6 Signs That It’s Time To Seek A Child Therapist

Child Therapist

What To Do When Your Kid Is Struggling

6 Signs That It’s Time To Seek A Child Therapist

“How do I know when it is time to take my kid to see a child therapist?” This is one of the most common questions that I receive from parents. My answer is almost always the same. If you think that whatever your child is struggling with is affecting his/her functioning, then it is best to consult with a professional. I also tell parents that if there is anything that is going on, it is best to treat it early on. Most importantly, if you think that there is something that is worth investigating with your child, then always trust your instincts as a parent. I meet so many parents who tell me that their pediatricians or their friends and family told them they had nothing to worry about, and it turned out that there was something. Always think that it is better to be safe than sorry. As parents, we know best if there is something going on with our child.

Child Depression

Importance of Early Detection

Depression presents itself differently in children than it does in adults. It’s hard to imagine a preschooler being depressed — why is that? When we think of depression, we think of how it affects an adult: the inability to get out of bed, eating too much, not eating enough, crying unexpectedly, isolation, etc. But what does it look like in a 2-year-old? In a 4-year-old? In young children, the signs can be very different from what we expect to see in a human who has depression, so often it is difficult to diagnose.

It is now widely recognized that preschoolers get depressed, and it is treatable, but not much research has been done on the subject. The importance of early detection is starting to come to light, though. Research suggests that 1 to 2 percent of children ages 2- to 5-years-old have depression, and that undiagnosed depression in toddlers can lead to more of it later in life. Many disorders and symptoms have been linked to early-life stress, including anxiety, cardiovascular disease, fatigue, fibromyalgia, and addiction. Getting treatment early on is vital.

Don’t Bottle It Up

Many of us know that if we bottle up stress, anxiety, and fear, it can live inside of us for years, which is damaging in the long run, or it can explode when we least expect it. If we work through it as it comes, however, it’s more likely to work itself out in our day-to-day lives, allowing us to live healthier lives overall. The same is true for children who do not have an outlet to talk about their feelings or experiences. The earlier we are able to diagnose and detect something in a child, the better.

ADHD

This week, I had a mom approach me with her 12-year-old, whom she claimed wasn’t listening when addressed directly, and was easily distracted, intruding on others, always “on the go,” and forgetful.  As the mom was talking, I counted at least five symptoms of inattentiveness and hyperactivity in her child, and I am certain that if I kept speaking with her, I would have found one more that, together with the existence of these behaviors, would indicate that her child most likely has ADHD (Attention- Deficit/Hyperactivity Disorder).

Many studies have linked depression in children to ADHD, and research has shown that early intervention can make beneficial differences to outcomes for people with ADHD. The earlier ADHD is noticed and treated, the earlier intervention can begin. This will help prevent more severe symptoms from developing down the road.

And now, onto the good stuff! Below are 6 signs that your child may need to see a therapist.

#1 – Exhibiting Signs of Depression or Anxiety

While it is normal to experience feelings of sadness or anxiety, your child might need professional support if these feelings start affecting his or her daily activities. For instance, if your child is missing school or social activities that he/she didn’t miss before because he/she is feeling too sad or anxious, then you might want to explore this further and make sure that there is nothing clinically going on. I find that most parents already know when something is going on with their child, and if it is sadness or anxiety, it is something that requires extra attention. The most common anxieties among children are separation anxiety, social anxiety, and generalized anxiety disorder.

Here are some specific signs that they may be experiencing depression or anxiety:

  • Depressed or irritable mood
  • Difficulty sleeping or concentrating
  • Change in grades, getting into trouble at school, or refusing to go to school
  • Change in eating habits
  • Feeling angry or irritable
  • Mood swings
  • Feeling worthless or restless
  • Frequent sadness or crying
  • Withdrawing from friends and activities
  • Loss of energy
  • Low self-esteem
  • Thoughts of death or suicide

It is important to note that everyone feels sad sometimes! Just because your child isn’t happy-go-lucky all the time doesn’t mean that he or she has a disorder. If the above symptoms persist for long amounts of time, though, and they begin to interfere with your child’s or your family’s daily life, then it is important to get it checked out.

#2 – Acting Out or Struggling at School, Home, and Other Places

If you find that your child is having a hard time across activities, such as hitting others or acting out of control, then you might want to seek professional help. If your child is experiencing issues one day here and one day there, and the teachers are not complaining, then you probably have no real reasons to seek treatment for your child. However, if you are getting repetitive calls from your child’s teachers, and other parents complain about your child’s behavior, then it is time to intervene.

#3 – Experiencing Change in Sleep

Today, I spoke with a concerned mom of an 8-year-old, who shared that her daughter had been having a hard time falling asleep for the past two weeks. The mother told me that she had been working with a sleep specialist, thinking that the issues were related to sleep. However, after two weeks of working together, the mom and the sleep therapist agreed that the daughter had other behavioral issues that required a behaviorist. It turned out that she was suffering from anxiety.

Many children have changes in sleep patterns throughout their childhoods, but if it is interfering with their life, then it is good to look into it.

#4 – Experiencing Regression in Behavior

What To Do When Your Kid Is Struggling

This can include behavior such as going to the bathroom differently, using a pacifier, or bed-wetting. While it can be normal for children to experience a regression in behavior following events such as having a new baby or moving into a new house, it is still good to monitor your child to make sure that these behaviors are only temporarily and not affecting his/her regular functioning.

One example that comes to mind is when one mother called me concerned about her-5-year-old. Her daughter had started drawing on her face while sucking her thumb again, two years after she originally stopped. When I asked for any recent life changes, the mom couldn’t think of anything that would have affected her daughter. When I asked about other people who were involved in her daughter’s life and if they had any meaningful events in their life, the mom told me about her nanny, whose mother had recently died. It turned out that the nanny was depressed and didn’t pay much attention to the 5-year-old, who felt scared and worried about the nanny. The results were that the daughter regressed developmentally and started demonstrating behaviors that had helped to soothe her earlier in life. After I connected the mom with the right child therapist, her daughter was able to express her fears and anxieties surrounding the death of her nanny’s mom. With the help of the child therapist, the mom learned that her nanny shared her feelings of sadness with her daughter and cried during the time she spent with her daughter. This affected her daughter in such negative ways, but with the help of her therapist, her daughter started to feel much better. Also, the mom realized that her nanny was too depressed to work and care for her daughter, and therefore decided to find another nanny.

#5 – Experiencing Loss of Appetite

If you notice that your child is skipping meals or eating less at every meal, than you might want to take note of how many meals he/she skips, and keep track of what is happening around or during meal time. While this can just be a stage or nothing to worry about, you should pay close attention to the number of times your child skips meals or restricts foods, because this could be a symptom that something is going on. It is possible that this is how your child is expressing his/her feelings.

In previous blogs, I talked about my daughter and how she stopped eating bread and pasta because one of her classmates made a comment that pasta and bread would make her fat. She also asked me to buy low fat milk because she was concerned that she would get fat if she drank 2% milk. At first, I didn’t pay much attention to what was happening, but then I found out that she was also hiding her lunch boxes. I ended up calling one of the more experienced eating disorder specialists I work with and consulting with her on the best way to handle this.

As an eating disorder specialist, I wanted to make sure that this was something we handled right away. With the help of Dr. Judith Brisman, who helped guide me, we decided that the best thing to do would be to first contact the school counselor to inform her about what had been going on during lunch. I also set up a call with my daughter’s teachers to make sure that she was doing well in school, and to chat about other issues that may have been going on while in school that I should be aware of. Second, I decided to have an honest and open conversation with my daughter to let her know that I noticed that she had been hiding her sandwiches after school. I also told her that if she didn’t like what I made, if what she took for lunch was too much, or if she wasn’t hungry, it was absolutely okay. I told her I could modify what I made her every day. Most importantly, I wanted my daughter to know that I trusted that she would make the right decision when it came to eating, and that she didn’t have to hide food from me. I was curious about why she was hiding the food from me, as I would not get angry if she trashed it in school or even once she got home. It seemed to me that she was doing that to get attention, especially because her older sister had received extra attention in the weeks before. After we had an open and honest conversation, I told her that we would have special time the next day, and she was excited about that. We ended up going to a sushi place after school, and she ate everything she ordered. I decided not to worry, and to keep reinforcing to my daughter that I honored that she would make the right decision.

