Category Archives: Adolescents

Woo Hoo! Back To School! (Part 2)

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Part 1 of my back-to-school blog covered basics of ensuring a smooth transition for you and your child(ren) as a new school year begins. This post focuses on the back-to-school “jitters” and those children who truly get anxious.

Not only do students encounter beginning-of-school jitters, but teachers and school staff also feel the emotions of a new year, a new beginning.  I worked in schools for 30 years and can safely affirm that I rarely had a good night’s sleep the night before school started.  It’s a natural phenomenon to get excited, scared, eager, or overwhelmed at the start of something new. Although some accept change with ease and slip into new experiences with little fanfare, others just – well – worry, stress, and get anxious.

The following tips (extrapolated from NASP “Back to School Transitions: Tips for Parents”) are to help those of you with children who are beginning school soon and tend to get anxious.

  • The first few days may be rough; try not to overreact. Particularly the younger student may suffer separation anxiety after a summer with parents and loose schedules. School personnel are trained to deal with children who may have a hard time adjusting.  Best advice:  Drop off your child without lingering, say “I love you and will be back at the end of the day,” then leave.
  • Talk to your child and let them know that you care. Model optimism and confidence and reinforce your belief in their ability to cope. Tell them that it’s o.k. to be nervous about starting something new, but he/she will be fine once they become more familiar with their new surroundings. Best advice:  Send positive, short notes in their lunch box or backpack and listen to any concerns when they arrive home. Reinforce positives as they discuss their school day.
  • Try to remain calm and positive about any bad experiences from the previous year. Those who had a difficult school year may have more anxiety about their return to school. Children who were teased or bullied, those encountering academic problems or any other difficulties may be reluctant to start another year with a positive attitude. Best advice: Talk to school personnel before school begins about this and then reassure your child that this is a new year and a fresh start. Reinforce that you will be working with the school to ensure a smooth school year and prevention of further issues.
  • Give your child strategies to cope if they are feeling anxious. Be open with the school and keep open communication with your child’s teachers. Encourage your child to tell you or the teacher if problems continue.  Best advice: Maintain open communication with your child and your child’s teacher.
  • Try to allow your child to meet with other students and school friends before the first day to ease your child into the new academic year. Best advice: Encourage your older child to contact friends, or if your child is younger, call the parents yourself to schedule play dates.
  • Plan to volunteer in your child’s classroom periodically throughout the year. This reinforces to your child that you are interested in their learning and that school and family are communicating. Additionally, you are building relationships with teachers, classmates, and other school personnel, as well as learning about classroom routines and atmosphere. Best advice: Even if you can’t regularly volunteer, periodic parent help is often welcomed and only benefits your child.

If your child’s anxiety becomes problematic, extreme in nature, or lasts for an extended period, make an appointment to speak with the teacher or school psychologist. More in-school support may be indicated or other resources in the school or community may be suggested. Remember: most children are very resilient and with support, encouragement, and communication will be able to have a successful school year.

Leave me a comment if you liked this entry.  I’d love to hear from you!  Any suggestions for future entries?  Let me know.

Woo Hoo! Back to School! (Part 1)

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It’s August already and it’s time to think—Back to School. With most schools across the country starting their school year before Labor Day, now is a great time to begin preparations.

Of course, each developmental/grade level may bring different challenges or expectations.  But there are a few general guidelines for ALL children that I’ve highlighted below:

