Monday, November 23, 2009

The Sibling Situation


by Lauren King, MA

Here, at Southeast Psych, we work with a great deal of children on the Autism spectrum. What we don’t see is what happens in their homes. Many of these children have countless hours of therapy in their home such as ABA. They might also have speech and OT appointments during the week. The child on the spectrum needs a great deal of support in order to function at the highest level of social, behavioral, academic, and emotional functioning possible.

The stress experienced by families due to the care involved for a child on the Autism spectrum can be tremendous. Parents can oftentimes express their feelings, but what about siblings? How do they feel about having a sibling who is different? What do they think about having different types of therapists in their home all week?

We know that the potential stressors for children who have siblings on the autism spectrum are changes to the family structure, feelings of confusion brought on by the sibling’s behavior, and loss of attention. They also experience feelings of jealousy, embarrassment, and guilt.

What siblings need right now and how you can help:

  • Education about Autism/ Asperger’s (depending on age/maturity level): Have a “sit down”, and teach them about their sibling in clear and age-appropriate terms.
  • A support network potentially of sibling peers to normalize their experience (feelings of jealousy, embarrassment, or guilt): Have them join a group such as Sibshops or the sibling support group at Southeast Psych (for more information, contact lking@southeastpsych.com).
  • To be able to respond to peers about their sibling: Model problem-solving about peer situations when out in public or with family friends.
  • Alone time with parents: Make a date with them each week
  • Realize their own unique characteristics and strengths: Make a point to comment on their specific strengths and characteristics—their likes and dislikes
  • Understand how to voice needs/Freedom to do so: Give them license to share feelings about sibling with you
  • Learn coping strategies for having an Autistic or Asperger’s sibling: Model healthy coping at home. Support groups for kids also teach a great deal of coping strategies.
  • Healthy modeling from mom and dad: Take care of yourself! We know that parental stress is linked to decreased socialization in siblings.

**The good news is that research shows that these kids are resilient, reasonably well-adjusted, and have good self-concepts. They are frequently more empathic than peers. In fact, moms and dads often overestimate the stress of the non-affected sibling.

Lauren King is a pre-doctoral intern at Southeast Psych who specializes in working with individuals with eating disorders, as well as children and adolescents who have autism spectrum disorders.

Thursday, November 19, 2009

Is My Child Ready for Kindergarten?



by Mary B. Moore







This time of year can bring stress to a lot of parents as they begin to plan for their child’s leap into kindergarten for the next school year. Parents are often uncertain if their son or daughter is ready for the academic, social, and emotional demands of kindergarten. Would transitional or junior kindergarten be a better fit? Will my son be challenged? Bored? Overwhelmed? Which school is right for him?

As a mother of 3 boys, I have experienced this anxiety-provoking process first hand. Selecting a school for our kindergarten child was more exhausting than my college application process! After many open houses, conversations with teachers, parents, professionals, and research, my head was spinning.

As parents we want our child to feel successful in school – to learn, make friends, have fun and develop a thirst for knowledge. A successful school experience involves more than academic skills acquired at a certain age. It depends largely on the right fit and at the right time and how your child’s overall development – his or her social, emotional, physical, as well as intellectual behaviors will match a program’s curriculum demands.

Understanding your child’s developmental readiness can greatly assist you in the decision-making process. No two children are alike. For example, one 5 year old may need a very small class size which incorporates hands on learning and opportunities for physical movement. While another 5 year old may thrive in a larger class sizes with more table work.

The Gesell Developmental Observation is one component of a comprehensive evaluation which can provide individualized information about your child. Knowledge about your child’s developmental functioning is a valuable tool to help you make an informed decision about the best available school placement for the unique needs of your child.

While information is power, so are some other healthy tips. Here are 5 to consider for you and your child during this time:

  • Get adequate sleep

  • Eat well and exercise

  • Maintain a consistent routine

  • Do not try to coach your child for pre-admission testing: school evaluations and testing assess where a child naturally and independently functions. Quizzing your child does not help, it only creates stress and may have a negative impact on your child.

  • Have fun together! Early childhood is a time of wonder, excitement and emerging growth. Laugh and enjoy this precious short stage with your child!
Mary B. Moore, LCSW is provides individual and family therapy to young children and their parents. She specializes in child development, parenting, anxiety, separation/divorce, grief/loss and Aspergers. Mary B. is a certified Gesell examiner and provides Developmental School Readiness Assessments to children ages 3-9 .

Monday, November 16, 2009

What is Body Dysmorphic Disorder?

by Dr. Bilal Ghandour

“I am fine but you’re obviously having a bad hair day.”

That line about ‘bad hair’ from the 1992 movie Buffy the Vampire Slayer popularized this expression commonly used today to describe a day when everything goes wrong. A day we hope will end soon so we can have a better tomorrow when our hair and, well, the rest of our life, is back in order.

But what if every day was a bad hair day? Or every day was a bad nose, skin, finger or ear day? We might all dislike one aspect of our body every now and then but when it takes on obsessive proportions and the experience is not reality based (read: everybody else in the entire universe think you look just fine) then it looks like what we call Body Dysmorphic Disorder. This problem in perception of one’s body can vary from thinking a microscopic pimple on a left cheek is the size of a soccer ball to the distorted state of mind of an anorectic person who is convinced she is fat when her weight is so low it endangers her life.

Psychologists have varied in their explanation of the causes of Body Dysmorphic Disorder. Behaviorally oriented folks believe it develops from learning to make a lasting connection between the occurrence of a ‘defect’ (i.e., a pimple) and feeling bad. They call it conditioning. For example, if you develop a pimple as a teenager and you were having bad grades at a time, then you learn to associate the pimple with the bad grade. If you don’t learn to ‘unlearn’ this connection so to speak you might end up generalizing this link to other things and believe that whenever anything bad happens to you, your pimple takes on gigantic proportions.

