Posts Tagged ‘ child mind institute ’

Why Every Parent Should Be Aware Of Autism

Monday, April 29th, 2013

As Autism Awareness Month is coming to a close, it’s important to remind parents why they need to be aware of autism spectrum disorder (ASD). 

ASD is no longer a rare disorder. The estimated rate keeps rising. Parents need to be aware of the most telling signs in order to promote early recognition in their kids – and also provide a platform for understanding why a pediatrician may broach the subject.

Such early recognition is essential because early intervention can make a huge difference for a child with ASD. New interventions hold particular promise. While intervention at any time is beneficial, it’s clear that the earlier it starts, the more effective it may be.

Even if ASD hasn’t touched your life directly, it’s still important to know something about it. ASD has become, in a way, like cancer – it seems like we all know someone with cancer. You may have a friend who will have a child diagnosed with ASD in the next few years. Your kid may become friends with someone who has a sibling with ASD. Your kid may become friends with a child who has ASD.

Here are a few good links to follow to learn more about ASD:

Autism Speaks

National Institute of Mental Health

Child Mind Institute

Autism Awareness via Shutterstock.com

 

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Sandy Hook Aftermath: Mental Health As A Public Health Issue

Wednesday, January 2nd, 2013

Mental health is one of the 4 public health topics being discussed in the aftermath of the Sandy Hook shooting. Should it be part of the equation for trying to reduce the likelihood of future school shootings? The answer is yes. 

The focus here, though, is not exactly going to be about the usual topics you’ve been reading about, all of which carry their own importance, such as: the need for better mental health screening; the importance of making mental health services more accessible to those who need it; failures in the system which make it difficult to continue with treatments. While these issues are important, we need to expand our thinking about “psychiatric disorders” with respect to preventing future shootings. Although there are empirical links between psychiatric illness and violence, the vast majority of individuals who suffer from any one diagnosed psychiatric disorder are not going to commit mass murder. Put another way, there isn’t one simple diagnostic test that would offer enough precision to tell us who may be at risk for that kind of behavior.

Our focus needs to be placed on promoting the healthy all-around development of youth, starting early in life, and parallel efforts to recognize signs of distress and maladaptive functioning and to do something meaningful about that. Psychiatric evaluation and diagnosis is part of the process, but experienced clinicians don’t treat disorders – they treat people. They know how to get a full picture of a youth’s life – how they behave at home and in school, how they interact with kids and adults, how they manage their emotions, what kinds of thoughts they have in their heads. Intervention for troubled youth is not simplistic, and there are many types of factors to consider. It takes a multidisciplinary effort to attend to numerous dimensions of development (cognitive, emotional, social, educational, neurological). And it’s critical to understand that key developmental stages (e.g., starting school, entering adolescence, transition from high school) offer particularly powerful windows into seeing which kids are making good transitions, and which kids may be troubled. They are important check points for evaluation and intervention – and looking for red flags in a kid’s developmental trajectory.

Consider the following thoughts offered by Dr. Harold Koplewicz, President of the Child Mind Institute:

We know that when we see someone suffering we shouldn’t look away. And when we see young people coughing, wheezing or bleeding, we insist that they get attention. But when we see young people with disturbing behavior, or young people in clear emotional distress, we ignore them and hope these problems will go away.

The first signs of 75% of all psychiatric disorders appear by the age of 24. We need to be on the lookout for signs of distress in young people to get them help as soon as possible. Research shows that early intervention improves the outlook for anyone with a psychiatric disorder—and drastically reduces the likelihood of violence.

To achieve this type of vigilance and action, we need a dedicated effort that includes better information provided to parents and school systems – and an infrastructure that provides the ability to coordinate with developmental and mental health experts to deliver the best supported interventions. It will take money (something that’s not exactly flowing these days at the national level) and it will take commitment. It needs to start at most local level and eventually spread to a national level.

So where do we go next? Since the Sandy Hook shooting, some have argued that mental health is not the issue – that our focus should be on gun control because we don’t see this type of violence in other countries who have similar rates of mental illness. I get that perspective – but I still believe that we are failing if we have individuals who are so socially isolated and filled with anger and rage that they commit murder-suicide. Trying to apply our best efforts to reduce the likelihood of having youth and adults in our society who get to that point is not the full answer – but it’s part of the equation.

Tomorrow, I will address gun control as one of the 4 public health issues we are all discussing.

Psychology Concept via Shutterstock.com

 

 

 

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Recognizing ADHD Symptoms In Your Child

Wednesday, August 15th, 2012

It can be very difficult to recognize the symptoms of ADHD in your child. You can certainly reference reputable and helpful sites (here’s one example from the National Institutes of Health) that list the common symptoms. But when you go through the list – fidgeting, can’t sit still, interrupting, being easily distracted, having trouble following directions, not able to wait for a turn – you might conclude that all young kids do these things. And to a degree, you would be right. 

