go to a charter school that emphasizes science, for example.

Some magnet schools will accept any student who wishes to attend there, others may require the student pass a test or show they excel in a particular skill before they can be admitted.

Private schools

Private schools are not funded by state or federal tax dollars – instead, students must pay a tuition fee in order to attend. These schools typically provide religious-based educations, but some are secular. Private schools either offer focused programs or they educate children according to a specific teaching philosophy (example: a Montessori school).

Choice schools

School choice is found in public schools and has two forms:

  • Parents can request that their child go to a different school if the one the child would normally attend has been identified as needing restructuring, improvement, or corrective action, or
  • School choice programs can allow parents to place their child in another school within the district if there are other options available. Parents may want to move their child out of a low-performing school, for example.

If you wish to move your child through school choice, the U. S. Department of Education says, “Districts must pay for students’ transportation costs, giving priority to low-income, low-achieving students if there are not enough funds available to pay for all students.”

Gifted schools

All states offer some type of gifted-specific education. Some offer advanced classes, others provide for acceleration of the student’s grade or curriculum. Some states also have gifted high schools.

Lab schools

Generally operated by universities or colleges, lab schools provide a curriculum taught by teachers in training, under the guidance of the college’s education department. These schools offer a way for the educators to try out their methods and theories and give the student teachers a way to learn how to teach, firsthand.

Things To Consider When Choosing A School

There are many things to consider when choosing a school for your child. Obvious factors are your child’s needs and interests (i.e.: gifted, special education, or a particular focus, such as music or math), along with the school’s ability to provide the type of education you would like your child to have.

You also will want to think about:

  • Whether your child would do better in a smaller or larger class size.
  • Would they be better off in the same school as their friends?
  • The school’s resources, such as their music program, gifted classes, sports team, or clubs.
  • The distance to and from the school. How will your child get to school if it isn’t in the neighborhood? Is public transportation an option?
  • How many kids graduate from the school vs dropping out?
  • How much does the school cost? Are there fees for extracurricular programs?
  • If your child has additional needs (example: developmental delays), how well can the school support those needs?
  • Will you be expected to be involved in the school and how much participation is required?
  • Are there online homework and learning options?
  • If it is a high school choice, can your child earn college credit from the classes?
  • What is the student to teacher ratio?
  • What security measures does the school have in place?

It can help your decision to visit the school and take a tour. Is the school well maintained? Speak with some of the teachers to gauge their enthusiasm for working with the kids. Check out classrooms and watch how the students behave between classes or in the classroom.

Find Support When You Need It

Changing schools can be stressful for kids. Usually kids bounce back after a period of adjustment, but sometimes a big change can have a long lasting effect on a child. If your child is struggling in school, is anxious or sad, or has developed behavior that is concerning, they may have an undiagnosed learning disorder, depression, or other mood disorder.

Don’t ignore a problem – talk with a compassionate child psychologist at the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us or call us today for more information at (561) 223-6568.

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Supporting A Child Whose Parent Has Cancer

It is October – a time for pumpkins, Halloween…and breast cancer awareness. The numerous pink ribbons we’ll see this month focus attention on the many women (and men) who are facing a breast cancer diagnosis and treatment. But what about the kids who have a parent or primary caretaker with cancer? For a child, coping with a loved one’s diagnosis can be particularly traumatic.

In this article, we’ll answer your questions about the best ways to discuss a parent’s cancer diagnosis and give you some ideas for supporting a child whose parent has cancer.

Should I Use The Word “Cancer” When Talking To My Kids?

Absolutely – and this applies even to young children. Although your first instinct is to shield your child from a harsh reality, kids need to have open, honest conversations with their parents – no matter the prognosis. Imagine how much more upsetting it could be to know there is something wrong, but not knowing what it is.

When you first talk to your child about a cancer diagnosis, do it privately and be sure to set aside enough time to answer their questions. If you don’t know the answers, let them know that you will do some research and get back to them.