  • Schedule all doctor and dental visits before the start of the school year.  Be sure to mention to your child’s doctor any concerns about their emotional or psychological development.  Your physician is able to determine the difference between age-appropriate issues or those that require further assessment.  Be prepared before school begins to notify school staff of any problems so they may be addressed early in the school year, if possible.
  • Start re-setting routines, such as mealtimes and bedtimes.  In the week or two before school starts, begin to talk to your child about the need for routines.  If you discontinued certain routines for summer, such as reading with your child before bed, then reestablish this. Stress the importance of a good breakfast, and start this every morning, as well.
  • Turn off the TV.  Emphasize quiet activities in the morning, such as games, reading, or coloring rather than turning on the TV. This will help your child ease into the school year. Try to maintain this throughout the school year; watching too much TV can be distracting before school.
  • Get rid of the TV in your child’s bedroom!  While I am on the topic of TV, I want to emphasize there is NO reason to have a TV in your child’s bedroom.  It has the potential to keep your child awake until late hours. Also, it’s impossible to monitor your child’s viewing. Even if you believe they will listen to you, they might turn it on before school (see above), and TV’s are not babysitters. Make TV viewing a family activity, or set guidelines for a certain amount of TV viewing during the school week.
  • Make copies of important school documents.  Keep a folder(s) handy of important documents, such as health and emergency information. Health records are often acceptable for over a year and can be used for other activities, such as extracurriculars, sports teams, or clubs.  Also keep important school records in a folder, including reports from teachers, report cards, special commendations, etc.
  • Homework areas.  Children should have a designated homework space in their house.  Older children should be allowed to complete homework or study in their rooms or other quiet areas of the home.  Younger children should be in an area of the house where they can be monitored by an adult, such as the kitchen, dining area, or family room.
  • Designate an area of the house for backpacks.  All children should be responsible for emptying backpacks every day and placing important notices and notes in a designated area for parents to read/sign/return. The backpack should be put in that specific area at night and repacked so as to be ready for a quick departure in the morning.
  • If your child is going to a new school.  Visit the new school with your child, once or several times depending on the age of the child. Designate meeting zones for after school pickups, visit the teacher, locate the classroom, etc. to ease anxiety.  Always call ahead to make sure the specific school personnel will be available for introductions.
  • Mark important dates.  As soon as you receive the school year calendar (and all schools distribute these), mark your calendar for important events, such as conferences, back to school night, concerts, etc. This is especially important if you have children in different schools and will also aid in arranging for babysitters when needed for those who must stay home.
  • Clothes.  Buy early and check your school to see if they require uniforms of a specific color or style. Schools often have rules about length of skirts or shorts, bare midriffs, halter-tops, flip-flops, tee shirts with inappropriate messages, etc. Specific guidelines will be available at the school; avoid conflict with your child by reading the guidelines before school starts.

My next blog entry will deal with the first week of school, and how to cope with the anxious child (and parents) as the new school year begins.

*These tips were extrapolated from NASP “Back to School Transitions:  Tips for Parents” at www.nasponline.org

Teenagers and Being Mindful: A Contradiction?

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Hi again.  I’ve been on a blog hiatus, but happily, I’m baaaaaaack!  Hope your summer is continuing to be relaxing and enjoyable.

If you haven’t noticed, I see many children and adolescents in my private practice. I also see many of their parents or speak to them on the phone. I’ve also worked in public schools for 30 years and have had contact with my share of young people, teachers, and parents. Perhaps the most troubling aspect of this age group for teachers and parents is understanding their pre-teens and teenagers.

What is it about this population that is so puzzling? Perhaps it is their tendency toward moodiness. Or….. the constant challenging of your authority? Throw in their past adorable-ness and how they soooo needed you, but now want only to avoid your very presence. Sometimes there is the mix of  “I need you” and then, “I don’t need you,” all in the course of half an hour! Absolutely, I’m sure there are “perfect” teens out there (I haven’t seen one, but perhaps you have), but inevitably most experience changes at this juncture, including social, academic, hormonal, and emotional. A mindfulness practice can help.

What is mindfulness? It is the deliberate practice of paying attention to whatever you are doing, right now.  It is learning to be aware, or mindful, during difficult times in life. We become aware of our thoughts, feelings, behaviors, and physiological changes. We don’t try to change things; just become aware, fully focused. Breathing in and out helps us to stay in touch with this moment. Mindfulness requires practice on a consistent basis.  Perhaps parent and teen can learn this together!

That is exactly why I have become very interested in Mindfulness for teenagers. Recent research published in the British Journal of Psychiatry (June, 2013) revealed that mindfulness could reduce stress and lessen symptoms of depression among high school age students and increase their well-being.