#6 – Isolating Themselves from Friends and Family

Therapist Child

This is a common trait in both adults and children, so it can be easier to detect than with other symptoms. If your child is changing how they interact with people who are close to them, it may be a sign that they are unable to connect and are experiencing depression or anxiety.

Children with learning disabilities and attention issues may feel lonely because they may experience life in a different way from those around them. It is common for them to feel isolated from their peers, and research shows that children with these struggles are more apt to feel lonely.

If your child is isolating themselves from friends and family, it could be a larger issue: They may have learning disabilities or attention issues, and/or they may be experiencing depression for another reason. Either way, when there is a noticeable change in how your child presents him/herself with those who are close to him/her, talk to your child about their loneliness. Depending on what you decide together, it might be a good idea to seek professional help.

What Can I Do?

First step? Talk to your child! They may provide answers for you on what steps to take next. They may want to talk to you about how they are feeling, and they may tell you what they need. Really listen to them.

Talk to your child’s doctor. Some medical problems can cause depression, and, if this is the case, your doctor may be able to help you find the cause.

Promote health. Exercise and diet are essential to feeling your best, which is the case for children, as well. Perhaps your child is willing to join a sport so they can get moving. Encourage them to join you on walks, and make the movement fun! Walk to the zoo, or run laps around the lake in silly ways. Many children do better when there is a goal at the end. Do anything to get them moving! And, make sure they are eating well. Even if they are picky eaters, there are many ways to get them to eat better and encourage health. (See our picky eater blog post for more information on that!)

Ask us! This is our specialty. We connect families with the health and wellness services they need. Whatever issue you are concerned about, we can find the best specialists for you in your area, from sleep specialists to psychotherapists to tutors to fitness coaches. Let us help you connect to the person who can change your child’s life! If you would like me to connect you with one of our expert child therapists or dietitians, please contact me. I look forward to hearing from you!

12 Things You Must Know Before Finding a Child Psychologist

12 Things You Must Know Before Finding a Child Psychologist

If you are a parent who believes your child might benefit from seeing a child psychologist, first of all, you are not alone. I also know firsthand that the process can be extremely overwhelming. If you have no experience with the process, it can be quite intimidating to think about putting your precious child in the hand of a professional.

As a mother of three girls, I have had several situations where I thought I needed an outside professional opinion. For example, last year, my 10-year-old started hiding sandwiches in her closet and became extremely aware of her physical appearance. I noticed that she had started bringing back most of her lunch home after school and would only eat small quantities at mealtimes. First I told myself to ignore my instincts and just hope that her behavior would subside. However, after finding five sandwiches in her closet and other places, I decided that I should consult a psychologist. Since I suffered from both anorexia and bulimia and was aware of the genetic predisposition, I chose to be extra cautious and make sure there was nothing serious going on with my daughter. I am also fortunate enough to work with colleagues who are experts in eating disorders, so I had easy access to professional who could provide me with the support I needed. I realize, though, that for most parents and other caregivers, the search can be quite daunting and challenging.

If you are seeking a child psychologist, it is most likely because you have either noticed something is not right with your child in terms of behavior or performance, or a professional such as a pediatrician, school psychologist, teacher or a friend has suggested that they see someone for support.

Acknowledging your child needs help can be difficult, but unfortunately, the search can be even more difficult. One of LW Wellness’ child psychologists, Dr. Allison Patterson, a licensed psychologist and certified school psychologist, compiled a list to equip you with some knowledge before you begin your search.

Searching for a child psychologist could be a daunting task for parents.  Many are not sure how to start and what should even be considered. Here are some ideas of things to consider when searching for a child psychologist to be sure they are a good fit for your child AND your family.

Tip #1

Environment– Upon visiting a potential office, take special note of the environment and atmosphere of the office itself. You first want to be certain the psychologist’s office is child friendly and has developmentally appropriate toys or activities to engage your child.

Tip # 2

Experience– Inquire about the experience the psychologist has with your child’s age. A psychologist who specializes in adolescents may not be appropriate for your preschool aged child. Does the psychologist have experience working with schools and other related service providers? Understanding the school setting would be important since your child spends a significant amount of time in that environment. You want to find someone who has significant knowledge about the specific issues you are looking to address.

Tip #3

Theoretical Orientation– There are various theoretical orientations such as behavioral, cognitive behavioral, psycho-dynamic, or family systems. Some approaches provide more concrete strategies to implement and require interventions from the child’s environment. They may focus on the responses of the adults in your child’s life to enact positive changes. Others may be more long term, require more frequent visits, and may not include parents in the process. It’s important to have a brief understanding of the different orientations and be prepared to work with the psychologist.

Tip #4

Location– Consider the amount of time it would take to travel to and from the office.  The amount of time in transit should not exceed the session time. Some psychologists may even be available to work in your child’s naturalistic environment such as their school. This is sometimes helpful in developing skills in the environment where struggles may occur. For example, working on social skills in the context of the child’s peers may be most effective in enacting change and developing skills. Regardless, if getting to and from the psychologist’s office is a major burden on you and your child, it will become too much of a distraction from the work done in the session.

Tip #5

ScheduleBe certain that the time for the session is manageable for your child and your entire family’s schedule. Young children will be more available to benefit from treatment if they are not exhausted during the session. Also, consider availability for parent sessions.  Are evening hours or early AM appointments necessary for your family and if so, is that an option that is available? Find a time where the appointments aren’t disruptive but also can be made a priority.

Tip #6

FlexibilityTalk with your psychologist about his/her various approaches to helping children with their specific problems. Choosing a psychologist who develops a treatment plan based on your child’s specific needs rather than a set formula is crucial.

Tip #7

ConsultationIt is important for the psychologist to be able to consult with all the adults who care for the child to ensure consistency. This could include parents, teachers, caretakers, speech pathologists or occupational therapists.  A multidisciplinary approach to treatment with children allows the psychologist to gain a better understanding of the child’s struggles and provide support in various environments.

Tip #8

Parent involvement and educationFind out how much parent involvement is expected and encouraged. If you are looking for tools to carry over in the home environment, be certain the psychologist is willing to meet with families. Is the psychologist available to answer questions, respond to emails or be available for phone calls? Evaluate your own commitment and willingness to attend sessions independent of your child. Consider the amount of time you are willing to invest.

Tip #9

Fee- It is important to consider the fee, insurance reimbursement possibilities and inquire about what is covered in that fee.  Are consultations with teachers, caretakers, phone calls, team meetings included in the price or do they have a different fee scale.  Some therapists rates may be higher but they include some consultation. For example, they may not bill for a 20 minute conversation with the child’s speech therapist.

Tip # 10

Credentials– The term Licensed Psychologist is a regulated term by New York State.  Other professionals can call themselves psychotherapists, counselors, or behaviorists but the term psychologist is a regulated term that only those who went through rigorous training and supervision are entitled to use. Further, insurance companies often provide reimbursement only to those with the License Psychologist credential. One must achieve a doctorate to be considered for licensure but not all doctors have the license.

Tip #11

Background check- For safety, it may be good practice to inquire about a background check prior to allowing a professional to work with your child

Tip #12

Temperament– Many parents choose to have either a phone consultation or meet the psychologist at the office prior to committing to ongoing treatment for their child. In this meeting, you as a parent could also assess if the psychologist would be a good fit for you and your child. Is the therapist’s temperament one that could fit with your own? Trust your instincts — if you don’t feel comfortable chances are it is not a good fit.

The above tips are important to keep in mind when seeking a child psychologist near you. It is also important to familiarize yourself with prominent figures in the child psychology world, which will help empower you as a parent to make smart decisions and to be an educated consumer when looking for a child psychologist. While there are several figures, the three I find most useful for parents seeking a child psychologist are Adler, Erikson and Piaget.

No worries, I will not be giving you too much information, but only information that I believe can empower you as a parent and as a consumer seeking a child psychologist.