Cognitive psychologists explain the problem by emphasizing the importance of how our mind develops these patterns. They argue that a repeated comment made by one or two folks whose opinion you value - possibly at a vulnerable time in your life - will lead to certain automatic thoughts as to how people view you. For example, if you were told to put a hat on to cover your ears because they are “kinda big” you might begin to think this is really how everyone thinks of your ears. Have not all middle-aged adults magnified the value of someone’s horrific mistake of guessing our age higher than it actually is? Don’t we sometimes automatically think – maybe for just a day or two – that everyone who looks at us think we already have a foot in the grave?

Psychologists who have a psychodynamic or, more precisely, a psychoanalytic approach (enter Freud) believe the problem is not really about one’s body but about other issues. They say it might be an unconscious hatred towards one’s parent or maybe a deep malaise about one’s life condition (e.g., stuck in a bad marriage, hating one’s job). For some however the deflection from relationship hatred to body hatred is conscious. But why do we not simply reveal or make conscious our real feelings? Psychoanalysts would say we tend not to reveal our true emotions because it is socially unacceptable to divulge that we hate the very folks who created us or announce to the whole world that we hate our partner (and can’t leave them). As a result, we begin to hate a part of ourselves that is socially acceptable to dislike: our bodies. The most famous example of someone who hated one part of his body (and we all know how much he hated his father but never really talked about it) is Michael Jackson. Just take a look at his skin change over the course of his career and you can notice how he constantly tried to alter the way it looked.

Finally, feminists and social constructivists have also given their perspective on Body Dysmorphic Disorder. And yes, you probably guessed, BDD is to a large extent a female disorder. Why? I will let your own mind think about it as you interpret this quote from Andrea Dworkin:

“In our culture, not one part of a women's body is left untouched, unaltered. No feature or extremity is spared the art, or pain, of improvement. Hair is dyed, lacquered, straightened, permanented; eyebrows are plucked, pencilled, dyed; eyes are lined, mascaraed, shadowed; lashes are curled or false- from head to toe, every feature of
a woman's face, every section of her body, is subject to modification,
alteration." (Dworkin, 1974, p.112)

Dr. Bilal Ghandour is a licensed psychologist at Southeast Psych who specializes in issues related to body image, binge eating, and self-harm.


REFERENCES


http://www.phrases.org.uk/meanings/bad-hair-day.html

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2225586/

http://www.britannica.com/blogs/2009/07/michael-jackson-bdd-body-dysmorphic-disorder/

Woman Hating: A Radical Look at Sexuality (1974)

Monday, November 9, 2009

10 Signs of an Eating Disorder

by Lauren King, M.A.

How do you know when a loved one has crossed over from dieting to an Eating Disorder? Unfortunately, in our culture, dieting is now an expectation for women; it’s the norm. We cannot escape the commercials, online advertisements, and magazines that tout the thin ideal and the “7 easy steps” to obtaining it. Women are beginning to diet at younger and younger ages, even into childhood. Repeatedly, research shows that dieting is a HUGE risk factor for developing an Eating Disorder.

Often parents do not find out that their daughter or son has been struggling with an Eating Disorder until the disorder has taken a strong hold. Below are 10 signs that indicate potential Eating Disordered behaviors:

1. Sudden weight loss

2. Grades at school dropping

3. Becoming highly irritable

4. Clear anxiety when eating around others or frequently requesting to eat in his/her room

5. Avoiding certain restaurants or places where s/he cannot see the food being prepared.

6. Playing with food on his/her plate, but not really eating it

7. Eating unreasonable amounts of food (either too small or too big) or eating food very slowly or at a rapid rate

8. Consistently asking to be excused immediately following meals to go to the bathroom or take a shower

9. A driven quality to exercise—drops other interests in pursuit of going to the gym

10. Large amounts of food are disappearing

If you observe these or other obsessive food behaviors and withdrawal, it is important to talk to your loved one with warmth and honesty about your concerns. Educate yourself about Eating Disorders, and seek help. Because Eating Disorders are multifactorial, it is best to seek multifaceted treatment from a nutritionist, a medical doctor, and a mental health professional that specializes in the treatment of Eating Disorders.

Lauren King is a pre-doctoral intern at Southeast Psych who specializes in working with individuals with eating disorders, as well as children and adolescents who have autism spectrum disorders.

Monday, November 2, 2009

Get Your Girls Involved in Sports!

by Nyaka Niilampti


The impact of playing sports for young children is an issue that receives much debate, particularly when more than 20 million children participate in youth sports programs. Although parents frequently wish for their young ones to be engaged in sports, their rationales are often based on a number of factors: ‘because I did it,” learning how to work with others, sportsmanship, and the simple benefits of exercise and being active. Those opposing the idea of youth sport participation argue that sport (or some sports in particular) promotes aggressive behaviors. However, there are significant additional reasons to encourage sport participation for youth, and young girls in particular. Here are six of them:


Greater self-esteem and self-confidence: Research suggests that sport participation psychologically impacts young girls and females differently than it does for males, with higher self-esteem and self-confidence, as compared to their non athlete peers. This self-esteem seems to contribute to greater academic success, less of chance of dropping out of school, and less chance of becoming a teenage mother.


Lower levels of depression: Research suggests that female athletes report lower levels of depression when compared to their non-athlete peers.


Healthier body image: Research suggests that sport participation gives women a sense that their bodies belong to them, producing a self-esteem that is a great antidote for anorectic behavior. While there are some sports that have a higher tendency for disordered eating, in comparison to females in general, athletes tend to view their bodies more realistically.


Greater access to break the glass ceiling: It has also been suggested that females who participate in sport are at an advantage over their non athletic peers. Research argues that because the American business environment is structured and organized based upon a male model, females who have had some interaction in sport have greater access.


Greater academic success and likelihood of graduating college: Despite the theory that athletes are lacking in intelligence and perform poorly in school, high school female athletes tend to have higher grades and graduation rates than their non-participating peers, and college female student athletes boast the highest college graduation rates than female non-athletes and all male students, both athletes and non-athletes.


Lower risk for breast cancer and osteoporosis: Females who exercise at least two hours a week can reduce chances of developing breast cancer by 20-30 percent, and four or more hours of exercise a week (45 minutes a day) can reduce the risk by almost 60% (McTiernan, 2006).


