Friday, August 12, 2016

Teaching Young Children Emotional Regulation

Young children often express their emotions in big ways. Often times a child's emotional experience can be very overwhelming for their adult caretakers. Anger and frustration become tiny fits of rage and tantrums; fear becomes loud, dramatic, inconsolable wails; disappointment may be stomping feet, kicking the ground and negative words. How to help children manage their emotions is one of the biggest questions I get from parents bringing their kids to therapy. Here are some of my go-to ways to helping children learn emotional management.

Help your child identify emotions. Helping kids label and identify their emotions is a first step towards giving them emotional control. You can help your child learn to identify and label emotions by offering suggestions that normalize the experience, such as "Many kids feel a bit nervous about the first day of school. It can be hard not knowing what to expect, but remember what a great first day you had last year? I am looking forward to hearing all about your day when you get home!" Games such as Moody Monsters and Feelings in Bloom Bingo are fun ways to engage kids in learning about emotions. Make a feelings chart by drawing blank faces on large poster board and writing an emotion word (ex. sad, angry, happy, shy, embarrassed, worried, bored, etc) and have your child draw in what each feeling looks like for them. Books like, The Way I Feel by Janan Cain, are also excellent for helping young children learn about emotional identification.

Don't minimize your child's emotional experience. Emotions themselves aren't the problem. Allowing your child to express their emotions - the good, the bad and the ugly - is imperative to helping your child be an emotionally healthy individual. We can say no to any negative behaviors that manifest from the emotions, but allowing kids to experience their emotions lets them know that feelings are not taboo. When a child experiences emotional dysregulation, it is because he or she does not have the verbal capacity to discuss the feelings behind the behavior. That is where your job as the parent comes in - it is up to you to identify and validate the emotions, while encouraging problem solving. For example, "I know you are feeling frustrated that you didn't win your baseball game. It's okay to feel that way, but it's not okay to throw your bat.  Let's come up with a plan for me to help you improve your batting skills."

Model healthy emotional expression. Suppress the urge to throw an adult tantrum of yelling, cursing and getting uncontrollably angry in front of your children. Children learn emotional regulation from the adults in their lives.  Demonstrate mindful responding versus impulsive reacting by using respectful words, a controlled voice and problem solving directives. Know when you need to take a break from frustrating situations. Children will pick up and imitate your emotional responses.

Come up with coping strategies. Engage your child in some brain storming to discuss what activites he/she finds calming. Activities can range in energy level and can include quiet activities like coloring, listening to soothing music, hugging a stuffed animal, making a craft, or playing a video game, to more energy externalizing activities like running around the back yard, bouncing a ball, dancing wildly to loud music or jumping rope. Make a list of coping strategies - or create a picture list for non-readers - to keep in a visible area. Teach your children to recognize their emotions by noting them, i.e., "It looks like this game is getting frustrating to you, why don't you pick something off your list to do for awhile and come back to play the game a little bit later?" For smaller children, keep a basket of "cool down" activities in an accessible area for instant access.

Practice coping strategies. Practice makes perfect. Child or adult, common coping skills such a deep breathing or meditation rarely work in the midst of a significanf emotional experience if it isn't a skill that has been practiced. I often equate calming coping skills, such as deep breathing, mindfulness, counting to 10, and meditation, to a performance. Very rarely can someone go out on the field or take the stage without hours and hours of practice and rehearsal. This holds true for coping skills as well. Practicing coping skills daily, in moments of calm, makes them more effective to use when needed. Set aside a minimum of 5 minutes a day to help your child practice some self-soothing skills.

Don't re-direct in the moments of a melt down. When your child is in the midst of a big emotional experience, reminding him of his calming skills is most likely going to fall on deaf ears. Children are never reasonable in the midst of a melt down. Your best bet is to allow the experience to happen, and only limiting behaviors that may be harmful to the child or others around him. If a melt down occurs in a public place, you can move your child to a more socially acceptable area, but remain with the child. Sending a child on his own for a "time out" only sends that message that he is alone in his experience. Remain nearby and wait it out. When your child is in a calmer state, validate their experience and help them identify more positive ways to handle those feelings in the future.

