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What Does Depression in Children Look Like?

2/18/2019

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Mental illness can affect people of all ages, but the symptoms may appear differently in children. It can be difficult for parents to tell if their child is just “going through a phase,” because signs like irritability or mood swings may be chalked up to adolescent hormonal changes. Childhood depression can be “masked” by different behaviors, such as angry outbursts or defiance, so parents should learn the common warning signs of depression before dismissing uncharacteristic behaviors as a sign of normal adolescent development.

What Causes Childhood Depression?

Like most mental illnesses, depression can be caused by a variety of reasons, but there are some factors that may increase the risk of developing the illness. Research has shown that depression has a genetic component because children who have a parent with depression are 4 times more likely to be diagnosed with the disorder themselves. Other risk factors for depression include traumatic life events, a dysfunctional home life, financial troubles, or being bullied at school. Children with physical conditions and learning or cognitive problems are also more likely to suffer from depression as well.

Signs and Symptoms of Depression in Children

Children with depression experience many of the same symptoms that adults with depression have, but they may express these symptoms differently. Symptoms of depression can manifest in ways that might make your child appear to be lazy or unmotivated. For example, depression often causes people to experience fatigue, so if your child is often “too tired” to complete homework or other tasks, try not to assume they’re just procrastinating. Look for other symptoms of depression, such as:​

  • Irritability or anger.

  • Feelings of sadness and hopelessness.

  • Frequent complaints of physical pain, like headaches or stomach aches.

  • Social withdrawal.

  • Trouble concentrating or making decisions.

  • Feeling overwhelmed.

  • Vocal outbursts and crying.

  • Not enjoying activities they used to like.

  • Not functioning as well in daily activities, like going to school.

  • Changes in appetite and/or sleeping habits.

  • Thoughts of death and suicide.

What to Do If Your Child Shows Signs of Depression

If you’ve noticed that your child has displayed symptoms of depression for at least two weeks, schedule an appointment with your child’s doctor. While there is no specific test to diagnose depression, your doctor can rule out other potential causes for your child’s symptoms and use tools like questionnaires to get a better understanding of your child’s condition. During the appointment, the doctor will probably do a complete physical check-up and may ask to talk to your child alone. 

​If your child receives a diagnosis of depression or a similar mood disorder, your child’s doctor will likely have several different resources and treatment options for you to consider. Psychotherapy is recommended for most children suffering from depression because a well-qualified therapist can help them understand their feelings and learn how to manage their symptoms. Your child’s doctor may also suggest antidepressants because depression is best treated with both therapy and medication.

Warning Signs of Suicidal Behavior

Although it’s rare, children under the age of 12 may attempt suicide. Children may be more at risk for suicidal behavior if they’ve experienced violence, abuse, or have a family history of alcoholism. Some red flags that your child might be suicidal include:​

  • Showing multiple depressive symptoms or an increase in symptom severity.

  • Reckless or careless behavior.

  • Giving away their possessions.

  • Either crying much more or becoming much less expressive.

  • Social isolation.

  • Talking about death or other morbid themes.

  • Feeling hopeless or worthless.

How You Can Help

Childhood depression might improve with just therapy and medication, but having family support can make a huge difference in your child’s mental health. Depressive symptoms can last for months and your child might need to try different medications and therapists before finding the right fit for them. Know that there is no “quick fix” for depression, or any other mental illness, but you can help your child combat depression by:

  • Maintaining healthy habits. Make healthy meals, encourage your child to exercise, and have them develop a regular sleep schedule. You might also want to limit your child’s screen time or encourage them to spend time with friends.

  • Be empathetic. Your child’s depressive symptoms can be disruptive and frustrating at times. They can become easily upset, not do their homework, or act out at school. Try to understand the real reasons behind these behaviors so you can talk to your child about it and work towards finding a solution.

  • Help reduce stress. Children with depression can become easily overwhelmed. You can assist them by breaking up a problem into smaller steps, encouraging them, and helping them look at it from a different, more positive perspective.

  • Listen. Actively listen to your child, especially if they open up to you about their feelings of hopelessness or sadness. Tell them that no matter how depression makes them feel, you will always love and care for them.

For more information and guidance, visit Dr. Syras Derksen or Oakville Wellness Center.

By:  Dr. Syras Derksen
Registered Psychologist

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Navigating Postpartum Depression

2/11/2019

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Having a baby is a complete overhaul of your life. Such a big change is enough to stress out even the most prepared of us. Add on top of that the sleep deprivation and chaotic hormone changes and many new moms find themselves feeling a little down at times. It’s completely normal and extremely common. In fact, this phenomenon has its own name: the baby blues.

