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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Increase Your Child’s Executive Functioning Skills

As we previously learned in our blog What Are Executive Functioning Skills?, executive functioning skills are what help all of us achieve goal-directed behaviors. They are the building blocks of successful planning, appropriate communication and relationships, and task-oriented behaviors. Executive Functioning

To help your child increase his/her executive functioning skills, we must look at the whole child. If there are other issues, those must be addressed with qualified professionals, supportive family members and school staff.

To help your child become a prepared, organized individual, increase his self-esteem and aid him in social situations, executive functioning skills are crucial.

It is never too late to offer and obtain help; and for your child to learn the skills needed to increase his abilities. As with any skill, it will take effort, practice, praise and patience.

Try these tips to help your child improve their executive functioning skills:

Pre-school and Elementary School

Helping your child increase executive functioning skills may involve adding more structure to his environment.

Aid your child with putting out clothes the night before school or having her backpack ready at the door. Show your child how to put away her toys and allow her to do it on her own.

Do homework shortly after she gets home and in the same spot each time, with minimal distractions. If she is having trouble with staying on task at school, then the school may offer (and you can advocate for) accommodations through an Individual Education Plan.

Demonstrate through your actions and encouragement that being prepared is a positive message that creates less stress for her and the entire family. Model being on time and planning ahead. Use a calendar to plan playdates and appointments, and encourage your child’s participation in basic planning skills (like setting the table for dinner, studying for a spelling quiz, or writing a card for an upcoming party).

Help her notice when it is her turn to talk, and how others feel if she interrupts. Ask her to think about others’ feelings and behaviors and how her actions or words may impact them.

Middle School and High School

As your child gets older, help him to develop skills aimed at organization and time management. Continue encouraging your child to prepare for school the night before. Sit in the same place to do homework every day. Try to begin assigned work when still fresh and not wait until late at night.

Use an assignment notebook. If needed, have the teacher sign it, check it and give it back to provide accountability. Offer positive reinforcement for fulfilling goals. Limit electronics and distractions. Use a timer to discourage procrastination. Give praise.

Enlist help from the school. If your child’s grades are extremely inconsistent, his work is disorganized and he continually forgets to bring/do homework assignments, it is likely time to speak to your child’s teacher, counselor or social worker.

Your child may need further accommodations at school. These may be resource time to finish homework, meetings with the counselor for encouragement, checking his backpack and locker, preferential seating in class, checking of his assignment notebook to ensure he is writing down his assignments and knows what is expected.

College Years and Beyond

The goal is for our children to be prepared to not just handle the world of work and daily living on their own, but to be happy and successful doing so. Using executive functioning skills such as time management, planning, and organization enables kids to be successful when they are on their own. Being prepared for a work presentation takes planning, time constraint considerations, and organization.

Increase confidence in your child and help him build positive relationships as he learns to navigate social interactions, anticipate possible outcomes and problem-solve to come up with potential consequences of his behavior.

Executive functioning skills will allow your child to cope with many of the stresses presented in his daily life.

Let’s help our children now to increase executive functioning skills that will allow them to be productive and successful in their future. Help them continue to blossom!

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 Get Your Kid to Sleep in Their Own Bed

Bedtime can be a stressful time of the day for both children and their parents. Getting your child to sleep in their own bed at night can be quite the challenge. Figuring out what works best for you and your child can be exhausting and may require a trial-and-error process. Sleep Blog

If you are searching for ideas to help your child sleep in their own bed at night, you may be interested in exploring some of the options below:

Bedtime routine

  • A bedtime routine is extremely important if you are having a difficult time getting your child to stay in their own bed. It may be helpful to have them take a warm bath, put on their pajamas, brush their teeth and pick out a book, as well as a stuffed animal to sleep with before getting into bed. Establishing a before-bed routine will reduce your child’s stress levels and assist with falling asleep, staying asleep throughout the night and waking up feeling refreshed. Many children benefit from a visual schedule, so that they can follow a step-by-step picture sequence of their routine.
  • During the hour or so before bed, make sure your child engages in calming activities. Activities that are alerting or stressful for your child can make the transition into bedtime more difficult. Examples of calming activities may include guided meditation, listening to calming music, yoga, drawing or reading a book.
  • Keep in mind that consistency is key! It is important to establish a routine and stick with it, even if you may not be noticing immediate results.