“The most important thing is to communicate openly, honestly and frequently,” say social workers, Wendy Griffith and April Greene, with the M. D. Anderson Cancer Center. “Children tend to think in very concrete terms and like to know what’s going on and what to expect.”

Keep in mind, too, that many people’s first reaction to a cancer diagnosis is the fear that the person will die. Children who are old enough to understand the concept of death will understandably be concerned about that possibility as well, even if they don’t ask.

Ms. Griffith and Ms. Greene recommend using “the 5 C’s” when you discuss a cancer diagnosis with your kids:

  • Say that it’s cancer.
  • Tell your kids, “You didn’t cause it. You can’t catch it. You can’t control it.”
  • Also, tell your kids that you can still spend quality time together, participate in care, still be a kid, have fun, etc.”

How To Talk To Kids About Cancer

When talking to children about cancer, consider the age of the child and keep it simple, but informative. Just lay out the facts:

  • Cancer affects cells – the tiny units that make up all living things. Each person has billions of cells in their body.
  • Usually, cells grow and divide. They are programmed to stop growing after a certain point and to eventually die.
  • In cancer cells, this normal progression gets interrupted and the cells do not stop growing and dividing. They also do not die.
  • These abnormal cells clump together to form a tumor. Tumors can kill the healthy cells around them, which makes the person sick.
  • Doctors aren’t sure why some people get cancer, although some unhealthy habits can make it easier for someone to get cancer. These include things like smoking or using tobacco products and drinking too much alcohol daily.
  • Cancer is not caused by germs and it isn’t contagious. It is okay to hug or kiss someone with cancer.

How To Explain Cancer Treatments To Children

When discussing cancer treatments with a child, gear your explanation to the child’s age level. Young children need to know the basics, while teens and tweens will likely want a more in-depth explanation:

  • Many cancers are treated with surgery. The surgeon will try to remove as much of the cancer as possible and the person will need some time to heal afterward. Let your child know that you can still hug and kiss them, and even play with them, but that they will have to be gentle around the surgery site and you may be limited in what you can do while you are recovering.
  • Often, chemotherapy (chemo) is used for cancer treatment. Chemo is specialized medicine that attacks and kills the cancer cells. Sometimes people take a chemotherapy pill, sometimes the chemo is given intravenously through an IV. Some people have a port put in under their skin to make it easier to get the IV form of chemo. A port is a small device that inserts into a large blood vessel in the chest – it will look like a big “bump” on the chest after it is implanted. The person will need to be careful and protect the port site. The port will be removed after chemo is finished.
  • Some people may get radiation treatment for their cancer. Radiation uses something like an xray to kill the cancer cells.
  • All of these treatments can make the cancer patient very tired and they may have trouble eating, might lose their hair, and may experience nausea and vomiting. This is all temporary and goes away after the treatment is finished.
  • During treatment, the person’s immune system will be very low, so they should stay away from the child if the child has a cold. If the person does get sick, reassure the child that it isn’t their fault – it happened because the cancer treatment has weakened their body’s immune system.
  • After the cancer treatment is finished, the goal is to be in remission, which means there are no signs left of the cancer. The oncologist (cancer doctor) will do tests to see if the cancer is gone. If there is still some remaining, which sometimes happens, the doctor may give the person more chemo or radiation.

The National Cancer Institute has a free, comprehensive guide for teens whose parent or loved one is facing cancer. It is available in a PDF, a Kindle version, and ePub form and the information can be scaled down to help younger kids.

Coping When A Parent Has Cancer

Children will worry about their parent’s health and will also likely feel some resentment that life has upended for everyone. They may also feel guilty, sad, and angry.

