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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

Chocolate Chips

I just finished a bag of chocolate chips. To be fair, I had been slowly working through the bag for six months. But this morning, I finished the whole bag. By 9:30 in the morning. Getting all four kids off to school by myself wasn’t as difficult, or fraught with stress, as it could have been. But it’s wearing. And I know I’m not the only one. I’m not writing this to give myself, or you, a pep talk; I’m not looking for pity either. Just to say, sometimes, you have those days. Sometimes, my children are wonderful. They can be kind, and warm, and loving. They can be compassionate and conscientious. But most of the time, they aren’t. They yell at each other; they yell at their parents. They try to reinvent the wheel when it comes to homework and projects (“I don’t need to study”, or, “I kinda know it, it’ll be fine”). They don’t do their chores. Their rooms are a mess. And we, as parents, try to compensate. We say “It’s not a big deal, I can empty this dishwasher.” Or, “It was his first failure/suspension/whatever,” or, “Give him another chance.” Sometimes we just do it ourselves because it’s easier. And that’s exhausting. Raising children is mentally exhausting. Letting our kids make their own mistakes and missteps, while providing love and supervision is hard. Letting them know when they can try on their own (i.e. studying), and when the rules need to be obeyed (i.e. sitting down to a meal with the entire family), is tough. But there is a light at the end of the tunnel. Even the most oppositional child learns, eventually, what the family considers truly important. And the lessons they learn through their own trial and error make a greater impact than any amount of yelling or bribery we can offer. And so, go enjoy that occasional bag of chocolate chips. You earned it.

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.

Cognitive Behavioral Therapy and Your Child

In my various roles as a mother, a friend, a psychologist, president and a board member of a psychological association, I meet a variety of people with different outlooks on life. Most people have their own opinions on how to do things. However, if I were to take everyone’s opinions as fact, I would be befuddled, and confused, and sometimes, paralyzed. To help me deal with several different perspectives, I need my own set of tools to help filter the information I receive. That way, I can analyze any given puzzle to find the solution that best works for me. In a nutshell, that is what cognitive behavioral therapy is. It provides tools to help one look at the world in a certain perspective. Cognitive behavioral therapy strives to adjust one’s thoughts, feelings and actions, so as to help one function in the world better. A trained cognitive behavioral therapist can help your child see the world differently from how he or she is accustomed to seeing it. We work on helping children recognize their thoughts as separate and apart from themselves; we work on talking back to those thoughts. Moreover, we work on knowing when something can’t be changed and how to accept that. A cognitive behavioral therapist teaches children how to be responsible for their own actions, and not those of others. When you change how you act, you can change other people’s actions and reactions as well. And when we change our thoughts and actions, our feelings change, too. In the end, it’s not the only way to view the world. But it’s about helping your child grasp the way that might make sense to him or her. And if it does, then it’s the best way to effect change.

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.

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.

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