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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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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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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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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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Helping The Anxious Child Using Exposure Therapy

Anxiety and worry serves a biological purpose. It helps protect us from potential danger by pumping our body with the chemicals and energy to fight or flight. However, sometimes children (and adults) experience anxiety over situations that pose no danger.BlogExposureTherapy-Main-Portrait

What’s a parent to do in this situation? When your child expresses discomfort or anxiety over something benign, like riding a bike or the neighbor’s friendly dog, a parent’s first inclination is to do anything to alleviate that anxiety. For example, a parent with a child who begins to develop worry over sleeping in their own bed might allow the child to sleep in their bed because it eliminates that uncomfortable, anxious feeling. This approach might help in the moment, but avoiding situations that provoke anxiety often further perpetuates that anxiety. This fact is the underlying theory for exposure and response prevention therapy, a treatment approach for anxiety that has been empirically validated through multiple research studies.

How Does Exposure Therapy Work?

Exposure therapy involves creating a hierarchy of situations around a specific fear with the most anxiety provoking situation at the top. In treatment, therapists can support your child in developing this hierarchy, learning coping strategies, and providing exposure to each trigger on the hierarchy starting from the bottom. While exposure therapy is typically a short term therapy for mild to moderate cases (8-12 sessions), the goal is to go slowly and at the child’s comfortable pace. You only move on to the next step on the hierarchy when the anxiety provoked by the previous step has faded.

What is the One Simple Step Parents Can Take to Help Their Anxious Child?

Help them face their fears and not avoid them. Talk to your child about how you want to help them feel comfortable in that situation and ask them to identify baby steps to slowly work towards that comfort. Exposure therapy should only be done under the care of an experienced clinician. If your child struggles with specific fears or obsessive-compulsive symptoms, seek a skilled therapist to guide you and your child in overcoming these symptoms and improving their daily functioning.

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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How to Help When a Child You Love Suffers Trauma

Early trauma can leave a lasting impact on a child’s brain.  The younger a child is, the more vulnerable their brain may be to the impact of trauma.  Childhood trauma can include any negative experience that causes major stress.

Having healthy relationships with caring adults can help children who have experienced early trauma.  When children feel unsafe, they spend more time in the “survival” part of their brain as opposed to the “thriving” part of their brain where they are bonding with caregivers, learning to talk, etc.  Early trauma can interfere with learning and may lead to other health problems in the future.

You can help a child who has suffered childhood trauma in the following ways:

  • Facilitate opportunities for children to talk about what happened.
  •  Help children play out their feelings.
  •  Allow the child to talk and tell their story without pressure. Read more