While girls are often as active as young boys in sport, the peak age of participation is 12 or 13, when many girls drop out of sport for a range of reasons. The drop out rate of females in sports is six times that of boys, and occurs during a time in development and identity formation when these characteristics would be most important. However, as females approach adolescence, they become aware of the socially negative aspects of being an athlete. This is the time when they will need the most encouragement, as the potential benefits of continuing (or beginning) become so much greater.


So, encourage them to get involved, and to the best of their abilities, encourage them to remain involved. Young girls will learn so much more than just how to catch a ball.


‘If you Let me Play’

If you let me play.
If you let me play sports. I will like….myself more.
I will have more self-confidence.
If you let me play.
If you let me play!
I’ll be 60% less likely to get breast cancer.
I’ll suffer less depression.
If you let me play sports.
I’ll be more likely….to leave a man who beats me.
I’ll be less likely…to get pregnant before…I want to.
I will learn
I will learn
What it means to be strong…To be strong.
If you let me play…Play sports…If you let me play sports.


Rachel Nelson, Jennifer Smieja, and Angelina Vieira (1996) of theWeiden and Kennedy Ad Agency for the Nike Corp. Some research by Karen Sarpolis, M.D.


McTiernan, A. (2006). Cancer Prevention and Management through Exercise and Weight Control. Boca Raton: Taylor & Francis Group, LLC.


Dr. Niilampti is a licensed psychologist at Southeast Psych. One of her specialties is sports psychology.


Thursday, October 22, 2009

Book Signing Cancelled for Tonight Due to Illness

Dr. Pohlman's appearance and book signing at Joseph-Beth Booksellers at Southpark has been cancelled tonight due to illness. Check back soon for information about when it will be rescheduled.

Monday, October 19, 2009

Meet the Author of How Can My Kid Succeed in School

Dr. Craig Pohlman, author of the acclaimed book How Can My Kid Succeed in School? will be speaking this Thursday night, October 22, at Joseph-Beth Booksellers beside Southpark Mall in Charlotte.

The presentation starts at 7pm and will include a presentation, a chance to ask questions, and the opportunity to get your book signed. It's a practical book that is must reading for parents or teachers of any child who is struggling with school.

Many of the Southeast Psych staff will be there, as well. It should be a good night and we hope to see as many of you as possible there.

Sunday, October 11, 2009

Do Violent Video Games Cause Violence and Aggression?

by Dr. Frank Gaskill & Dr. Dave Verhaagen

Editor's Note: The following is an updated version of one of our most popular posts ever.



In 1955, the U.S. Senate blasted comic books, deploring their depiction of every horrible thing from murder to cannibalism. The lawmakers heard from a prominent psychiatrist who singled out the Superman comic books as especially "injurious to the ethical development of children" because they "arouse phantasies [sic] of sadistic joy" in our youth. Another witness testified that children had been jumping off high places in attempts to fly like their hero. Shame on that Superman. He ruined the lives of so many children!

Half a century later, violent video games are the comic books of our day. Testimony before our state Senate included descriptions of horrific-sounding games. One witness described a game where the player scans in faces of classmates and teachers and then shoots them. He also referenced another game called Postal that gives points for watching innocent people beg for mercy before you kill them. The only problem is that we've never met one kid - or any person of any age, for that matter - who has even heard of these games. They are straw man arguments.

One frequently cited research article criticizing violent video games includes several studies. One of these studies was a "correlational study" from which the authors concluded, "Playing violent video games often may well cause increases in delinquent behaviors, both aggressive and non-aggressive." However, in a remarkable moment of self-contradiction, they later said that making such causative statements with a correlational study is "risky, at best." Why is it risky? Because correlations are just relationships between two variables; you can never say one causes the other. We could say that during the season when ice cream sales increase, shark attacks also increase. But we could not say the more ice cream you sell, the more you cause shark attacks.

Why would a couple of child psychologists come to the defense of violent video games? Because some legislative initiatives and public opinions across the country are based on fallacious assumptions, personal biases, political posturing and weak science. One recent systematic analysis of the research literature found "insufficient, contradictory and methodologically flawed evidence on the association between television viewing and video game playing and aggression in children and young people with behavioral and emotional difficulties. If public health advice is to be evidence-based, good quality research is needed," (Mitrofan, Paul, Spencer, 2009). Another extensive study found "no support for the hypothesis that violent video game playing is associated with higher aggression," (Ferguson, 2007). In fact, that same study found some positive benefits of playing violent video games, particularly improvements in visual-spatial thinking.While there are studies that find people who play violent video games may have a brief increase in violent thoughts and feelings, newer research finds that these thoughts and feelings typically last less than four minutes (Barlett, Branch, Rodeheffer, & Harris, 2009). And remember, having a violent thought is a whole lot different than actually committing violence.

Common sense tells you that you don't let an elementary school kid or an older child with a history of aggressive behavior play Grand Theft Auto. But that same common sense tells you that if 90 percent of households have owned or rented a video game every year - while the juvenile crime rate has been going down for more than a decade - then a little Halo 3 ODST never hurt anybody...


Frank Gaskill is a child psychologist with Southeast Psych who specializes in technology issues and Asperger's Disorder. He has pioneered the E-Parent curriculum to help parents better understand the tech world of their teenagers. He is also co-author of the forthcoming Max Gamer graphic novel.


Dave Verhaagen is a child and adolescent psychologist with Southeast Psych who works mostly with older adolescents and young adults. He is the author or co-author of six books, including Parenting the Millennial Generation and the forthcoming Therapy with Young Men.


Both have Ph.D.'s in psychology from UNC-Chapel Hill (Go Tar Heels!).


References:


Barlett, C., Branch, O., Rodeheffer, C., & Harris, R. (2009). How long do the short-term violent video game effects last? Aggressive Behavior. Vol 35(3), May-Jun 2009, 225-236.


Mitrofan, O., Paul, M., & Spencer, N. (2009). Is aggression in children with behavioural and emotional difficulties associated with television viewing and video game playing? A systematic review. Child: Care, Health and Development. Vol 35(1), Jan 2009, 5-15.


Ferguson, C. J. (2007). The good, the bad and the ugly: A meta-analytic review of positive and negative effects of violent video games. Psychiatric Quarterly. Vol 78(4), Dec 2007, 309-316.

