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Autism Spectrum Disorder (ASD) Parenting

When my son was diagnosed with ADHD, I thought, as a psychologist, I was prepared for the continuing challenges of parenting. But I was wrong. All my knowledge went out the window as I attempted to plead, cajole, beg, bribe, yell my way through parenting my son.  Those early childhood years of his life were increasingly tough. There were many moments I wished that there could have been a support group, a therapist, someone, who knew what I was going through. So that all of these increasingly difficult behaviors weren’t on mine and my husband’s shoulders alone. We were very lucky. We had friends and family, and a WONDERFUL therapist who helped us through it all. And even with all the support, we felt isolated from our parent-peers.  There are many parents out there who don’t have the support base we had. And it’s not just parents of children with ADHD that experience this burn out. One population of parents in particular has an exceptionally high rate of anxiety and depression. Parents and primary caregivers of children with Autism Spectrum Disorder (ASD) have significantly high rates of depression and anxiety (50% and 40% respectively).  Despite this, very few seek treatment for themselves. We know that if treatment is received, we can decrease these rates of anxiety and depression, thereby increasing satisfaction and effective parenting techniques, and decreasing alienation and loneliness. A recent study by Lushin and O’Brien (2016) has found that using the Early Intervention Program to provide treatment to parents, either in a home-based or clinic-based setting (where their child receives services) helps reduce the symptoms and severity of the depression and anxiety related to parenting s child with ASD. Receiving treatment for their depression and anxiety helps them parent effectively, which in turn helps their children. The Early Intervention Program seems like a perfect vehicle to provide these services. And we know that the early the effective services are provided to the child (and that includes appropriate parenting), the better the child is in the long term. And the better we all are. Lushin, V., & O’Brien, K.H. (2016) Parental Mental Health: Addressing the unmet needs of caregivers for children with autism spectrum disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 55, 1013-1015. http://dx.doi.org/10.1016/j.jaac.2016.09.507

OCD and Sensory Overresponsivity in Children

Many of us can walk into a familiar room and get a sense if something is out of place or moved around, or “not quite right.”   We can handle that.  We shrug our shoulders and think, “it’s not a big deal,” and we continue on with our day.  But what if you can’t? When obsessions (ideas or thoughts that continually preoccupy or intrude in one’s thoughts) and compulsions (irresistible urges to behave in a certain way, even if you don’t want to) interfere with daily functioning, it’s called Obsessive Compulsive Disorder (OCD).  Sometimes, the compulsions associated with OCD are driven by the thoughts, or obsessions. But sometimes, especially with some children, the compulsions are driven by that sensory experience of things “not being quite right.” Sensory overresponsivity is often seen in children who have an Autism Spectrum Disorder, and issues with anxiety.  Research is now showing that some children with OCD also exhibit sensory overresponsivity, and that it leads to a significant impairment in functioning. In the latest study by Lewin, Wu, Murphy, and Storch (2015) as much as one third of children diagnosed with OCD have sensory overresponsiveness, which is higher than the general pediatric population. This overresponsivity is more common among preschoolers as well and children who are also depressed, have disruptive behaviors, and ADHD. They found that the sensory overresponsivity was related to compulsion (doing) severity, not obsession (thinking) severity.  Children who had higher the sensory overresponsivity, suffered from a higher global OCD and impairment. As might be expected, the highest levels of sensory overresponsivity were found in children who had contamination obsessions, eating compulsions, and symmetry compulsions. Sometimes that feeling of “just not quite right” can stop us from getting on with our day. We can’t be the best “we” until everything is “perfect.”  But it never is.  Knowing where these feeling are coming from, with regard to OCD, can help us understand and treat it better.

Exercise and Your Child

Remembering back to one hot spring day years ago, as siblings often do, my first and third son were just at each other; screaming, yelling, possibly trying to pull the other one’s hair out. And I had had enough. The lawn was a mess. It was a beautiful day. I screamed for everyone to go outside and start pulling up every weed that I could see. And three hours later, we had a beautiful lawn and garden. More importantly, my son’s behavior was impeccable for days. He was polite. He sat when appropriate. He was kind. He got along better with everyone. This lasted for about three days. Then everything went back to normal. Sigh. What is it about sweaty and sustained activities that changes these children? There is a plethora of scholarly articles that talk about how various parts of the brain are “rewired” temporarily through exercise. There are probably even more anecdotal stories you will hear about how this person’s life changed when they began to, say, play soccer. While there’s a lot of neurochemistry involved, here’s a simple analogy to understand how learning works with kids, especially those who have ADHD. Imagine you ride a bicycle through dry dirt which is hard and packed solid.  Regardless of how often you ride the same path, you probably won’t make a significant dent.  Now, try riding the same path after it has rained. The ground is wet and muddy. The more you ride in that same path, the deeper the trench you make with your tires. Even when it dries, that trench will still be there for a bit.  After a while, sure, it dries out and you have to start again. But riding over that same area, again and again, over years, creates a deep groove in the ground, and that’s the path your bicycle will naturally want to follow. This is how children learn. And the more they exercise, the more they are able to pick up on appropriate social cues and provide appropriate responses.  By being rewarded, even by the simple fact of feeling good because they aren’t being yelled at, the more likely they are to do that behavior again. These kids need a little more help to understand how they should behave. Exercise helps them read the social cues being thrown out all around them. The more they exercise, the more they are able to read the social cues. The more they practice that behavior, the more reinforced that behavior is. In the long run, children who regularly exercise will not only develop a love for it, but will have the tools to help them relieve and cope with stress.  Ultimately, it is a wonderful way to help them learn how to be able to learn.