The Baby Blues

Most mothers experience at least some symptoms of depression following the birth of their child. The following are not uncommon experiences for new mothers.
  • Fatigue
  • Difficulty concentrating
  • Sleeping too little or too much
  • Unprovoked crying
  • Irritability and mood swings
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If the baby blues are going to hit you, it’s likely to begin a day or two after childbirth. The exact causes of the baby blues are not fully understood, but it is thought to be the combination of the extreme hormone variations that come with childbirth, coupled with stress and lack of sleep.

The baby blues are regarded as normal and unconcerning. The symptoms can usually be minimized by a healthy diet, some exercise, and a few hours of quality relaxation time. And they should clear up in a couple of weeks.

Postpartum Depression: when the baby blues are unmanageable or last too long

It can be tricky to differentiate the normal ups and downs of postpartum life from postpartum depression, at least at first. The biggest indicator that your baby blues are actually depression is the duration of their stay. If it’s been significantly longer than two weeks and the symptoms are still persisting, then the situation is no longer normal. The other big warning flag that your baby blues are something more serious is if they are unmitigatable. If you’re feeling like you can’t cope or your symptoms are interfering with your ability to take care of your baby or yourself, then what you are going through may be something more serious than the expected baby blues.

Symptoms of Postpartum Depression

The symptoms of postpartum depression overlap greatly with the baby blues, but there are some unique identifiers as well. 
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  • Mood swings: Like with the baby blues, people suffering from postpartum depression often experience mood swings. However, unlike the baby blues, where mood swings are manageable and taper off after a few weeks, the mood shifts associated with postpartum depression are much more severe. They can include crippling anxiety or full-on panic attacks that may leave you isolated from friends and family. 

  • Hallucinations: In some cases, postpartum depression can induce hallucinations. Hallucinations of any severity are not normal and should be immediately reported to a physician. 

  • Suicidal thoughts or actions: Suicidal ideas are the culmination of untreated postpartum depression and a sign that you need to see a doctor immediately. Thoughts of hurting yourself are never normal.

With postpartum depression there is also usually a constant fear of being an inadequate parent that intertwines itself with all the other symptoms. While it’s normal to worry about your child and be a little judgemental of yourself, it is cause for concern if you can’t seem to see anything positive about how you and your baby are doing together.​

Postpartum depression may not be immediate. It could creep up anytime in the first year, so don’t avoid getting help just because it’s been “too long” for your symptoms to be postpartum depression.

Treating Postpartum Depression

The biggest mistake people make is waiting too long to talk to a doctor or psychologist. Schedule an appointment and go in as soon as you think your depression is more than just the “normal” amount. Follow these steps to get the best help possible from your physician. 

  1. Read up on postpartum depression
Do your research before your appointment so you can know exactly what questions to ask. This will help your treatment get started immediately.

  1. Choose your physician wisely
There is no “postpartum depression” physician. You should choose whichever doctor you think will be your best advocate. And know that you can always get someone else if you feel you’re not being listened to. Always remember that what you are feeling is real. 

  1. Consider bringing someone with you
Some people prefer to see their doctors alone. Others are more comfortable with some backup. If you think it will help you be honest or calm, then consider taking your partner, a family member or even a friend with you to your appointment. If your doctor tries to tell you that you must speak alone, see a different doctor. 

  1. Be candid
Above all else, be honest. Your doctor can’t get you the help you need if you don’t share everything. It can be difficult to do, but just remember that you are not a bad parent. In fact, seeking help for postpartum depression is the mark of a very good parent. And contrary to popular myth, women with postpartum depression are not at risk of deliberately harming their children (that is a risk of postpartum psychosis, a much rarer pregnancy complication).

By:  Dr. Syras Derksen
Registered Psychologist

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What Should I Do If My Child is Struggling Academically?

1/21/2019

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If your child has been bringing home bad test grades, or excels at some subjects while doing poorly in others, you might be at a loss for what to do. Trying to convince them to do their homework can become a daily battle, or they might refuse to let you help them at all.

​If you feel helpless, you’re not alone. Millions of parents have expressed their concerns with their child’s academic performance. The good news is that there are many ways you can help, and plenty of resources are available. In some cases, you may find that there’s a medical reason that explains your child’s difficulty with learning. In any case, once you understand what is contributing to your child’s academic struggles, you will be able to better assist them in making meaningful improvements. Read on to learn more.

How You Can Help

As a parent, you’re the biggest influence on your child. It’s important that you show interest in how their day at school went, but more importantly, keep a consistent routine for your child. Make sure they eat nutritious meals, get enough sleep, and have time to play. No child will be able to focus properly in school if they’re hungry, tired, or hyper. Other ways you can help include:​

  • Attend school events such as back-to-school night and parent-teacher conferences to gain insight about your child’s learning difficulties from their teachers.

  • Create a quiet area in your house for your child to do homework. 

  • Be available to help clarify questions about homework, but do not give your child the right answers or do the work for them. 