Gradual transition

  • Be sure to give your child ample warning time before bedtime approaches. Moreover, do not suddenly tell your child that it is time for bed while they are in the middle of their favorite activity. It is beneficial to give them a reminder that bedtime is approaching, roughly an hour before they should be asleep, with consistent warnings until it is time to go to sleep. If your child has not yet mastered the concept of time, using a timer can assist with this.

Bedtime fading

  • Another option is a concept called “bedtime fading.” This is putting your child to sleep somewhat later than their usual bedtime, so that they are more tired and fall asleep faster. After doing this for a few days, you can gradually shorten the time down closer to their actual bedtime. For example, if bedtime is typically 8 p.m., put your child to bed at 8:30 for a few days. Then 8:15 and so forth, until you get back down to 8. This allows them to gradually learn to fall asleep alone, especially if they prefer to have a parent with them in the room in order to fall asleep.
  • Your child may also benefit from keeping their bedroom door open. A child may feel better falling asleep on their own if the door is open at least halfway. If they do not stay in their bed, the door gets closed. You can also try using a nightlight to increase their level of comfort while they are trying to fall asleep.
  • Gradually moving yourself out of the room may also be beneficial. Explain to your child that you will stay on the floor next to them until they fall asleep. The following night on a chair nearby, etc. After a few days, the goal will be to phase yourself out of their room.

Reward system

  • A reward system works well for many children, especially during bedtime. If your child lays in their own bed without coming out, they can earn a breakfast treat or pick a prize out of a bin of options such as stickers or toys of your choice. You can even place that reward on a shelf in their room, so they know it is there for them in the morning. If your child comes out of bed throughout the night, they do not receive a reward; however, can try again the next night. It is best not to bring too much attention to the fact that they were unable to achieve the reward and focus more on earning it for the following day.

Re-direction

  • The first time your child gets up from their bed, take them by their hand, walk them back to bed and calmly state that it is bedtime and they need to go to sleep. The second time, do the same thing but just say the word “bedtime.” If it happens again, say nothing and silently walk your child back to bed. The less talking, the better, as to bring less attention to the situation.

Praise your child

  • Saying your final “goodnight” should be brief. You may want to discuss how your child’s day went and what will take place tomorrow. Praising your child for something he or she did during the day that you were proud of them for will help them to fall asleep on a positive note.

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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5 Things to Keep in Mind When Potty Training a Child with Autism

Potty training is a big milestone for any child. It definitely is an important milestone for parents as well! No more diapers!! However, there are some things to keep in mind prior to considering potty training as well as during potty training. Blog-Potty-Training-Main-Landscape