Uh oh—another study. Just what we need!!!  But I liked this one A-Lot. The Universities of Exeter and Cambridge in England enrolled 522 students between the ages of 12 and 16 during their summer exam period. 256 of the students completed a 9-week introductory mindfulness course; the others did not participate in that specific training. It was found that the ones who completed the course reported lower stress levels, less depression, and overall greater well-being.

Over the nine weeks, the students enrolled in the mindfulness course learned a different mindfulness skill each week including: recognizing worry, harnessing the power of attention, dealing with unpleasant feelings, and distancing from thoughts and emotions.

One of the interesting findings was that mindfulness training can help with the psychological well being of all students, not just those who have symptoms associated with mental health problems.  Mindfulness practiced by adults has been more widely researched and has shown to have the effects of lowering stress levels, enhancing sleep, increasing compassion and self-knowledge, and other health benefits. Fewer studies have focused solely on children and adolescents.

I believe a large part of teenage “angst” can be approached with mindfulness techniques.  I have incorporated them into my therapy practice, even with some of the children I see.  The practice of breathing, being in the here and now, focusing, attending, and learning are all part of teaching children and teens to be okay with themselves, become grounded, and self-aware. Not bad stuff to learn on the road to a healthy life.

If you have any questions about mindfulness or any other topic, please contact me.  I am always eager to respond to any inquiries!  Happy day and BREATHE.

Bedtime Blues or Bliss–II

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My last post provided guidelines for establishing bedtime routines for your children, with an emphasis on consistency. Consistency is the key to helping ensure that everyone gets a good night’s sleep. When your child gets into a consistent sleep routine, he or she will be at less risk for emotional, behavioral, and learning problems. Additionally, you – the parent – will feel more refreshed during the day and enjoy a better overall family life.

What if my child has more serious sleep problems? Some children and teenagers suffer from sleep disruptions and have difficulty following a good sleep diet. These disorders may include:

  • Insomnia
  • Nightmares
  • Sleepwalking
  • Night Terrors
  • Other sleep disturbances caused by hormonal changes and stress in adolescence

Let’s explore these more serious sleep problems in greater detail.

Primary insomnia occurs when your child has difficulty falling or staying asleep without any known underlying medical condition. This may be due to poor sleep patterns or erratic sleep schedules. Usually the establishment of a good sleep routine is sufficient to reduce or eliminate primary insomnia. Emphasize calming activities in the hour or so before bedtime, avoid giving your child caffeinated food or drinks before bedtime, and provide for plenty of exercise during the day. If these techniques do not help, consult your child’s pediatrician to rule out any underlying medical conditions that my interfere with sleep. A mental health professional may be sought out as well.

Nightmares are disturbing and/or frightening dreams. As many as half of all children may suffer from nightmares; however, they are most common in preschool and elementary grade children and tend to lessen over time. Nightmares may begin around age 2, peak in the 4 to 6-age range, and then slowly diminish, although they can occur in all ages. What causes nightmares? Stress, traumatic events, scary TV programs, violent video games or movies, vivid imaginations, fear (such as fear of the dark), and even some medications can all trigger nightmares. When your child experiences a nightmare, calm her down and repeat a shortened version of her bedtime routine to help her back to sleep. A nightlight in the bedroom may help a frightened child, or a shared storybook for those who have frequent nightmares.

Sleepwalking occurs during deep sleep, often 1 to 2 hours after initially falling asleep. Episodes can range from simply sitting up in bed to actually getting up and walking around the house, down stairs, or even outside. It can be very difficult to wake a sleepwalking child. When awakened, he may seem confused and usually will have no memory of the event. Comfort your child after an episode of sleepwalking and then return him to his bed. Sleepwalking usually stops in late childhood, although a few continue to sleepwalk into adulthood.