Let’s start with my favorite psychiatrist who is also trained in psychotherapy: Alfred Adler. He worked closely with Sigmund Freud, whom I am sure many of you are familiar with, but Adler is best known for his approach of looking at the individual as a whole. Adler believed that when children feel that they are not loved and don’t belong to this world they develop feelings of inferiority (what he called an inferiority complex). According to Adler, what people, particularly children, need most is a kiss and a hug and to be empathetically seen for who they truly are. Only then will they be able to be what they were truly meant to be in this life. Think about this for a moment. Think about yourself as a child or as an adult. How would you feel if your parent or friends saw you for who you are and loved and accepted you unconditionally and supported you throughout your journey? What are your passions? What would you have truly done if you could have choices without the social, parental or other societal constraints that might have pressured you? You don’t have to answer at this moment, but when it comes to our children, it is important to be aware of this. Now, think of this in the context of seeking a child psychologist. Are you seeking a child psychologist because you think your child is performing according to your expectations? Are they realistic? What are they based on? It might be a good idea to write these down and share with the child psychologist you choose. We often project our own anxieties and insecurities onto our children and as a result they develop anxieties and take on some of the parents’ fears, insecurities, etc.   

The next theorist that I think you will appreciate learning about is Erikson, who is best known for his psycho social theory. Erikson developed eight stages of development and a virtue associated with each of these stages. His stages are age appropriate trust vs. mistrust (age 0-18 months, virtue = Hope). Autonomy vs. shame and doubt (18 month- 3 years, virtue = Will), initiative vs. guilt (3-5y years, virtue= Purpose), industry vs. inferiority (5-13 years, Virtue = Competence), Ego identity vs. role confusion (12-18 years, virtue= Fidelity), intimacy vs isolation (18-40 years, virtue = Love), generativity vs. stagnation (40-65 years, virtue= Care), ego integrity vs. despair (65+ years, virtue= Wisdom). He focused on how people’s sense of identity develops and how people develop or fail to develop abilities and beliefs about themselves, which allows them to become productive, satisfied members of society.

Thinking about my three girls (ages 8,10 and 13), I found it helpful to think about their development in the context of Erikson’s stages because it helped me as a parent put things in perspective. For example, my daughter Shiloh, who is 8 years old, for the most part feels a sense of competence. During this stage of her development (Stage # 4 Industry Vs. Inferiority) I encouraged and reinforced her to take initiative and achieve her goals. However, if a child at that age is not encouraged, or restricted, then the child will begin to feel inferior and therefore will not reach full potential.

I also have great respect for Piaget because he was the first psychologist to make a systematic study of cognitive development. He was able to show that young children think considerably different than adults. Here are Piaget’s stages of development:. Sensorimotor (Birth-24 months), Preoperational (2-7 years) Concrete Operational (7-12 years) and Formal Operational (12 years-Adulthood).

Why are these important?

Piaget noted that all children shared certain developmental patterns. This can be helpful for you whether seeking a child psychologist or just curious about child development. They are easily understood. Back to the example of my 8-year-old, Shiloh, who is in the concrete operational stage (Age 7-12). I found it to be extremely helpful to read that Piaget found this to be a MAJOR turning point in the child cognitive development because it marks the beginning of logical or operational thought. This is good news for us parents! Because it means that the child can now work things internally in his head rather than physically try things out in the real world.  

You might think this is going too deep and you don’t need to know all of this, but the truth is, as a parent you have to be an active participant in your child’s therapy, so educating and empowering yourself with the basics of child psychology will help you be an educated consumer, ask the right questions and ultimately help your child succeed!

If you would like me to connect you with one of our expert therapists or dietitians, please contact me. I look forward to hearing from you!

Pediatric Dietitian Advice From The Pros

How YOU Can Help Your Picky Eater By Not Jumping To Conclusions!

 

Whether you have a toddler or a teen, nutrition is extremely important for your child’s physical and mental development. I’m sure you’ve seen the research stating that one in every three children is obese. But what are we supposed to do with this information? As parents, all the information and oftentimes conflicting advice on what constitutes “healthy and nutritious” for your child can be overwhelming. And what if we have a kid who just won’t eat nutritious foods?

As an eating disorder specialist and a mom of three girls, I know the challenges that parents and caregivers go through when raising children and trying to feed them healthy foods, while promoting a positive and healthy body image. For some parents, this is not such a big deal, and they allow their kids to eat whatever it is they want without paying attention to the nutritional value. Other parents end up getting in the way of their children by worrying too much about what they are (or aren’t!) eating. Which end of the spectrum do you fall on? To what extent can you actually help your child? Advice from an expert pediatric clinical dietitian — someone who has seen it all! — may help you realize that you aren’t alone, and that your kid isn’t different! Many children experience difficulty eating, and it’s completely normal. However, as a parent you do play a vital role in guiding your child down a healthy path.

It’s important to recognize that picky eating isn’t your fault, it isn’t your child’s fault, and it is completely manageable. Children are growing creatures who experience new senses every single day in their bodies, and that includes in their taste buds! You wouldn’t expect a child to understand what a word is until they are taught to read it (and even after that it takes some time to recognize it on their own), so why would you expect them to understand their sense of taste immediately? Children are sensitive, and they are constantly learning about the world around them. Remember, it’s brand new for them! Our anxieties only worsen the situation. Read on for some advice from professional pediatricians and specialists on how YOU can help your child overcome the boundaries of picky eating and lead them on a lifelong journey to healthy eating!

Normalizing Picky Eating and Learning to Manage Anxiety from your Child’s Fussiness

Below you will find several findings from various pediatricians, eating specialists, and therapists who have either conducted studies on or worked personally with children who are extremely picky eaters. These doctors and therapists have worked closely with stressed and anxious parents who live in fear that their children suffer from eating disorders. The specialists assure these worried parents that excessively picky eating is more normal than you may think in children. Doctors and therapists also stress the importance of remaining calm and not making a huge deal out of a very common childhood trait. They outline the importance of not jumping to conclusions, and not labeling your child’s fussiness. What we as adults may see as being “picky” is often actually just a child experiencing and growing in the world around him or her.

Kristen Lee Campbell, MD is a Pediatrician at St. Louis Children’s Hospital & Instructor of Pediatrics. She is also a mom herself and has a picky eater of her own. Findings from her thesis on fussy eating in children is outlined below.

It’s Completely Natural

According to Dr. Kristen Lee Campbell, children are stubborn creatures by nature, and sometimes they simply decide their mind/body doesn’t want something. This is natural, and can be conditioned and worked with without too much cause for alarm. Just because a child is selective with his or her eating habits, it doesn’t necessarily mean he or she has a disorder. Being an overly picky eater is actually congruent to biology and the natural development of a child’s taste buds and tolerance for certain foods. “It does take time for children to develop the sensory tolerance for certain flavors, spices, textures, and temperatures,” Campbell says. Therefore it is totally natural for a child to be extraordinarily picky and selective with food. You also shouldn’t continually compare your child’s progress with eating habits to others because “the definition of age appropriate foods varies with culture, and a myriad of contexts,” Dr. Campbell explains.

Keep Calm And Keep Cool

Dr. Campbell also encourages parents to keep calm, and keep cool! Children are unbelievably impressionable. Believe it or not, if they sense your anxiety in a situation, they are more likely to experience their own anxiety. It is important to not project your own fears and misconceptions of possible eating disorders onto your child. The last thing that is going to help your little picky eater is a mealtime full of tension, worry, and fear. Children will often do as they see. They are little mimics by nature. Remaining calm, encouraging, and optimistic will only help ease your child’s picky tendencies. They also respond well to visually appealing and fun foods! Dr. Campbell personally knows how difficult this can be for parents, but she urges them to be patient, and remain optimistic.

Dr. Lee Hudson is a Consultant Pediatrician with expertise in feeding and eating disorders. His findings with picky eaters among children are outlined below.

You Are Not Alone

Dr. Lee, first and foremost, points out that parents with picky eaters are not alone! “Picky eating is very common,” he states with confidence. Dr. Lee relays that a study in the Journal Appetite, released in January 2016, evaluated the eating habits of well over 100 children ages 3 to 11. Overall, 39% of children were identified as very picky eaters. It’s common among children, and of course common among parents, to jump to conclusions and begin labeling. However, Dr. Lee stresses the importance of parents remaining calm, and not overanalyzing during a child’s “finicky phase”.