To help your child cope:

  • Try to continue as normal a routine as possible while going through treatment.
  • Let them know that it is okay for them to talk to you and tell you about their feelings – both positive and negative.
  • Asking questions can help calm fears because, just like with adults, imaginations can sometimes get the best of us. Connecting with the parent through questions and discussions can help the child feel less alone.
  • For older children and teens, journaling can be a great outlet for their thoughts and feelings.
  • Getting together with friends and being active can help relieve stress. Encourage your child to continue doing the things they enjoy so they don’t feel guilty about having fun.
  • Let them know it is okay to talk to others about your diagnosis and treatment. They may feel more comfortable about sharing their fears and concerns with a close relative or friend.
  • Support groups can be very helpful for kids. They can share their feelings with peers and learn from those who are going through the same experience. There are online support groups or in-person groups. Often, the oncologist or the oncology social worker will have recommendations for local support groups.
  • Sometimes it isn’t enough for a child to talk to a parent, relative, or their peers. In this case, it may help to talk to a neutral person such as a guidance counselor, school nurse, or clergy person.
  • Watch for your teen’s risky behavior (smoking, drinking alcohol, sex or drugs). Sometimes teens turn to these activities in order to cope and you may need to seek outside help if it continues.
  • In some cases, psychosocial support may be needed from a mental health therapist, child psychologist, or other professional counselor.

Find Support At Our Children’s Center

If your child is struggling with the cancer diagnosis of a loved one, talk with a compassionate child psychologist at Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us or call us for more information at (561) 223-6568.

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First Day Jitters and Back To School Anxiety

For many kids, the end of summer and the beginning of school is something to look forward to, but for some, it can trigger a case of school anxiety. Children may be unwilling to get on the bus for the first day of classes or might cry when they talk about starting school.

There can be many reasons for this separation anxiety and the resulting back to school fears: a move to a new house, an attachment figure’s illness, or a friend who has moved away. Kids may also worry over how they will do in school or if they will make new friends.

School Anxiety Causes

One of the most common triggers for back to school anxiety is starting school for the first time. First of all, any separation from a parent can be scary, especially if the child is used to being at home all day with them. In addition, school days are very organized – the child has to adhere to a schedule and do tasks and lessons at prescribed times, and these set routines can add stress.

For teens and older children who have been in school before, back to school anxiety is often directly related to their worries about how well they will do in the upcoming school year. They may be concerned about having to answer questions in class or might fear being asked to read aloud in front of their peers. In some cases, a child may have been made fun of at school or might have been the target of a bully the previous year, so they feel anxious about the possibility of this happening again in the new school year.

Even teens who are starting college may have some school anxiety, despite the fact they want you to think they are above something so “childish”. Leaving home for the first time, not having their parent around to fall back on, and having to adjust to a new world can all be nerve-wracking for a teen.

Back To School Anxiety Symptoms

If your child is apprehensive the start of classes, they will show pretty obvious symptoms. Back to school anxiety is likely present if they have:

  • Nausea or stomachaches
  • Trembling
  • Fatigue
  • Headaches
  • A racing heartbeat
  • Need to use the bathroom more frequently

Some of the things you can do to help your child with school anxiety include:

  • Telling them you love them and that you will see them after school each day.
  • Role playing situations they may encounter so that they will be better able to deal with it if something happens.
  • Letting them know they are brave for going to school despite their fears. Tell them you are proud of them.
  • Reassuring the child that the first couple of days will be hard, but that things will be okay once they get settled in.
  • Visiting the new school with your child a few days before the start of classes, so they are somewhat acquainted with the building and their teacher.
  • Sticking to a familiar routine to make the child less anxious.
  • Talking about things that they can look forward to, both within and outside of school.

Coping With Parental Anxiety About A Child Starting School

We think of children as being the only ones who suffer from first day jitters, but many parents also have anxiety over the start of school. They’ve been their child’s protector, entertainer, and advocate all summer, so you would think these parents would be looking forward to getting a break.

Many parents actually dread seeing their kids head back to class, though, particularly those who have children starting kindergarten or whose teens are going off to college. Their worry over sending their “baby’ off to the unknown kicks in, leaving them with their own version of separation anxiety.

