All Posts Tagged: palm beach county

Telehealth

A Message About Telehealth Amidst COVID-19

We hope that you, your children and families are doing well in the midst of this unprecedented time. After carefully considering the CDC guidelines, we at The Children’s Center have decided that we will no longer be conducting therapy in our office at this time.

In good news, we have the capability to conduct appointments either over the phone or via Telehealth. We are happy to keep all appointments during this time. If you already have a scheduled appointment but you would prefer to postpone your to a later date or an alternate time, we are happy to do that as well.

We greatly appreciate your understanding during this difficult time. Please do not hesitate to contact us with any questions or to schedule an appointment at (561) 223-6568.

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woman talking on a cell phone

How Being On Your Phone Affects Your Child

woman talking on a cell phoneWe are all so “connected” nowadays. Everywhere you look, you see people of all ages engrossed in the online world. Children are asking for cellphones at younger and younger ages, while parents often seem so attached to their devices that they barely pay attention to their children. This brings up the question of how being connected to your own phone and devices might be affecting your child.

A colleague recently told me what she had witnessed during her last dental visit: a father came in with two young children under the age of 6. All three of them were on their own devices (dad had a phone, each child had an iPad).

When the little boy was being examined, he was told he had his first loose tooth. The child was so excited and he kept exclaiming, “Daddy! Daddy, my tooth is loose!”

The father barely acknowledged this milestone, even after several attempts by his son to get his attention. Finally, although he did not even look up from his phone, he muttered, “Uh huh, that’s great.” My colleague’s heart broke when she saw how disappointed the little boy was with his father’s lack of response.

In effect, the father had just told his son that whatever he was looking at on his phone was much more important than his child.

Are Parents Addicted To Their Phones?

Several studies and many experts say the answer is “yes.”

A 2015 study done by the online security company, AVG Technologies, found that more than 50 percent of the children who took part in the research ”felt that their parents checked their devices too often (54 percent); and their biggest grievance, when given a list of possible, bad device habits, was that their parents allowed themselves to be distracted by their device during conversations (36 percent) – something that made a third of the complainants feel unimportant (32 percent).”

How does this affect a child’s development? Children learn things like social cues, how to regulate emotions, and how to have conversations by watching and copying their parents. If a parent is hardly interacting with their child, it stunts the child’s development in these social skills.

In a recent opinion article in USAToday, Theresa H. Rodgers, a speech-language pathologist and the 2020 president of the American Speech-Language-Hearing Association (ASHA), stated that, “Many of my colleagues across the nation say they are seeing more children entering kindergarten with limited communication and social skills. Older children, they say, are unable to handle formal social interactions, like ordering from waitstaff at a restaurant.”

What Are The Effects Of Cell Phones On Family Relationships?

According to an article on NPR, after watching a mother ignore her smiling, babbling infant in favor of viewing a YouTube video, Dr. Jenny Radesky, a pediatrician who specializes in child development, began to wonder about the effects of cell phones on family relationships. This led her to conduct a study (albeit an unscientific one) with the help of two colleagues over one summer. Together, they observed 55 family groups who were eating at fast food restaurants.

What they found was “forty of the 55 parents used a mobile device during the meal” and seemed to focus more on their devices than on their kids.

When children feel ignored, they often act out to get their parent’s attention. In her book about parenting, called The Big Disconnect: Protecting Childhood and Family Relationships in the Digital Age, psychologist Catherine Steiner-Adair talks about how parents who ignore their kids in favor of their devices are telling their children “they don’t matter, they’re not interesting to us, they’re not as compelling as anybody, anything, any ping that may interrupt our time with them.”

Further, when Dr. Steiner-Adair did the research for her book, she interviewed 1,000 children, ages 4- to 18-years old. She kept hearing from the kids that they felt “sad, mad, angry, and lonely” when their parents were on their cell phones. This was so upsetting to them that some kids made a point of hiding or damaging their parent’s smartphones.

Help For Parent’s Cellphone Addiction

It can be hard to break your dependence on screen time, even though it’s what is best for your children (and, frankly, yourself). Try these ideas:

  • Limit your use of your cell phone and devices to just 10 percent during the time you are with your child. You can dash off a quick text if it is important, but for the most part – put the phone away.
  • Keep bedrooms, mealtimes, and parent–child play times screen free for children and parents.
  • Use phone apps to remind you when it’s time to stop using the phone.
  • Turn off the majority of your notifications.
  • Delete or limit 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.

Contact Us To Learn More

For more information and help with breaking your cellphone addiction, 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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Overcontrol and social anxiety

What Is Overcontrol And Is It Contributing To Your Social Anxiety?

One of the most quickly growing areas of clinical research and treatment implementation is for people who are considered to be overcontrolled. What does being overcontrolled mean, and what does it have to do with feeling socially anxious? The concept of self-control refers to the ability to inhibit problematic behaviors. This is generally accepted by our society as a positive thing to have! It is true that to an extent, being overcontrolled can be very adaptive and helpful. Overcontrol is associated with the ability to delay gratification, follow rules, and valuing accuracy and fairness. However, when these traits are very pronounced and overemphasized, they can become problematic and affect our mental health. It’s like having too much of a good thing.