Dr. Faye Powell is a developmental psychologist at the University of Bedfordshire specializing in children’s eating behavior. Dr. Jacqueline Blissett is a reader in childhood eating behavior. Natalie Morris is a lead therapist at Integrated Therapy Solutions’ Feeding Clinic. All three specialists have worked together to study children with picky eating habits, and to assuage anxious parents. Some of their findings and thoughts on picky eaters are below.

Every Child Develops At A Different Pace

Dr. Powell believes that every child is different, and just because your child is not eating as much as his or her sibling or friend did at a certain age, there is no need to jump to the conclusion of an eating disorder. “Child fussiness is largely down to innate differences between kids.” For instance, Dr. Powell mentions that, “Children who have ‘heightened sensory sensitivity’ are much more likely to be fussy eaters. These children are sensitive to different sensory aversions and textures – it can be rather overwhelming. Kids with tactile defensiveness, where they have high oral sensitivity, will be fearful of and not accepting of foods that are different — crunchy, for example.” This doesn’t mean there is something wrong with your child, it doesn’t mean your child has an eating disorder. It simply means every child is innately different, and every child will develop his or her eating tendencies at a different pace. As long as your child is not malnourished or severely underweight in any capacity, this fussy phase is normal, and patience and optimism are key!

It May Just Be How The Food Looks!

r. Powell & Dr. Blissett also say that innately, children are fussier about foods because of how the food may look, such as toast being burned. “As they grow older, food fussiness may be because they are associating that food with something they find ‘disgusting’,” Dr. Blissett says. “If they see worms in the mud, they may associate them looking like spaghetti.” Therefore, it is actually  more normal than you think for a child’s fussy eating habits to develop past the age of 5 or 6. Believe it or not, this shows positive cognitive development, and cognitive function. It just so happens that if your child is a picky eater, their cognitive development is influencing their food fussiness.

Repeated Exposure

Dr. Powell, just like Dr. Lee, stresses the importance of remaining calm throughout your child’s picky eating days. “The key thing to bear in mind when encouraging your child to eat something is to not put any pressure on them,” Dr. Powell says. And that includes the pressure of a hypothesized eating disorder. “All research into food behavior points to putting pressure (including the projection of eating disorders and your own anxiety) on children to eat having a negative impact,” Dr Powell says. “For children who are fussy, ‘repeated exposure’, where you offer the food repeatedly without the pressure to eat it, is really important. Over time, that child will typically begin to accept the food.” The key is remembering that this is something that will happen over time.

Model Behavior

Moreover, Dr. Powell and Dr. Blissett discuss how impressionable children are. They talk about the importance of modeling while coping with your child’s picky eating. “Watching other people and learning through modeling other people’s behavior is so important,” Dr. Blisset says. “In all of our studies, we’ve shown if your child is fussy, the most effective way of getting them to try something new is if you’re eating the same thing and modeling it enthusiastically.”

Be Patient

Most importantly, Dr. Powell and Dr. Blissett encourage parents of picky eaters to be patient. Excessive fussy eating is more normal than many parents believe it to be, and widely affects children up to the age of 11. Even science explains a child’s fussy eating, and how it will eventually begin to cease, as Dr. Powell explains that, “With age, we lose sensory capacity and foods will be tasted less intensively. This is one factor reducing a child’s pickiness.” Therefore it is naturally common for young children to be exceedingly picky. It makes complete sense for a child to be very picky when it comes to foods because of their heightened sense of taste, so don’t stress!

Dr. Blisset and Dr. Powell also relay several cases of parents believing their child’s fussy eating days would never end. However, with patience and a calm demeanor, these parents overcame their fears and anxieties of their children’s projected conditions.

Don’t Project Your Anxiety

Natalie Morris, lead therapist at Integrated Therapy Solutions’ Feeding Clinic, is yet another therapist to stress the importance of parents remaining calm and optimistic throughout a child’s (very natural) journey with picky eating. Natalie explains how she has seen parents get worked up and anxious thinking their child has an eating disorder, and in turn the parents’ anxiety may be hindering a child’s appetite.  Natalie states: ”Feelings of fear and the need to control are significant. When the brain is in this heightened state of anxiety, adrenaline is released and this suppresses the appetite, making the child even less likely to eat.” When these feelings of fear are projected from parent to child, a child’s appetite can be suppressed even further.

Dr. Powell, Dr. Blissett, and Dr. Morris all assure parents with picky eaters that they are not alone, and that, despite their hardships with fussy eating, what they are experiencing is actually a very normal and natural phase for numerous children. They encourage parents to try as best they can to eliminate anxieties and simply “take each day as it comes.”

How Can I Find a Great Pediatric Dietitian Near Me?

A pediatric registered dietitian can be hard to find if you don’t know where to look. Let us help you in your search to help your child! After thorough research and interviews, we match clients with the perfect fit for their needs, whether it is a registered dietitian pediatric specialist, a nutritionist, a coach, or something else entirely. We have a fantastic base of specialists, including, of course, professionals who work in clinical dietitian pediatric nutrition! Check out our website to view our many professional specialists, or email or call us to chat about connecting you to someone who can help change your and your child’s life for the better.

 

10 Tips From A Dietitian Nutritionist for Picky Eaters

 

“I know! She eats anything! I can’t believe it!” your friend exclaims, referring to her 5-year-old daughter as she chomps away on a Salmon Avocado Roll, while your child eats “orange mac and cheese only, Mom, not the white kind!”

Is your friend’s daughter more advanced? More gifted? More mature? Not at all! Your friend’s child is simply different from yours, and that’s OK. 

Feeding troubles affect up to 25% of normally developing children and up to 35% of children with neurodevelopmental disabilities. That’s a lot, right? It’s a common issue to have, but it’s not a problem — it’s something you can work with and overcome together as a family. It’s important for everyone in the family to understand what the “picky eater” is going through, so you can all help out. Many families work with a child dietitian nutritionist to help them along this tricky path, and you may want to, as well. It’s always good to seek help if something isn’t working for you or your family.

Here are 10 tips for families with picky eaters so you can understand where your child is coming from, and help them eat well in the process.

1. Establish A Routine

It’s important to have a routine. As adults, we should also look into this, because it’s been proven that our bodies are happiest when we have a specific schedule to stick to. Studies have shown that children and adults who eat at the same time every day are less likely to be obese and have lower BMIs and blood pressure than people who eat at random points throughout the day. According to Gerda Pot, a professor at King’s College London who was interviewed by the Times, appetite, digestion, and how our body processes food are actually linked to circadian rhythms. This means that our bodies follow a 24-hour pattern in relation to food, just like how our bodies need sleep. It’s so interesting! But it can be so hard to stick to a schedule…

Here are ways to feed your child in a way to encourage their appetite by establishing a routine.

  • Consistency — Serve small meals and snacks at consistent times of the day, with 2–3 hours between each meal and snack time, allowing the child to become hungry before the next meal. Young children feel most comfortable with scheduled mealtimes.
  • Beverages After — Offer milk, nutritional beverages, juice, soup, or water at the end of the meal or snack, and not before, in order to prevent filling their stomachs.
  • Duration
    • Eating should begin within 15 mins of the start of the meal.
    • Meals should last no longer than 20–30 mins.
    • When the meal is over, all food should be removed and only be offered again at the next planned meal. You should not become a short order cook!

2. Respect Your Child’s Appetite

Your kid may not be hungry! And even if they are, it’s important to never force or bribe your child into eating. Forcing or bribing creates pressure, which can lead to children eating even less in the long run. Positive tactics like praise or a gift can also create pressure, though. It’s hard to remember this when you’re trying to get your child to eat, but, believe it or not, pressure in any way makes kids like food less.

What are examples of pressuring messages or tactics?

  • Praise (“Oh my gosh, you are such a good boy for eating that! Good job!”)
  • Shame or guilt (“If you loved me then you would eat this…”)
  • Bribes (“If you eat this, I’ll give you a toy after dinner!”)
  • Distraction (“Just watch your favorite TV show while you eat this…”)
  • Threat or force (“You have to eat this or I won’t let you go to that birthday party this weekend.”)
  • Pressuring therapy (“We’re going to have to bring your nutritionist back for therapy if you don’t eat this…”)
  • Nutrition admonitions (“You need more spinach to grow stronger…”)

So what should you do?