If this sounds like you, don’t feel alone. It is perfectly natural to be distressed over this milestone. Even so, here are some of the most common parental fears, along with ideas that can help reassure you that everything will be fine:

  • Fearing that the child will be scared. Sure, your child may be nervous, but seeing that you are worried can make them wonder if there is something to be afraid of. Instead, show your child that you are calm and excited for them to take this new step. Try to keep in mind that they will be so busy learning new things and making new friends that they will be distracted and less likely to be afraid once they get to school and begin their day.
  • Worrying that the child will get lost. After all, your kid is going off into to what seems like a huge building – how will they ever find their way around? Remember that schools deal with this all the time. They have teachers in place (especially during the first few days of school) to direct students to classrooms and to help them find the correct bus at the end of the day. For added reassurance, you can visit the school with your child a couple of days before classes start, when the teachers are getting their rooms ready. You both can meet their new teacher, plus you can tour the school to find their classroom, the bathroom, the lunch room, etc.
  • Fearing that the child will be bullied. Let’s face it, kids can be cruel, even starting at a young age. The best way to address your concerns to have a serious talk with your child. Let them know that it is not okay for someone to be mean. Try some role playing with your child so they can learn how to respond if another child isn’t nice to them. Teach them to walk away from the bully. Practice how they should tell a teacher or another adult about the situation.

If School Anxiety Symptoms Don’t Resolve

For most kids, the uncertainties surrounding the start of classes will fade away as they get used to the routine of a new school year. If these fears don’t go away within four weeks, however, or if your child has school anxiety that is inappropriate to their developmental level or age, they may really have school refusal.

School refusal is not an “actual” diagnosis, instead it is a result of the child or teen having a deeper issue, such as a separation anxiety disorder, panic disorder, post-traumatic stress disorder, or a social phobia.

If you think your child has developed a school phobia, it’s important to seek treatment as soon as possible. The longer their school refusal continues, the harder it can be to treat.

We Can Help

To get help for your child’s school anxiety or school refusal, talk with a compassionate child psychologist at Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us or call us for more information at (561) 223-6568.

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Counseling Adults with Autism

Our very own Dr. Ali Cunningham recently released a book, Counseling Adults with Autism. The cover art for the book was produced by a local man with autism, Michael Vidal (pictured here with Dr. Cunningham).

Counseling Adults with Autism is a practical guide for counselors, psychologists, and other mental health professionals looking to improve their confidence and competence in counseling adults diagnosed with mild to moderate autism spectrum disorder (ASD). Organized into 11 chapters based on key areas for guiding assessment and treatment planning for this population, this book highlights evidence-based practices and therapeutic interventions through case examples to demonstrate how assessment and treatment can be applied. Replete with insights from a variety of disciplinary approaches, this is a comprehensive and accessible resource for practitioners looking to support and empower clients struggling with social and behavioral challenges. Buy the book here.

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Social Skills Training can help children and young adults connect with other.

Social Anxiety In Toddlers

Toddlerhood is defined as the age range from 12 to 36 months. During this period, a child’s emotional and cognitive development grows by leaps and bounds, as do their social skills. This also coincides with the time when children are likely to go into a daycare environment or head off to preschool. As they engage more often with other children and adults, it may also be the stage when a toddler’s social fears begin to emerge.

Just as with adults, some children are comfortable with social interactions while others may not be. Each group of kids will have the social butterfly as well as the “shy” child who quietly observes and doesn’t interact as much. It is one thing to be shy, however, and another to be intensely fearful and anxious in a social setting. Because we know it can show up early in life, a toddler who shows such strong reactions in a social environment is often regarded as having social anxiety.

What causes social anxiety in toddlers?

We aren’t really sure what causes social anxiety in toddlers. Genetics likely plays a role, since it contributes to a child’s temperament and personality. We also know that some genetic traits can influence certain mental health conditions.