  1. When should you consider potty training?
    • On average you would consider potty training when the child is around 2.5 years of age and above, can hold urine for 60-90 minutes, recognize the sensation of a full bladder, and show some form of awareness that they need to go to the bathroom.
    • Do at a time when you can spend large amounts of time at home! Some parents find it best to do in the summer (less clothing!).
  2. What schedule should you use when potty training?
    • You want to take your child to the bathroom every 90 minutes, if your child urinates then you wait for the next 90 minute interval, if not you reduce the time by 30 minutes.
    • Consistency is extremely important to ensure success.
  3. While on the toilet what should we do?
    • Praise your child for sitting appropriately on the toilet.
    • You can do activities with them as long as they are not too engaging or involved.
    • If they do urinate you want to CELEBRATE!
    • You need to wait up to 15 minutes if there is still no urination, then you let them get off and bring them back after 60 minutes (this keeps decreasing by 30 minutes each time there is not urination).
  4. What should you do when there is an accident?
    • It happens! Make sure you have your child help you clean it up, this is not meant to be punishing but more a natural consequence of having an accident. Keep a neutral tone and assist your child if needed to clean up the mess.
    • If your child is having too many accidents you may need to shorten the intervals of going to the toilet, or it may be that your child is not ready to be potty trained yet. Always rule out any medical reasons as well!
  5. Things to remember!
    • When starting potty training you want to make sure you child can sit on the toilet for up to 15 minutes with minimal challenging behaviors.
    • The goal is INDEPENDECE, you want to work towards your child walking to the bathroom on their own and removing and putting on their underwear and pants independently as well as washing their hands.
    • Make sure you child is in underwear throughout potty training! NO DIAPERS/PULL UPS!
    • Diapers and pull-ups are okay during nap time and bed time.
    • Number one thing to remember is PATIENCE, try to be consistently upbeat and encouraging to your child and deal with accidents as calmly as possible!

It is important to ensure that potty training is as positive an experience as possible for your child! Maintain your positive energy and constantly praise appropriate behavior seen throughout the potty training process! This will encourage your child to become more independent as well as want to go to the bathroom more often on their own!

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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The Difference Between Positive and Negative Reinforcement

Trying to figure out different ways to approach behavior can be overwhelming and frustrating. One thing to always remember is to try and focus on reinforcing the behavior you want to see moreBlog-Reinforcement-Main-Landscape
than punishing the behavior you are wanting to decrease. Using positive and negative reinforcement can both help achieve the same goal of increasing the behavior you would like to see more of.

The difference between positive and negative reinforcement is simple. The use of positive reinforcement is adding something (typically something that is liked) to the environment after a behavior occurs that will increase the future instance of that behavior. The use of negative reinforcement is taking away something (typically something that is not liked) from the environment after a behavior occurs that will increase future instances of that behavior.

 Examples of positive reinforcement include:

  • Giving a praise after a specific appropriate behavior occurs and then that behavior continues to increase.
  • Earning a special treat after a specific appropriate behavior occurs and then that behavior continues to increase.
  • Getting a 5 minute 1:1 time with parent after a specific appropriate behavior occurs and then that behavior continues to increase.

Examples of negative reinforcement include:

  • Removing a chore from the chore list from the schedule after a specific appropriate behavior occurs and then that behavior continues to increase.
  • Taking away a specific school related task after appropriate behavior occurs and then that behavior continues to increase.

The key to making sure either type of reinforcement is working is to measure and track the behavior and see if that behavior is increasing over time!

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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Parenting vs. Technology: Helpful Strategies to Combat Electronic Overload

Chromebooks, iPads, Nooks, oh my! It would not be surprising if your child has access to more than one piece of technology in your home. With that said, the struggle to balance technology needs for school with the games and activities that take over your child’s night and weekends is real. BlogParents-vs-Technology-Main-Landscape

Although it may be frustrating to accept that technology is not going away, it’s important to recognize these moments as learning opportunities and a way to become a more creative parent.

Below are some helpful strategies to implement when combating technology:

Reward Responsibility – Create a system in which your child can earn ‘technology minutes’ for completing chores. Similarly to earning an allowance, this can be a great way to get your child more active in helping around the house.

Limit Bingeing Behaviors – Allowing your child to play on technology for multiple hours at a time on the weekend will likely make shorter episodes more difficult to transition out of. When your child has more time available, limit play to 30 minute or 1 hour increments, with other family activities in between.

Practice Transitions – Turning off the iPad, Xbox, or computer is a great opportunity to practice transitions. Provide your child with time warnings, clarify expectations, and work with your child to plan for the next opportunity to use electronics. Remotely turning off the family Wi-Fi can also be a helpful way for children to recognize that their time is up.

Become a Minecraft (or fill in the blank of which game your kiddo likes) expert! – Many of the games and activities your child plays can be a great way for you to spend quality time with your child in “their world.” Ask questions about the games. Read up on the latest news. Show interest and join in!