Recognize and acknowledge positive emotional expression.  Identifying undesirable behaviors is easy, but acknowledging desirable behaviors is beneficial. When your child demonstrates positive emotional regulation, verbal acknowledgments go a long way and is a positive way to reinforce desirable behaviors. So the next time your kid keeps his cool in a frustrating situation, let him know that you noticed and appreciated his calm approach. 

Emotional regulation is a process, but with patience, guidance, encouragement and appropriate modeling of positive emotional management, your child will soon successfully learn how to deal with big feelings on his own!

Tuesday, August 2, 2016

What No One Tells You About Having A Kid With ADHD

As a therapist, ADHD was never in my wheelhouse. That changed the year my then 6-year-old son was diagnosed with ADHD. This diagnosis did not come as a surprise, my husband has ADHD, but it did open my eyes as a therapist, and as a mother, to the challenges kids with the diagnosis face. Challenges that go beyond the stereotypical image of a child who is easily distracted or hyperactive. There is so much more to ADHD that I have learned along my journey, here’s a few of them:

My kid says "weird" things.  Kids with ADHD are often impulsive. This impulsiveness may manifest verbally. Children may blurt out things that may not make sense, or seem strange. They may even blurt out things that seem concerning.

One day, my son, who was having a particularly challenging day, was in the midst of a meltdown. With a glint of rage in his eyes, he turned to me and shouted, "I'm going to blow up this house and everyone in it!" The mom side of me immediately got alarmed and wondered if I had a future psychopath on my hands. The therapist in me knew that this wasn't my sweet boy speaking, it was the impulsiveness speaking. The part of the brain that doesn't pause before blurting out whatever words are running around in his mind. Sometimes what comes out of my son's mouth is funny in a "Kids Say The Darnedest Things" kind of way. Sometimes it is so cringe-worthy, I want to dig a deep hole and hide.

What to Do:
Teach children to take a deep breath and count to 10 before talking. This encourages children to not blurt out first thoughts, and gives your child a chance to consider their words.

When you observe your child making impulsive statements, pull him aside and discuss why the statement was inappropriate or harmful. Encourage apologies for any hurtful words. Speak with your child privately, rather than address the statements in front of an audience.

The challenge of friendships. Many kids with ADHD may experience difficulties in making friends. This is often because children with ADHD are impulsive in nature and these impulsivities translate to off-putting behaviors on the playground, such as making unfiltered statements, interrupting others, displaying thoughtless behavior or creating disruptions.

When my son entered kindergarten, his uniqueness became more apparent to peers. Kids were starting to notice that my son was different. Nothing is more heartbreaking than to have your child come home and tell you that the other kids don't like him. Unfortunately, my son, although a sensitive soul, has a tendency to speak without thinking, often saying things that are hurtful. He will intrude on, and interrupt conversations. He will disrupt a child who is quietly playing. He will walk away mid-conversation. Things that weren't as noticeable in preschool, began to raise eyebrows in elementary. My son's tendency to miss social cues will only become more noticeable with age.

What to Do:
Social skills groups are a great way to learn how to interact with peers. Check with your school or local counseling centers for age appropriate groups.

Role-play common social situations with your child. This will help ease any social anxieties and give your child the opportunity to practice appropriate interactions.

Evel Knievel has nothing on this kid. Children with ADHD can be the ultimate risk takers. Most people expect children with ADHD to be overly energetic, but most do not expect to be witness to impulsivity-driven, dangerous acts. A child with ADHD may run into traffic, climb on top of the refrigerator, hang from the second floor banister, whack a beehive with a bat - the possibilities are endless. The bigger the kids, the more dangerous things become. Teenagers with ADHD are particularly susceptible to engaging in reckless drug and alcohol use, as well as sexual activity.