Social and Emotional Impact of Overcontrol

There are common difficulties with people who have maladaptive levels of overcontrol. The first is low receptivity and openness. This can result in avoidance (a hallmark of anxiety disorders) and an aversion to having new or novel experiences. Also, there tends to be a strong need for order, structure, and rules. There is a focus on right and wrong, which we know is not conducive for more flexible thinking (which is important for decreasing anxiety symptoms). The third feature is reduced emotional expression and emotional awareness. This means that people who are maladaptively overcontrolled may not display emotions that one would expect (having a flat face when someone tells a joke), making it difficult for others to feel connected to them. The final trait that tends to cause difficulties for people is feeling a lack of closeness to others, and/or feeling different from other people. Loneliness and isolation are often experiences of those who are overcontrolled.

 

Given these features, it is not uncommon for people with chronic social anxiety to also be overcontrolled. The reliance on emotional and situational avoidance makes it difficult for people to learn new things (challenging their social anxiety) and feel connected to others. Their difficulty in successfully social signaling to others often results in them being disliked or rejected (a self fulfilling prophecy). People who are more overcontrolled also tend to engage frequently in social comparisons, which is also frequently observed in the socially anxious population.

Learning to Open Up and Connect

The most effective treatment for disorders of overcontrol (which include chronic depression, treatment resistant anxiety, obsessive compulsive personality disorder, and anorexia nervosa) is called Radically Open Dialectical Behavior Therapy. It is a skills-based protocol to help people struggling with overcontrol to be more open to experiences, and more emotionally expressive in order to connect with others in a more meaningful way. We are a social species, and when we feel disconnected from others, this impacts our mental health. RO-DBT is conducted both individually and in thirty-week classes. For more information, check out www.radicallyopen.net.

How to Get Help for Social Anxiety

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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person typing on a laptop

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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marijuana plant

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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girl being bullied

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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young boy in school

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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pink ribbon for breast cancer

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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child crying

Hurricane Anxiety

This summer’s hurricane season was fairly quiet until Hurricane Dorian blew through offshore earlier this month. Then, Humberto threatened the South Florida area last week, putting everyone on high alert for the second time in less than a month. For some children, hearing about the devastation in the Bahamas, watching parents make storm preparations and evacuation plans, or knowing that there are other menacing storms out there can bring up hurricane anxiety.

Symptoms Of Hurricane Anxiety

While you are listening to updates and getting ready for an impending tropical storm or hurricane, don’t forget to talk with your child about their fears. If a storm is coming, they will likely be worried about their friends, their home and school, their pets, and all the disruption that a major storm can bring.

In addition, if they have ever been through a hurricane, they will remember the fear they felt while sitting in the dark, listening to the wind howl and feeling the house shake. After a terrifying experience like that, even hearing the pounding rain of a normal storm could bring up some post-traumatic stress for the child. This can be magnified by the act of going through preparations for another hurricane.

Children who have hurricane anxiety might show their fears in the form of physical or emotional symptoms, or both.

Physical symptoms include thing like:

  • Trembling
  • Having headaches
  • Saying that they feel dizzy or lightheaded
  • Stomach aches, vomiting, nausea
  • Experiencing nightmares, having trouble sleeping, or being afraid of the dark

Emotional symptoms can show up in the form of:

  • Being clingy or wanting to keep you or another caregiver in sight at all times
  • Crying or being overly whiny
  • Talking incessantly about what they experienced in a past storm
  • Being jumpy and on edge
  • Getting physically ill or acting distressed if they are being separated from their loved ones for any reason
  • Expressing fears about them or someone they love possible being harmed because of the storm
  • Being afraid to be in a room by themselves
  • Refusing to participate or avoiding taking part in activities that will keep them away from their parents or caregivers, even briefly

How To Help A Child Who Has Hurricane Anxiety

If your child shows a heightened level of concern or fear about storms, our child psychologist recommends that you:

  • Talk to your child about their fears and let them know that it is okay to be worried.
  • Talk positively about the preparations you will be making to keep them safe and where you all will go if you have to evacuate. If the child knows they will be in a safe place, it can help to reduce their anxiety.
  • Assist them in soothing their fears by letting them sleep with a favored stuffed animal or allowing them to keep a nightlight or hallway light on at night during a storm.
  • Help your child choose something to take with them just in case you do have to go to an evacuation shelter. For example, they can pack a backpack with toys, books and games, then keep it nearby so they feel more prepared for the storm.
  • Remind your child that hurricanes can and do routinely change course. Many times, the storm won’t impact your area, despite the warnings. We saw this when Hurricane Dorian skirted the shore of Florida instead of hitting the state directly as forecasters first thought would happen.
  • This should go without saying, but do not tell your child about any bad experiences you might have had during a hurricane or bad storm! There is no need to add to their fears.

Even though you talk to your child about the steps you are taking to keep them protected, their hurricane anxiety may still continue. If their stress level seems too high for the current situation, it is best to seek the help of a child psychologist.

These experts can help your child identify and change their anxious thoughts. Through role-play and modeling of positive behaviors, your child will learn coping strategies to lessen their fearful response to an approaching hurricane or other storm.

Talk With A Child Psychologist At Our Children’s Center

If your child seems unduly worried about storms or overly fearful when there is talk of a possible hurricane, it may be time to speak with a child psychologist. 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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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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