  • Volunteer at your child’s school as a classroom assistant or be a chaperone on field trips. However, it’s important to take your child’s opinions into account for this; if they feel uncomfortable when you’re involved in their class, it can hurt, but you can always join the PTA or simply attend your child’s school plays or concerts.

  • Help them stay organized by creating a daily to-do list, color coding their subject folders, or by using another organization method.

After-School Help

If your child resists help from you or you feel like they need extra assistance, many parents look into after-school options. Depending on your child’s difficulties or needs, there are a few different options for after-school support:​

  • Tutor. A tutor specializes in a specific subject, so they’re ideal if your child is having difficulty in a certain academic area. They can explain concepts to your child one-on-one in greater detail, help them practice skills, and answer questions.

  • Homework helper. If your child is very bright and does well on tests but struggles with completing their homework, a professional homework helper can help by setting structured times for your child to work. Once it becomes a routine, parents typically take over this role. 

  • Educational therapist. If your child is struggling to keep up with his classmates, an educational therapist can work with them to develop skills, provide individual attention, and encourage your child’s strengths. Educational therapists are professionals who often have a background in psychology, speech-language therapy, or special education.

Signs of Learning Disabilities

It’s estimated that about 30% of school-age children struggle on some level with reading or learning, and 7% of these students become diagnosed with learning disabilities. They can be difficult to notice because children might try to hide how much they struggle. However, some common signs of learning disabilities include:​

  • Difficulty reading and/or writing.
 
  • Problems understanding concepts, following directions or paying attention.
 
  • Difficulty with math.
 
  • Working at a slow pace.
 
  • Clumsiness and poor memory.
 
  • Trouble staying organized and telling time.
 
  • Difficulty speaking or expressing thoughts.
 
  • Impulsiveness or “acting out.”

If you suspect your child might have a learning disability, talk to your child’s doctor or psychologist. Only a professional can accurately diagnose your child, and they can refer you to resources that can help your child succeed.

Schedule Vision and Hearing Checks

Sometimes, a child’s difficulties in school can be directly caused by difficulty seeing the classroom board or hearing their teacher’s instructions. Auditory and vision problems can arise at any point in a person’s life, and children should get regular screenings from a pediatrician. Your child might simply need glasses in order to do better academically!

However, although some kinds of hearing problems are found when a child is a newborn, hearing loss can occur later in life due to exposure to loud noises, trauma, infections, or medications. 15 out of 1,000 children under age 18 have some degree of hearing loss, according to nurse Sue Griffard. If your child is found to have hearing problems, there are numerous ways to help them, such as cochlear implants, certain procedures or therapies, and training in sign language or lip reading.​

If your child is frequently upset or discouraged by his experiences in school, therapists are available to help them manage feelings, gain confidence, and develop healthy coping skills. Reach out to our experts at Oakville Wellness Center for more information and further assistance.

By:  Dr. Syras Derksen
Registered Psychologist
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How Can I Help My Child Improve Fine Motor Skills?

1/14/2019

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Fine motor skills involve coordinating the eyes with small movements and muscles. Many of the most common daily activities, such as holding a toothbrush or using a spoon, require good fine motor skills. Young toddlers often struggle with fine motor skills at first but quickly improve with encouragement and practice.

Typical Development of Fine Motor Skills

Children go through many rapid changes and developments during the first several years of their life, and each child will develop at their own pace. If your child is healthy and meeting other developmental milestones, there’s probably no reason to worry if they can’t get the hang of certain tasks as quickly as other children. To make sure your child is on track with their development, some of the basic fine motor skills a child should have by the time they turn 3 include:​

  • Folding a piece of paper in half.

  • Drawing straight lines and circles.

  • Using scissors to cut across a piece of paper.

  • Using a fork or spoon to eat.

  • Buttoning large buttons.

  • Putting on certain items of clothing.

  • Building towers with more than 9 blocks.

  • Turning single pages in a book.

  • Holding a crayon or marker with the thumb and fingers.

Signs of Fine Motor Skill Difficulties

It can take some time for children to learn all the different types of skills we usually take for granted, and some tasks can be harder to grasp than others. But if your child seems to be struggling with several different types of activities involving fine motor skills, it might be a sign of developmental coordination disorder, also known as dyspraxia. Signs of motor skill difficulties might not appear until your child is in preschool or kindergarten because these troubles often become more apparent in the classroom. Your child may struggle with activities such as: ​

  • Tying their shoes or buttoning clothing.

  • Holding a pencil properly.

  • Writing or drawing neatly.

  • Speaking and expressing themselves.

  • Tasks involving good hand-eye coordination.

  • Learning new fine motor skills.

  • Typical age-appropriate tasks, such as getting dressed.

  • Typing on a computer.

  • Completing tasks involving fine motor skills due to easy fatigue.

