Archive for September, 2009

PostHeaderIcon Signs that a child has been sexually abused

A tough question that is often asked of medical doctors, psychiatrists, psychologists, and therapists, is do you think my child has been sexually abused?  It is very difficult for parents to think that this may have occurred to their child and will say, “but I don’t let her go anywhere except to family’s house or our friends.”  The painful fact is that sexual abuse of children is usually from a close family member or friend. 

When children or teens display inappropriate behaviors or make sexual remarks, parents are often at a loss to determine if this is from something they have heard their friends say or seen on the television set, or if something has happened to their child.  Whether a child is very young or even an older child, they usually can not or will not verbalize abuse from a perpetrator. 

There are many physical signs and symptoms associated with sexual abuse, however we will focus on the behavioral or emotional signs that are seen in a child that has been sexually abused.  

The most common symptom for children is sleep disturbance or more specifically nightmares.  They don’t seem to be able to be explicit in describing what is happening in their dreams but they do know that “it is bad.”  Children that have been abused have advanced knowledge beyond their years about sex and they often act very seductive or sexually inappropriate around adults.  They are usually angry and either will cry or they are aggressive towards younger children without exactly knowing why they are behaving in that manner.  Often times in younger children they  display regressed behaviors, such as talking like a baby or they start wetting the bed.  In older children, they will often begin finding places in the house in which to touch themselves or masturbate. 

Other symptoms that may be present are self-mutilation, usually seen in older children, lying or stealing, sudden changes in behavior, running away from home, eating disorders, excessive fears, drugs/alcohol, or threatening to kill themselves.  There is no one sign/symptom or behavior that is proof that a child has been sexually abused, however these are some key symptoms for parents to look for to help them determine if abuse has occurred.  As always, a professional whether it is a pediatrician, psychiatrist, or a mental health professional should be consulted in order to assist with the behavioral/emotional symptoms that are being displayed.

PostHeaderIcon Why are kids overeating?

Binge-eating disorder is a very common problem among children and teenagers.  However, it is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) although in my opinion it should be.  Binge-eating disorder is simply when a person eats a very large amount of food at none time and this occurs two days a week for a period of at least six months.  The child or teenager that is binge eating usually are eating thousands of calories at a time and these are teens that usually have a history of weight problems. 

Bingeing episodes have these qualities:

1.) When a person eats alone because they are humiliated or embarrassed

2.)When they eat until they feel very uncomfortable

3.) They eat much faster than they normally would

4.) Eating when they do not feel hungry

5.) Feelings of disgust, humiliation, or guilt after the binge-eating episode

With all that said, what would cause a child or teenager to binge eat?  Current research believes that the main reason that children or teenagers binge eat is to help calm themselves down or to self-soothe.  It is thought that stress as well as negative emotions such as depression, anxiety, and guilt are the major contributing factors to binge eating. 

The signs of binge-eating are:

When kids or teens start to miss school or events so they are able to stay home and eat.  When they eat, they usually do so in their room with the door locked and they hide food that they have taken from the kitchen in their rooms, usually under the bed.  Watch for eating episodes after a meal is finished as well as their eating large amounts of food that is uncharacteristic for them. 

Binge-eating disorder is usually treated with Cognitive-Behavioral Therapy (CBT) and medications are not usually the recommended treatment for binge-eating disorder.  The goal of psychological treatment is to help the teenager recognize the thoughts and feelings that are causing them to binge eat and help them with strategies to help reduce and eventually extinguish the binge eating episodes.