  • Start to learn and notice your child’s hunger signals.
  • Allow your child to choose how much or how little of the offered food to eat. Don’t make them clean their plate!
  • Respect your child’s natural inner signals of hunger and fullness. They will change from day to day, so be open for differences!

3. Make Food Fun

Let your child have fun with food! Food is a glorious thing, and we should treat it as such, as long as we aren’t negatively affecting others in the process. Why not enjoy it? Cut pieces of toasts into silly shapes! Make funny faces with fruit on the plate! Make everything on the plate the same color in different shades! When we understand that food is meant to be enjoyed, we’re more apt to be curious for more options. Discover your playful side, too!

Here are some ways to make meals fun for you and your child:

  • Make Faces On Plates — Paint plates at a paint studio or buy plates with faces on them, so you can move the food around to become different parts of a person’s head. Spaghetti can be the hair, broccoli can be the nose, corn can be the teeth, and so on.
  • Be A Monster — Allow kids to act like monsters destroying and devouring their food, as long as they don’t make a mess around the house, or as long as they take responsibility for cleaning up afterwards. The spinach can be the grass in the yard, the chicken can be the house, the pasta can be the fence… and THEY ARE THE MONSTERS EATING THE NEIGHBORHOOD!
  • Grow Your Own Food — This gives kids a chance to see where it came from, and have a hand in the process. When a child plants something and watches it grow from seemingly nothing over a long period of time, it makes it rewarding to try a bite of what they saw growing on the windowsill or in the garden!
  • Watch Cooking Shows Together — Shows like “Master Chef Jr.” are a great way to get kids excited about food. When they see other children their age making food and becoming masters at cooking, it makes it more exciting. Try some of the recipes that you see on the cooking shows together! Notice what excites your kid, and incorporate that meal into your next plan.
  • Use Dips And Spreads — Get kids to eat their fruits and veggies by offering fun things to dip the food into. It’s fun to try different tastes, and the physical movement of dipping gets them connected to their food in a different way.
  • Eat A Rainbow A Day — Focusing on color is a great way to get kids to try different food groups. Encourage them to try to eat something of each color of the rainbow every day, and keep track of what they ate already!
  • Make Up Your Own Food Names — Teach children the proper names of foods, but come up with your own silly words for them, too. A green smoothie can be “monster juice” and pineapple can be a “ferris wheel.” Ask your kids to help you come up with their own funny names!
  • Make Food Into Fun Shapes — Does your kid have an obsession with the solar system? Cut things into stars and circles for the planets! Are they learning to spell? Make the food spell out their name on a plate. Make the meals look fun and enticing, and your child may be more keen to try a bite or two… or more!

4. Be Creative

Systematically introduce new food! Provide some of your child’s favorite foods together with a small amount of new food. If the child refuses a new food, offer just one bite of the new food without tricking, hiding, bribing or forcing. (If the child continues to refuse after three attempts, do not force the child.) Attempt to reintroduce the new food after a few days or weeks. A child’s preference often changes, even if it takes a few tries!

5. Minimize Distractions

Avoid allowing television, tablets, toys, electronics or books at mealtimes, as this takes away the experience of eating. Instead, engage children using food or by allowing children to self-feed.

6. Establish Rules

Don’t make a second meal if your child refuses the first one. Having a second option always available, like a salad or a bowl of cereal, takes the pressure off both parent and child, because everyone knows the child will still be able to eat something. (If your kid wants to have a sugary bowl of cereal every night, obviously this option doesn’t work for you!) Your child should know that you will not drop what you’re doing to make them what they want, even if they don’t like what’s offered.

Everyone should wait at the table until they are excused from the table. This means that if your child doesn’t want the meal, they still have to sit at the table until everyone else is finished, whether they eat or not.

Whatever your rules are, stick to them as much as you can.

7. Be Patient

Encourage independent feeding – allow for food spillage and age-appropriate mess during mealtimes; cover the floor if it makes cleaning up after meals easier.

Maintain a neutral attitude during feeding time and never become or even appear angry. Your child shouldn’t associate anger with food!

Be patient with your kid, but also be patient with yourself! This may be a trying experience for both of you, but if you give in to what your child always wants to eat, they won’t grow.

8. No Sweets As A Reward

Dessert is not a reward for eating well. This teaches your child that the dessert is the best part, and they should save room for it. It only increases your child’s desire for sweets! Think of making your family’s typical dessert fruit or yogurt, or only offering dessert once or twice a week.

9. Have Your Child Help

Ask your kid what they want! What vegetables and fruits are they craving? Have them help you pick out healthy food at the grocery store. They can help you prep the meal, too! Many kids love to help wash veggies, set the table, or stir a sauce.

10. Set A Good Example

  • Eat Together As A Family — Families should eat together as often as possible. Three-four times a week is what you should aim for, and if you can get more than that in, great! Keep in mind that this doesn’t have to be dinner. It can be breakfast or lunch. It also doesn’t have to be a home cooked meal! Eating together can include ordering your favorite takeout every once in a while.
  • Try Things You Don’t Like — If there is a particular food that you yourself don’t like, tell your child you are going to try it prepared in a different fashion to see if you like it in a new way. Show your child that people can change, and it’s ok to try things again.
  • You Have To Eat Your Fruits And Veggies, Too! — Don’t tell your child to eat a nutritious meal and then only serve yourself the pasta and tomato sauce. Do what you’re asking your kid to do.

 

Should I seek the help of a CDN Certified Dietitian Nutritionist?

It’s OK to ask for help. There is a certified dietitian nutritionist in your area who has trained for this, and who may know the ups and downs better than you do. Why not seek the help of a professional?

If you want to find a dietitian nutritionist, ask your pediatrician about where to start. They can lead you in the right direction on where to look in your area.

Or, ask us! We’re always happy to help you find a dietitian or nutritionist who’s right for your family. We’ll match you with a professional specialist, and their expertise, knowledge, and planning tools will help you solve your picky eater concerns. Whether you want to seek the advice of a licensed dietitian nutritionist, a therapist, a fitness guru, or a tutor, we’re your one-stop-shop to help you and your entire family — adult or child. Contact us for more information!

 

How To Manage Your Child’s ADHD: A 5-Week Child Psychologist Plan

ADHD and ADD are acronyms that you are likely familiar with by now. Many parents and medical professionals are concerned about the marked rise of ADHD over the last decade. Numerous people believe that the diagnosis is too readily given, and that ADHD medication is overused on American children. I have had many parents ask me to write about this topic, and I wanted to bring in an expert to help you with some skills and tools to manage your child’s ADHD.

 

According to the new data from the federal Centers for Disease Control and Prevention, in the U.S., nearly one in five high school-aged boys and over one in ten school-aged children have been diagnosed with attention deficit hyperactivity disorder (ADHD).

 

To give you a better sense of how serious this in the U.S., an estimated 6.4 million children age 4 through 17 have received an ADHD diagnosis at some point in their lives. This is a 16 percent increase since 2007, and a 41 percent increase in the past decade!

 

Before I discuss the most effective ways to manage your child’s ADHD, I think it’s helpful to first discuss the criteria that pediatric psychologists use to diagnose a child with ADHD. ADHD can only be diagnosed if an individual displays at least six symptoms of inattention or hyperactivity impulsivity.

 

Symptoms of inattentiveness include the following: difficulty sustaining tasks or play activities, not listening when being addressed directly, failing to finish school work or chores, being easily distracted, forgetfulness, frequently losing items, and avoiding tasks that need prolonged mental exertion.

 

Symptoms of hyperactivity-impulsivity include the following: frequently fidgeting or squirming in a seat and getting out of a seat, running or climbing in inappropriate situations, difficulty playing quietly, excessive talking, interrupting, intruding on others, and seen as “on the go” or restless.

 

The onset of these symptoms must be before the age of 12, and they must be persistent for at least six months. Finally, the symptoms must not be motivated by anger or the wish to displease or spite others.

 

If you think your child might have ADHD, I highly suggest that you consult with a local child psychologist who can best assess and determine the correct diagnosis.