Ongoing trouble with fine motor skills can lead to bigger problems as your child grows up. If your child is unable to write legibly or struggles to complete homework assignments because writing is too challenging for them, this may cause their grades and self esteem to suffer. They might compare themselves to their classmates and wonder why they’re not able to do the same activities as well. Therefore, it’s crucial to schedule an appointment with your child’s doctor if you suspect they might have a developmental coordination disorder. The doctor can give your child an accurate diagnosis, and will likely recommend occupational therapy or other resources to help your child succeed.

Treatments for Improving Fine Motor Skills

If your child receives a diagnosis of dyspraxia, rest assured that there are many treatment options for your child. Although there is no cure for this particular disorder, early intervention and treatment can help lessen your child’s difficulties with everyday tasks and improve their confidence. Some of these treatment options include:​

  • Occupational therapy. Occupational therapists can help ease your child’s frustrations about certain tasks, such as writing. They’re able to take your child’s likes and interests into account to create enjoyable ways to practice their motor skills and break up difficult tasks into more manageable parts for your child to work on.

  • Classroom accommodations. For children with fine motor skill difficulties, assistive technology like voice-to-text software can be especially helpful in the classroom. Your child’s teacher may also allow your child extra time to complete homework or make other accommodations.

  • Equine therapy. Many children with dyspraxia have benefitted from therapeutic horse-riding. Equine therapy helps children improve their balance and coordination, but studies show that it also lifts the children’s moods.

  • Speech-language therapy. Dyspraxia may cause difficulties with speech and writing skills, and a great speech-language pathologist can help your child make significant improvements in these necessary areas.

Fun Ways to Develop Your Child’s Fine Motor Skills at Home

You should always encourage your child to do things involving fine motor skills on their own, but step in to help if your child becomes fatigued or overly frustrated. To make practicing their motor skills fun, you can do a variety of different activities at home with your child. Here are just a few fun ideas for you to consider:

  • Play with Play-Dough or make slime.
 
  • Try a color-by-number or paint-by-number activity for your child to practice coloring “in the lines” and holding a paintbrush. 
 
  • Have your child help you in the garden.
 
  • Make bracelets or necklaces.
 
  • Play with blocks or Legos.
 
  • Cut pictures out of old magazines and create a collage.

For more guidance, visit Oakville Wellness Center or Dr. Syras Derksen. 

By:  Dr. Syras Derksen
Registered Psychologist
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How Can I Help My Defiant Child?

1/7/2019

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It can feel like a daily battle when your child doesn’t listen to you or flat-out refuses to obey your requests. Even the sweetest and most well-behaved children can behave defiantly and push you to the limits of your patience. In order to keep peace at home, help your child be successful at school, and keep yourself sane, you first need to take care of yourself.

How to Stay Calm Amidst Defiant Behavior

When your child is screaming at you, staying calm can be a huge challenge. You might be tempted to start yelling as well, but clinical director Emily McNeil says that more yelling will do nothing but escalate the situation. McNeil says, "It's neurobiologically impossible for a child to be more regulated than his parent.” She offers a few tips for parents to keep their cool when handling hot-headed children:​

  • Take care of yourself. If you’re neglecting your own basic needs by not eating well or sleeping enough, you’ll have less patience and energy to deal with your child. Talk with your partner or spouse to make sure both of you are getting the right amount of self-care and “me-time” so you can be at your best when dealing with your child.

  • Create a mantra. McNeil says that staying calm in a chaotic environment is a skill that doesn’t come easily to anyone. You’ll need to be dedicated to practicing calmness. In order to do so, she suggests coming up with a phrase to repeat to yourself in frustrating situations, such as, “I will not yell at my child,” or “I can stay calm.”

  • Get some space. Before responding to angry behavior from your child, take a moment to do some deep breathing, or if your child is old enough, leave the room until you’ve collected yourself.

  • Empathize, then explain. Dr. Laura Markham says that parents should acknowledge their child’s feelings before setting the limit. For example, try to say, “I know you’re having fun playing and don’t want to leave, but we need to go home. Say goodbye to your friends and tell them you’ll see them tomorrow.”

Steps for Managing Defiant Behavior

Once you feel calm and collected, then you can start to effectively managing your child’s behavior and disciplining them appropriately. Many parents feel at a loss when it comes to disciplining their defiant child because they might simply ignore the parent’s instructions. To regain control of your child, school psychologist Rachel Wise shares some of her best advice that she’s utilized during her 18 years of work:
  • Set expectations to earn rewards. Instead of punishing kids by taking away privileges or rewards, let them know what your rules are and then let them earn privileges for good behavior. Having them choose their rewards can also encourage them to follow the limits you set for them.
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  • Give reminders. Let your child know when you expect them to complete a task. For example, give them a heads-up that they have ten minutes to finish their game and come down for dinner instead of asking them to come to the table as soon as the meal is served.

  • Be empathetic. Acknowledging your child’s emotions will help your child feel understood and cared for, and they will be much more likely to follow through with your expectations.