Monday, October 5, 2009

Trauma in Our Lives, Part Two: Helping a Child Through a Trauma

It is estimated that in the United States approximately five million children experience some form of trauma each year. Car accidents, natural disasters, abuse, sudden deaths of loved ones, and exposure to community violence are examples of events that can impact children. Trauma does not just happen to one person; it touches family members, friends, and others involved in children’s lives. When something traumatic has happened to your child, there are things you can do to help facilitate recovery.

Guidelines for helping a child who has experienced a trauma:

Do not be afraid to talk about the traumatic event. When a child brings up the topic of what happened, don’t avoid it. Listen, provide support and nurturance, and answer questions honestly and to the best of your ability. It’s okay to say that you don’t know something (such as why the tornado hit your house, where people go when they die, etc.). Follow the child’s lead in discussing the event; stick to answering his or her specific questions and don’t address the topic unless your child is the one to initiate it. Be aware of your own reaction to the trauma and do not over react or appear out of control with your own emotions in front of your child. Verbalizing your own feelings of sadness, hurt, and anger is appropriate.

Create predictability and safety in your child’s daily routines. Imposing structure and patterns increases a child’s sense of safety and control throughout the day. Keep consistent times for regular activities such as meals, homework, play, and bedtime. If there are changes in the routine, give explanations for them. Keep promises you make to your child during a crisis time so he or she knows he can count on you.

Notify other adults in the child’s life about what has happened. It will be important that adults who interact with children on a regular basis (e.g., teachers, coaches, other parents, etc.) are aware of what your child has experienced. This helps others have more awareness and sensitivity and may allow greater tolerance of trauma-related behaviors that might otherwise wear on one’s patience.

Discuss your expectations for behavior. Make sure your child knows the rules at home and the consequences for breaking them. Be consistent in your discipline and focus on reinforcing positive behaviors. While it is good to be flexible at times, make sure you provide a clear rationale for any changes you make to consequences. It may be tempting to refrain from enforcing rules when your child has been through something traumatic, however, following through on consequences provides predictability, consistency, and the sense that you as the parent are in control; all three provide emotional comfort and safety.

Keep your child safe. Physical safety is one piece of this and emotional safety is another. Try to limit exposure to activities, events, and other reminders of the trauma, especially if you see your child’s symptoms increase during such activities. It’s okay to stop an activity if you see it is upsetting or retraumatizing your child.

Recognize the impact that the trauma has had on you. Sometimes parents experience the same traumatic event as their children, and in other cases parents feel the vicarious effects of trauma that has happened to their child. Feelings of helplessness, guilt, and sadness are common reactions of parents of traumatized children. Seek help from friends, family member, and/or professionals to cope with the painful emotions you have. Do not expect your child to take care of you as you deal with your own emotions. For example, do not keep your child home with you to assuage your own fear of separation from him or her. It is important to take care of yourself in order to be able to best help your child.

Know when to ask for help. Following a trauma, it is normal for children to show signs of distress. You may notice signs of disorganization, such as poor concentration and confusion. Some children begin to display behaviors that are characteristic of younger children, such as clinginess, loss of toileting, and general fearfulness. A child may reenact an event or themes relating to the event through play and artwork. Physical complaints are also common. Symptoms will usually become less severe after a few weeks, however, if the severity persists, consider consulting a mental health professional.

Dr. Jessica Bloomfield is a psychologist at Southeast Psych who specializes in treating trauma, as well as depression, anxiety, and a range of other issues.

Monday, September 28, 2009

How Can My Kid Succeed in School? Arrives in Bookstores

Southeast Psych's own Dr. Craig Pohlman's latest book, How Can My Kid Succeed in School? is now in bookstores and, of course, you can order it online at amazon.com. What you will find is a highly practical book for both parents and teachers who want to help a child who is struggling with school.

The book helps adults understand their child's unique strengths and struggles, explains how to gather clues for understanding the child's learning profile, and gives practical strategies for helping each child.

Dr. Pohlman in an internationally-known, well-respected neurodevelopmental psychologist who has conducted or supervised thousands of assessments with struggling learners. This terrific book is a tremendous resource for parents and educators and should be on their must-read list.

You can see Dr. Pohlman in person on Thursday, Oct. 22 at 7pm at Joseph Beth Booksellers at Southpark Mall in Charlotte. He'll be giving a presentation and signing copies of the book. Come out and meet him.

Monday, September 21, 2009

How Can My Kid Succeed in School? Part Four: Improving Listening Skills


Editor's note: This is the fourth of a four part series from Dr. Pohlman's new book, How Can My Kid Succeed in School? which is now available at amazon.com and will be in bookstores next week. Today, he shares ideas for parents who want too improve their child's listening skills.

Receptive language is the capacity to understand word sounds, word parts, whole words, sentences, and large chunks such as stories and lectures. It is not the same as reading comprehension. We use receptive language to understand when listening as well as when reading. The act of reading involves a lot of skills related to decoding text, making it a more complex activity than listening. On the other hand, listening is more closely aligned with receptive language in many ways.

If your child has limited receptive language, providing practice with listening skills may be necessary. Since listening doesn’t also require decoding printed text (which may also be problematic for your child), it provides more targeted practice with comprehending word meanings, sentence structures, and extended descriptions and arguments. You can provide listening comprehension practice for your child in a lot of ways, the most obvious being to read to him. You may need to pause after every paragraph or so to pose questions about what you just read, make predictions about what will come next, or contemplate how the material connects to other things (personal experience, other books read, movies, and so on). Audio books also provide great listening experiences; you (or somebody) should know enough about the content to converse with your child about it.

Television is a fact of life for most families, and fortunately it does provide a lot of educational programming about a range of topics. Also, high-quality entertainment shows, sports, and news can challenge your child’s receptive language (much of this content can also be accessed via DVDs or downloaded from the Internet). Many Web sites convey information via audio, but often with visual supports such as photos and diagrams which can help your child make connections (obviously supervision is necessary when kids are online).

