Topic for October 10th

Trauma in Children and Adolescents

Tips

Post Traumatic Stress Disorder (PTSD) in children can occur when there is an event that involves a threat to their own or another’s life or physical integrity. Examples of such events are physical or sexual abuse, family or community violence, experiencing or witnessing potentially fatal accidents or natural disasters, or the sudden death of a loved one. A traumtized child will typically respond with intense fear, helplessness or horror.

1. Some child-specific symptoms of PTSD are bedwetting, excessive attachment to a caregiver, the development of new phobias, increased irritability, or the continued re-enactment of the trauma through play, stories and artwork. Children may also become socially withdrawn, have difficulty concentrating, experience more problems sleeping, or a loss or increase in appetite.
   
   
2. When a child has experienced a traumatic event, adults can help by remaining composed and not overreacting. In other words, it helps when parents model positive coping skills.
   
   
3. Not every child who has been exposed to a traumatic event will develop PTSD. Children can be quite resilient. Most kids are able to absorb the trauma and move forward. Girls appear to be more vulnerable than boys, along with those with pre-existing psychological disorders and those who have experienced a traumatic event more than once.
   
   
4. For those children and families who need help after a trauma, there are evidence-based treatments available, such as cognitive-behavior therapy and medication. Parents should continue to provide a warm and structured environment to help the child feel safe.
   
   
5. Following some types of trauma, it is important to help children face their fears. The more the child avoids what she is afraid of, the more anxious she will become around that place or situation. For example, if the child was in a car accident, one method of treatment may involve slowly exposing her to the car again. Have her first wash the car with you, then maybe have her get something out of the car, followed by a drive around the block. By providing a gradual exposure, most kids are able to eventually "get back on the horse."
   
   
6. Some children feel guilty, blame themselves, or feel responsible for the traumatic event. If a child responds this way, help him correct this distortion by providing evidence to the contrary. Let him know that he is not responsible for what happened.
   
   
7. Although we are still learning about what makes some children more resilient, we know that investing in quality time with your child, especially at a young age, providing a safe home environment, and being tuned-in to your child’s emotions (e.g., providing structure and guidance around negative emotions) help with building secure attachments and, in turn, a child's ability to cope with negative events and emotions.

Topic for September 26th

Self-Injurious Behavior in Adolescents

Topic for September 19th

Risky Behavior

Tips

1. If you know your child has recently gone through a sex education lesson at school, ask about what he learned and have a conversation with him about what the teachers discussed. A lot of the time, especially with younger children, they will be too embarrassed and uncomfortable to actually pay attention and take in what the teacher has said. Talking one-on-one with your child about the physiological and emotional changes they will experience, how pregnancy happens, peer pressure, and sexual diseases will help to reinforce what they went over in school. It is also useful to provide visuals, such as age-appropriate books and pictures of male and female anatomy, and to continuously talk to them throughout their childhood about sex and the responsibilities and consequences it entails.
   
   
2. It’s never too early to talk to your children about sex. Know your kid and where she is at emotionally and physically. Often parents think that if they talk about sex too early, they will be putting ideas in their children’s heads. We know that this is not true. Children see the intimacy and conflict that goes along with a relationship simply by observing their parents. Parents are consistently giving messages to their children through their actions, so it is never too early to ask your child if s/he has any questions about mommy and daddy, babies, sex or intimacy.
   
   
3. Kids are exposed constantly to messages about relationships, sex, smoking and alcohol through the media. It is important for parents to know which websites, TV shows and movies their kids are watching. Take the time to sit with your child and watch their favorite show with them. When there is smoking, alcohol, or intimacy between characters in the show, talk to them after and ask them how they feel about it. Take this time to educate them. This is also a good way to bond and spend time with your child. Research has shown that children who feel close to their parents are less likely to partake in risky behaviors.
   
   
4. It’s not easy to speak to your children about drugs, alcohol, sex, and smoking. If you catch your child smoking or drinking and find yourself boiling over with anger, it is sometimes good to send them to their rooms, take a break and think about how you should approach your child on the matter. A kid needs to feel like they are being heard. Have a conversation with them, show them that you’re listening by sometimes repeating back what they are saying to you, acknowledge that you’re happy they are talking to you, and then discuss an appropriate consequence for their actions.
   
