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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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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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Kindergarten Firsts: Fire Drills, Lock Down Drills and Tornado Drills

It’s that time of year: backpacks are filled with new crayons and pencils, new shoes and outfits have been selected and are ready to go. Along with back to school clothes and medical check-ups, Blog-Kindergarten-Firsts-Main-Landscapethere is another important detail to remember to address with your kindergartner, talking about fire drills, lock-down drills, and tornado drills.

For some children, the idea of fire trucks arriving at school is thrilling and having a break from their classroom to walk outside is a welcomed break. For other children, particularly children with sensitivity to loud noises or changes in routine, fire drills, lock-downs and tornado drills can trigger uncomfortable feelings and even panic. Unfortunately, safety drills are a part of life, but the good news is, there are steps you can take to help your child be prepared for them.

The first step in preparing your child for safety drills is to have a conversation, or several conversations, about them. Approach your child at a time of day when he/she is calm and broach the topic. You can introduce the topic by talking about how excited you are for your child to begin school, reminding him/her of the fun of meeting his/her teacher and seeing his classroom. Next, talk about a variety of things he/she will learn about, like animals, letters and numbers. Then, mention that you want to tell him/her about something that teachers and students learn about and practice so that they are prepared in all situations. Explain that drills are routines that teach them steps to do to keep them safe in case of a fire at school or an unsafe person, or unsafe weather.

You will want to keep the language you use very simple and non-threatening. Emphasize that schools are very safe places and that these routines are practiced because “practice makes perfect;” and that practicing the drills will help them remember the instructions that will keep them safe and keep them calm. If your child has sensitivity to loud noises or changes in routine, you will want to alert your child’s teacher before school begins.

Finally, remember to use calm and reassuring words as you discuss the drills, reinforcing the idea that teachers and staff are trained and that schools are strong and sturdy. If you feel your child may need additional support or reassurance, notify your school principal and your child’s teacher. Remember that North Shore Pediatric Therapy’s services provide counseling and can address persistent worries or other concerns.

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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What Are Disorders of the Corpus Callosum?

This guest blog post was written by Amy Connolly, RN, BSN, PCCN of a community hospital in Chicago.

The corpus callosum is the large bundle of nerve fibers that serve as a pathway, connecting the right andCorpus Callosum left hemispheres of the brain together. Disorders of the corpus callosum, or DCC’s, are “conditions in which the corpus callosum does not develop in a typical manner.” This important brain superhighway is usually formed by 12 to 16 weeks after conception. However, there are some people born without a corpus callosum at all, this is otherwise known as agenesis of the corpus callosum. My 4 year old son has hypoplasia of the corpus callosum, which means that his corpus callosum is thin and therefore may be less efficient. A few other included disorders are partial agenesis, as in partially absent, and dysgenesis, or malformation, of the corpus callosum.

DCC’s, like Autism, are a spectrum disorder, where there is no textbook answer to how happy or healthy someone will be just based off of diagnosis. Many parents are finding out during pregnancy due to the advancement in technology and equipment. Unfortunately, they are not always getting the best advice or support, due to the lack of knowledge on provider’s part. My best advice to them is to be proactive with recommended testing and therapies, but not to stress over the diagnosis itself. Having a disorder of the corpus callosum is nothing to fear in itself.

Every individual with a DCC, will have their own paths and abilities. The diagnosis should not define them or stop them from reaching their true potential, whatever that may be. There are plenty of people who found their diagnosis after a MRI or CT scan was done due to headaches or some type of accident. Someone with a DCC may live a pretty ordinary life and you would never have even been able to tell that they had a “special” brain, if they did not have a diagnostic test for some reason or another. Many people with a DCC have trouble keeping up with their peers when they get closer to their teen years. They may be socially awkward and they may not get the punchline of jokes right away.

For others with a DCC, a lot of therapy and repetition will help them to tell their story. Many of those with a DCC may also be diagnosed with ADHD, Autism, depression, anxiety, and so forth. Some who haven’t had an MRI or CT scan may only be diagnosed with one or more of the other things and do not even know that they have this disorder. Many people with the disorder may also have seizures, low muscle tone, and sensory disorders. Other midline defects can also be common such as eye or vision problems, heart problems, thyroid or growth disorders, and the list goes on. Some people with a DCC may also have feeding tubes as children and they may or may not still need them as they get older.  There is a lot we still do not know about disorders of the corpus callosum, but what we do know is that people with them are pretty awesome! They may usually have to work harder to make those important brain connections, but they always continue to put smiles on our faces no matter how big or small their accomplishment may be in someone else’s eyes!

The National Organization for Disorders of the Corpus Callosum, NODCC, is a nonprofit organization that strives to find out more about people like my son and to spread awareness about the disorder. The NODCC holds a conference every other year in a different U.S. location for individuals living with a DCC, families, professionals, and anyone else who would like to attend. There are multiple sessions on different tracks going on at the same time. This year approximately 600 people are expected to attend. Attendees will be from all over the U.S., with some even flying in from abroad. The conference is at the Marriott O’Hare in Chicago from July 22-24, 2016. For many with the disorder, and their families, conference is like a home away from home. A place where everybody gets each other without having to say a word. High functioning, low functioning, we are all functioning. Together.

To learn more about disorders of the corpus callosum, please go to www.nodcc.org.

Resources:

http://nodcc.org/corpus-callosum-disorders/faq/

Amy CAmy Connolly RN, BSN, PCCN lives in Franklin Park, Illinois.  Amy is a registered nurse at a community hospital in Chicago.  Amy is also stepmom to Patrick (16), mom to Jesse (6), Jake (4), and Marcey (2).  Jake, now age 4, was diagnosed with hypoplasia of the corpus callosum at ten months of age, after a MRI was done due to delayed developmental milestones and a lazy eye.  Amy’s nursing experience did not prepare her to navigate the world with a child with special needs.  She has learned a lot over the last four years and enjoys sharing and learning more with other families.  Amy is also actively involved as a volunteer for the National Organization for Disorders of the Corpus Callosum due to her strong belief in their mission and values.