  • Give specific praise. All children want to be recognized when they do something well! If your child does well on a test, praise them for all the hard work and studying they did. Let your child know that their good behavior doesn’t go unnoticed.

  • Offer choices. Giving your child options as often as possible allows your child to make a decision themselves instead of being told what to do. 

  • Ignore tantrums. Stick to your rules, and don’t try to bribe your child or negotiate when they start acting out. Rachel Wise says that doing this only encourages this negative behavior.

  • Know the right time to teach. In the midst of a tantrum, lecturing your child about their behavior isn’t very likely to work. Wait until later in the day when everyone has calmed down to bring up the behavior. McNeil suggests saying, “Something happened earlier that bothered me. What could we do differently next time?”

Oppositional Defiant Disorder

Occasional defiant behavior is to be expected when raising children. However, if your child has been having defiant behavior for months and they are easily annoyed, hostile, or argumentative, they might have a disorder known as oppositional defiant disorder, or ODD.

ODD is described as a constant pattern of “defiance, negativity, and hostility” that lasts for at least 6 months. Some signs of this disorder include frequent outbursts, excessive arguing, refusing to follow rules, and lying. If you believe your child could have ODD, talk with your child’s doctor to explore treatment options such as family therapy or parent management training.

By:  Dr. Syras Derksen
Registered Psychologist

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Is it Bad Behavior or ADHD?

12/31/2018

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Nearly every parent has seen their child throw a temper tantrum or have a “meltdown” over seemingly little things. Children are constantly learning and being bombarded with different stimuli everywhere they go, and each child will react differently to the same situations. Occasional meltdowns are to be expected, but it can become worrisome if your child becomes agitated or upset over everyday occurrences multiple times a week. 

​One possible sign your child could have ADHD is that they have emotional outbursts or have trouble explaining their feelings. However, it is also possible that your child may just be “acting out” due to other circumstances such as being bullied at school, having a friend move away, or other events that seem life-altering to them at the time. Learning the signs and symptoms of ADHD is a start to helping you either rule out the possibility of ADHD, or to seek a professional’s help and diagnosis for your child.

Signs and Symptoms of ADHD

Some people, and even other parents, can be quick to say that all kids have trouble sitting still and focusing. But these aren’t the only signs and symptoms of childhood ADHD. There is a wide range of symptoms ADHD can cause, including :​

  • Impulsivity. 

  • Defiance.

  • Self-focused behavior, such as interrupting or having difficulty waiting their turn.

  • Emotional outbursts or temper tantrums.

  • Trouble organizing, initiating or completing tasks.

  • Daydreaming and forgetfulness.

  • Difficulty paying attention or staying focused.

While it is likely that most children will display these signs at some point, it is important to notice if your child is regularly displaying ADHD symptoms in different environments. For example, it makes sense if your daughter thinks math is boring and is prone to daydreaming in her algebra class. However, if she seems to be unfocused in most of her classes and while she is at home with family, this can be a sign of ADHD. 

Another sign of ADHD is that one or more of the listed symptoms is starting to impact your child’s life in a negative way. This can be shown through fighting with peers, falling behind in school work, forgetting to do assignments, or other events. If your child’s grades are beginning to slip or they’re getting in trouble with teachers for not completing their homework, it may be time to seek help from a psychiatrist or therapist.

Why Do Kids with ADHD Act Out?

As mentioned, emotional outbursts or temper tantrums can indicate ADHD. These meltdowns can cause your child to become angry, inconsolable, and defiant. While it is difficult for parents to watch their child become so upset, it is important to know why children with ADHD act out at certain times.​

  • Repetitive or boring tasks can be very challenging for someone with ADHD, and it can be even more frustrating for them if they have to stop doing something fun or enjoyable to go do their homework or do their chores. 

  • Dr. Anderson notes that along with impulsivity, children with ADHD find it “excruciating to wait,” and that they have trouble with delayed gratification. These would be the kids unable to wait for the second marshmallow in the famous Stanford marshmallow test.

  • Unfortunately, children with ADHD may have more trouble making friends. This can be due to their lack of focus causing them to lose track of the conversation, constantly interrupting other kids while they’re talking, or impulsively yelling at others when they don’t get their way. In one study conducted at a boy’s summer camp, researchers noted children with ADHD were more likely to be disliked or ignored than boys without an ADHD diagnosis. Feeling lonely and unliked by peers can increase irritability and frustration in children with ADHD and this can lead to more outbursts or tantrums.

Advice for Parents.

It is recommended to ask your child’s doctor or psychologist for a professional diagnosis and treatment plan if you suspect your child has ADHD. If your child is diagnosed with ADHD, one of the most important things you can do is to establish a consistent daily routine for your child. This minimizes the chances they will forget something, and it will lessen arguments about when it’s time to go to bed, eat dinner, or do homework.