When my son was still running into traffic at age five, I knew that this was way more than just typical hyperactivity. While you expect to have to use the death grip on a 2 or 3 year old in a parking lot, you don't think of an older child needing as much reminder and supervision about the dangers of moving vehicles. Or, so I thought. My son would catch the gleam of a penny or hear the bark of a lone dog in the distance and would be consumed with one thought - the thought to run towards whatever attracted his attention. He would bolt without warning into a sea of moving cars. My heart has stopped beating more times than I can count.

What to Do:
When a child displays severely dangerous activity, it is best to consult professionals. Seek specialists in ADHD. A variety of therapies are available to help decrease impulsiveness and assist in establishing safer outlets for your child's energy.

You thought nights with a newborn were bad, you ain't seen nothing yet. Children with ADHD often experience challenges "shutting off" their brain. That little mind is constantly filled with thoughts and images, and that doesn't stop just because the little hand on the clock hits 9. You may find your child is refusing to go to bed, stating that he/she is not tired, and if they do make it to bed, they are wide-awake for the majority of the night. Many kids with ADHD - those on meds AND those not on meds - experience sleep issues. For children who are on medication, stimulants are usually the culprit and decreasing or stopping the dosage will typically eliminate sleep issues. For those children not on medication, developing healthy sleep patters requires a bit more trial and error.

My son actually slept like a baby, when he was a baby. Not a peep would be heard out of him until the morning. Then somewhere around toddler-hood, a myriad of sleep issues crept in. Getting him to sleep was an exhausting experience, but only for me as he would be wide awake hours after I would drop into bed out of defeat. I would spend hours begging and pleading with him to go to bed, only to spend the majority of my night escorting him back to his room when he would wake me in the middle of the night requesting snacks, water or "something to do" because he was "bored." We finally found a rhythm that works for us, but the journey getting there was a long one.

What to Do:
Setting a routine will help define sleep expectations for your child. Set a reasonable bedtime and have a set routine for the 2 hours leading up to bedtime. Include quiet time with no electronics or stimulating activity, a warm bath, and downtime by reading a book or listening to soothing music in the routine.  Replace bright lights with warm, soft lights to create a serene sleep space.

Low self-esteem struggles. Many kids with ADHD experience low self-esteem. Kids with ADHD tend to have more academic and social struggles. At home, the symptoms associated with ADHD may lend to a tense family dynamic. An overwhelmed parent may become easily frustrated by ADHD behaviors. Children with ADHD are used to being criticized for their lack of attention, forgetfulness, poor social skills and behavior. This criticism from others quickly turns into a nasty inner critic that takes a toll on a child's self-esteem.

Being a parent of a child with ADHD is no doubt overwhelming at times. It's easy to feel frustrated when nothing seems to work to calm your wild child. Before my son was diagnosed, he struggled with an array of social, academic and behavioral challenges. The frustration my son was feeling over his lack of self-control, combined with the frustrations my husband and I were feeling over the challenges, led to a strained home environment. In the midst of all this I noticed that my son didn't seem as eager to try new things for fear of failing and didn't seem as confident. I'll never forget the day my son came to me and said, "I know everybody hates me because I always mess up. I'm dumb and I know it." Talk about a punch to the gut.

What to Do:
Take a step back and look at what you as a parent, may unintentionally be doing to feed your child's self-esteem monster. Don't compare your child to others. Recognize what your child is doing right, and stop focusing in what your child is doing wrong. 

Focus on your child's strengths and involve him/her in activities that will allow him/her to excel.

Allow your child to succeed by breaking up tasks into smaller steps, simplifying goals and directions and making accomplishments attainable rather than complicated.

ADHD looks different with every child, and every child's journey is different. With love, support and understanding each child has the ability to excel in their own way. I have learned to find the positive in my son's energetic spirit and cherish all parts of this journey we are taking together.