Regardless of the form listening practice takes, here are some pointers for getting the most out of audio media for your child:

• Push the edge of the envelope in terms of difficulty. You don’t want to overwhelm your child with material that is too advanced, but you do want to make it a little challenging.

• If possible, leverage your child’s interests. If your child is into sports, suggest watching one of the many shows devoted to analysis of games and player profiles.

• Talk with your child about the material (before, during, and after). Stretch your child’s receptive language by asking questions (you might have to act na├»ve about the subject), modeling the forming of connections (“You know, this reminds me of . . .”), and asking for a summary (“So what were the main reasons they thought this happened?”).

• Expand expressive language at the same time. Take advantage of opportunities for your child to improve things such as summarizing, describing, explaining, and supporting an opinion.

• Be transparent about what you’re doing. You want your child to better understand his mind, and discussing the rationale behind the tactics you’re using will promote that understanding.

Dr. Pohlman conducts and supervises learning assessments for Southeast Psych and is available to present on learning issues. Feel free to contact him at 704-552-0116 or speakersbureau@southeastpsych.com. His new book is due out in stores Sept. 28th and can be ordered online now. Watch out for a special announcement about Dr. Pohlman's upcoming appearance at Joseph Beth Books in Charlotte.

Monday, September 14, 2009

How Can My Kid Succeed in School? Part Three


Editor's note: This is the third of a four part series from Dr. Pohlman's new book, How Can My Kid Succeed in School? which arrives in bookstores in two weeks. Today he talks about two kinds of questions kids ask when learning that may give parents insight into what might be going on with their child.

How-to Questions
Kids often fire some other kinds of questions at parents when doing their homework, and each can provide clues about their learning. Two such question categories are how-to and what’s up? How-to questions relate to the various procedures and rules that kids need to access when doing their homework. Asking these questions is a tip-off that long-term memory isn’t working well, especially if the student can readily use the procedure or rule once prompted (which suggests he understands it). Examples include the following:

• How do I borrow a number?
• How do you spell summary when there’s more than one summary?
• Do you put the period before or after the quotation mark at the end of the sentence?
• How would I solve for n in this problem?

Sometimes, however, how-to questions result from something other than memory problems, such as how well the student can reason through a problem. Applied reasoning refers to the use of logic to solve problems and tackle challenging situations. A student who asks a lot of deep how-to questions, such as, “How would I figure out the amount of water in this canister if this cube is submerged in it?" or “How could I show that climate change is affecting this habitat?” likely has shaky reasoning.

What’s-up Questions
These often reveal shaky understanding of the material and of important concepts. They are often accompanied by complaints such as “I don’t get it!” or pleas such as “Explain this to me.” What’s-up questions take many forms, but they all boil down to a less-than-firm grasp of a concept. A concept is a set of critical features of a group of ideas or objects that define that group, determine group membership, and connect it to other groups. Some of the many concepts taught in school are freedom of speech, integers, and symbiosis. Here are some example questions that relate to concepts:

• What’s the difference between a cold-blooded animal and a warm-blooded animal?
• What does extremism mean?
• Can I just add the tops and bottoms of these two fractions?
• Aren’t a phrase and a clause pretty much the same thing?

Dr. Pohlman conducts and supervises learning assessments for Southeast Psych and is available to present on learning issues. Feel free to contact him at 704-552-0116 or speakersbureau@southeastpsych.com. His new book is due out in stores Sept. 28th and can be pre-ordered online now.

Friday, September 11, 2009

Trauma in Our Lives, Part One: Anniversary of 9/11

by Dr. Jessica Bloomfield

On the 8th anniversary of September 11th, we are once again reminded of the events that took place on that beautiful Fall day. Most of us can still recall exactly where we were when we heard the news of the unthinkable—terrorist attacks on our home front. We remember that moment when the safety and security we knew so well were whipped out from underneath us, and we could no longer go about our everyday lives thinking of terrorism and tragedy as things that happen far away to other people. The World Trade Center, Pentagon, and Shanksville, Pennsylvania became epicenters of hurt, suffering, and pain. Like an earthquake, the effects are felt intensely at the center, and have ripple effects that are far reaching, marked by aftershocks, destruction, and devastation; and life is never quite the same.

Thus is the nature of trauma.

Trauma comes in many forms, affects people near and far, forever changes lives, and leaves some people unscathed. Physical scars are left as well as emotional ones—and some hurts never seem to fully heal, leaving the bearer forever changed in both good and bad ways.

What constitutes a trauma? A trauma is an event which happens outside the realm of “normal” experiences. It overwhelms a person’s regular coping abilities. Trauma comes in many different forms. Wars, hurricanes, school shootings, rapes, abuse, sudden deaths, and car accidents are only a few examples. Trauma can affect a person emotionally, biologically, and socially. It impacts survivors as well as family members, friends, and acquaintances.

Emotional reactions to trauma vary widely and there is no right or wrong way to feel after experiencing or witnessing a traumatic event. Two people could experience a terrible car accident together and may respond in very different ways or even recall the event differently. Genetics, personal history, feelings about control over the event, gender, and physiological reactions are some of the factors that affect whether or not a person will experience psychological difficulties following a traumatic event. Approximately 60% of people living in the U.S. will be exposed to at least one traumatic event during their lifetime.

Posttraumatic Stress Disorder (PTSD) is a clinical diagnosis for people who have experienced a trauma and experience specific distressing symptoms afterwards. It is estimated that 9 to 15 percent of the general population in the U.S. have PTSD, although that number rises to 50% for women who have been raped. While less than a quarter of people who experience a trauma develop full-blown PTSD, there are many who still suffer from posttraumatic stress symptoms, which can greatly affect their lives.

It can be difficult to recognize the impact of trauma, and feelings of shame, anger, powerlessness, depression, and anxiety are common. Some people believe they should not feel the way they do following a trauma; some believe they could have prevented what happened, or that having difficulties means they are weak. Some feel as if they are going crazy. It is important to know that posttraumatic stress symptoms are normal reactions to abnormal situations.