   
5. If your child experiments with alcohol, smoking, drugs, or sex, it doesn’t mean that he is a bad kid or that you’re a bad parent. While many parents just tell their kids, “Don’t drink or smoke,” it is also important to explain to them why they shouldn’t. Tell them that their brain is not fully developed, and tell them what can happen if they engage in risky behavior. Many of the kids who report drug, alcohol, or smoking dependence started smoking or drinking before the age of 16. While it is often inevitable that a child will experiment, it is important as a parent to postpone this behavior as long as possible.
   
   
6. As a parent, be aware of any sudden changes in your child’s behavior (i.e., a change in social circle, withdrawal from family, decline in school success or interest in extracurricular activities, etc.). These may be signs that your child has started using drugs or alcohol. Many parents struggle with distinguishing between normal teen behavior and sudden unusual changes that may signify drug or alcohol use. It is important for parents to stay involved and connected. Trust your instincts as a parent – if your child’s behavior changes suddenly, look very closely.
   
   
7. Kids group themselves into social networks with common behaviors and common beliefs. Don’t be too quick to criticize your child’s friends because this will immediately isolate you from your child. Ask yourself why she is hanging out with this specific crowd. What is going on in your child’s life and what does her peer group offer her?
   
   
8. Remember, parents are still the most important influence on their children and the choices they make. Continuously work with them, educate them, and give them the confidence to make right and informed decisions. Do not give up.

To read more about our guests and their work, visit these websites.

www.ppsinc.org
www.Drugfree.org
www.projecthealth.org

Topic for September 12th

Sleep Disorders

Tips

1. Sleep has many functions - it is restorative for you and your body; it is important for the regulation of body temperature and conservation of energy; and it appears to be necessary for consolidating memory.
   
   
2. Sleep is closely linked to the regulation of behavior and emotion. Just an hour less of sleep each night can reduce computational speed, impair verbal fluency, and decrease creativity and abstract problem solving ability. It also can contribute to problems with attention and memory, increase the likelihood of hyperactivity and impulsivity, and promote anxiety and depression. Thus, it is important to treat insomnia and other sleep related disorders early.
   
   
3. It is common to take up to an hour to fall asleep. If you want a good nights rest you should attend to sleep hygiene and employ the following steps:
   1. Set a routine sleep/wake schedule.
   2. Exercise daily and at least 4 hours before sleep.
   3. Avoid caffeine, cigarettes, and alcohol.
   4. Create a relaxing bedtime ritual (i.e. reading or taking a warm bath).
   5. Use the bed for sleeping or sex, nothing else.
   6. When you wake up, expose yourself to the morning sunshine.
   7. Sleep in a comfortable room temperature, not too hot or cold.
4. There is some individual variability in the amount of sleep we each need. The recommended averages for different age ranges in a 24 hour day (e.g., including nighttime sleep and naps) are:
   1. Infants: 14-15 hours
   2. Toddlers: 12-14 hours
   3. Preschoolers: 11-13 hours
   4. School-age children: 10-11 hours
   5. Adolescents: 9 hours
5. We advise against allowing your child to have a television in his room for two main reasons:
   1. As a parent you will be much less able to monitor what your child is watching; and
   2. falling asleep to the television often makes children incapable of learning to fall asleep on their own.
6. About 25% of children will suffer from some type of sleep problem at some point during childhood. Research has consistently shown that parents report sleep difficulties in 50% of preschool children, 30% of school-aged children, and 40% of adolescents.
   
   
7. Should children sleep alone or should they sleep in bed with their parents? Some research suggests that children who sleep in their parent's bed sleep less, going to bed later and waking up earlier. Yet some parents like the closeness they feel when sleeping with their children, and many cultures promote co-sleeping (e.g., either sleeping with the children in the same bed or sleeping in the same room as the children). Regardless of what you decide as a parent, you should do what makes you most comfortable as long as your child is not suffering in any way. Clearly no method is "best;" it's more a matter of being consistent so that your children have a regular routine that they can count on.
   
