The Anxiety category compiles any blog related to anxiety on the North Shore Pediatric Therapy website into one place. The blogs in this category are meant to help educate, inform and encourage parents of children with anxiety. Readers will learn about separation anxiety, other forms of anxiety, school, red flags, what parents can do to help, what teachers can do to help and more! If you are looking for any information related to anxiety, this category will help you get started. IF you need additional assistance, please give us a call at (877) 486-4140.

Anxiety Disorders in Children

Although anxiety is often thought of as an adult problem, it’s also a childhood disorder. While children do not face the same life obstacles as adults, they have their own issues and struggles. 

Anxiety may be rooted in a specific phobia, such as fear of the dark or fear of spiders, or it may be related to specific situations, such as school or social phobias. Separation anxiety or significant difficulty with transition is often seen in children as well, as is generalized anxiety and discomfort with the unknown and unpredictable.

Children may manifest symptoms of anxiety in several different ways. While some children are able to articulate their fears and stressors, others may express their anxiety through somatization of symptoms, avoidance behaviors, crying, or tantrums.

Anxiety in children should be addressed the same in home and school settings with the goals of identifying the sources of anxiety and learning adaptive coping skills.

Areas of focus in therapy should include:

  • Learning techniques to address emotional regulation
  • Learning strategies to improve impulse control, self-regulation, and on-task behavior
  • Learning and practicing relaxation techniques
  • Promoting emotional identification and social skills development
  • Developing skills to promote healthy self-esteem and decrease negative self-statements.

Children dealing with anxiety in the school environment should also receive academic accommodations and services, whether through a 504 plan or an Individualized Education Plan (IEP). Parents are encouraged to work with school staff to develop the plan.

Some recommendations may include:

  • School social work services or social groups
  • Isolated and quiet areas for completion of assignments and tests
  • Extended time for the completion of tests and assignments
  • Structured physical classroom to minimize distractions (e.g., seat near quiet students at the front of the classroom, clearing desk of materials not essential to the immediate task)
  • Ample repetition of novel information and multi-step instructions
  • Providing information in small chunks and one assignment at time
  • Allowing movement breaks, as appropriate, to provide kinesthetic release and promote leadership within the classroom (e.g., handing out papers, collecting assignments)
  • Allowing the student to take a break when needed to collect him or herself or talk to a trusted adult.

Extra-curricular programming and relaxation (e.g., art, drama, playing a musical instrument, yoga, martial arts, running) are also recommended, as they have been proven beneficial in supporting the development of self-regulatory capacity. It is recommended that children participate in structured social or athletic activities in order to facilitate healthy peer relations and self-esteem.

There is often a strong chemical component in children with anxiety disorders. In some instances a combination of therapeutic intervention and pharmacological intervention will yield the best outcome. It is recommended that parents consult with their child’s pediatrician to learn about the potential risks and benefits of pharmacological treatment.

Cognitive Behavioral Therapy (CBT) is the most empirically supported format for therapy in addressing anxiety. Resources are also available for families through the Anxiety and Depression Association of America website, www.adaa.org. Other resources for families include workbooks such as the What to Do When You Worry Too Much series by Dawn Huebner and The Coping Cat by Philip C. Kendall.

NSPT offers services in BucktownEvanstonDeerfieldLincolnwoodGlenviewLake BluffDes PlainesHinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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How to Talk to Your Children About Hurricane Harvey

In the age of social media and 24 hour news coverage, information spreads faster than ever and parents cannot always screen what their children are seeing. Children will have their own reactions to what they see and this will elicit emotional responses that they often do not know how to handle. Hurricane Harvey

Below are tips to help you explain Hurricane Harvey to your children:

  • Make them feel safe. Whatever you say, end with the message that they don’t need to worry—even if, as an adult, you know that’s not necessarily true.
    • You want them to feel that their little world is still secure. Remind them that there are a lot of people to protect them and that lots of people are working to make sure resources and safety plans are always available.
    • Sit down and have a family meeting to ensure that everyone knows what to do in an emergency. Having set plans will help your child with the fear of the unknown and give them solid ground.
  • Find out what they know and correct any misperceptions.
    • School-age children have undoubtedly heard about the tragedy from their friends, in the classroom and on TV. It’s still important to find out exactly what they know before you start talking.
  • Ask them what they think and how it makes them feel.
    • If they are experiencing anxiety or stress, give them coping skills to work through those feelings.
      • Deep Breathing Exercises
      • Journaling/Coloring pictures about the event
      • Mediation/Mindfulness Exercises

Educate your children on the importance of helping those in need during natural disaster situations such as this. Don’t focus on the destruction, but on the people who are there assisting others.