So, on the anniversary of an event that was traumatic for our nation, it is good to take a moment to recognize the effects it had on us individually and as a culture and to be aware of the impact such events can have on our lives. Anniversaries can be very hard for those touched by trauma and some of the following activities may be helpful during such times:

• Writing down thoughts in a journal or blog

• Sharing memories

• Spending time with loved ones

• Connecting with spiritual or religious organizations

• Beginning the process of healing old wounds with the help of a professional

Dr. Jessica Bloomfield is a psychologist at Southeast Psych who specializes in treating trauma, as well as depression, anxiety, and a range of other issues.

References:

Busuttil, W. (2007). Psychological trauma and post-traumatic stress disorder. In N. Mervat, K. Baistow, and Treasure, J. (Eds.) The Female Body in Mind: The Interface Between the Female Body and Mental Health (pp. 41-56). New York: Routledge/Taylor & Francis Group.

Foa, E. B., Hembree, E. A., & Rothbaum, B. O. (2007). Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences. New York: Oxford University Press.

Herman, J. (1997). Trauma and Recovery: The Aftermath of Violence—from Domestic Abuse to Political Terror. New York: Basic Books.

Treadwell, K. & Foa, E. (2004). Assessment of post-traumatic stress disorder. In W. T. O’Donohue & E. R. Levensky (Eds.) Handbook of forensic psychology: Resource for mental health and legal professionals. (pp. 347-366). New York: Elsevier Science.

Van der Kolk, B. A., McFarlane, A. C. (1996). The Black Hole of Trauma. In B. A. van der Kolk, A. C. McFarlane, & L. Weisaeth (Eds.) Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society (pp. 3-23). New York: Guilford Press.

Thursday, September 10, 2009

Help Prevent Suicide

Today is World Suicide Prevention Day, with this year’s theme being “Suicide Prevention in Different Cultures.” The purpose behind the day is to help educate about facts related to suicide, decrease the stigma associated with the topic, and most importantly, raise awareness that suicide is preventable (IASP, 2009).

Few words carry as much weight as the term “suicide”, which is often almost afraid to be uttered for fear that it may affect someone we know. However, as with similar fears, suicide is an issue that is best addressed directly in a community environment to decrease stigma, clarify misperceptions, and equip people to help friends seek support.

Suicide prevention research views suicide as a public health issue, as its impact is most often felt on a community level. Studies suggest that for every suicide committed, at least 6 people are directly impacted, and more than that indirectly (National Center for Health Statistics, 2006). Suicide is also the second leading cause of death among college students in the U.S., the third leading cause of death for young people between the ages of 15-24, and the 11th cause of death overall (National Center for Health Statistics, 2006). In 2006, there were 33,000 suicides in the U.S., which averages out to about one suicide every 16 minutes. Add to those statistics the fact that untreated depression is considered one of the leading contributing causes of suicide. In many cases, with the ability to identify the risk factors and with the proper intervention, suicide can be prevented.

There are a number of warning signs that may be indicators of distress and present an opportunity to reach out and offer help:

Expressed hopelessness: Hopelessness is one of the key predictors of suicidality. A sense of hopelessness indicates that a person is unable to see past this particular point, and feels that they no longer have options.

Untreated depressive symptoms: Depressed mood, lack of motivation, low self-esteem, decreased pleasure in once enjoyable activities, and feelings of worthlessness are all symptoms of depression.

Increased alcohol and/or substance use: An increase in the use of substances suggests that someone is having increased difficulty in coping with their current challenges and experiences.

Increased isolation and/or withdrawal: An individual may begin to pull back from friends and/or loved ones. This increase in isolation will often contribute to the perception and sense of hopelessness.

Increase in impulsive behaviors: Feeling and behaving as if they have “nothing to lose” may be an indicator of suicidal ideation.

There are ways in which you can offer assistance to someone who you are concerned may be considering suicide:

Don’t be afraid to ask the question: If you are concerned that someone may be considering suicide, it is okay to ask the question directly. If you aren’t comfortable asking the question, share your concerns with someone who may be more comfortable with asking it. Asking the question will often bring relief to an individual who may be contemplating suicide and open up communication. The goal is to instill hope, which helps prevent suicide.

Listen: Take the time to listen more than talk. Make sure that when you ask the question, you have the time to sit and listen non-judgmentally. Express your concerns and convey realistic hope that the problem can be solved, with the goal of encouraging them to seek support.

Don’t keep it a secret: If someone shares with you that they are considering suicide, share it with someone who can get them help or get them to help—a parent, a teacher, a counselor.

Here are two websites to check out for more information:

International Association for Suicide Prevention

National Vital Statistics Reports on the National Center for Health Statistics

Suicide prevention is a community concern. Education, involvement, and the simple act of caring can instill hope and help to decrease this form of death.

Editor's Note: Dr. Nyaka Niilampti is a psychologist at Southeast Psych in Charlotte. She has a Ph.D. from Temple University, a master's in sports psychology from UNC-Chapel Hill, and a bachelor's degree from Princeton. Before coming to Southeast Psych, she has worked in university counseling centers, secondary schools, and community mental health centers.

Monday, September 7, 2009

How Can My Kid Succeed in School? Part Two


Editor's Note: The following is an excerpt from “How Can My Kid Succeed in School?” by internationally-recognized psychologist, Dr. Craig Pohlman, who has recently joined Southeast Psych and directs our Assessment Center.

How a kid goes about doing his homework can be very revealing. A lot of parents are dismayed when their child seems to just leap right into tasks without first contemplating the best course of action. Courtney, a sixth grader, fits this bill. Her mother describes her as a “bull in a china shop” when it comes to homework (and incidentally, most other times when a methodical approach is called for as well). When Courtney gets to a math word problem she seems to start scribbling calculations before she even finishes reading it. Sometimes she answers almost all of questions in social studies assignments before realizing that the directions wanted her to do something else. But above all, writing is a disaster. The notion of starting with an outline is totally alien to Courtney, who would much rather just get to writing; as a result, many of her great ideas never make it to the page or get hidden in a disorganized stream of sentences.

Courtney has a weakness in an aspect of her attention called production control, which is like the brain’s dashboard; her mind doesn’t have a reliable speedometer, meaning that she jumps into tasks too quickly, without first coming up with good plans. Dashboards also provide many signals to let you know how well things are working (such as a low fuel light and a door ajar signal), but Courtney’s production control doesn’t monitor her work very effectively. Her mother gets exasperated by all of the “careless” mistakes she makes in her homework. For example, she might miscalculate in math or misspell a word, but when prompted to take a second look, she readily finds these kinds of errors and fixes them.