A toddler’s environment could also predispose them to social anxiety. For a young child who already has a higher genetic risk, living with trauma or a severe parenting style may be enough to initiate social anxiety.

Social anxiety may also be learned from a parent, according to a 2006 study by de Rosnay, et al. Their research focused on indirect expressions of a mother’s social anxiety on their infant. The results showed that, “compared to their responses following their mothers interacting normally with a stranger, following a socially anxious mother-stranger interaction, infants were significantly more fearful and avoidant with the stranger. Infant-stranger avoidance was further modified by infant temperament; high fear infants were more avoidant in the socially anxious condition than low-fear infants.”

Is Social Anxiety a form of autism?

Studies have shown that social anxiety is not a form of autism, although the two have overlapping indicators, such as separation anxiety and avoiding eye contact. In fact, not only are they two distinct disorders, but the symptoms and diagnostic criteria for each are vastly different.

As the name implies, social anxiety is driven by anxiety. A child who has social anxiety will function within the parameters of their level of unease. For instance, they may simply keep to themselves, avoid other children, or might talk too quietly. Some kids may not talk at all.

On the other hand, a child with autism spectrum disorder doesn’t behave based on their anxiety level. Instead, this child has trouble understanding social cues and the nuances of communication. They might speak too loudly, may push their way into a group of children, or might misinterpret facial expressions or gestures.

Does my kid have social anxiety?

Children who have social anxiety may be branded as difficult kids because their anxiety can show up in forms other than just in social interactions.

Toddlers with social anxiety often show certain signs, such as:

  • Being a picky eater
  • Easily startled by noises
  • Not adapting well to new situations
  • May have a higher sensitivity to tactile sensations
  • Acting shy around new people and fearing strangers
  • Disliking being separated from their parents (separation anxiety) and distraction doesn’t calm them
  • Having strong emotional reactions and difficulty self-soothing
  • Might have sleep issues
  • Seems afraid to interact with peers, both individually or in a group setting
  • Often has other phobias or fears

Therapists who specialize in treating children’s mental health concerns can do an assessment, however a definitive diagnosis in a toddler with social anxiety may not be feasible due to their young age. The results should highlight challenging areas, though. It may also reveal the basis of the child’s social anxiety, which allows for early intervention.

How to help a child with social anxiety

At home, parents can demonstrate healthy social interactions when their child is with them, so the toddler learns not to be so fearful.

They can also rehearse a new situation with their child before it comes up. For example, a toddler who will be going to daycare for the first time might role-play some of the things they’ll do while they are there. Practicing certain aspects of the day or even dropping by the daycare a couple of times before officially attending can ease fears because the daycare will already be familiar. It would also be helpful to let the teachers or caregivers know about your child’s fears, so they can help build confidence.

Other supportive methods include:

  • Encouraging your toddler, but not forcing them into social interactions.
  • Using praise when the child successfully navigates a scary situation.
  • Not criticizing them for their fears.
  • Being calm and showing the toddler that you are confident.
  • Not being overprotective, which only reinforces the idea that the toddler has something to be afraid of.
  • Reading books or watching videos that show confident children.

Get Help for Social Anxiety in Toddlers

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. Additionally, our facility is the South Florida regional clinic for the National Social Anxiety Center (NSAC).

For more information about how our child psychologist can help your child with their social anxiety or other mental health needs, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

References

  1. de Rosnay, M., Cooper, P. J., Tsigaras, N., & Murray, L., (2006). Transmission of social anxiety from mother to infant: An experimental study using a social referencing paradigm. Behaviour Research and Therapy, 8(44), 1165-1175. Doi: https://doi.org/10.1016/j.brat.2005.09.003
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Autism Spectrum Disorder: ASD And Anxiety In Children

Autism Spectrum Disorder (ASD) comes with a variety of challenges. For many children, it can mean issues with compulsiveness and repetitive behaviors, learning and social deficits, and a resistance to change. ASD also can manifest with various emotional difficulties – although not specifically linked, we know that ASD and anxiety frequently appear together in children.