Counseling is a great way for your child to learn how to process and express their emotions in a healthier way. Seeking a therapist’s help can make a positive impact in your child’s life by teaching them skills they can utilize for the rest of their life, such as coping strategies for boredom, learning how to communicate better with peers, and channeling their energy into creative outlets. Oakville Wellness Center allows parents to view profiles of several qualified therapists, schedule appointments online, and there are even convenient weekend and evening hours available. 
​

By:  Dr. Syras Derksen
Registered Psychologist

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Is My Child’s Autism Diagnosis Correct?

12/24/2018

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If your child has received a diagnosis of autism, you probably have several questions about what to do next, where to find services to help your child, and what you can do to help your child at home. You may even question the diagnosis and wonder if it could be something else. Does your child avoid eye contact because they’re on the autism spectrum, or are they simply very shy? Are your child’s odd fascinations a symptom of autism, or simply a quirky personality trait? If you find yourself asking these questions, rest assured that you’re not alone.

How Often is Autism Misdiagnosed?

In 2012, researchers ran a study and tracked 1,400 children who were diagnosed with autism. By the time the children reached 8 years of age, 61 of these children were no longer diagnosed with autism spectrum disorder, or ASD. Researchers noticed that most of the children who lost their diagnosis of ASD had been diagnosed before they were only 30 months old.

​However, almost all of these children who were no longer classified as having ASD were diagnosed with at least one other condition, such as a language delay or ADHD. Dr. Blumberg, who conducted a study on older children with autism states: "Our study suggests over-diagnosis of ASD may occur and may be more common than expected. But our study also shows that some children are said to have lost the diagnosis due to treatment or maturity.”

Conditions That May Be Mistaken for Autism

Professor and psychologist Tony Attwood says, ““I would say that between 10% and 25% of children diagnosed with ASD will not be classed as having the disorder as adults.” This can be due to early intervention or treatment, or it could have been a different condition than autism all along. In young children, potential signs of ASD may overlap with symptoms of other conditions and lead to misdiagnosis. Some conditions can include:​

  • Developmental delays. When a child isn’t speaking or interacting similarly to other kids their age, this can be a sign of autism, or it might be caused by another condition such as Down syndrome. Sometimes, developmental delays may have no known cause.

  • Psychological disorders. Obsessive-compulsive disorder (OCD), avoidant personality disorder, and other mental illnesses may cause a child to exhibit behaviors that look similar to symptoms of ASD.

  • Sensory processing difficulties. Children with ASD may be over-sensitive to stimuli and not like loud noises, crowds, or bright lights. However, young children may have trouble processing sensory input without having ASD. 

  • Intellectual disabilities. Sometimes, an intellectual disability may appear to be ASD when a child is very young because it can cause difficulties with language and learning.

  • Genetic disorders. Some genetic disorders such as Fragile X Syndrome, Angelman Syndrome, and Rett Syndrome share many of the same symptoms as autism.

How to Approach a New Diagnosis

Dr. Epstein, a neuropsychologist and specialist in diagnosing ASD, believes that doctors need to have the full picture of the child’s behaviors and symptoms before making a diagnosis. She thinks the process should be a comprehensive assessment including:​

  • Screeners or scales. There are a variety of questionnaires and screeners including the M-CHAT and the Ages and Stages Questionnaire that should be the first step in finding a diagnosis. These results alone shouldn’t be the sole reason for a diagnosis.

  • ADOS. If your child receives a score that suggests it may be ASD, the next step is to have them evaluated by a professional. The ADOS, or Autism Diagnostic Observation Schedule, is a common test that helps evaluate the child’s behaviors.

  • Interviews. It’s helpful for professionals to interview you and others who are close to your child, such as your child’s teacher.

  • Cognitive testing. This type of test helps evaluators learn how a child thinks and solves problems, and can give more insight into that than the ADOS test.

What to Do After Receiving a Diagnosis

If your child is found to have ASD, ask your child’s doctor about early intervention programs. These programs will help your child receive the help they need, and are usually highly successful in teaching children useful skills such as communicating with others, finding coping skills, and managing their behaviors. For more guidance on ASD-related issues, feel free to reach out to Dr. Syras Derksen.

​By:  Dr. Syras Derksen
Registered Psychologist
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How to Help Your Teenager with Autism in Secondary School

12/17/2018

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Secondary school is a whirlwind of changes for all teenagers, but it can be especially overwhelming for those with autism. Getting used to a new environment, different teachers, and all kinds of social rules can cause significant anxiety for teenagers with autism, and you may be worried about how your own child will respond to the stress.

​To help your teen thrive academically and socially, it’s important to allow them to have more freedom, help them ease into the new routines, and make sure they get the resources they need.