Top Three Tips to Help Your Child Build Better Friendships

As parents, we want the best for our children. We want the best education, the best toys, the best friends etc. However, what happens when we can’t give them that, when we can’t dictate their friendships or even help our kids to keep their friendships healthy and thriving? It’s the hardest thing to watch your child try and fail, or not try at all. Yet, there are things you can do and ways to help your child succeed in their friendships. I hope my top three tips prove useful to you and your child. 1. Check your ego at the proverbial door. It’s not about you. Sometimes we want our children to like whom we like, or be friends with the type of kids we weren’t able to build friendships with when we were younger. This isn’t about that, after all, they have their own needs and wants. Our job is to steer them into making healthy decisions. They don’t need to gravitate to the richest or the most popular kids, and that’s hard for some parents to understand. True, healthy, thriving friendships should always be the goal that every parent seeks for their child. Sometimes our children choose to engage in friendships that we think are not the best options for them. Step back, encourage and support them; let them know that you’re there. The friendship may continue for a long time or it may abruptly fail. It will be difficult to see your child hurt but this real life experience helps them learn best. As long as they are safe, let them engage in that opportunity to gain experience and learn more about healthy friendships with the group they have chosen to be with. 2. Find their group where they are at. If your child gets along better with younger children, so be it. The friendship skills are similar. Getting them comfortable in their own skin, with their own developmental peers, is more important. Remember, it’s best for your child to have one or two good friends than to continually try to break into many other unhealthy friendship groups. 3. Find their passion. This is often harder, because it may change monthly, or daily. So don’t go spending tons of money on hockey equipment at first, try to rent or find some used. Expose your kids to many different types of activities and know that something will stick. It may not happen today, it may not happen in a year and that’s ok. The more exposure to various activities, the better rounded your child will become. The wonderful added bonus in this approach is that it gives your child even more exposure to different peer groups and a greater chance for them to find their niche. Remember, above all, a calm, loving and supportive parent is most important. Everything else will come in time.

Top Four Tips to Combat Loneliness for Parents of Children with ADHD/ODD

I remember the first time a parent said to me “Your son is too violent. I hope you understand. I don’t want my son to get hurt. I can’t let him play with your son.” I remember being devastated and feeling so alone. If you’ve ever been in a similar situation, I bet you’ve asked yourself questions like, ‘how do you find yourself again? How do you find a group, who loves you and understand you AND your child?’ Here are four tips to help you navigate through this difficult time. 1. Smile. Through the tears, through the feelings of sadness, hurt and anger. Just smile. When you look happy, you are more approachable to other people. And when your child looks back at you and sees you smile, they will be more assured and calmer. 2. Go out. Put yourself out there. No one is going to come to your door and making you leave your bed, house or den. That might mean going to a coffee shop, a painting night, joining a book club or any other fun event. The point is, to get yourself out there and connect with others. 3. Take an exercise class. It’ll have a dual effect of pumping your endorphins and making you feel better and meeting people who are also happy. You will be involved in a group activity that gives you a common goal, and a common topic to talk about and do together. 4. Find your “like”. Join a support group. There are other parents out there who have children similar to yours and they will have a wealth of understanding for you and your child. It’s tough now, it feels unfair, unjustified, not right, but your child will grow up. While you’re on your journey of raising your child, put yourself out there and you will find people who understand that your child’s behavior is not your own, they will see that you’re doing your very best and they will be a blessing to you and your child just like you will be a blessing to them.

Dr. Deena: Interviewed on "Psyched Up" with Dr. Howard Gurr

Dr. Deena Abbe PhD, a leading clinical psychologist specializing in infant and children, was recently invited to talk to Dr. Howard Gurr, the host of Suffolk County Psychological Association's videocast "Psyched Up" about therapy with children. Dr. Deena’s areas of expertise include ADHD, Tourette’s Syndrome, Autism, Social Phobias, and Aggression in children. She is currently affiliated with O’Connell, Selig and Associates, Island Therapies, and other Long Island Early Intervention agencies.