Night Terrors are episodes during which the child screams, seems disoriented and anxious, does not recognize parents, but at the same time appears wide awake. They usually occur between ages 3 and 8, and often 3 hours into the sleep period. Night terrors typically end by age 12. I often refer to them as “Parent Terrors” because it can be very scary to be awakened by a screaming, anxious child who may not recognize you. While children who have night terrors seem to be awake, they are not consciously awake, and may fight the parent who is trying to calm them. When the night terror eventually ends, often after 10-15 minutes, the child will return to sleep and have no memory of this terrifying event. Although parents are usually frightened (and I have personally experienced this!), there is little or no impact on the child. Hold your child gently until the episode ends and then return him/her to bed. Night terrors are NOT a sign that your child is troubled or emotionally disturbed.

Teenagers usually outgrow nightmares, sleepwalking, and night terrors; however, other sleep disturbances caused by hormonal changes and stress in adolescence may crop up.  Changes in sleep cycles can be triggered by puberty, hormonal fluctuations typical to adolescents, and the stresses of growing up in a complex society. Most teens do NOT get enough sleep at night, nor do they fall asleep quickly when they lie down for the night. Teens begin their days with school early in the morning. Extracurricular activities, such as jobs, homework, athletics and other social events often work against teens, preventing them from getting an adequate number of hours of sleep. Parents can intervene by reducing stress, encouraging adequate exercise, eliminating caffeine and energy drinks in the evening and removing distractions from their bedrooms.

If you believe your child has any of these serious sleep issues, a sleep diary may be helpful. Record the number of hours your child sleeps, how many times he/she wakes during the night, what happened before the child fell asleep, and any parental intervention taken during the disruption. Your child’s pediatrician should be consulted for serious sleep problems. The sleep diary information will be a useful tool to determine if your child has a sleep disorder.

Does your child or teen have sleep disturbances?  Please share your interventions or frustrations. I’d love to hear from you.

Bedtime Blues or Bliss?

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One of the most frequent inquiries I get from parents involves children and bedtime issues. Even the best sleepers can go through a period of resistance to going to sleep. Why does this happen and what can you as a parent do to set up healthy sleep routines, or what I like to call a “sleep diet.”

Set bedtimes so your child gets the appropriate amount of sleep. Preschoolers generally require 11-13 hours/night, while school-aged children typically need about 10-11 hours.  Most children respond best to bedtime if a routine consisting of a set of activities that are the same EVERY night, including the weekends, is set up early in their lives. Activities may include a signal or warning that it is time to get ready for bed, readying for the next day (for older children), taking a bath, reading a book, conversing or maybe even singing a soothing song.

Still, some children refuse to go to sleep. Very young children may become fearful and experience separation anxiety (a general fear of something happening to their parent(s) while they are asleep). Children ages 4-6 may experience more specific fears, such as fear of monsters, darkness or fear of having a bad dream—all normal for this age group. In the 3-10 age range, disturbing dreams may occur, peaking at about age 10. And teenagers may suffer from disturbances in their sleep cycles due to puberty, hormonal imbalances or stressors such as growing up, college or career plans, relationships or other social concerns.

How parents handle the reasons for their child’s resistance or difficulty getting to bed will play an important part in outcomes. When the child’s resistance persists and becomes a learned behavior and parents give in to the child due to their own fatigue or other reasons, rules are relaxed and new behaviors pop up. The child learns that nagging, whining, crying, stalling, one more drink of water, etc. will put off going to bed.

You may be noticing a common theme in my posts—CONSISTENCY! As with time-out and grounding, consistency is the key. Inconsistency can turn good behaviors bad and make bad behaviors worse. When parents try to buckle down after rules have been loosened for a time, the child learns to push back harder to get what he/she wants. Riding this roller coaster may cause you and your child to lock horns in a battle over bedtime that nobody wants to endure.