   
8. Bed-wetting (enuresis) is common among children. It occurs in approximately 30% of 4 year-olds, 10% of 6 year-olds, 5% of 10year-olds, 3% of 12 year-olds, and 1% of those 15 years old or older. There are many approaches a parent can take to treat bed-wetting.
   1. Discontinue all caffeine
   2. Restrict late night fluid intake
   3. Have your child nap in the afternoon, to decrease deep sleep at night when bed-wetting occurs.
   4. Briefly wake child for toileting before you go to sleep.
   5. Consider behavioral treatments, such as the bell and pad which sets an alarm off when child begins to urinate. This wakes the child, who can then walk to the bathroom before wetting the bed.
   6. There are also numerous medications which are effective in the treatment of enuresis.
9. Benadryl should not be used to treat chronic insomnia, although it can be used occasionally for many children. Melatonin has increasing data to support its use in children with chronic sleep problems due to insomnia, jet lag, and circadian rhythm disorders.

Topic for September 5th

Back to School

Tips

1. As the summer comes to an end, it is important to start getting your children into their routine for the school year. Gradually change their bed times and wake times to an earlier hour, take them shopping for school supplies, and talk to them about their thoughts of the upcoming school year in order to mentally prepare them and help them to make a smooth transition from summer to school. When children know what to expect and what is expected of them, they tend to be more prepared and relaxed when entering new situations.
   
   
2. If your child seems overly anxious about going back to school, invite your child to pinpoint their specific fears and talk about each one individually. Talk them through each concern - do not just tell them not to worry.
3. A child can sense when their parent is worried or anxious, and this will often make the child anxious too. Stay calm and optimistic about their new grade and new responsibilities.
   
   
4. To help your child get organized, show him how to use his new notebooks and folders; demonstrate how to get his backpack ready for school, and how to pack it up when leaving school; and demonstrate writing down the homework assignments. Let your child know that on the first day of school the teacher will be explaining the rules and procedures and that he should keep his ears open.
   
   
5. For a child with ADHD or a learning disorder, it will be more difficult to employ organizational skills. For these children, practice may not be enough because the steps one needs to go through may seem tedious and boring, and the kids often become easily distracted. These children may need to be shown more than once what to do. Parents should talk to teachers and gain their assistance in preparing their child, and the child should have a checklist to help her remember to take everything home before leaving school. If a child consistently forgets, parents and teachers should use behavioral modification techniques, such as positive reinforcement (e.g., rewards and encouragement), to help shape the behavior. A parent should strive to figure out exactly where and when the problems with organization are occurring and how the child can do things differently next time.
   
   
6. At the beginning of the school year, all children, but particularly those who struggle with learning, are exhausted when they come home from school. Let them have a little down time before sitting down and starting homework.
   
   
7. Set a clear homework time and place for your child. It is not good for your child to sit in front the television or on their bed to do homework. A desk or table in an area of the home with little distraction (e.g., not the dining room table) is best.
   
   
8. When it is time to do homework, sit down with your child and review their assignments with them. Ask them which assignment they would like to do first and which one will take the most time. Once they have been working for a bit, let them take a 2 minute break to walk around and stretch out. Do not invite long and distracting breaks from study, such as playing computer games or watching TV.
   
   
9. For children with learning difficulties, the child and parent need to work as a team. Parents and teachers should not expect that all children can necessarily complete the same amount of work. Homework is not a punishment. If your child is overwhelmed with homework, speak to his teacher about the optimal amount he requires in order to support his learning.
   
   
10. Do not do your children's homework for them! Homework is intended to support a child's learning and to reinforce the basic concepts taught in class. Parents inadvertently interfere with that process when they complete the work for their kids.
    
    
11. Homework allows children to practice the skills they have learned in school that day. It teaches them to organize themselves and practice time management.
    
    
12. If your child is being bullied at school, inform the teachers and make sure the child is not isolated throughout the day. Bullies thrive when kids are not well supervised. A parent should talk to the child about what is happening and role-play different ways to handle the situation. Children often come up with good answers themselves. With role-play, the child can find a way to respond in a way that works for him, whether it's walking away or looking the bully in the eye and saying they really don't like what he is saying. Adult intervention is still much needed if the bullying is serious and repetitive.