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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

Major Depressive Disorder in Young Children

What happens when being sad doesn’t go away? Or, what does it mean when a young child is jumpy, unfocused, sad, and angry, more often than not? When young children are diagnosed with Major Depressive Disorder (MDD) often medication and/or therapy are prescribed. Many times, despite our best efforts, children with MDD often relapse. A new study looked at children prescribed fluoxetine (Prozac) as well as relapse prevention cognitive behavioral therapy (CBT). Interestingly, regardless of whether children received relapse prevention treatment, 80% of them experienced remission; that means that 80% of children in the study got better! But there was a group of children who relapsed. Children in the fluoxetine and CBT relapse prevention group stayed mentally healthy more than three months longer than those just receiving medication. Booster CBT relapse prevention therapy, along with appropriate medication management, has been shown to be effective in helping children diagnosed with MDD. Reviewing mastered skills, before they are needed, can help prevent further relapse, and quicker recovery, so that kids can get back to being kids. Emslie, G.J., Kennard, B.D., Mayes, T.L., Nakonezny, P.A., Moore, J., Jones, J.M., … King, J. (2015). Continued effectiveness of relapse prevention cognitive-behavioral therapy following fluoxetine treatment in youth with major depressive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 54, 991-998. http://dx.doi.org/10.1016/j.jaac.2015.09.014

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.

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.
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