Autism During Teenage Years

Chantal Sicile-Kira, author of the book Adolescents on the Autism Spectrum, is also a public speaker dedicated to helping parents raise and understand their children with autism. She reports that many parents tell her that their child’s behavior seems to be getting worse as they reach their teenage years, but Sicile-Kira thinks this is simply a misunderstanding. "The teens are not getting more noncompliant because their autism is getting worse. It's because they're teenagers," she states. 

​Just like every other teenager, your teen will crave independence. They may become more moody due to hormonal changes, and they may not want to talk or listen to you as often. However, unlike their peers, teenagers with autism usually don’t have the same outlets to express their teenage woes. Their moodiness may manifest in different behaviors, such as frequent mood swings or becoming non-communicative at times. 

It’s crucial for parents to remember that those on the autism spectrum tend to have trouble identifying and expressing their feelings, and puberty may cause unfamiliar emotions. During hormonal and physical changes, your teen might not understand why they feel upset or sad. They may also be confused as to why they need to make changes in their routine, so try to clearly explain the reasons to them. Being patient, direct, and encouraging can help your teen get off to a great start.

Challenges of Secondary School

As your teen enters secondary school, they will likely face more challenges than their peers. Most people have common knowledge about how to navigate social situations and know what’s OK to discuss and what should remain private. Teens with autism may have more trouble fitting in because they don’t necessarily understand the social rules that seem like “common sense” to their peers. Along with communicating, teenagers with autism might face other challenges including:​

  • Bullying. One study showed that middle and high school students with autism were bullied nearly 5 times more than their peers. Because children and teenagers with autism may come across as awkward when socializing or have seemingly strange behaviors or rituals, they can be an easy target for bullies. 

  • Isolation. Over 40% of teens on the autism spectrum said that they never saw friends outside of school. Sicile-Kara says, “People think they don’t want to have friends, but they do.” Like most other teenagers, teens with autism to want to be accepted and liked, but it’s often more difficult for them to connect with their peers.

  • Personal hygiene. As your teen begins going through physical changes, they might not understand why they need to shower more often or start shaving. It’s important to explain to them why good hygiene is necessary.

  • More responsibility. Dr. Amy Keefer, a clinical psychologist, says that children with autism usually get the support they need during grade school, but that support can slowly disappear as they advance in their education. However, with the demands of secondary school, such as going to different classes, organizing homework, and following complex instructions, most teens with autism still require support with their education.

What You Can Do to Help

Beginning a new routine can be a turbulent and frustrating time for your teen. To help them transition into secondary school and make sure they continue receiving support, it’s recommended to create a transition plan. Depending on your child’s wants and needs, the plan may be more detailed, but the basic aspects of a plan include:​

  • Discussing the plan with the school staff and teachers before your teen begins secondary school so they have time to accommodate for them.
 
  • Visiting the school with your teen before school begins to show them where each class is held. If possible, have your teen meet their teachers and other school staff as well.
 
  • Communicating to the school what supports your teen needs, and finding out who will provide the supports.
 
  • Establishing how you and the school will communicate when your child begins school.
 
  • Planning simple solutions to ease your teen’s anxiety. For example, if your teen gets overwhelmed in crowds, ask if they can have permission to leave class a few minutes early to avoid the loud, overstimulating hallways.

Secondary school comes with many challenges, but with the right support, patience, and understanding, your teen will excel and thrive. For more guidance, reach out to Dr. Syras Derksen.
​
By:  Dr. Syras Derksen
Registered Psychologist
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The First Signs of Autism in School-Age Students and Teens

12/10/2018

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According to this study, about 90% of parents who have a child with autism noticed symptoms by the time their child reached 2 years of age. Autism spectrum disorder can cause developmental delays or other noticeable symptoms in infants and toddlers, but some children with autism may develop normally and show no observable signs of the disorder. However, because autism is on a spectrum, the severity of symptoms varies and affects every individual differently. A significant number of children with autism may not exhibit any common signs until they begin school.

​One parent of a child with autism mentioned in an article that, “My child is developing behavioral problems. That’s because he can’t communicate well at school.” School can cause numerous difficulties for children on the autism spectrum due to the changes that occur in their environment and routines. The stress of school may increase the severity of symptoms, influencing how a child interacts with others, learns, or behaves.

Signs of Autism in Grade School Students

Signs of autism may become noticeable when a child begins school because they tend to have difficulty with different aspects of socializing with others. A child with autism may have difficulty taking turns in conversations, reading the reactions of others, or having conversations about what others want to talk about. Other possible effects of autism in children include:​

  • Speaking in an overly formal or monotone voice.

  • Having highly specific or unusual interests.

  • Difficulty making eye contact.

  • Trouble “fitting in” with their peers.

  • Not understanding the emotions or expressions of others.

  • Being overly sensitive to stimuli such as loud noises or specific textures.

  • Having repetitive or compulsive behaviors.

