All Posts Tagged: the children’s center for psychiatry

kids at summer camp

More Pandemic Grief: No Summer Camp, Plus School At Home

We’ve hit midsummer and kids across the country have had to deal with the disappointment of canceled summer camps this year. Now, many school districts are making parents choose between virtual learning this fall or sending their children to school during a pandemic. Some school districts are going entirely virtual. Having to face more upheaval in a year of unprecedented changes has brought up grief and anxiety for both kids and parents. Yet, despite this turmoil, there are some good things that have come from the pandemic.

The Good – Some Pandemic Silver Linings

One of the most significant changes are the family ties that formed or remodeled after our hectic lives were halted. Parents and kids are spending more time together as a family because extracurricular activities aren’t taking precedence. Plus parents who are working from home have extra time to interact with their children since they don’t have to commute.

Just being able to play like children has been good for kids. Often their lives are structured from the time they awaken until they fall into bed at night, so being able to simply play has been good for developing their imagination, exploring their world, and just being a kid.

The Bad – Pandemic Grief And Anxiety

For many kids, having no summer camp has been very distressing. It’s something they look forward to –often, they have friends there that they don’t see for the rest of the year because they live in a different state. For teens who were anticipating becoming camp counselors or who were attending their final year of camp, not being able to go is beyond frustrating.

Furthermore, children haven’t seen most of their school friends in person for several months and are now being told they likely won’t see them this fall, either. In addition, when it comes to learning, many kids do better in a classroom environment where they can see examples and question the teacher directly, so it’s upsetting for them to know they will be stuck at home and struggling with virtual learning.

Parents faced similar emotions at the canceling of camp and the prospect of having their children home for at least some of the fall school semester. Along with having to figure out how to keep kids meaningfully entertained, they’re grieving the loss of their own couple’s trips and trying to navigate another semester of being involuntary teachers.

PTSD And Anxiety In Children During COVID-19

Just as with adults, the stress of life during coronavirus has dramatically altered children’s day-to-day world.

Natural disasters like a pandemic can have long term effects on kid’s emotional and mental health. In studies of children’s mental health after Hurricane Katrina, researcher Carolyn Kousky, reported that, “researchers found high rates of PTSD symptoms as well as other negative mental health impacts and behaviors, such as aggression in adolescent.” Furthermore, a 2013 study found that kids who had gone through a quarantine for disease control scored four times higher on a post-traumatic stress test than children who hadn’t been quarantined.

You can see why it is vital for parents and adult family members to help kids make sense of the pandemic, especially in an accurate way that minimizes their fears.

  • Be available to talk if they have questions (and be sure they know they can come to you).
  • Speak to your children in a calm voice. Try to be reassuring about their fears. Remember that kids can and do pick up on cues in your tone and body language.
  • Validate their feelings of loss and try to show empathy.
  • Try to reduce or limit news broadcasts and screen time so your child (or you!) doesn’t become overwhelmed by news coverage of the pandemic.
  • Try not to condemn or ridicule someone you know to your kids if they have been sick with the virus.
  • Remind kids that rumors run wild on social media. Many stories are inaccurate.

To avoid any long term consequences, it’s essential that parents take steps to address and reduce any COVID-19 anxiety their children may have. KidsHealth.org provides great resources for keeping kids busy during the pandemic and has some helpful ideas for addressing the topic with your child.

Helping Children With Anxiety

For more information about how our mental health professionals and child psychologists can help your child deal with anxiety about the pandemic, 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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teen wearing fack mask

Is The COVID-19 Pandemic Affecting Your Child’s Mental Health?

Schools have been closed for the last couple of months since the coronavirus pandemic began to spread across the country. Stories about the virus’ effects and death rates abound on the news and on social media. Usually, we wouldn’t expect children to be too affected by broadcasts about a new disease unless someone close to them gets sick. In this case, however, their lives have been upended by school closings, parents working from home (or losing their jobs), the requirement to shelter in place and wear masks, and the inability to gather with friends or go to familiar venues.

Children are also likely tapping into their parent’s own fears and concerns. In turn, they may worry that they, their friends, or their family will catch COVID-19. We can estimate how this affects American kids by reading through the studies that were done on children in China, where the outbreak began.

In an article on Psychology Today, Jamie D. Aten, Ph.D., founder and Executive Director of the Humanitarian Disaster Institute at Wheaton College, reports that, “due to uncertainties surrounding the outbreak and ongoing scientific research, it’s estimated that 220 million Chinese children are at a risk of facing mental health issues due to potential prolonged school closure and home containment.”

If this is true for the children in China, why would it be any different here for kids in the United States?

Why Kids Need Mental And Emotional Support During COVID-19

The stress and apprehension surrounding the coronavirus pandemic has altered children’s day-to-day world in a huge way. We know that natural disasters such as this can have a long term effect on kids, just as they can for adults.

As an example, one researcher, Carolyn Kousky, noted that in studies of children’s mental health after Hurricane Katrina, “researchers found high rates of PTSD symptoms as well as other negative mental health impacts and behaviors, such as aggression in adolescent.”

For older children, the added disappointments that have come along with the safer-at-home orders – such as the cancellation of graduations and proms, no school athletic games or activities, and isolation from friends – is sure to have emotional consequences, too.

In fact, it was reported in a 2013 study that researchers found that kids who had gone through a quarantine for disease control scored four times higher on a post-traumatic stress test than children who had not had that same experience.

How To Help Your Child Through Pandemic Anxiety

It’s important for parents and adult family members to help kids make sense of the pandemic, especially in an accurate way that minimizes their fears.

  • Let your child know that you are available to talk if they have questions.
  • When talking to your children, do so in a calm voice. Try to be reassuring and also remember that kids will pick up on cues in your body language and tone.
  • Consider reducing or limiting news broadcasts and screen time so your child doesn’t become overwhelmed by news coverage of the pandemic.
  • Remember that this pandemic can affect anyone, so try not to condemn or ridicule someone you know who may have contracted the virus.
  • Remind kids that rumors run rampant on social media and that many stories are inaccurate.

Teach your children how to stay safe during the pandemic (and afterward):

  • They should wash their hands with soap and water for at least 20 seconds (have them sing the birthday song twice as an easy way to count the time). They especially need to do this after sneezing, blowing their nose, or using the bathroom, and before eating or handling food. Hand sanitizer is a great option if soap and water are not available (supervise young children if they are using hand sanitizer).
  • If your child needs to sneeze or cough, they should do it into their elbow or a tissue (then throw the tissue in the trash).
  • Stay away from those who are sick or are sneezing or coughing.
  • Keep things that they touch clean. Wipe down frequently used objects such as doorknobs, light switches, the television remote, their phone or tablet frequently with a disinfectant to avoid spreading germs.

It’s important for parents to take steps to address and reduce any COVID-19 anxiety their children may have, so they can avoid any long term consequences. KidsHealth.org provides some great resources for keeping kids busy during the pandemic and offers some helpful hints for addressing the topic with your child.

Connect With A Child Psychologist At Our Children’s Center

If your child is experiencing anxiety related to the COVID-19 pandemic, our child psychologists are available for online services. 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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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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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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