NSPT offers services in Bucktown, Evanston, 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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Help! My Child is Wetting the Bed

Wetting the bed is a very common issue that occurs with many children. Below are some preventative and reactive strategies to help decrease bed wetting from occurring. Blog-Wetting the Bed-Main-Portrait

Preventative Strategies for Wetting the Bed

Liquid Intake

It is important for children to drink liquid throughout the day to stay hydrated, but it is best to stop drinking liquids before bed time. This may prevent the bladder from having to be emptied while the child is asleep.

Bathroom Schedule

Scheduled bathroom breaks help empty the bladder when it may need to be emptied. Many times when children are engaged in a preferred activity they choose to not use the bathroom when it is needed. Bathroom breaks/schedules throughout the day can prevent other issues like infection or wetting pants during other parts of the day. Using the bathroom multiple times or at least one time right before bed may help the child from needing to empty the bladder while he or she is sleeping. Parents can also wake their children up when they are getting ready for bed and have them use the restroom one more time.

Reactive Strategies for Wetting the Bed

Waterproof bedding

When a child does wet the bed, use waterproof bedding, blankets, and padding to prevent any damage to mattress. Clean up will also be easier.

Alarms

Sometimes children are in such a deep sleep that the signal of wetting the bed does not wake them up. There are alarms that can be bought to help signal/wake the child when he or she needs to use the bathroom in the middle of the night.

Open Communication

It is important to not embarrass your children or make them feel bad when they wet the bed. This can be a sensitive topic and it is important for open communication and to make you child feel comfortable when it happens.

NSPT offers services in Bucktown, Evanston, 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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Help for Defiance

Life can already be busy enough making sure your child gets through all of the tasks he or she needs each day. The last thing you need is your child refusing to follow directions. Here are some proactive and reactive strategies for when you need help with defiance. Blog-Defiance-Help-Main-Portrait

Preventative Strategies for Defiance

Clear Directions/Expectations

When asking your child to complete a task, make sure you are crystal clear with the directions. For example, if you ask your child to clean their room, your child may go pick up their clothes off of the floor and then say they are all done. When you go to check the room you say, “Your room is not clean.” This may cause an argument/conflict. To your child, a clean room means there are no clothes on the ground. To you, a clean room is a made bed, clothes folded and put away, and a clean desk. Clearly state your expectations to leave no room for confusion and make success more achievable for your child.

Offer Choices

Sometimes, your child may get overwhelmed and become defiant if they have numerous tasks to complete. Giving them the option to choose what tasks they need to complete each day may make them more compliant and successful. For example, give your child the option of making the bed or cleaning the clothes off the ground. Another example is giving your child the option of which homework assignment they would like to complete first.

Shortening Tasks

I know many teachers who use this tip when working with students who refuse to do their work. For example, they might give a student a math worksheet of 20 problems and ask them to complete 15. Another way to use this tip is asking them to work on one problem or one part of the task and then increasing the number of problems/parts of the task over time. Following strategies like this may feel like you are giving in to them, but in the end they are still completing part of the task, as opposed to refusing to address it at all.

Offer Rewards

Many children are motivated by rewards. When stating your expectations, ask them what they would like to earn after they complete the task or give them options of what they can earn. You want to make sure you do this while stating the expectations. If you do not, and your child engages in defiant behavior and you then offer the reward, it becomes a bribe. Bribes are dangerous for growth because they teach children that if they refuse to do something at first, they will eventually get something extra. We want them to learn that they get a reward by complying with the task.  For example, “What do you want to earn when you complete your chores? You can get 15 minutes on the iPad or a candy bar.” Make sure the rewards are activities or items that your child enjoys and will motivate them. If earning a reward is not enough, you can also present the consequences of what will happen if they refuse to do the task.