 

Let’s assume that you find out that your child has ADHD — now what? First, I suggest reading the book “Driven to Distraction” by Dr. Hallowell. I love this book because the psychiatrist, who is an expert in ADHD, presents ADHD in a positive light, which I think can help people see it as an asset rather than a disorder. I have other books that I highly recommend, but this one will be a good intro to start!
Once you have a good grasp on what ADHD is, it’s time to take some steps for you and your child. Here are five actions you can take that help you work with your ADHD child.

 

It’s important to note that nothing happens overnight. If we try to introduce many changes in one day, we are less likely to follow through with them, and we become overwhelmed by all of the newness. Take these steps one week at a time! Solidly focus on one task a week, and gradually add in each of the other tasks. Your child will not benefit from disrupting your entire routine. Focus wholly on just one step, and know that it is enough to do just that.

Our 5-week Plan

This is the plan that one of our trusted providers, a top child psychologist, uses with her clients.

Week 1: Hold Your Child Accountable

Many parents and educators wonder how accountability is important for a child with ADHD. They think, “If my child’s disability is out of his control, is it fair to hold them accountable for their actions?” The answer is unequivocally yes. Your child’s ADHD does not prevent them from understanding consequences, and the first step to maintaining consistency in behavior is to not excuse them from accountability. Furthermore, help them remain accountable by showing you have faith in their abilities, and expecting them to do what is needed. Do not make excuses because of ADHD, rather encourage the appropriate behavior and hold you child accountable.

 

Here is what to do the first week:

  • Initial meeting and rapport building with your child psychologist: This is the MOST important week, as without a strong rapport and trust of our provider, your child will not be able to make the progress we expect.
  • Introducing CBT skills through activities such as games/playing sports
  • The focus of CBT is on how people think.
  • Noticing details about child’s behavior (i.e. he has automatic, reflexive thoughts and interpretations of events). Catching those thoughts and analyzing what one is thinking at a particular moment is extremely important. Provider will be able to assess child’s way of thinking by understating their way of thinking and helping to guide the child to think in a more constructive/positive way.

 

Week 2: Create Consequences

There are many healthy techniques to use to discipline your children – all of which will help you to restore safety and calm things down, reinforce rules, teach children, and help them find a way to make amends.

Natural Consequences

  • The first are Natural Consequences, which happen automatically without any action on your part. For example, if your child does not wear a raincoat on a rainy day, he will get wet. If she forgets her lunch, she will be hungry.
  • You can use Natural Consequences whenever the result is not morally, physically, or emotionally damaging. They are highly effective because as the saying goes, “Experience is the best teacher.”

Logical-Related Consequences

  • The second type is Logical-Related Consequences, where you step in.  For example, if your child won’t dress properly for the weather, she may not go out. Or, if he does not clean up a toy, you may clean it up and then he is not allowed to play with it for a specified amount of time.
  • This works well when there is a specific issue and the consequences are clear.
  • Logical Consequences are imposed by the parent. However, logical consequences are different from punishment in some important ways:
    1. Logical consequences are planned in advance by the parent. They are not reactive or angry responses.>
    2. Logical consequences are often planned with input from the child.
    3. Logical consequences make sense in relation to the behavior. They are “logical.”
  • Logical consequences require time and are thought out on the part of the parent. They need to be planned in advance to be most effective. There are some basic guidelines that can be helpful to parents in developing logical consequences.
    1. Give your child a choice and speak to them in private about the consequences
    2. The Three Rs and an H for Logical Consequences is a formula that identifies the criteria to help ensure that logical consequences are solutions, rather than punishment.

The Three Rs and an H of Logical Consequences

  1. Related
  2. Respectful
  3. 
Reasonable
  4. Helpful

Details:

  1. Related means the consequence must be related to the behavior.
  2. Respectful means the consequence must not involve blame, shame or pain, and it should be kindly and firmly enforced. It is also respectful to everyone involved.
  3. Reasonable means the consequence must not include piggybacking and is reasonable from the child’s point of view as well as the adult’s.
  4. Helpful means it will encourage change for everyone involved. If any of the Three Rs and an H is missing, it can no longer be called a logical consequence.

(These could also be renamed as the Three Rs and an H for Focusing on Solutions.)

Tools that will help you better connect with your child and empower them:

  • Learning about your child’s core beliefs and using exposures to practice those beliefs.
  • Core beliefs can be positive in the case of someone who is confident in their ability. They can also be negative in the case of someone thinking they’re bad at a particular task.
  • Emotional exposure is also one potential strategy that’s traditionally associated with phobias and traumatic experiences. One tries to challenge the emotion and negative thoughts enough that they can bring it down to a manageable level.
  • Normalizing stressful and negative emotional tasks can make them more approachable.

 

Week 3: Suspend Privileges

Obligations vs. Privileges

As part of imposing consequences, you may suspend privileges. But before you can do so, you need to understand what privileges are. Sometimes parents get so caught up in giving to their children that they miss what power they do have.

Your relationship with your children can be categorized as:

  • Parental obligations – what you absolutely must give your children, such as basic nutritious food, proper medical care, school attendance, and respect.
  • Privileges – what you choose to give to your children, such as special foods that meet their preferences, outings, sports, and activities.

The delineation between a privilege and an obligation may be different in different households. For example, in one family, playing a sport may be a privilege, while in another, once registered, it may become an obligation. The idea is to figure out what in your household is a privilege and as such can be taken away when necessary.

 

Week 4: Foster Time Management Skills

Children with ADHD suffer from “time blindness,” meaning they lack the ability to stay aware of time and use it well. This leads to wasting time, and lack of productivity. In order to help your child with “time blindness,” try to make time external. If you make time physical, rather than conceptual, you can help your child see how much time has passed, how much is left, and how quickly it’s passing. Do this by using measurable things like clocks, timers, counters, or apps.

 

Week 5: Teach The Importance of Respecting Adults

It is important to establish a healthy relationship between the child and the adults in their life. They must understand what is, and is not, appropriate to say to their authority figures. They must understand that there is a right time and place for certain behaviors and language. What will begin to help your child understand this is building a strong relationship with a positive role-model (i.e. his coach).

Executive Functioning

Children with ADHD tend to struggle with the following core executive functions:

  • Self-awareness
  • Inhibition
  • Verbal working memory
  • Emotional self-regulation
  • Self-motivation
  • Planning and problem solving

What Can Help With These Struggles?

  • Enforce Accountability (as described above in week 1)
  • Foster Time Management Skills (as described above in week 4)
  • Write It Down
    • Help the working memory by making information visible using notecards, signs, sticky notes, lists, journals, etc. When your child sees information right in front of them, it will be easier to jog their executive functions and help build their working memory
    • Also consider getting a planner- this can be an essential step to helping with time management. This will be a place to keep track of deadlines, homework, and also fun activities such as sports practice and birthday parties.
  • Offer Rewards
    • Help self-motivation by making motivation external using rewards</
    • Children with ADHD have trouble motivating themselves to complete tasks if they do not have immediate rewards
    • It is best to create artificial forms of motivation like token systems, or daily report cards
    • Reinforce long-term goals with short-term rewards to help strengthen the child’s sense of self-motivation
  • Make Learning Hands On
    • Making a problem as physical as possible, like using jelly beans or colored blocks to teach math, or word magnets to teach sentence structure, will help to reconcile the verbal and non-verbal working memory
  • Stop to Refuel
    • Emotional self regulation can be deleted when a child works too hard over too short a time (i.e taking a test)
    • Take frequent breaks to refuel during tasks that stress the executive system
    • 3-10 minute breaks are best in order to aid the child in getting the fuel they need without getting distracted or losing track
  • Get Physical
    • Exercise will give a boost to a child’s executive functioning
    • Physical activities help to refuel, and can help your child cope with ADHD symptoms
  • Sip on Natural Sugar like a Juice
    • During a test or project, have your child sip on a lemonade, a fruit juice, or sports drink for just the right amount of natural sugar (not too much added sugar, though!)
    • The glucose will fuel the frontal lobe, which is where the executive functioning comes from
  • Show Compassion
    • Children with ADHD are generally just as smart as their peers, but their executive functioning problems keep them from showing what they know
    • It is important to show compassion and a willingness to help them learn
    • Do not revert to yelling at your child for their mistake, instead, try to understand what went wrong, and help them learn from it

What About After the 5 Weeks?

