Archive for February, 2010

PostHeaderIcon Social Phobia in Kids

Social phobia, which is also known as social anxiety disorder (SAD) is diagnosed with a child or teenager has a persistent fear of social situations, performing, and talking in front of other people. SAD is usually seen when your child or teen has a fear of being criticized or judged or when they are put in embarrassing situations with people that they are unfamiliar with. Social phobia affects one in every twenty-five children, and is diagnosed twice as often in girls than it is in boys. Teenagers are particularly occupied with how they compared and how they are viewed by their friends, and being self-conscious is relatively normal. SAD, however is diagnosed when the symptoms become extreme and interfere with your child or teens ability to function.

For a child/teen to be diagnosed with SAD the symptoms must last for a period of at least six months and this disorder is not simply when a child is experiencing some discomfort when they are put in any new situation. There is no one symptom that defines SAD, rather it a cluster of symptoms and when your child experiences a variety of symptoms.

Symptoms of SAD are:
Fearing scrutiny by others in social situations
Crying, throwing temper tantrums or anger episodes, or freezing when a child has to be a social situation
Avoiding the situations that cause the fear
Complaining of being sick in order to avoid having to go to school
Feeling like they are outside of the group or playing solitarily, or having few to no friends
Unwillingness to participate in group activities at school or on group projects, fear of raising their hand in class to avoid anyone looking at them, or being afraid to read in class

Four out of every ten children that have SAD refuse to attend school because of their anxiety. When your child/teen finally does go to school, they will most likely ask to go to the nurse’s office in order to avoid being in class and having to be around others or having to interact socially in a group. If your child has SAD, then they will most likely struggle with speaking up in class or asking the teacher for help and will have problems making friends. Social anxiety also causes physical symptoms in a child/teen and they will most likely blush or start sweating, experience dry mouth, feel nauseous, start trembling or shaking, and experience heart palpitations or dizziness.

Kids/teens that suffer with social anxiety when they are younger, are more likely to remain single in the future, attain less education, consider hurting themselves, have an erratic work history, abuse drugs or alcohol to deal with the anxiety, or have other psychiatric disorders. SAD is a disorder that requires psychiataric or psychological treatment. An effective treatment for SAD is Social Effectiveness Training that teaches children how to cope and effectively deal with social situations. This is a treatment that teaches children the necessary skills in order to handle any social situation in a competent manner, which in turn increases their self-confidence and self-esteem.

Adapted from The Everything Parent’s Guide to Children with Anxiety by Ilyne Sandas, M.A, and Christine Siegel, M.A. , 2008.

PostHeaderIcon Letting kids suffer consequences

As parents many of us have significant difficulty in letting our children suffer the consequences of their actions. We feel obligated to bail them out of their troubles that they have actually created for themselves. Here is a good example of this:

Your child has a class project that is due and they tell you the night before that it is due tomorrow. You as the parent do not want your child to get a bad grade so you stay up half the night helping them work on the project. You of course ask your child, “how long have you known about this project?” Your child answers, “a few weeks now.” Of course all projects need supplies so you run to the store in the middle of the night to get paper, glue, and everything else that is needed for your child’s project as well.

In essence, what has happened here is that the parent has enabled the child to not be responsible for their actions and they bailed them out. A better scenario would have been for the parent to emphathize with their son/daughter that the project was due but make them stay up to do it. Yes, this may sound harsh, but think of it as more as “tough love.” The lesson that needs to be taught is for the child to look to the future and to know that their decision to do or not to do something is entirely up to them, however their choices result in consequences.

If a parent bails their child out of situations of which their are negative consequences, then the parent has taught their child to be irresponsible and a negative pattern of behavior for future actions/behaviors has developed. Of course, every child forgets things now and then, and you as a parent can help them, but if you notice that this occurs all the time, then it is time to let your child suffer the painful consequences of their actions. If you find it difficult to allow your child to suffer consequences, then be sure to find someone that can help you through your own resistance of enforcing rules/boundaries.

PostHeaderIcon ADHD Medications for kids

The question as a parent of a child with ADHD is often, “should I give my child medication or not?” Parents are often at odds with themself and with their spouse on the decision of whether or not to give their child medications because of the potential side effects. In addition, they often hear other parents saying negative things about the medications. As a therapist, what I often hear from parents is, “I don’t want anything that will make my child like a zombie.” To make the decision to medicate your child is often a difficult one and you and your doctor will have to consider many factors in making this important decision.
As a parent, if you decide to medicate your ADHD child then you need to monitor your child’s reactions to the medications and if their are adverse effects then the trial of medication should be stopped immediately.

Stimulant medications are the most popular medications used with children with ADHD, especially when your child’s inattention or impulsivity/hyperactivity is interfering with their school work or in their ability to get along with other children due to behavioral problems. Also to consider as a parent are alternative treatments such as individual counseling for your child as well as holistic treatments such as Attend, Focus or Omega 3 with Fish Oil, which are considered alternative treatments. Your child’s dietary intake should also be considered as well as if they are getting enough exercise. The food your child eats really does make a difference in their behaviors.

There is no way to predict which children will respond well to ADHD medications and which children will not, which is unfortunate because children often have to be tried on a number of treatments before something finally works for them. The most helpful criterion to date in predicting which children will respond to medications is the degree or severity of the child’s hyperactivity or inattention. The more severe these symptoms, the better a child will respond to the medications. However, a diagnosis of ADHD does NOT mean that a child should automatically receive ADHD medications. There are other things to consider before medications are used and these need to be discussed with your child’s doctor. For example, the age of the child should be considered, have other approaches been used, have all physical or developmental disorders been ruled out, can the medications be properly supervised by you as a parent, is the child’s behavior severe enough to warrant the use of medications, and lastly how does your child typically respond to medications.

If all of these things have been taken into account and have been discussed with your child’s doctor, then medication for ADHD can be considered. ADHD medications should never be used as a first resort but as a last resort when all other treatment approaches and factors have been looked at. If a parent makes the decision to medicate their ADHD child, then medications should be monitored regularly by their child’s physician. The decision to medicate your child is a difficult one and all factors need to be considered before making the choice to give your child ADHD medications.