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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

Social Anxiety in Young Children

Sometimes, walking into kindergarten can be super scary; new children, new teacher, no mommy. It may take a few days or weeks for some children to warm up and be comfortable. Those who don’t warm up, who continue to cry and have difficulty adjusting to novel social situations may be suffering from Social Anxiety. Social Anxiety doesn’t end in kindergarten, but may continue throughout a person’s lifespan. In young children, parents and caregivers are more likely to schedule social interactions, which help young children become less socially anxious. A recent study by Hoff et al (2015) found that older children who suffered from social anxiety had greater difficulty in social, academic, and overall functioning as they aged, even when home and family problems decreased. Interestingly, these social and academic problems were greater among children who suffered from social anxiety than those who suffered from other types of anxiety. It’s possible that socially anxious adolescents are more able to avoid social situations, whereas younger children’s social calendar is controlled by their parents. Whatever the cause, early intervention for social anxiety might prevent socially anxious younger children from becoming socially anxious adolescents and adults. Hoff, A.L., Kendall, P.C., Langley, A., Ginsburg, G., Keeton, C., Compton, S., … Piacentini, J. (2015) Developmental differences in functioning in youth with social phobia. Journal of Clinical Child and Adolescent Psychology. http://dx.doi.org/10.1080/15374416.2015.1079779

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.

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.

TS, OCD and Exercise

Packer-Hopke, L. and Motta, R. A Preliminary Investigation of the Effects of Aerobic Exercise on Childhood Tourette’s Syndrome and OCD, the Behavior Therapist, October 2014 Tourette’s Syndrome (TS) is typically diagnosed in childhood. Motor and vocal tics are the hallmark of TS, but there is often the comorbidity of OCD and ADHD. Studies have shown that 12 weeks of moderately intense exercise three to four times a week can reduce OCD symptoms drastically (as measured by a well-known Obsessive Compulsive Scale—the Y-BOCS).
That being said, what about those children who have both OCD and TS? OCD is an anxiety disorder, and tics can be exacerbated by anxiety. Aerobic activity decreases anxiety and OCD symptoms. Packer-Hopke and Motta looked to see what effect aerobic activity had on tics and OCD symptoms in children who suffer from TS, OCD, and Anxiety. They found that kids who were engaged in six weeks of moderately intense exercise twice a week had a significant reduction in symptoms of both the TS and OCD, and a moderate to large reduction in symptoms of anxiety.
It’s hard to live with TS, let alone its “friends and neighbors “OCD, ADHD, and Anxiety. Wouldn’t it be nice to let these kids, “just be kids”, and in the process help them reduce their symptoms? This isn’t the full answer, but it’s certainly a start.
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