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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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Boy with heart shaped paper

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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Tips to Improve Your Child’s Executive Functioning Skills

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

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

Learning Tools for Executive Functioning

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

Some keys to building executive functioning abilities are:

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

Apps Turn Daily Routines into Fun Activities

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

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

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

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

Learn More about Giant Leap and Executive Functioning

For information about how our Giant Leap app can help your child improve their executive functioning skills, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

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Autistic Children Find Help through Virtual Reality Therapy

Autistic Children Find Help through Virtual Reality Therapy

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

How Does Virtual Reality Therapy Work?

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

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

How Can VR Therapy Help Autistic Children?

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

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

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

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

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

Need More Information about Autism and Virtual Reality Therapy?

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

For more information about how our skilled professional can use virtual reality therapy to help with your child’s autism, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

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