From our experience, when parents stick to this plan, they start to see a change by the end of 4 weeks after meeting with a children’s psychologist. It takes anywhere from 12-30 weeks to fully change a behavior, so stick with it. Just remember that, step by step, you are making a positive change in you and your child’s life. Families who are committed to this plan have a high success rate with this 5 week plan! Keep at it, be vigilant, and you will see drastic differences. You’ve got this!

Interested in finding the best child psychologist in your area? We can help! Call us for a free consultation, and we’ll set you up with one of our incredible providers.

Identifying Eating Disorders in Young Children: What Can You Do As A Parent?

If you’ve read some of my recent blogs, you are probably somewhat familiar with my journey and years of struggling with an eating disorder. Most of those blogs focus on my young adult years, but these past few weeks, I’ve been approached by several moms who are concerned about their kids developing disordered eating habits or worrying that their young child might already have a serious eating disorder.

 

As a mother of three girls and as an eating disorder therapist, I’m acutely aware that the average age for children developing eating disorders has dropped from 12 to 7 in recent times. That figure sounds crazy even to me, but I know firsthand how real it is.

 

I was recently approached by a frantic mother whose 7-year-old daughter had been told by her grandfather that she shouldn’t eat the whole bagel because it would make her fat. This mom was so upset because she said she worked so hard to instill healthy eating habits in the house and avoided using the word “fat” or obsessing over body image. However, that one comment had made her daughter obsessed with the idea that she was fat and she started to use language like, “I feel really fat today.”

 

This brings up several things that parents should be aware of. First, we may think of eating disorders as something that only affects teenagers and young adults but it can actually affect children of any age — both boys and girls. Second, it’s important to realize that as a parent, we aren’t the only voice our children hear. They are susceptible to comments from family members, friends, teachers, television, and any other voice they deem trustworthy. Of course it’s essential that you model healthy eating habits and refrain from talking about your own weight or obsessing over diets around your children, but that doesn’t mean they aren’t getting conflicting information from somewhere else. So it’s not enough to establish healthy eating habits in your home because, let’s face it, we can’t guard kids from the outside world all the time.

 

If you hear your child make a comment about being “fat,” it’s important to ask yourself what this evokes in you as a parent. How do you feel when your child talks about this topic? This will establish awareness, which will help you best deal with the issue. Dismissing it or not acknowledging your own reaction to this as a parent will only further the problem.

 

When responding to your child, you want to give them your full attention. Make eye contact, but speak in a regular voice. While it’s not something that you want to dismiss, you also want to avoid blowing a comment out of proportion or giving it too much attention.

 

So what’s a good response to a child who says they feel fat? Start by asking a follow-up question. “When you say you feel fat, what do you mean? What are you actually feeling? Fat is not an emotion or a physical feeling so use your words to help me understand what you mean by that.” Getting your child to open up about their true feelings is an important first step. From there the conversation can continue.

 

Talk to your child about negative self-talk and steer them away from it. Children will often compare themselves to other children (“I’m heavier than my friends at school”) or make comments regarding how their clothes look on them (“I shouldn’t eat this because my shirt is too tight”). One study found that 81% of 10 year olds are “afraid of being fat,” and they are taking the issue into their own tiny hands by dieting, which can often lead to eating disorders. Additionally, with the focus on childhood obesity in this country, the way that food and weight gain are talked about in school and at home can trigger issues. We get into the idea of food and weight being good vs. bad and the fear that instills can be very powerful. I found a good explanation of this from a trusted online resource: “By temperament, most of the children at risk for anorexia are often focused on doing the right thing and doing it perfectly. They focus on the details (don’t eat bad foods) and miss the big picture (balanced diet and health).”

 

It’s also important to be aware of any major changes in your home life, as children who are experiencing anxiety, family problems, or any kind of issues with peers will sometimes turn to unhealthy eating habits as a way of gaining control in their lives.

 

Finally, the strongest advice I can give you is this: If you think you need to consult with a specialist, don’t hesitate. When problems are picked up on at a younger age it’s much easier to work through them then when unhealthy habits and thought patterns have become ingrained.

 

Being a parent is challenging and it doesn’t come with a guide. Often the issues facing your kids are much different than the ones you may have faced growing up. A good first step is to stay close to your kids and keep the dialogue open. As a parent, you want to be able to help your child but remember that it’s also OK to ask for help.

 

If you think your child might be struggling with eating disorders or body image issues, asking questions is a great first step. LW Wellness Network can provide support, counseling, and guidance for families working through these types of problems. We know that every situation is different because every child is different. Visit us at: www.lwwellness.com and on facebook at: https://www.facebook.com/RecoveringTogetherEatingDisorderSupport/. Another wonderful resource is the “Parent Toolkit” from NEDA (National Eating Disorders Association). You can find this at: https://www.nationaleatingdisorders.org/sites/default/files/Toolkits/ParentToolkit.pdf.

I’d love to hear from other mothers with any questions, comments, or fears you might have regarding your children and establishing healthy eating habits so comment on the blog or reach out on our Facebook page!

If you would like me to connect you with one of our expert therapists or dietitians, contact me or book an appointment with me. I look forward to hearing from you

The Benefits Of A Psychological Assessment For Children Who Are Struggling

Our guest blogger this week is clinical psychologist Dr. Jessica Escott. She explains the important benefits of a psychological assessment for children and outlines specific cases where the results led to positive behavioral changes.

 

As a parent, you want the absolute best for your children so it is extremely difficult to watch them struggle, whether it be in school, with friends, behaviorally or emotionally. When such struggles occur, you may seek out the school counselor, set up recurring meetings with teachers, add services and/or utilize therapy. These efforts often feel like a Band-Aid solution that only lasts temporarily only to surface again, perhaps in a new form, soon enough. You want to find the cause, but how?

 

Medical issues can sometimes seem more straightforward. For example, if your child had a persistent cough, you’d take him or her to the doctor, who would perform a check-up and, after a series of tests, you’d find out if it were virus/bacteria, asthma or a problem in the lungs. Each cause has a distinct course of treatment for the problem. A cough is only a symptom of something, just as sadness, anger, inattentiveness or failed relationships are symptoms of a deeper issue. With relationships, there are always underlying dynamics as well as coping and learning styles at play. Many think there isn’t a complementary psychological instrument to look into the mind and see where the issues lie. In fact, psychological instruments do exist but are often underutilized.  Meyer et. al. (2001) compared psychological testing with medical testing and found psychological testing to be on par with, and sometimes even more accurate than medical testing.

 

Psychological assessment is a series of personality, cognitive and/or neurocognitive tests custom hand selected for each individual situation. The tests are administered, scored, analyzed and integrated with one another in a detailed written report. Here are just a couple of examples of how a psychological assessment has helped clients:

  • A 12-year-old boy was having difficulty with friends and completing homework. Personality testing revealed themes of helplessness, negativity and coping styles of looking at the broader picture at the expense of smaller details. Cognitive testing reflected this style by highlighting his low processing speed and difficulty planning. Taken together, when approached with social engagement, the child came off as depressed and disinterested. He could not plan how to effectively engage. Instead, he would hastily read the social picture. Therapy helped him understand these situations better and give him a better skillset for developing positive relationships. His executive functioning difficulty (slow processing speed and difficulty planning) led to a diagnosis of ADHD along with corresponding educational accommodations and psychiatrist referral for medication.
  • A 17-year-old girl’s parent found her cutting herself. Therapy was stalled and not helping. Personality testing revealed that she tended to “fake good.” She wanted to please others and kept any negativity hidden in efforts to be seen as likable. Testing also revealed she had underlying anger and suicidal thoughts. Therapy was able to progress once the therapist unmasked the anger in a way that was congruent and accessible to the patient’s coping style.

 

Assessment can help shine light on any difficult situation diagnostically, educationally, psychologically and cognitively in order to provide the best evidence-based treatment for the given situation. The summer is a great time to get your child tested, as it’s a break from stressors and can start the next school year off right. I am currently offering special testing pricing for the summer to make this service more accessible to most families. For more information, please go to http://jessicaescottpsyd.com/services/psychodiagnostic-assessment/.

