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
  • 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.


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.