Kids with ASD and anxiety can have physical symptoms (example: racing heart or a stomach ache) or their anxiety may also show up in the form of rituals that can help calm them (for instance: shredding paper). Because many autistic children are either non-verbal or have trouble communicating, an outward display of anxiety may be their only way of telling you that they are distressed.

Autism And Anxiety Comorbidity

“40% of young people with ASD have clinically elevated levels of anxiety or at least one anxiety disorder, including obsessive compulsive disorder”, according to an article by Dr. Elisabetta Burchi and Dr. Eric Hollander of the Autism and Obsessive Compulsive Spectrum Program at Montefiore Medical Center and the Albert Einstein College of Medicine.

They stress the importance of anxiety treatment for children with autism spectrum disorder. “While untreated comorbid anxiety has been associated with the development of depression, aggression, and self-injury in ASD, an early recognition and treatment may convey better prognosis for these patients“.

Some studies have shown that high-functioning children suffer from more anxiety disorders than do lower functioning children on the spectrum. Additionally, other research reports that adolescents and teens with ASD may be more challenged by anxiety than their younger peers.

How To Recognize Anxiety In Asperger’s and ASD

It can be difficult to spot the signs of anxiety in a child who has ASD for a couple of reasons: kids who are verbal may not be able to recognize and express their emotions, while children who are nonverbal can’t tell you that they are afraid or worried.

Also, children with ASD often display common behaviors that can look similar to those found in anxiety disorders. For example, the compulsions that are carried out in obsessive compulsive disorder can look much like the repetitive behaviors that a child with ASD will use, however the autistic child may not actually be anxious.

Although there are no specifics to watch for, anxiety often presents in the form of physical or behavioral issues. The signs may not be apparent in a younger child, but may show up in later years as they mature and their world expands to include school and other settings.

  • Social anxiety may show up in the form of avoidance of social situations. This keeps the child from experiencing interaction with peers and the opportunity to practice social skills.
  • Separation anxiety may be present if the child acts out when being parted from their parent, such as when a babysitter comes to the home or when the child goes off to school for the first time.
  • Phobias are anxiety responses to specific fears (i.e. fear of insects or acting out after being startled by a loud noise).
  • Distress about changes in routine can show up in the form of physical rituals or repetitive behaviors that the child uses to soothe themselves until they can calm down.
  • Controlling behavior or threats to hurt themselves or someone else are often a sign of high levels of emotional distress.
  • In adolescents and teens, alcohol and drug abuse are destructive coping methods that may be used to mask anxiety.

Treatment For Autism And Anxiety

Research has shown that behavioral interventions are helpful for many ASD children who have anxiety. One of the most effect therapies for treating autism and anxiety is cognitive behavioral therapy (CBT). This therapy is best for a child who has some verbal abilities.

CBT teaches kids how to uncover the fear beneath their anxiety so they can challenge their negative or inaccurate thoughts. For instance, if a child has anxiety about going to school, they may actually be afraid of getting lost and not being able to find their parents again.

Once the fear has been identified, the therapist can use small doses of exposure therapy to provide the child with evidence that they are safe. In the case of school anxiety and the resulting fears surrounding being separated from a parent, exposure therapy might involve having the child spend a minute or two in a room without their parent. When mom or dad come back in, the child feels safe. As the length of time apart from their parent increases with an end result of the parents returning, the child’s anxiety level can begin to decrease when they are away from the parent in other situations.

Depending on the child, an anxiety medication, such as a selective serotonin reuptake inhibitor (SSRI) like Prozac, may also be used in combination with behavioral therapy.

Need More Information About ASD And Anxiety In Children?