Saturday, July 30, 2016

Getting Your Teen Ready for School – Academically and Socially

While many parents around the country are breathing a sigh of relief as summer slips away and school starts up again, many teens are groaning at the thought of returning to textbooks and teachers. The start of school can bring many mixed emotions – for some, excitement at daily social interaction and being one more step closer to graduation; for others the impending start of school may bring up feelings of anxiety. For teens that face social and academic challenges, the start of a new school year is often overwhelming, but with a little support and preparation your teen can conquer those anxieties and tackle the new school year with confidence.

Academic Preparation

 Poor academic preparation often sets teens off on the wrong foot when returning to school. Improving your teen’s organizational skills can help eliminate the feelings of anxiety that come with being unprepared in class. Start by sitting down with your teen to review their class schedule and engage your teen in a discussion regarding what classes he/she is most excited about and what class is the most dreaded. Come up with goals and objectives for each class (i.e. If your teen fails two tests, he/she will agree to have a tutor). Set clear and realistic expectations for the school year. If your teen has an after school job or partakes in an extracurricular activity, set expectations of the GPA your teen needs to maintain in order to continue the activity. Don’t be afraid to set some incentives for accomplishing academic achievements. It never hurts to reward positive behaviors and it’s human nature to be motivated by incentives. Would you go to work if you weren’t getting a paycheck at the end of each week? I sure wouldn’t!

Help your teen gather up needed school supplies at least two weeks in advance. There’s nothing like rushing around last minute for supplies to create feelings of anxiety. Teens with poor organizational skills may benefit from purchasing different color coordinated notebooks and folders for each class to help stay organized. Set up a workstation in the home that is free from distraction for teens that have difficulty focusing. Purchase an academic planner for your teen and make a schedule with your teen for homework and study time. Allow your teen the opportunity to have an active part in setting goals and schedules. The more control your teen has in setting their own academic goals, the more likely they will be motivated to achieve those goals.

Social Preparation

For shy teens, the social aspect of school often creates feelings of anxiety, particularly if your teen has experienced peer conflict in the past. Begin by establishing open dialogue with your teen about social anxieties. By letting your teen know that you are available to listen and provide emotional support, you can help ensure that your teen will continue to turn to you throughout the year when issues arise. Normalize your teen’s concerns and show you empathize with your teen’s experiences by acknowledging that there have been times when you’ve felt nervous, alone or left out. Engage your teen in a discussion regarding how you were able to successfully cope with those feelings and experiences. Don’t brush off your teen’s concerns by dismissing or minimizing them. Teens need to know their feelings and experiences are normal. During the last weeks of summer, encourage your teen to reach out to friends who they may not have seen recently.

If your teen is nervous about attending a new school, contact the school to arrange for a tour. During a tour, your teen is able to explore the school without being overwhelmed by a crowd, and can familiarize his or herself with the layout of the building which may help decrease first day jitters of being lost among the maze of hallways.

No matter how much you prepare your teen, there is always a chance that something may not go as planned. Remember for a moment that adolescents are awkwardly caught in the middle of childhood and adulthood and are often internally struggling with finding themselves and their place in the world. Offer compassion and support for your teen’s feelings and experiences no matter how trivial they may seem to you. Lend an ear, give a hug and be understanding.

Thursday, July 28, 2016

Reduce School Anxiety

As we enter the last month of summer, and September creeps upon us, many parents will be sending their little ones to school, and many will be sending them for the first time ever.  In most cases it's the parents that have the hardest time with this transition, but it's not uncommon for kids to experience their share of fear and anxiety regarding the first day of school. Parents of anxious kids can take a few steps to emotionally prepare their child in this last month of summer and the beginning weeks of school in order to make it the best start possible.

1. Have Discussions About School - Begin talking to your children about school and what to expect in a typical school day. Discuss the social aspects of school in addition to the academic aspects.  Talk about lunch time, recess, peers and what drop-off/pick-up will be like. Head to your local library or bookstore and select books about going to school to read during the remainder of the summer.  Talk about your own positive experiences from school. Dig up your old class pictures if you have any to add a few laughs to the discussion.