Tate is a fourth grader and his dad says that homework “takes forever to get done.” The reason? Tate is very susceptible to distractions and daydreaming due to his attention processing control. His dad frequently reels him back in with little reminders like, “stick with it, Tate” or “come on back, dude!” Getting homework done in a reasonable amount of time usually requires staying focused on the task at hand.

Everyone, including adults, experiences difficulty with concentration from time to time. Even if you’re working in a place with few distracting sights and sounds, your thoughts may wander like Tate’s. For some people, processing control does not do a sufficient job of resisting “mind trips” and avoiding distractions. If given a choice between finishing homework and spending time on recreational activities, most kids would choose the latter; but kids with weak processing control are pulled even more strongly than other kids toward fun stuff and away from work.

A kid can have a hard time staying on task for reasons other than weak attention, however. Active working memory is what we use to mentally juggle or manipulate information. Monika frequently gets lost in the middle of homework tasks. As a seventh grader, much of her work involves multiple steps (such as when solving a math problem) or numerous components that have to be attended to simultaneously (such as all the aspects of writing a book report). In other words, she has to handle a lot of moving parts and her parents see her losing track of a lot of them. So she may get lost in the middle of a math computation and complain that she is confused about what to do next.

Dr. Pohlman conducts and supervises learning assessments for Southeast Psych and is available to present on learning issues. Feel free to contact him at 704-552-0116 or speakersbureau@southeastpsych.com. His new book is due out on Sept. 28th.

Monday, August 31, 2009

How Can My Kid Succeed in School? Part One

by Craig Pohlman, Ph.D.

Editor's Note: The following is an excerpt from “How Can My Kid Succeed in School?” by internationally-recognized psychologist, Dr. Craig Pohlman, who has recently joined Southeast Psych and directs our Assessment Center.

Brady is a 2nd grader who’s having a very hard time learning to read and spell. He’s great at art, enthusiastically listens to stories, and absorbs information he hears (he loves learning about reptiles). He is picking up math skills with no trouble and is a natural when collaborating with peers. Both adults and kids really enjoy being around him, but his reading troubles are starting to deflate him. In 1st grade he dashed out the door every morning to get to school. Now he asks if he has to go, and longs for weekends and vacations.

Cetera is Brady’s classmate, and she also struggles with reading and spelling. Though not quite as social as Brady, she belongs to a very close threesome of friends. She loves sports, especially soccer and basketball. Cetera also is starting to have some trouble with math. Like Brady, she picks up information very nicely when listening, though sometimes she has a hard time making connections with her prior knowledge. Lately, she’s been complaining to her mother about how hard school is for her.

How can Brady and Cetera’s learning problems be conquered? How can their parents and teachers get them to enjoy school again? Figuring out what is causing their reading challenges is the first step. The good news is that their parents and teachers can gather lots of information, analyze it, and then select targeted learning strategies. But they have to know what to look for and how to make sense of what they find.

Like all students, Brady and Cetera leave plenty of clues about their learning. For example, Brady has a hard time coming up with rhyming words. When he reads aloud he drops out word sounds (like reading “block” as “bok”) and inserts letters that shouldn’t be there when he spells (like spelling “candy” as “canku”). Cetera struggles with memory for several types of information, like math facts and prior knowledge.

Brady’s clues add up to the conclusion that word sounds are very confusing to him. He doesn’t clearly process small sounds like /f/ in “leaf,” which means he has a hard time connecting sounds with letters (like /f/ with “f” or “ph” or even “gh”, as in “cough”). In contrast, Cetera processes small word sounds just fine (for instance, she can rhyme and move sounds around to change words). As it turns out, she has a hard time remembering which sounds go with which letters.

By the way, both Brady and Cetera probably would meet criteria for a learning disability (or, more specifically, a reading disability or dyslexia). But labeling them wouldn’t do much good. That would be akin to claiming that a child with stomach pain has something like Abdomen Soreness Disorder- a label that is pretty useless when it comes to a treatment. Labels tend to oversimplify students by not capturing unique characteristics, like the differences between Brady and Cetera. Also, labels don’t convey strengths and interests, like Brady’s affinity for reptiles or Cetera’s listening comprehension.

Brady and Cetera are experiencing unique challenges. Understanding the specifics of those challenges helps identify what they need in order to be more successful readers. For Brady, the key is to bolster his capacity to process word sounds. Cetera, on the other hand, needs drill in matching sounds to letters in order to solidify this information in her memory banks. By working in these specific areas, they can make strides in their reading and feel successful again.

Dr. Pohlman conducts and supervises learning assessments for Southeast Psych and is available to present on learning issues. Feel free to contact him at 704-552-0116 or speakersbureau@southeastpsych.com. His new book is due out on Sept. 28th.

Wednesday, August 26, 2009

Southeast Psych Rated Excellent By Most Clients

Southeast Psych just completed our client satisfaction surveys and the results were amazing. During a ten-day period in August, we randomly surveyed over 100 of our current clients (N=122) and asked them what they thought about their experience at Southeast Psych. We asked about everything from the check-in and check-out experience to the waiting area. We asked about their therapist’s empathy, skill, and helpfulness, and we asked about their overall experience at Southeast Psych, rating each component of our service as either poor, fair, good, or excellent. All the surveys were completed anonymously and put into a box in the waiting area. Participation in the survey was completely voluntary.

Across the board, the results were remarkable. The average rating for “Overall experience at Southeast Psych” was 3.9 out of a possible 4.0. Our therapists were uniformly rated as “Excellent” by a clear majority of our clients and they also told us we excelled in every single category we surveyed.

Even though the survey did not ask for additional comments, we still got many encouraging words written across the bottom. One client wrote, “Thank you all for the best therapy experience I’ve ever had.” Another wrote, “I can’t think of a thing I would change.” Still another wrote, “You have all been such big help and a blessing to our whole family. Thank you.”