Here is how your family can help:

  • Find a local food pantry and donate supplies such as canned goods, diapers, pet supplies
  • Contact local Red Cross Chapters and ask how you can help
  • Have a lemonade stand and donate the proceeds to helping families in need

NSPT offers services in BucktownEvanstonDeerfieldLincolnwoodGlenviewLake BluffDes PlainesHinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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IEP Meetings From a Mom’s Perspective

I have worked for North Shore Pediatric Therapy for more than two years in the marketing department. I thought I was familiar with the many challenges families go through with their children, Blog-IEP-Meetings-Main-Landscapehowever, the idea of going through “the IEP process” never crossed my mind, until I had to.

When my son started kindergarten, we had some concerns about certain behaviors, but honestly really thought they were only phases. A few weeks into the school year as they began practicing drills, he had a severe panic attack requiring help from the school social worker. At that time, his teacher recommended he begin seeing the social worker more frequently and that led to our process of seeking a full evaluation to really understand him.

He was evaluated by Dr. Greg Stasi at NSPT and given a diagnosis of Anxiety Disorder and Sensory Processing Disorder. It was then that we were faced with the dreadful IEP meetings. I had heard so many stories of hardship parents faced when fighting for their child’s needs. As a result, I went into the process expecting a fight, and boy would they get one if necessary because in my mind, nothing was going to come between my child getting the help he needed.

Because of my job, I am fortunate enough to have access to excellent professionals and resources, who understand the IEP process, and who helped me prepare for the initial IEP meeting. I was ready for that day. And you know what happened? I didn’t have to fight. I was so fortunate to have a wonderful team wanting and willing to give my son everything he needed to succeed. Everything I was prepared to fight for was already part of their plan, too.

I know this isn’t typical, and so many families struggle to get their child’s needs met.

Here are some tips, from a mom’s perspective on how to approach IEP meetings to get what you, and your child, need:

  1. Be prepared. Those same resources I have access to because of my job…guess what? YOU have access to those same things! NSPT has so many blogs and infographics to help you begin your journey. Having a full neuropsych evaluation is a real plus as it lends a direction for goal development and is appreciated by the district staff.
  2. Be understanding. Understand that those on the other side of the table really do want to help. Often they are restricted by legal mandates. So you may find that there are questions you ask where they can’t fully answer.
  3. Ask questions. Don’t be afraid to ask any and all questions you have in order to understand each element being addressed. It goes fast. And they use a lot of terms you don’t recognize. Stop them and ask.
  4. Bring help. Don’t be afraid to bring outside support, such as a school advocate, to help speak on your behalf. They know the rules and can help you “fight.”
  5. Don’t sign the plan if you are not happy. You will be asked to sign the plan at the end. If you are not comfortable, don’t do it, unless it’s on the condition that you are requesting another meeting to go over the details again to re-write the goals.
  6. Hold Accountability. As the school year continues, don’t be afraid to check in on the team, the therapists, and the teacher to ensure all accommodations are being met.

Be the voice. Remember, you are your child’s voice. Don’t be afraid to speak up.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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Separation Anxiety and Sleepovers

Distress around separating from a primary caregiver can be very common among children and a normal part of development. Children from 1-year-old to about 4-years-old are in the process ofBlog Separation Anxiety Main-Portrait gaining confidence to be independent. Because of this natural part of development, symptoms such as worry, tantrums and clinginess when separating can be common.

If as your child gets older the fear of leaving a parent or caregiver does not decrease that could be a sign that your child is experiencing separation anxiety. Separation anxiety can be defined as intense nervousness around leaving a primary caregiver. Obvious signs of separation anxiety vary from children verbally expressing resistance to go somewhere or displaying unhappiness through crying, fighting or physically holding on to a parent/caregiver. The not-so-obvious ways children can display anxiety around separation can look like silence in a child who is usually talkative, shutting down or physical symptoms like being sick.

There are a number of factors that can attribute to nervousness and hesitation around separating from parents or caregivers. Lack of familiarity in a new environment, break in routine, fear that something will happen when they are away from their family or an over-bearing and clingy parent. If a child feels that their parent does not want them to leave then they will be more likely to fear leaving as well.

As children enter middle school and high school, sleepovers become a more common occurrence among friends. This can be a fun activity for some children or a source of anxiety for others. A sleepover to a nervous child can mean sleeping in an unfamiliar environment, not being able to say goodnight to a familiar person and losing structure/routine often found around bedtime.