To give parents a better sense of how clinicians approach ADHD, I spoke with Dr. Steven Kurtz, who is the Senior Director of the ADHD and Disruptive Behavior Disorders Center at the Child Mind Institute. Here are some key take-home messages that I derived from my conversation with him.

Dr. Kurtz agreed that many kids can show the behaviors associated with ADHD. However, kids with ADHD demonstrate these behaviors with much more frequency and intensity than other kids – in fact they show about 3 times the intensity and frequency. So there is a matter of degree here. Kids with ADHD also have a consistent pattern of demonstrating this higher frequency and intensity – these behaviors can be regularly observed in the home as well as in school. To give a better sense of what the behavior of kids with ADHD might look like, Dr. Kurtz gave me the following examples at different ages.

Imagine a 4-year-old being on a platform to the monkey bars at a playground, seeing another child walk by on the ground with a big ice cream cone, and literally walking off the platform without looking to take the ice cream (and getting a trip to the ER in the process).

Imagine circle time at school with the teacher reminding all the children to stay on their bottoms (“criss cross applesauce”) and having to address the one 5-year-old who scurries into the middle of the circle to grab the materials – which happens day after day, well after others have learned the “simple” skill of waiting.

Imagine being the 2nd grader whose teacher – even in April – has to tell you where the “Do Now” work goes, when others learned that in September, and feeling like you are hearing it for the first time.

Unless you have observed lots of children, it may be difficult for you to determine if the frequency and intensity of your child’s behavior may be a signal to be evaluated for ADHD. That is why it is helpful to consider the impressions of teachers, who see lots of kids on a daily basis. Keep in mind that only licensed clinicians are able to make a formal diagnosis of ADHD – so if a teacher (or teachers) make the suggestion to you, you should consider it seriously and talk to your pediatrician and school about potential recommendations for a professional evaluation.

The primary reason to seek out an evaluation is that kids with ADHD show evidence of impairment – these behaviors have negative consequences for them and interfere with their functioning. (Just re-read the examples above to prove the point). Kids with ADHD struggle with day-to-day things – especially in school – and can also experience problems with peers (as things like not being able to take turns can affect social interaction). A comprehensive evaluation will help provide a full picture of a child – their behavior at home as well as in school. Since kids with ADHD can show a variety of the symptoms (there is no one typical profile) and don’t always show signs of ADHD, the focus will be on assessing those symptoms that indicate increased frequency, intensity, and impairment. It’s also critical to keep in mind that kids with ADHD are not just “misbehaving” or suffer from a lack of good parenting. Rather, the idea is that they have difficulties coordinating their attention and directing their behavior (and the root of this is assumed to be biological in origin). Dr. Kurtz refers to this as “attention modulation disorder” – they often pay attention to the wrong things. The goal is to set up a treatment program that can help parents (and teachers) aid kids with ADHD to direct their attention to the right things. And while medication is helpful for some kids, a key element is to utilize behavioral therapy that will provide many practical ways to help shape a kid’s attention and behavior.

Kids with ADHD who do not receive interventions often go on to experience many difficulties down the road in school. The typical window for reliably seeing the first signs of ADHD is now believed to be between 4 and 7 years of age. Dr. Kurtz suggests that the average parent will wait 2 years after ADHD is suspected before seeking an evaluation, which he believes is akin to digging a deeper and deeper trench for a child. All that said, keep in mind that 3-7% of kids will be diagnosed with ADHD – that’s a lot of kids, but really the vast majority of kids do not have ADHD according to clinical diagnostic guidelines. If you suspect your child might have ADHD, the idea of the evaluation is to decide on a plan. In some cases, that might only involve tracking behavior closely over time – in others, some type of immediate treatment plan may be suggested.

There is no doubt that recognizing ADHD symptoms is not easy. Keeping in mind some of these tips may at least give you a framework for viewing your child’s behavior and development over time, and for interpreting the feedback of others. Being vigilant about these observations and having a good dialogue with your pediatrician and school may help you understand if you may need to seek out an evaluation.

ADHD graphic via Shutterstock.com

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8 Tips To Help Prevent Your Child From Bullying Others

Friday, June 22nd, 2012

By now, you’ve probably heard about (or seen) the viral video which captured a group of junior high school boys relentlessly taunting a 68-year-old grandmother who was performing her duties as a school bus monitor. The excerpts (some of which you can see here) are beyond disturbing – vicious, non-stop insults (and threats) were hurled her way for what was reported to be at least 14 minutes. Other aspects of the story continue to unfold, including apologies from a dad of one of the boys, and a fundraising campaign that has raised hundreds of thousands of dollars for the victim. But the point of this blog post is not to cover all these emerging details – rather it’s to step back and ask the question every parent should consider after hearing this story: 

How can I make sure my child does not engage in bullying?