Reactive Strategies for Defiance

Reassess Motivation

After the child decides what they want to earn, they still may not complete the task. Their behavior shows that the reward may not be motivating enough for them. You can offer new choices or remind them what they are earning if they complete the task.

Stay Calm

When your child is engaging in defiant behaviors you want to stay calm. Use a neutral tone when you speak to them and make sure your facial expressions stay neutral, too.

Stay Consistent and Follow Through on Expectations

If you offer your child a reward after they complete a task, make sure you give it to them immediately. If you do not, your child may not be motivated by rewards because they will become skeptical. Additionally, you can’t give them the reward at a later time if they do not complete the task.

Deliver Verbal Praise for Appropriate Behaviors

When your child is being compliant instead of showing defiance, please deliver verbal praise!

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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Handling Breaks from School

Join one of our BCBAs, Jennifer Bartell, to learn about handling breaks from school. She discusses using multiple kinds of visual schedules.

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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Help! My Child is Biting

Biting can be a very challenging behavior to deal with. It can result in physical and emotional distress to all individuals involved. In order to accurately address biting situations, we must blog-biting-main-landscapedetermine why the individual is engaging in that behavior. In other words, we need to know the function of the biting. Like any behavior, biting has a history of reinforcement. This history plays a big role in the function of biting.

We can determine the function by analyzing what occurs immediately before the behavior (antecedent) and what occurs immediately following the behavior (consequence). Sometimes we may not be aware that our own behavior is impacting the child’s behavior. Once we are able to identify why a child is engaging in a behavior, we can change our own behavior which will lead to changes in their behavior.

There are many possible functions for the biting which can include: escape, attention seeking, gaining access to materials, or sensory stimulation. Below you will find a detail of the functions and suggestions to decrease biting given that particular function.

Functions and Working Tips for Biting:

  • Escape or Avoidance: The child might behave in a way to get out of doing an unfavorable task/activity or to remove themselves from a particular situation. The child might engage in biting in order to avoid doing something they do not want to do.
    • Working Tip: If you ask a child to follow your instruction, but they engage in refusal behavior and biting occurs, it is important that you continue to present the request for the child and follow through with your instruction. By not allowing the child to escape the demand, biting is no longer resulting in an inappropriate escape of demands.
  • Attention seeking: The child might bite as a way to gain the attention of others. When a child bites you or themselves it is natural to react in a certain way. You may raise your voice, make different facial reactions or pull away quickly. By providing this attention after biting occurs, the child may be more likely to repeat this behavior in the future to gain your attention.
    • Working Tip: If a child is biting to gain your attention, ignore this behavior by providing no facial or vocal reactions. Instead, provide attention for appropriate behaviors during periods of time when no biting is occurring.  If the child is engaging in self-injurious biting behavior, you can block the behavior without giving additional attention to the child to ensure safety.
  • Access to materials: The child might bite to gain access to preferred items or activities. If you are giving a child something they want after they bite you, you are likely reinforcing this behavior.
    • Working Tip: It is important to refrain from giving the child access to any preferred items or activities when this behavior occurs. Instead, provide access to these after they engage in other appropriate behaviors (i.e. asking appropriately, handing you the appropriate picture exchange card, etc) to tell you what they want.
  • Automatic (sensory stimulation): The child may be biting because it is something that feels good to them.
    • Working Tip: To address this behavior you can give the child something more appropriate that they are allowed to bite on like a rubber chewing item.

Things to Remember When it Comes to Biting:

  • Consistency is key: Once a function of the behavior is determined, it is important that everyone who interacts with the child addresses the behavior in the same way in order for the intervention to be effective. As long as the biting behavior is working for the child to get what they want, even if only on some occasions, they will continue to engage in this behavior.
  • Reinforcement: Reducing/eliminating the biting behavior is important, but at we also want to teach children appropriate behaviors to replace biting to ensure they are getting their wants and needs met. By applying the principles of behavior, you can teach your child more appropriate ways to gain attention, access to preferred materials, or to ask for a break from a non-preferred activity.

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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