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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.

Early Signs of Autism

Children are increasingly being diagnosed with Autism Spectrum Disorder (ASD) at higher  rates than previous years.  It can look different at different stages of life.  But what does it  look like preschoolers? Here are some behaviors to look out for.  Remember, if you are concerned, please  seek out an early childhood specialist, such as a psychologist, to get a clear diagnosis. Signs in Language Development
  • Young children are learning to talk. So they remember words, and then forget words. They make up words. This is typical. Some children who are suspected of having ASD have words, and then lose them.  But, they don’t regain those words. They may use language in their own way, such as calling a “cookie” a “coocoo.”  These children are resistant to changing their language.
  • Young children tend to repeat words just for the sake of repeating them. This, too, can be a normal part of language development. Children repeat words, as a way to grasp what the sounds are or how their mouth moves.  But children showing signs of having ASD have no obvious intention for repeating words.  For instance, they might hear someone say a phrase like “Do you want a cookie?” and repeat it over and over again.  They aren’t looking for a cookie; they are just repeating the phrases.
Social Cues Children with ASD often have poor eye contact.  Also, they often don’t respond when their name is called.  Their lack of response is not with a smirk or meant to give silent treatment.  There is simply just no response.  Many of these children also seem very independent. They don’t need your help because they do everything themselves. And when they can’t, they don’t ask for help; they may take your hand and use your finger to point or reach for what they want. At Play Play in early childhood develops at different rates. Some children like to play by themselves. As they get older they may choose to play near other kids, doing different or similar things. Only later do they play together, in a group, towards a common real or imagined goal.
  • Children with ASD tend to play by themselves, their own games, even when most of their other same-aged peers have moved on to a more parallel or cooperative play.
  • They may be interested in parts of a toy, playing with it in ways that are unintended, such as spinning the wheels of a truck over and over again. They may lay on their head, looking at the truck out of the side of their eye.
  • Their toys may have to be laid out in a certain manner, according to their own organizational rules. They may play with their hands or body in ways that other children don’t, such as flapping, rocking, moving their fingers near their eyes.
As with all other diagnoses, if you have concerns, seek out a trained medical professional.  A psychologist, who specializes in early childhood, can help determine what the concerns are, and how best to treat your child. Autism Spectrum Disorder is not the end of childhood, but these children have a much better prognosis if they receive treatment earlier rather than later.

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.

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.

Mommy/Daddy Guilt

There are so many things we want to pass along to our kids: love of music, love of sports, good work ethics, beautiful curls or blue eyes. Sometimes, our genetics adds little “bonuses” with our gifts, like ADHD. Or Celiac. Or any number of other genetic blips. It’s hard to parent a child in general, but adding the guilt on top of that makes it even more gut wrenching. I remember feeling terribly guilty that my son had ADHD. It’s because my husband has difficulty starting a project without being asked many times. It’s because I was bouncy and combative as a child. Maybe if we didn’t have so many kids. Maybe if we didn’t send him to school so early, or to camp. Maybe if I didn’t work. If I did ‘x’ differently, maybe then he’d be able to listen, and sit, and keep his hands to himself. I’m here to tell you that almost everyone feels some level of guilt. It’s normal to second guess yourself and your choices. But don’t let that overwhelm you or your ability to parent. It’s not anyone’s “fault”. It is what it is. It’s also important to know if you are consumed with guilt, or any sort of overwhelming emotion for that matter, you can’t parent effectively. Let’s play devils advocate. Let’s imagine, for example, that it is totally your fault. As in, you hand-picked these genetics to give to your child. You can get upset that you shouldn’t have done that and that you made a mistake. You want to wish it away but you can’t. Your child has green eyes and that’s it. However, if your child has diabetes or autism, your job changes; it gets more interesting.
How do you teach your children not to rail against their nature, but to embrace their strengths, their idiosyncrasies? It’s a tough job but you start with the fact that everyone has something that they come up against in life. It’s not that they have this, but how they handle it that makes them the person that they are. Who they are isn’t bad; each little negative has a flip side, a positive. Our job as parents is to find the positive and help them shine, even if our children can’t figure out how to do it for themselves yet. Feeling guilty comes with being a parent. You don’t want to hurt or disappoint your child, but no, they can’t have the $300 toy car. They will cry about it and you might feel bad. What makes you a good parent is the ability to know what is within your control, and what isn’t. The genes that are passed along to your child are not within your control, but how you love and live with your child is. That is what makes all the difference.
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