Monthly Archives: April 2019

Anxiety 101 for parents

Anxiety is a normal response to stressful events such as tests or friend drama

Anxiety disorders arise when the anxiety is out-of-proportion to the situation and impairs daily functioning

If anxiety impairs functioning, then it is important to recognize and seek treatment. First line treatment is usually Cognitive Behavior Therapy through a trained therapist/counselor

Symptoms include overwhelming worry, difficulty tolerating uncertainty, an overactive response to fears and avoidance of situations

Some children react with explosive fear and others react by shutting down emotionally

Children with anxiety disorders often avoid situations that may trigger anxiety

What can you do to help?

Explain that anxiety is a normal part of life and learning to identify and respond to anxiety thoughts can really be helpful

  1. Model positive coping skills in your own everyday anxiety provoking events
  1. Remain calm and carry on
  2. Reframe (change) your own thoughts to recognize that you can work through the anxiety
  3. Make positive comments such as “I know this is stressful, but I can handle this”
  4. Avoid negative comments like “I’ll never get through this”
  5. If you think/say that you cannot handle everyday events, your child will quickly think the same about themselves
  1. Help your childidentify the anxiety provoking thoughts he/she may have and show them how to reframe (change) their own thoughts
  1. It is okay to validate fears by asking your child what makes them afraid
  2. For a simple example, if a child is afraid of the dark at bedtime
  • Turn on the light, look under beds, in closets to show there is nothing to fear
  • Turn off the light, lie with your child, point out shadows that are stuffed animals, furniture, etc.
  • Turn on the light and point out the items that caused the shadows
  • Repeat this process as many times as necessary for the child to gain confidence that the frightening shadows are really not frightening at all
  1. You are showing the child that he/she can think through the fear using logic
  2. And that he/she is in control of their own thoughts
  • I can be afraid but face the fear and make it go away
  • I am not in danger
  • I can be strong/brave
  1. What not to do
  • Do not say or think: “He probably won’t hold up if I don’t help him”
  • “I have to save her from this awful feeling”

There are many types of anxiety in children and adolescents:

  • Separation anxiety: When children are worried about being separated from caregivers
  • Social anxiety: When children are excessively self-conscious around others or in groups
  • Selective mutism: When children cannot speak in some settings, like at school
  • Generalized anxiety: When children worry about a wide variety of everyday things. Kids with generalized anxiety often struggle with perfectionism
  • Specific phobias: When children have excessive fear of particular things. This includes arachnophobia, fear of spiders, or school phobia, refusing to go to school
  • Panic disorder: When children have sudden, unpredictable panic attacks that may cause feelings of impending death or doom and symptoms of rapid heartbeat, difficulty catching their breath, and sweating
  • Obsessive-compulsive disorder (OCD): When children have unwanted thoughts that feel stuck in their minds and they try to neutralize the thoughts with ritualized behaviors such as touching the light switch 3 times or counting steps
  • Post-Traumatic Stress disorder (PTSD): When children have symptoms after a disturbing event such as difficulty sleeping, nightmares, irritability, and flashbacks or reliving the event

Does your preschooler have ADHD?

All preschoolers are naturally active, impulsive, oppositional, sometimes defiant, and impatient. ADHD is a neurodevelopmental disorder, so how can you tell if your child’s behavior is typical or outside the range of typical development?

1. How Often Are You Getting Calls from Preschool?
Are you getting calls about your child’s behavior a couple of times a month? Or is it multiple times a week? Typical preschoolers push boundaries and may get in trouble occasionally. However, preschoolers with ADHD are more disruptive and get into things they shouldn’t much more often than their peers. Preschool teachers are concerned because they frequently can’t sit in one place and have problems with impulse control.

2. How is Your Child Doing with Circle Time?
Preschoolers with ADHD often have difficulty with circle time. The teacher is interacting with the whole class and not directly with your child. Kids with ADHD have difficulty in these settings and their attention wanders. They do much better with one-on-one learning situations in which they get immediate feedback.

3. Can Your Child Follow One or Two-Step Directions Without Getting Distracted?
Preschoolers should be able to follow one- and two-step directions, such as, “Hang up your coat and put your shoes away.” Sure, there are some “typical” preschoolers who won’t follow instructions because they’re feeling defiant. But kids with ADHD often have more problems with working memory than other children. They may want to do what you’ve asked, and may begin to attempt it, but get distracted by something else.

4. Does Your Child “Dart”?
Kids with ADHD will frequently “dart.” They’re flight risks. They’re supposed to be in line at school, moving from class to recess, but go in another direction or “dart” in a parking lot or store. This could be an indicator of your child’s distractibility and impulsivity.

5. Do You Avoid Taking Your Child Out in Public, Even to Casual, Family-Friendly Places?
Children with ADHD can’t sit still and will frequently run off and get into things. This can become so problematic that parents avoid taking them to family-friendly restaurants. Some refrain from short trips to the store because of this problem.

6. Could Your Child Have Another Health Condition?

For example, some behaviors are due to other issues but look like ADHD.

A) Difficulty Hearing can lead to not seeming to listen when spoken to directly

B) Language or Learning Issues can also lead to not seeming to listen or not following through on directions

C) Sleep Apnea or Poor Sleep can cause symptoms of hyperactivity and inattention. Preschoolers do not typically snore so if your child does, it could be a sign of sleep apnea

7. Have There Been Recent Acute Stressors for Your Child?
If you’re seeing an acute behavioral problem following a big family stressor, be patient and help your child deal with the stressor before considering ADHD. For example, a recent death in the family, an illness, a parental separation, or a new baby can all impact a child’s behavior negatively. Behavioral issues should be going on for six months or longer before we would consider ADHD as a possibility.

PUTTING IT ALL TOGETHER
Remember that children with ADHD are often:

  • More sensitive to environmental factors than other children
  • Tend to do better in one-on-one situations with adults rather than in a group
  • Act differently in the presence of an authority figure when rewards are present
  • Despite this day-to-day or moment-to-moment variability in behaviors, children with ADHD show ADHD-related behaviors in more than one setting. Not just at home or just at school, but in both.

As you’re answering the above questions and considering whether your child’s behavior is consistent with ADHD or not, think about how often the behavior is happening and how intense it is. When a child has ADHD, there is a long-standing, high frequency, chronic nature to the concerning behaviors. If this is the case for your child, it may be time to contact Greenville ADHD Specialists, P.A.