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 child psychologist can help your child with their ASD and anxiety, 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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Intensive Outpatient Therapy Helps Children With Depression And Anxiety

We all have our anxious moments or times when we are depressed. It’s normal to feel these emotions when we are in stressful situations. In children, anxiety and depression can manifest differently than it does in adults. We often see more dramatic signs of frustration, irritability, and even anger. Kids might be restless, withdraw socially, or lose their appetite.

Usually these conditions go away once conditions improve. For many children, however, anxiety or depression can drag on and on. It may get worse over time and might even start to interfere with their school life, social relationships, or daily activities. When it reaches this point, it is likely that the child has an anxiety or mood disorder that requires treatment from a child psychologist. Be assured that these conditions are highly treatable.

Traditionally, children who are undergoing treatment for anxiety or depression will see their therapist once or twice a week for 30-60 minute sessions. These sessions often continue for three to four months, but could go on much longer depending on the severity of the child’s disorder. However, a relatively new concept in psychotherapy, called intensive outpatient therapy, is showing promise for helping kids get better faster.

What Is Intensive Outpatient Therapy?

Intensive outpatient therapy is focused therapy that is given over longer treatment sessions. For example, intensive treatment might be concentrated into daily, three-hour sessions given five days in a row over a two to four week period.

Just as with a regular psychotherapy session, intensive treatment uses methods like cognitive behavior therapy CBT, mindfulness, and exposure response and prevention (ERP). The idea behind the intensive sessions is to teach strategies to decrease the child’s symptoms and provide support, but to do it within a framework that allows them to live at home and continue school and family activities.

An intensive outpatient therapy program includes:

  • Comprehensive treatment planning
  • Learning to recognize unhealthy behaviors
  • Building successful problem solving abilities
  • Learning coping strategies and skills
  • Methods and practice to aid in asking for and getting support
  • Follow up sessions to reinforce these new skills

Although intensive therapy is fairly new, research is showing that it is just as beneficial as long term therapy or in-patient centered therapy. A 2012 study of adults by Ritschel, Cheavens, and Nelson at the Emory University School of Medicine reported that, “Depression and anxiety scores decreased significantly and hope scores increased significantly over the course of treatment.“

Children who have anxiety and depression make similar advances when they undergo intensive outpatient therapy. These gains are long-lasting, just as they are for traditional treatment.

Intensive therapy involves parents as well as children. During treatment, family meetings are held so that parents can better understand the therapy process and learn how to best support their child.

Additionally, children may interact with other kids so they can see that others are going through similar challenges. This is also an opportunity for them to relate to children their own age in a way they may not be able to with their peers or siblings who don’t face the same concerns.

If you are looking for an intensive program for your child, be sure that whichever one you choose utilizes therapists who have been highly trained in treating anxiety and depression in children and teens.

Also, you want the program to be individualized to your child. They should feel a connection with the therapist. The therapist should work with your child to develop a plan specifically for their needs in order to maximize the outcome of their treatment.

Who Would Benefit From Intensive Outpatient Therapy?

Sometimes a child struggles with depression or anxiety symptoms while still being able to function in their daily life. At other times, they may need more focused therapy and support. Intensive outpatient treatment would work for both children. Intensive therapy can also provide rapid and effective management in someone with severe symptoms who has taken time away from school for their recovery.

To be most effective, children who participate in intensive therapy should:

  • Attend every session. This can be difficult if they are having bad days, but they will get the most benefit by coming to every appointment.
  • Allow themselves time to process what they are learning.
  • Treat themselves gently while they learn that it’s okay to make mistakes
  • Trust in the therapy and therapist.

Learning coping skills and effective management of symptoms may continue on and off during a child’s life. Sometimes kids need a “booster” even after intensive therapy, but trusting that the psychotherapists and treatment will help can aid in quickly reducing and managing moderate to severe anxiety and depression.

Learn More About Our Upcoming Intensive Outpatient Therapy Sessions For Children – Starting Soon!

For more information about our upcoming intensive outpatient therapy sessions for children and teens, talk to the professionals at the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us or call us today at (561) 223-6568.

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