About Jessica:  Jessica Escott, PsyD MA is a clinical psychologist with private practices on the Upper Eastside and Scarsdale, NY. She specializes in treating adolescents and young adults through individual psychotherapy and psychological assessment. Dr. Escott has taught psychological assessment classes to psychology doctoral candidates and has conducted psychological assessments in a variety of mental health and academic settings for individuals ages 5 and up. Contact us at www.lwwellness.com to book an appointment.

Helpful Tips About Your Nanny’s Legal Status From An Immigration Lawyer

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Our guest blogger this week is Wendy Yevoli, an incredible Immigration Lawyer and partner with Yevoli and Malayev, PLLC. Wendy is often asked by parents how they can help with their Nanny’s immigrations challenges.

We understand that finding a reliable caregiver for your child is one of the most stressful – and important – parts of being a parent. Once you find your trusted caregiver, the thought of losing that person because she or he does not have legal status in the United States can be terrifying. As immigration attorneys and working mothers, we are often asked, “How can I sponsor my caregiver for a green card?”

Can I sponsor my caregiver for citizenship?
This question breaks our hearts, not only as attorneys, but also as mothers. We know that many families would do anything, and pay any amount, to sponsor their caregiver for a green card. But the reality is that in most situations, you cannot sponsor your caregiver for U.S. citizenship. If she or he is here illegally (e.g., by overstaying her or his tourist status or entering the U.S. without inspection), the law essentially says that there is no way for that person to become legal. As immigration attorneys, however, our job is to come up with solutions to help you – and your caregiver.

What are my options?
Through our years of experience working with caregivers (and the families who hire them), we have found that in some cases there may be a way to help them legalize their status.
For example:
-If the country your caregiver is from is undergoing political unrest, the U.S. may have issued TPS (Temporary Protective Status) for the citizens of that country. If so, your caregiver may qualify for TPS and be able to obtain an immigration benefit for as long as the TPS is in effect.
-If your caregiver’s family had filed a green card petition for the caregiver before April 30, 2001, she or he may be able to benefit under the life act.
-If your caregiver has a child or spouse who is a U.S. citizen, she or he may have an opportunity to legalize her or his status.

These are just a few possibilities, and every person’s background and situation are unique.

What should I do now to help my caregiver apply for a green card?
Your first step should be to speak with a reputable immigration attorney. If your caregiver has already engaged an immigration attorney, you can help by speaking with the attorney to understand the strategy he or she is using in the green card process. If your caregiver does not yet have someone representing her or him, this is the time to consult an experienced immigration attorney with a solid reputation to learn what options may be available.

What should my caregiver and I be careful about?
Unfortunately, many caregivers go to agencies or visa consultants for help with immigration matters. Often, these agencies and consultants file frivolous green card applications that they know will not be granted. If that happens, your caregiver will become known to the immigration authorities and at risk of being put in removal proceedings. It is very important to understand the risks associated with filing an application with the Department of Homeland Security, and to speak with an immigration attorney before the application is filed.

And finally…
Immigration laws are complex and constantly changing – which is why it is so important to speak with a knowledgeable immigration attorney. Keep in mind that any conversation you or your caregiver have with an attorney is confidential, so do not be afraid to sit down with the lawyer, provide all relevant information, and express your concerns.
We understand the bond that you and your family have with your caregiver, and the importance of protecting that special relationship by helping her or him remain legally in the U.S. Please feel free to call us at 212-634-6322 or email us at wyevoli@yandmlaw.com with any questions you may have.

Yevoli & Malayev, PLLC (www.yevoliandmalayev.com) is a full-service immigration law firm located in New York City. Our firm represents individuals and businesses across the country and around the world. Immigration law is highly complex and individualized. Our firm offers personalized service. We help our clients define their immigration strategy, taking into consideration long-term goals as well as short term needs. You will get advice tailored to your unique situation. Unlike most other law firms, our services are conducted on an affordable flat-fee basis. You’ll know in advance the costs involved. The information on this website in this post is for attorney advertising purposes only. No Attorney-client relationship is formed out of reviewing this post. Do not rely on information found in this post to make any decision concerning your legal rights. Prior results do not guarantee a similar outcome.

If you’re interested in more information about our services as they relate to your nanny, check out our nanny consulting page  or contact us today.

The Importance Of Seeking A Nanny Before You Give Birth

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When you are pregnant with your first child, there are so many things to think about and people are constantly giving you advice. It can be such an exciting and overwhelming time! One thing I recommend to all new parents, though, is really taking the time to search for a nanny prior to giving birth. I’ve seen many parents wait until their child is born, thinking they will have plenty of time in those first few weeks to really search for someone. Here are five reasons to consider finding a nanny while you are still pregnant.

  1. It gives you time to really do your research before you are stressed out with a newborn. While those first few weeks are magical, they are also exhausting. The last thing you are going to feel like doing on such little sleep is looking through resumes and talking to references.
  2. You won’t make a decision based out of fear of doing it alone or having to find someone in a rush before you go back to work. If you are in a hurry or getting worried about having no help, you might make your decision based off fear or desperation. You want to have all the time you need to find someone who is perfect — not just okay for the time being. The more time you give yourself, the more relaxed and thorough you can really be in the process.
  3. You will have plenty of time to get to know the person before leaving her with your new baby. It’s very tough to leave your baby with anyone, but especially someone you feel like is a stranger. If you hire someone way ahead of time, you can get to know the nanny in the weeks before the birth and then after the birth, as well. You want to feel very comfortable with the person before you have no option but to leave your child with a childcare provider.
  4. You can really focus on the type of parenting philosophy and type of nanny care you want your child to have. While you are pregnant, it is the perfect time to have discussions with your partner as well as focus on awareness just by yourself. You can think clearly about the type of parent you want to be, the type of childhood you want your baby to have and the type of person you think will be an asset to your family. If you wait until after the baby is born, a lot of time you are thinking more about immediate needs and not the big picture. It can get easy to get hung up on someone who can start right away and completely forget about finding that ideal person who will make your family life better in the long run.
  5. You will have plenty of time to train your nanny once the baby is born and she can get to know you and your routine before you absolutely need her. I think it’s a great idea to have your nanny start to get to know you and your baby before you are ready to leave her with your child full-time. The earlier you hire someone, the more likely it is that you’ll have plenty of time to train her and get acclimated to your home and family.
 If you’re interested in more information about our services as they relate to your nanny, check out our nanny consulting page or contact us today.

Parenting Tools: Love and Logic And Counting To Three

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I’ve talked briefly about Love and Logic parenting because I think it’s a great philosophy, and I’ve seen it work. I want to equip parents with as many tools as possible, because as we know, being a mom and dad does not come with a guide. There is a great book that I highly recommend called 1-2-3 Magic by Thomas W Phelan.

The book talks about practical strategies to help give your kids choices and also set appropriate boundaries – without yelling. I think one thing most parents say before they have kids is that they don’t want to be the type of parent who is always screaming at their kids. But, as we all know, once you become a parent and you are faced with the day-to-day stress and the task of teaching your child responsibility, it is so easy to resort to yelling. The thing is, though, that only creates more stress and hinders our children, who don’t respond well to anger.

The idea of Love and Logic parenting is to be very clear with your kids about their choices and the consequences. Make your rules make sense to them. The key here is that you have to follow through. Empty threats are the worse because they teach your children nothing and make you upset and angry. Instead, tell your children what you expect, why you expect it and what will happen if those things aren’t done. Then, simply follow through with a consequence that makes sense.

For example, we were having trouble getting my youngest child to brush her teeth before going to bed. At some point, it needs to become the child’s responsibility. So, one day, I decided to stop the nighttime struggle and presented her with this scenario. I said, “They are your teeth and therefore it is your responsibility to brush them. I’m not going to do it for you. However, as a parent, I have to protect you from getting cavities. That’s part of my job to keep you healthy. So, if you don’t brush your teeth then you won’t be able to eat any of the sugary treats or candy that you like because that is what is most likely to cause cavities.”

This blog talks more about Love and Logic parenting as well as using the “1-2-3 strategy.” The idea with counting is that you are giving your child a formal warning and time to focus on what the consequence will be for a certain behavior. After three, you need to take action and follow through with a consequence.

What other strategies do you use that you’ve seen are effective? I’d love to hear your feedback!