We still want to keep getting better, but it’s feedback like this that lets us know we are creating a special experience for our clients. We have great staff and great therapists, and we think our clients are some of the best people anywhere. Thanks for the feedback!

Wednesday, August 19, 2009

How Parents Can Help a Teen Through a Loss

by Nyaka Niilampti

Many young people have had limited experiences with death. Typically it comes in the form of the loss of a grandparent or an older family member. Less frequently, it comes in the form of the loss of a peer, which often results in complicated emotions for both teens and their parents.

The loss of a friend, classmate, or peer can result in a loss of the sense of safety for young people. Despite what we know about the stages of grieving, the processing of grief is a highly individual experience, and each child or teen will deal with it in his or her own way.

There are a number of common reactions to loss including sadness, panic and anxiety, a fear of death, denial, guilt, shame, anger, poor concentration and confusion. There are also a number of ways parents can offer assistance following a loss. Here are a few suggestions for how parents can help:

Be available. It is common to be uncomfortable talking about death or loss. Even with that discomfort, make sure that your child is aware that you will be open to that conversation. Letting them know that you are available for questions, conversations, or simply silence will be encouraging. Some children will need to process their grief by talking, while others process their grief differently. Send a note, or write a card, both right after the event as well as after some time has passed to let them know the option is still open. Communicating your availability will help them be more comfortable approaching you when that time comes.

Encourage them to communicate with their friends. Some adolescents may be uncomfortable reaching out to adults. Communication with peers and friends may provide an additional and necessary support, particularly those in the same community and teens may be more able to share their emotions with peers than with adults.

Listen. Allow them to tell their stories, including their favorite memories of that person. Use open questions or prompt them with, “Tell me about…” Ask what they would like to remember most about the person they have lost.

Create a ritual. A memorial service is an important ritual that helps families and individuals grieve a loss. There can be other, less formal rituals that help young people grieve the loss. Encourage and allow them to participate in rituals or find their own way to say goodbye. This may include doing something individually or with a group.

Be supportive and patient. Don’t try to “fix” the situation or offer reassurance that this will not happen again. Talk openly and honestly with them, then validate their experience. Encourage them to share their feelings, but don’t push them. If you have had similar experiences, share those; however, keep in mind that even with similar experiences, it is impossible to know exactly how they may feel. Let them know there is no “right way” to grieve the loss, and that the difficulty they may be experiencing is normal. Encourage them to be patient with themselves and to take time to heal.

Keep an eye out for drastic changes. Significant changes in behavior patterns, eating, or sleeping, may be indicators that they are not coping well with the loss, and may be in need of additional support.

Encourage self care. While it may seem simple, encourage them to do the necessary daily tasks and activities. Eating and sleeping on as much of a “normal” schedule as possible will help them feel more secure.

With time and support, most children and teens will cope with and process the death of a classmate or peer and resume their regular activities. However, be open to the possibility that your child may need additional support to help them process this loss. If you notice they are not able to cope with their daily activities, isolating themselves from friends and family, or other significant noticeable changes, suggest that they speak with a professional as a means of gaining additional support.

Editor's Note: Nyaka Niilampti is a psychologist at Southeast Psych in Charlotte. She has a Ph.D. from Temple University, a master's in sports psychology from UNC-Chapel Hill, and a bachelor's degree from Princeton. Before coming to Southeast Psych, she has worked in university counseling centers, secondary schools, and community mental health centers.

Monday, August 17, 2009

The Truth (So Far) About Facebook

There are lots of opinions out there about whether Facebook is good or bad for things like relationships, grades, and productivity. Since there isn't a ton of good research yet, we don't know all the answers, but the results are mixed. Here's what the studies say so far:

* Facebook usage contributes to jealousy in relationships. When young adults spend more time on Facebook, they tend to get more jealous in their romantic relationships. The more jealous they get, the more time they spend searching for other information about their partner that fuels their jealousy and puts them into a negative cycle.

* Facebook users tend to be more willing to engage in face-to-face interactions and relationships rather than less, which challenges the notion that Facebook and similar online social networking sites cause people to be less social in their real-world interactions.

* There is no strong evidence that Facebook use negatively affects academic achievement in high school and college students. A pilot study had suggested this, but bigger studies have shown no negative impact on grades for the vast majority of students.

* There is evidence that a person's level of narcissism can be predicted by their Facebook profiles. Those who were more narcissistic tend to have more glamourous, self-promoting profile pictures and far more social contacts or "friends" than those who were less narcissistic. There is no evidence that Facebook users as a whole were more narcissistic than average, however.

* Facebook has become part of the "social glue" that helps incoming freshman settle into college and build campus relationships. It may also decrease the likelihood they will drop courses in their first year.

That's what we know--or think we know--about Facebook and similar sites so far. We'll keep you posted as new research emerges.


Sources:

Sheldon, P. (2008). The relationship between unwillingness-to-communicate and students Facebook use. Journal of Media Psychology: Theories, Methods, and Applications, 20, 67-75.

Mary Ann Liebert, Inc./Genetic Engineering News (2009, August 7). Does Facebook Usage Contribute To Jealousy In Relationships? ScienceDaily. Retrieved August 16, 2009, from http://www.sciencedaily.com/releases/2009/08/090806112558.htm

Ohio State University (2009, April 14). Facebook Use Linked To Lower Grades In College. ScienceDaily. Retrieved August 16, 2009, from http://www.sciencedaily.com/releases/2009/04/090413180538.htm

Northwestern University (2009, May 8). Facebook Use Not Found To Correlate Negatively With College Grades, New Study Shows. ScienceDaily. Retrieved August 16, 2009, from http://www.sciencedaily.com/releases/2009/05/090507164403.htm

University of Georgia (2008, September 23). Facebook Profiles Can Be Used To Detect Narcissism. ScienceDaily. Retrieved August 16, 2009, from http://www.sciencedaily.com/releases/2008/09/080922135231.htm

University of Leicester (2008, October 14). Facebook Is 'Social Glue' For University Freshmen. ScienceDaily. Retrieved August 16, 2009, from http://www.sciencedaily.com/releases/2008/10/081014111056.htm