Although the simple (and good) answer is to teach your child, from a very young age, to respect others and practice kindness, the reality is that the tween and teen years can be volatile for lots of kids. Parents need to step up their efforts in many ways to be informed about their kid’s social and emotional development as well as their social circles. To get at this from a clinical perspective, I’ve reached out to Dr. Steven G. Dickstein of the Child Mind Institute, who offered the following perspective and 8 very real tips for parents:

Although it’s difficult to accept or understand that your child could be a bully, it’s a reality. Happily, it is one that you can work to prevent. Some tips:

  1. Communication. If your child is open with you about his thoughts and feelings, it is easier for you to notice if something isn’t right. To encourage this, you need to be open yourself. Having a clear line of communication also allows you to explain concretely your expectations for behavior. No matter the age, kids like to please—even if they don’t show it.
  1. Take bullying seriously. If you don’t downplay bullying behavior as just “boys being boys,” then your child will understand that not only is it unacceptable—it can also cause real harm.
  1. Teach kids how to react. A child who knows the best response to the bullying behavior of others—stand with the bullied child, not idly by; alert an adult—is far less likely to engage in bullying behavior themselves.
  1. Don’t minimize life at school. School is tough for kids; they’re getting the hang of being part of an expanded social universe. This is as true in kindergarten as it is in high school. So taking an interest and being compassionate when your child is troubled shows them a constructive outlet for their feelings, whether they are anger, sadness, or frustration.
  1. Introduce kids to peer pressure. The seemingly limitless power of peer pressure is illustrated by the helplessness we feel when we face it. “If everyone jumped off a bridge…” is a pretty lame comeback. Still, parents have to keep making the point. Some children may feel pressure to participate in bullying behavior in order to fit in with peers or to avoid being bullied themselves. Let them know that the easy way out isn’t always the right way.
  1. Be aware. For younger kids, know what your child is doing in and out of school, and make certain that adequate adult supervision is present in every situation. For tweens and teens, know their peer group. In many ways you’ve turned over the rearing of your child to his or her friends by that age—so try to make sure they are teaching what you would—well, within reason.
  1. Create an anti-bullying environment. Bullies can be the alphas in cliques, or they can be loners on the edges of the social scene. Giving your child opportunities to learn the social ropes and avoid being overly dominant or disconnected is key. So—team sports, theater, art classes, music. If a child learns to play well with others early, and continues through adolescence, he or she will have learned a lifelong skill—and hopefully avoided the bully trap.
  1. Work together with the school. Too often, parents and teachers can have a contentious relationship because communication is lacking. Building a collaborative relationship means you can focus not on a “he said, she said” back-and-forth, but on the child, where everyone’s attentions belong. Teachers are with your child for the majority of the day; together, you can better help a child make the right decisions.

From a research perspective, I would reinforce the idea that there can be a “social contagion” as kids get older – especially in the tween and teen years. Sometimes goofing around and teasing (which can be perfectly normal behavior) can spin out of control when a group of kids get together – even a group of “nice” kids. (Trust me, if you spend a lot of time around tweens and teens, you will see this happen). These kinds of moments (if you witness them) are important opportunities to set boundaries and make sure kids connect what they say to how others feel – and to convey that this kind of behavior is not acceptable. If you send that message strongly enough, and frequently enough, you can help your kid know how to respond when they are around overtly bullying behavior (such as the sickening school bus incident), and also give them the social and emotional knowledge to know how to put on the brakes when they might be crossing the threshold into bullying behavior themselves.

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Tweetchat On Brain Science And Kids On Tuesday March 13 Hosted By Child Mind Institute

Sunday, March 11th, 2012

Have a question about children’s developing brains? Want an answer from an expert? 

You may want to participate in a live Tweetchat being hosted by the Child Mind Institute (@ChildMindDotOrg) on Tuesday March 13, 2012 from 1:00 – 2:00 PM ET in honor of Brain Awareness Week. CMI will moderate a discussion about research in the field of brain science that will include Dr. Michael Milham, Director of the Center for the Developing Brain. Dr. Milham will be moderating a discussion about research in the field of neuroscience and answering questions posed by the public concerning brain development.

So feel free to share this information with anyone who may be interested. Here are the specs:

Who: Moderator @ChildMindDotOrg
What: Brain Research
Where: Twitter at #CMIChat or http://tweetchat.com/room/CMIchat
When: March 13, 2012  1:00pm-2:00pm

Image of human brain via Shutterstock.com

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