PostHeaderIcon How to stop arguing with your kids about bedtime

A frequent complaint from parents is how to get their kids to bed at night without arguing and complaining.  Does this sound familiar to you?  You put your child/children to bed at the designated time and five minutes later your daughter or son is out of their room complaining about something.  They tell you that they have to go to the bathroom, they need a drink of water, they are not tired, they are scared, the television is too loud and they can not go to sleep, or they are still hungry!  Most kids have said this or something similar to their parents at least a million times.  So how exactly do we get our children to go to sleep at night and stay in their room asleep.  Here are a few simple tips that may be helpful:

1.) Make sure you are not putting your child to bed too early.  A 3-year-old child most likely has a bedtime that is much earlier than say a 9-year-old child.  Most children require alot of sleep, however if you are putting your eight or nine-year-old to bed at 8 p.m. and they don’t get up until 7  a.m. then you want to consider letting them stay up a little later.  Yes, it is true that children require more sleep than adults, however some children do not require as much sleep as others.  Try letting the older child stay up a little later.

2.) Sitting around playing video games or watching television after dinner will most likely not tire most children.  Try letting them play outside or go for a walk or some type of physical exertion.  Physical exertion wears children out not T.V. or sitting in their room. 

3.)  Turn off most of the lights in the house and if you are watching television then turn the T.V. down.  Most kids, no matter what the age will not go to bed if they think that you are doing something interesting.  Kids have the attitude, “but I don’t want to miss anything” and if they see or hear you laughing or doing something interesting they will struggle to go to bed. 

4.)  Do not feed your child sugar or caffeine at night.  If children are struggling to go to bed, the last thing they need is a soda or chocolate bar after dinner.  These types of snacks, if given should be given after lunch or earlier in the daytime. 

5.)  Keep a routine time to go to bed and stick to it.  If you have a schedule of what your child does before they go to bed, then don’t deviate from the routine.  For example, if your routine is to eat dinner, let your child play outside, then take a bath, then go to bed, then stick to it.  Changing routines, no matter how old the child is disconcerting and most kids and adults do better when they know what to expect. 

Above all, be firm and consistent.  If you give in over and over, then your child will try to manipulate you and test your patience.  You can expect your child to cry, plead, and whine about going to bed.  Expect the argument that will ensue, but remember to be consistent.

PostHeaderIcon How to help children with separation anxiety

Separation Anxiety, which is a common disorder seen in children, is usually seen in younger children, however can affect older children.  What exactly is separation anxiety? Simply stated, separation anxiety is the fear someone has of being left alone.  Parents often see their child become panic-stricken or tearful when they drop them off at school or when they try to leave their child alone with another family member or a babysitter.  Separation anxiety usually begins in childhood and is a mental health disorder.  A child’s temperament plays a large role in whether or not a child is able to move past the normal anxiety that comes with separating from parents.    

What can parents do to help their child through this difficult transitional stage of being alone and separated from them.  First of all, separation anxiety in children is usually seen by parents when their child refuses to go to bed at night by themselves or when they refuse to attend school.  Children will often complain of a headache or a stomach ache in order to get out of attending school. 

The preferred method for treating a child’s separation anxiety is individual counseling and not pharmacological treatment.  The most common treatment method used to treat separation anxiety is behavioral modification.  Behavioral modification is a therapeutic intervention that addresses the specific behaviors associated with separation anxiety.  In this model, parents reward instead of punish a child’s attempts to be alone and the child’s fears are not punished.  For example, when a parent drops their child off at school and their child begins to whine and cry, the positive behavior of the child getting out of the car and going into school after a minute or two to calm down is rewarded.  On the other hand,  the whining and crying the child exhibited as a result of being separated from a parent is not punished.  To help a child that is suffering with separation anxiety a parent should focus on any positive attempts to be separated from them and this behavior should be praised. 

An excellent resource for parents, is the children’s book, Oscar the Pig-Mommy Goes to Work written by Megan Calhoun.  Ms. Calhoun is the founder of and has written an excellent resource book for parents to read with their young child.  Her book helps children understand that separation is a normal and healthy part of growing up.

Treatment of separation anxiety should include the assistance of a mental health professional in more severe cases and counseling focuses on the child and the family.  If psychological treatment is not effective then medication can be considered.  Remember, parents must praise a child’s attempts at separation no matter how small the attempt is.  Even if your child sits alone in the next room and not right next to you, this behavior should be praised.  Allow your child to feel success at every single step of their separation from you and their ability to separate will slowly be achieved.