2. Check Out The School - Most school's have orientation days for new students that include a tour of the school. If your school does not offer this, call your school or district board of education and arrange for a tour of the school or a meeting with your child's teacher to establish some familiarity. At the very least, prior to the start of the school year, take a trip with your child to the school to allow him/her to see the building up close. Walk around as much of the school grounds as you can and point out areas that would be of interest to your child, such as the playground. Visit the school more than once if possible for a particularly anxious child.

3. Schedule Playtime With Future Classmates - If your child is entering school for the first time, scope out your neighborhood for potential classmates and arrange for some play time. If you are unable to find potential classmates, explain the unknown peers as a fun "surprise". Make a game out of it and have your child guess the number of boys and girls that will be in their class and the possible names of some classmates. If your child has been to school before but hasn't had contact with classmates since the summer started, invite a few school friends over for lunch or a play date. Acquainting your child with a few classmates will decrease feelings of anxiety regarding peer interactions. If you are feeling particularly ambitious, host a small "back to school" party the week before class starts.

4. Involve Your Child in Back To School Shopping - Get your child involved in school supply list shopping and other back-to-school items.  Present your child with choices on such items as backpacks, lunchboxes and clothing. Have your child help you plan out his/her lunch menu for the first few weeks. These small activities will allow your feelings a greater sense of control, which is important a child who is anxious.

5. Role Play - If your child has a particular anxiety (bullies, riding the school bus, interacting with peers, navigating a large school, etc), role play the event with your child.  For example, if your child has anxieties about riding the school bus, practice walking to the bus stop together. Have a relative or friend play bus driver and have them drive up to the bus stop. Practice saying goodbye and putting your child on the "bus."  If possible, have your friend or relative drive your child to school just like the bus would and drive back to the bus stop to practice drop off with your waiting. Coming up with a plan and brain storming coping skills for your child's fears will help him/her feel more confident when faced with the event. Practice often and problem solve potential solutions together.

6. Reward and Reassure - Reward for brave behaviors that your child exhibits. Reward for a successful first day of school. Reward your child for using the coping skills practiced. Now is the time to boost your child's mood and spirits with a special gift or outing in response to positive behaviors.

Sometimes all the planning in the world won't ease an anxious child. An anxious child may exhibit a variety of negative behaviors as the first day of school approaches including physical ailments, withdrawing, fighting with siblings, being defiant towards parents/caregivers, bed wetting, thumb sucking, and other aggressive behavior. Acknowledge that your child is engaging in these behaviors due to school related fears. Normalize your child's fears and anxieties, and encourage your child to discuss those fears and anxieties. Encouraging your child to continually and openly discuss any fears and anxieties with you serves as positive coping skill and gradually increases your child's confidence with continued parental validation and support. If there isn't a noticeable decrease in your child's school anxiety level as the school year progresses, reach out to your school's guidance counselor for additional support and resources.

Thursday, October 15, 2015

Dandy Like a Dandelion

Most people disregard dandelions as annoying "weeds" that blemish a pristine lawn.

These people couldn't be more wrong.

The usefulness of the dandelion is almost limitless and spans from medicinal to culinary. Many don't recognize the true value of the dandelion, but those that take the time to get to know the dandelion - not for the annoying weed that it appears, but for the amazing plant that it is - will be amazed by the worth and treasure that the dandelion has to offer.

 The dandelion is a beautiful and tenacious flower. The dandelion may look unassuming, but in fact the dandelion is amazingly resilient. The dandelion can persevere in harsh weather conditions and will grow against all odds. When faced with barriers, the dandelion will find the smallest cracks and push through in order to flourish and shine. Militant garden owners will pull and spray and cut down the dandelion, cursing it’s strength and perseverance to continue to grow and bounce back no matter how many times someone tries to cut it down.

The dandelion will thrive despite adversity and I think that's a pretty admirable quality, don't you?

I have met many dandelions in my life, one of them just might be you!