Recommendations for parents to help ease their children’s separation anxiety and embrace the pastime of a sleepover are:

  1. Acknowledge and identify the fears that your child’s experiencing. Figure out what are they most nervous about and what are their expectations for the sleepover?
  2. Support your child. Let them know you are proud of them for becoming more independent
  3. Plan a fun activity to do together the day following a sleepover. Planning an activity together reassures your child that though you are encouraging them to do something on their own you are still there to spend time with them
  4. Figure out if there is a parent or caregiver that your child separates more easily from, then try to have that person drop off your child

Children with a healthy attachment to their parent or caregiver are most likely to feel confident when leaving. As a parent, make sure you are promoting your child’s independence while also making sure to be available for your child when they need you.

NSPT offers services in Bucktown, Evanston, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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How to Help Your Child Who Feels Overworked in School

Does your child feel overworked in school? School-related stress is nothing new, but it is now happening to even younger students. With the increased importance of testing on students, teachers, and schools- children are facing more stressBlog-Overworked in School-Main-Landscape in school than parents may have experienced when they were younger.

Here are some helpful tips for how to help your child if they are overworked in school:

Don’t over-schedule kids

Although it is important to have children in activities outside of school like sports or clubs, don’t schedule so much that they are not able to do their homework. If you only have an hour scheduled for homework because they have to run to their art class, then swimming class and they only have time for a quick dinner and then bed, a child may feel rushed or pressured to get everything done. In addition, ask your child what works for them and let them have some control over their schedule. Some kids like to get to work as soon as they get home, while others need a break after school.

Praise effort, not grades

Everyone wants their child to succeed and most importantly everyone wants their child to feel successful and proud of themselves. In some children, that may mean that they bring home straight A’s every quarter or semester, but in some children that may look different. Emphasizing that a child needs a certain grade can lead to them feeling stressed and anxious. The truth is that some students may not be an A student. Praise effort and improvements, rather than A’s. Also, don’t ignore those classes like art or music.

If a child is really struggling in math, but excels in the fine arts, praise them for that specific talent rather than ignoring those “easy” classes. In addition to praising effort, it is important to try and limit consequences for lower grades. If a child studied and put forth effort, but came home with a lower grade than what was expected, don’t punish them- talk about it and how they could have studied or completed the work differently.

What not to say: “7th grade is the most important” “Junior year is the most important” “you need this grade in order to do this…”

When adults make these statements to children, they often hope it will motivate them to study longer or focus more, but it can often do the opposite. If a child hears these statements regularly, it can cause feelings of anxiety. If a child is anxious, they are less likely to be able to study and focus efficiently. It may be more helpful to show specific examples of how certain topics can be used in real life situations. This shows that the information they learn is important, but it alleviates the pressure that if they don’t master the topic, they won’t be successful.

Teach kids effective study habits, and how to balance it.

Sometimes it is not how much you study, but how you do it. Help kids learn good study habits like taking breaks, not cramming for tests, healthy sleep habits, and being organized. Ask your children what works for them. Some people need absolute silence, while some enjoy music in the background. Don’t force a habit on a child that may not work for them. Teaching children these skills will not only help them in school, but as a future employee as well.

Finding a work-life balance is something that a lot of parents and adults struggle with. It is important to model a healthy balance of work and fun to your children, so they can learn how to achieve that balance.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Separation Anxiety and School

It’s normal for children to sometimes feel worried or upset when separating from their main attachment figures. Although it can be difficult for parents and the child, it’s a normal stage of blog-separation-anxiety-main-landscapedevelopment.

Kids will often cry, whine, refuse to part or be overly clingy when it’s time to separate. Usually, these behaviors decrease with age, but sometimes, some kid’s reactions are extreme, and they interfere with their functioning in different areas of their lives. These kids may be suffering from Separation Anxiety Disorder. Kids who suffer from Separation Anxiety Disorder have a persistent fear of possible harm occurring to close attachment figures or excessive fear that they will leave and not return.

Some common behaviors related to separation anxiety include:

  • School refusal
  • Frequent somatic complaints (headaches, stomach aches, nausea)
  • Recurrent nightmares
  • Crying or having temper tantrums
  • Avoiding going to new places
  • Refusal to be alone

A common place where these behaviors occur is at school. For some kids, they might refuse to go to school, or they might have a hard time when being dropped off. No matter what type of anxiety the child is dealing with, it’s important to educate and teach your child about anxiety.