So, as a parent, what can I do to attain bedtime bliss? Here are several suggestions:

  • Establish effective bedtime routines that include—the same bedtime each night, quiet time for one hour before bedtime, providing time cues for bedtime, story time, etc.  You set the routine however it works for your household, but once you’ve set it, keep it consistent!
  • Provide healthy daily routines for your child including good nutrition, physical activity during the day to promote sleep at night, and no violent video games or TV shows before bed.
  • One “get out of bed free” pass.  The child receives a ticket to be used ONCE per night to get a drink or ask a question of the parent. This ticket may not be used more than once per night. This technique may work for some as it feels like fun to your child and gives them a little leeway for any problem they may have getting to bed.
  • Planned ignoring is a technique in which the parent makes it clear that once the child is in bed and the routine is complete, no more interactions will occur.  If the child objects, then the parent ignores the child and provides no further attention.  That means NOT responding to questions, comments or statements from the child. If he gets out of bed, escort him back to bed with minimal interaction.  Expect an increase in negative behaviors for several nights, but the child will eventually learn to go to sleep without protest. This usually takes about three nights. Planned ignoring is often most difficult for parents; hence, set the routine early.

Next week, I will continue with this topic and focus on more serious sleep issues. Stay tuned, and as usual, send me a note and let me know what you think.  Any topics you want explored?

 

 

Beyond Time-Out: Challenges of the Older Child, Tween and Teen

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Several readers of this blog have commented to me that time-out is a useful tool with younger children, but what are they to do with their older children, tweens, or teens?

Remember, the idea of time-out is to withhold (i.e. take time-out from) positive reinforcement with the goal of reducing undesirable behavior. Sometimes traditional time-out (see blog posts 3 and 4) doesn’t work with an older child, tween or teen, and other negative consequences for reducing inappropriate behavior must be implemented.

For example, your 11-year-old is talking back to you and it’s becoming a problem within the house. She thinks time-out is for babies. You explain to Sally that talking back is an inappropriate behavior and will not be tolerated. You make it clear to Sally that every time she talks back to you, a privilege will be removed. Examples are: TV, telephone or cell phone use, staying up late, outside play time, electronic games, trip to the mall, etc. Construct a privilege list alone or together with Sally PRIOR to implementation of this technique. For each new day, when Sally talks back, an item is crossed off the list for that day. The procedure starts anew daily, allowing Sally to begin each day with a clean slate. Do not choose too MANY behaviors at first. Like time-out for younger children, concentrate on a few of the most troublesome behaviors that your child exhibits and focus on those, ignoring the less serious ones. Consistency is the key.

What if my teen misbehaves? Grounding is a technique that can be used for disciplining teens. Of course, grounding is effective with older children and tweens as well, but for now, let’s concentrate on your teenager. Grounding is like time-out in that your child is removed from a desirable activity for a period of time—things like borrowing the car, watching TV, computer time, telephone privileges, going out with friends, electronic gaming, etc.

When you utilize grounding with your teen, consider the following:

  • Discuss with your teen what grounding means. Make your expectations and rules clear; write them down and post if necessary.
  • Set an appropriate time limit on the grounding relative to the age of your child.  For a teen to lose the car for one week is not unreasonable, but a month may be too long. Remember that the grounding loses its effectiveness if the period of time of grounding is too long. Your child’s incentive for good behavior during the grounding may be lost.
  • When you are angry is NOT a good time to set a grounding limit. Calm down first and make a decision based on what you feel is reasonable for a specific unwanted behavior.
  • When you set the grounding limit based on thoughtfulness, do not change your mind. When parents give in and reduce the time of grounding your child will quickly learn that you won’t follow through.
  • So that the entire family is not punished for your teen’s misbehavior, make arrangements for that child if the family goes out. A sitter should be used so that the grounded child remains in the house while the family can still enjoy their outing.

As always, parents should not disagree with each other about discipline in front of their children. Be consistent by rewarding or punishing the same behavior in the same way as much as you can. Parents should agree with what is acceptable or unacceptable behavior and how to respond to both. When speaking to your child about unacceptable behavior, be very specific. Displeasure over a “messy kitchen” isn’t clear enough. Instead, be specific about what “messy” means. For example, the dishes are not in the dishwasher; the books are spread across the table; there are crumbs on the floor; etc. Reward desirable behavior as much as possible throughout the day, and remember that your children are modeling your behavior.

What behaviors exhibited by your teens are challenging to you?  Let me know by leaving a response or sending me feedback. As always, I’d love to hear from you.