Mental Health Blog Day – May 20th

Today is Mental Health Blog Day and I remember when my son was first officially diagnosed with ADHD, he was about 6 years old. Kindergarten. Hmm…. How to explain to him, “Yeah! You were diagnosed with a neurological disorder that makes you move, and fidget, and call out, and have some social issues with your peers!” No matter how smart he was, that wouldn’t go over well. So I started thinking; in life, everyone has something. Some people are good at sports, but not a reading. Some people have difficulty letting go of their blankie. Sometimes, people’s strengths and weaknesses don’t have a name: they are just a group of behaviors, while sometimes if we’re lucky, those groups of behaviors have a label. That’s good; in many cases that means that there are many other people who also have those behaviors and we may know how to help. Many times, when we give something a label or a name, it means that it’s real. It validates the experience. So that’s what I did for my son. What’s good about this approach is that it normalizes the experience for kids. It also gives parents much needed perspective. ADHD isn’t a bad thing. It’s just a thing…and everyone has to deal with something. Feel free to read more of my blog posts here: Long Island Child Psych Blog. Remember, don’t be ashamed of your story; it will inspire others. It’s time to think outside of the stigma. Today is the day: #mhblogday

How to Choose a Summer Camp for Your Child

In our minds, summer is usually the time to break loose. Our kids get excited about having no more rules, no more books, riding around the neighborhood with their friends. However, let’s take the time to imagine if summer wasn’t that carefree. Our kids know the rules in school, they know where to sit, who to talk to and how to play. Yet, in the summer those rules don’t apply. It’s as though they are thrust into a world they aren’t yet ready for. They have a bundle of energy, they want to play but they don’t know how. For a child encountering these feelings, summer can be really stressful for them. Enter summer camp! It provides a structured environment that is wholly centered on fun. Like school, it clearly defines how to have fun, when to have fun and with whom. The right camp provides a structured, active environment that can help your child blossom and learn to have fun with their friends, whether they have ADHD or not. Now that we’ve established camp can be a lifesaver for you and your child, here are some tips on choosing the right summer camp for your little one(s). 1. Ask. The most important thing you can do is, ask your child. They go to school and try to listen/follow the rules all year long. This is the time to listen and find out what activities they enjoy? Do they want to meet new people or go to camp with familiar faces? If they are involved in the process of choosing a camp, they are more likely to enjoy their summer. Ask their teachers and school staff as well. They know your child and have a different opinion on how they interact with others at school. Remember to keep this information in mind when you are choosing a summer program. 2. Staff. There are a few important things you want to look for in a camp. The smaller the camper the counselor ratio, the more supervision there will be. Imagine everyone is off playing basketball and your child doesn’t want to. A small camper to counselor ratio will allow someone to take a walk with your child, cool them off, and maybe even tutor them on the game while sitting on the sidelines. This approach is wonderful because it doesn’t stress out the rest of the group or embarrass your child. This experience really happened with my son and it was the best solution possible!
You also want to know the age of the counselors and their training. You might choose to pay more for a camp where every counselor is a teacher, as opposed to a teenager but you know they have more patience and training to work with your particular child. You also want to know how many nurses are on staff. This is important if your child is going to be receiving medication. It’s reassuring to know that someone is on staff that can either administer the medicine or keep a trained eye on your child to make sure no adverse reactions occur in the hot sun while they are running around. 3. Activities. In this day and age, many kids want to spend the summer glued to an electronic device. Don’t let them. The more physical activities they are involved in, the better and happier they will be. This is true of all children, but especially those with ADHD. There’s something to be said about being outside, running around in the fresh air. There are tons of studies that say that one of the most effective treatments for ADHD. Outdoor exercise is highly beneficial, so look for a camp that provides outside activities, shade and access to water and hydration. On the flip side, you want to know that if it rains the fun doesn’t stop. A good camp will have an organized rainy day plan. 4. Types of Camp. There are camps that specialize in working with children who have been diagnosed with ADHD, learning disabilities, or Tourette’s Syndrome etc. These may be a great option for you. However, don’t rule out the local programs either. They may be just what your child needs. Remember, each camp is different, and each child is different. It may take some investigating, but there is a program out there to help your child have the best summer of their lives.

Ask Dr. Deena

Licensed clinical and school psychologist Dr. Deena Abbe has over a decade of experience successfully diagnosing, treating, and helping children and families live with ADHD/ADD, Autism, Depression, Anxiety, OCD, ODD, feeding concerns, and more. She has a thriving practice and is well-known for her sound and comprehensive mental health work. Dr. Abbe is a member of the New York State Psychological Association, Suffolk County Psychological Association, Association for Behavior and Cognitive Therapy, and American Psychological Association. For the next month leading up to National Children’s Mental Health Awareness Week, beginning on Sunday, May 3rd till Saturday May 9th, 2015, Dr. Abbe will be opening her social media pages for you to ask any mental health questions regarding children and youth. You can ask her your questions on Facebook, Twitter, the Long Island Child Psych website or via email. At the end of the month, Dr. Deena will choose a question and answer it in a vlog and post it on her social media sites during National Children’s Mental Health Awareness Week. Ask Dr. Deena your questions through any of these channels: Facebook: Long Island Child Psych
Twitter: Dr. Deena Abbe Twitter Page (Tweet questions: @DrDeenaAbbe and hashtag #AskDrDeena, or send Dr. Deena a direct message)
Website: Long Island Child Psych website
Email: deena@longislandchildpsych.com Dr. Deena wants to help your family be its best.
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