If your child is having anxiety about separating from you, here are some recommendations to consider:

  • Do not allow your child to stay home from school. This only worsens the symptoms over time and doesn’t allow them the opportunity to face their fear.
  • Do not ignore or deny the child’s worries. Teach your child about anxiety and its impacts.
  • Keep calm during separations. If your child sees you staying calm and cool, they are more likely to do so as well. When it’s time to say goodbye, make sure not to sneak out. This will only make the child more afraid.
  • Once your child makes it to school, identify a safe place for them if they are having a hard time. You can work with teachers or school counselors in identifying what would be appropriate.
  • Allow your child to pack a comfort item from school (favorite blanket or animal or a picture) that they can use when they feel homesick.
  • Create a goodbye ritual- maybe a special handshake or goodbye which can help the child feel more secure during the transition.
  • Praise your child’s efforts. Reward brave behaviors, however small they are!

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Managing Anxiety in the Classroom

Anxiety is one of the most common mental health issues in our country, affecting millions of adults and children alike. Children with anxiety at school may be experiencing it for several different blog-anxiety-in-school-main-landscapereasons. A few common reasons children may be anxious at school revolve around separation from parents or caregivers, social anxiety or test anxiety. Sometimes, it’s hard to pinpoint exactly what the cause is, which is okay too. The important thing is that the symptoms are managed appropriately. Since kids spend the majority of their day in a classroom, it is paramount that teachers and other staff are trained to recognize, support and advocate for anxious students.

Identifying anxiety early on is a very important step as it can help mitigate larger problems later on in adolescence and adulthood.

Let’s start by discussing some common signs and symptoms that we may see in an anxious child. These include, but are not limited to:

  • Refusal or reluctance to attend school
  • Difficulty concentrating
  • Negative self-statements
  • Perfectionist tendencies
  • Withdrawing from other children
  • Lack of participation
  • Tearfulness
  • Excessive worrying
  • Frequent trips to the nurse
  • A decline in academic performance

Over the years, our education system has made tremendous progress in identifying and helping children struggling with anxiety. One of the most common are accommodations under a 504 Plan. An example of an accommodation used in a 504 Plan would be adjusting the child’s seating arrangement (often referred to as “preferential seating”). An anxious child may feel more comfortable sitting closer to the teacher, or further away from a highly-energetic or rambunctious child. Another accommodation is extra time on tests (often referred to as “time and a half”), since test-taking can be a common trigger for anxiety. If you feel a 504 Plan might be helpful and appropriate for your child, it would be a good idea to plan a parent-teacher conference to discuss your options.

Close communication and collaboration between teachers and parents is a great way to ensure that your child is getting his or her needs met in the classroom. Sometimes, anxious kids just need a little extra encouragement and reassurance. Positive reinforcement is an excellent tool used for pointing out a child’s successes and efforts, and rewarding them for it. Many schools have a social worker or counselor on staff as well. Social workers and counselors are specifically trained to help children struggling with anxiety and other social-emotional issues. One-on one or small group sessions can be extremely beneficial in helping manage anxiety at school. Incorporating social work minutes into your child’s schedule is a great way to provide your child with extra support during the day.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Sensory Tips for Crowded Holiday Spaces

The holidays are a festive, fun and exciting time to celebrate with family and friends; however, they also bring about a plethora of sensory stimuli everywhere you go! Between the sights, sounds, smells and crowds our senses are overloaded with the spirit of the holiday season. For some people, particularly children with sensory processing difficulties, this time of year can cause stress, anxiety and uneasiness. blog-holiday-sensory tips-main-landscape

In addition to increased environmental stimuli around the holidays, typical routines are thrown off due to breaks from school and travel plans. Children with sensory processing difficulties benefit from a schedule that is predictable, so they know exactly what to expect and how to plan for new or different sensory experiences.

Below are 8 sensory tips to help make the holidays and crowded holiday spaces more enjoyable for your whole family:

  1. Prepare your child for the various events that he will experience over the holidays including specific parties, shopping events or travel. Give explanations of where you are going, what you will do there, what he may see, hear or smell. This will help him to know what to expect at these different places without being worried.
  2. Practice! Before going to various holiday events or places, practice. Stop by the mall with your child for a few minutes a few times before the holiday season, spend time at family or friend’s houses that will be visited over the holidays or visit the airport a few times ahead of your travel day. Giving your child an opportunity to experience these places when they are not as crowded will help him be successful during the busy times.
  3. Use a visual calendar that identifies daily activities over the holidays so your child feels comfortable with their winter break routine. Review each day’s events prior to leaving the house, so your child can better prepare himself for what to expect.
  4. Review pictures or videos from the previous year’s holiday events to remind your child of the sights, sounds, smells and crowds he will experience.
  5. Be prepared! During over stimulating situations your child may benefit from sensory strategies such as headphones, ear plugs, sunglasses, weighted objects or a favorite toy. Be sure to be prepared with these items during crowded holiday events. These strategies will help decrease the intensity of environmental stimuli.
  6. Be proactive! If you see your child becoming upset or overstimulated, find a place to take a break from the situation (bathroom, car, quiet hallway) and help him calm down.
  7. Arm your child with strategies ahead of time to help him through a situation where he feels he is becoming upset or overwhelmed. Strategies such as deep breathing or counting to 10 may help decrease anxiety. Encourage your child to let you know when he feels he needs a break.
  8. Talk to family members and friends about the difficulties your child may have and educate them on how they can help.

Have a wonderful holiday season!

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Helping Your Anxious Child Return to School

With the summer months winding down, and the back to school sales in full force, it’s probably time for Blog-Anxious-Back-to-School-Main-Landscapeyou and your child to start the annual transition from summer camp to school! For many children, this transition is filled with excitement and happiness. For others, the worry monster might be just around the corner. Children might demonstrate tearfulness, tantrums, and frustration due to their anxiety about school.

Below are a couple suggestions to help you and your anxious child get through the first few days back at school:

Create a School Day Routine

The structure of the school day might look a lot different than your child’s summer schedule.  Before school begins:

  • Create a morning routine with a timeline of activities your child will need to accomplish. Depending on your child’s level of independence, think about how much supervision your child will need for each task.
  • Remember to adjust your child’s wake up time to fit the school day schedule if it had changed during the summer. Helping your child create this routine prior to the first day of school will allow your child to understand what is expected and can lead to lower levels of worry.

Transitional Object

Separation from parents in the first few days of school can be traumatic. For younger children, a handful of difficult drop offs is age-appropriate and should decrease over time as your child acclimates to this new routine. One way to support your child through this transition can be through allowing them to bring something to school that reminds them of mom and dad. Transitional objects should be small and minimally distracting in class. A special key chain, small plush toy, or laminated picture of the family can be used for this. Remind your child to hold or look at these objects if they are feeling worried or missing home.

If you notice that your child is having a harder than expected time, their functioning in school is being impacted, or their anxiety about school is not subsiding, reach out for additional support.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Teacher Tips: Accommodating an Anxious Child

Sometimes anxiety can be easy to identify, such as when a child is feeling nervous before a test. Blog-Teacher-Tips-Anxiety-Main-LandscapeHowever, in some children anxiety may look like something else, such as ADHD or a learning disorder.

The following is a list of tips to use in the classroom to accommodate a child with anxiety:

  • Some children may participate in therapeutic services. Therefore, it is imperative to talk with parents/guardian about strategies that work (and do not work) at home. Teachers can use and modify those strategies to help in the classroom.
  • Also, checking in with parents regularly is important to ensure that accommodations are helping and determine necessary adjustments

Homework & Assignments

  • Check that assignments are written down correctly
  • Using daily schedules
  • Modifying assignments and reducing workloads when possible
  • Allowing the child to take unfinished assignments home to complete

In the Classroom

  • Preferential seating that is less distracting
  • With regard to class participation
    • Determine a child’s comfort level with closed ended questions
    • Use signals to let the child know his/her turn is coming
    • Provide opportunities to share knowledge on topics he/she is most confident
    • If possible, only call on the child when he/she raises his/her hand
  • Extended time on tests
  • Provide word banks, equation sheets, and cues when possible
  • Allow for movements breaks throughout the day & relaxation techniques
  • Determine a discreet way the child can indicate he/she needs a break, such as a colored card the child places on his/her desk to signal he/she needs a drink of water, to use the restroom, or any other strategy to lessen feelings of anxiety
  • Allow the use of a fidget for children who have difficulty paying attention

Please refer to the following websites for additional information about anxiety in children and accommodations that can be used, or modified for use, in the classroom.

Resources:

http://www.worrywisekids.org
http://www.childmind.org/en/posts/articles/2015-4-13-anxiety-classroom
http://kidshealth.org/parent/classroom/factsheet/anxiety-factsheet.html
http://www.adaa.org/living-with-anxiety/children/anxiety-disorders-school

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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