Signs of Autism in Teenagers

It can sometimes be difficult to notice autism in children if they appear to be doing well in school and don’t seem to have any symptoms that are typical of those on the autism spectrum. However, the onset of puberty, high school, and increased expectations of their achievements may cause the signs of autism to become more apparent. Some common signs of autism in teens include:​

  • Difficulty understanding social cues.

  • Sensory overload.

  • Trouble expressing or identifying emotions.

  • Being easily upset by change.

  • Repetitive behaviors or compulsions.

  • Being withdrawn or depressed.

  • Difficulty adjusting their behaviors to different social situations.

  • Trouble with sleeping.

  • Anxiety or frustration, which may lead to aggressive behaviors.

Autism in Females

Many people diagnosed with autism may also develop a mental illness, but undiagnosed autism may lead someone to develop mental health issues as well. Psychiatrist Ian McClure has reported that females especially are developing mental health difficulties because they haven’t yet been diagnosed with autism. Girls are most commonly underdiagnosed because the diagnostic criteria for autism is more typical for boys’ behavior and symptoms, while girls may deal with their symptoms differently. 

​Teenage girls are usually better at studying other people’s behavior and copying them to mask their symptoms, and quieter girls are usually thought of simply being shy rather than unfocused or disinterested. If they show signs that are more typical of autism, such as severe anxiety when their routine is changed, they may be misdiagnosed with a mental illness instead. 

One woman wasn’t diagnosed with autism until she was 28 years old, but she had been misdiagnosed with several mental illnesses including bipolar depression and borderline personality disorder. She said that learning she had autism changed her life, and it’s much easier to manage her symptoms now that she finally has an accurate diagnosis.

Advice for Parents

If you think your child may be on the autism spectrum or dealing with a mental illness, it’s important to talk to a child psychologist who does autism assessments and your child’s doctor. The earlier a diagnosis is reached, the sooner your child can learn how to manage their symptoms, succeed in school, and communicate with others.

​If your child or teen is found to have autism, there are some ways you can help them adjust to school and other life changes. Try to go with your child to school about a week before classes begin. Show them where their classroom and bathroom is located, and walk around the school with them so they can be better prepared for the first day of school. Getting involved in your child’s school, such as joining the PTA, can help you get to know your child’s teacher and meet other parents who may also have children with autism. 

​Outside of school, therapy might be helpful if your child or teen is dealing with high levels of stress or anxiety, behavioral issues, or seems overwhelmed. A therapist can help them work through their emotions, find healthy coping mechanisms for stress, and provide an outlet for your child’s frustrations. Scheduling an appointment at Oakville Wellness Center can be simply done online, or you can call for more information.

By:  Dr. Syras Derksen
Registered Psychologist
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5 Things Everyone Should Know About Autism

11/26/2018

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Awareness and understanding of autism have been steadily improving over the past several years. Groups such as the Organization for Autism Research coordinate events to educate people of all ages about autism and use donations to continue research about autism. This organization also offers resources such as scholarships and employment opportunities for adults with autism and gives self-advocates a platform to speak about their experiences. 

​Although organizations like these do a great job of educating people about autism, there is still a lot of work to be done. Research must continue before we can fully understand autism, but even with the information already available, many people still have misconceptions and questions about it.

1. What is Autism Anyway?

The Centers for Disease Control refers to autism, or autism spectrum disorder, as “a developmental disability that can cause significant social, communication and behavioral challenges.”  The autism spectrum includes a wide range of various symptoms, but people on the autism spectrum typically tend to think, communicate, learn, and behave differently than others. 

​Autism was first recognized in 1943 by Dr. Leo Kanner when he reported on eleven children who all showed similar symptoms of being uninterested in people, but rather highly interested in their environment. There is no single known cause for autism, but research done by various scientists today have proven that it’s a genetically based condition.

2. Symptoms of Autism: They Vary

People need to understand that autism is on a spectrum, and not every person with autism will have the same symptoms. People with mild autism, which used to be referred to as Asperger’s syndrome, may go undiagnosed for years, whereas others on the autism spectrum may be nonverbal or have significant cognitive impairment. While these are some common signs, this is by no means a comprehensive list or representative of everyone on the spectrum. 

Common Symptoms in Infants and Young Children
  • Avoiding eye contact.
  • Stimming, or self-stimulatory behavior, such as rocking or hand flapping.
  • Not responding to their name or ignores others.
  • Having a flat expression.
  • No babbling or pointing within the first 12 months.

Common Symptoms in Adolescents and Teenagers
  • Trouble relating to others, or being uninterested in other people altogether.
  • Difficulty expressing their emotions, wants, or needs.
  • Repetitive or obsessive behaviors.
  • Becoming easily upset by changes in their routine or other stimuli such as certain sounds or textures.
  • Unusual, specific interests.
  • Shows few facial expressions or may speak in a monotone voice.
  • Difficulty noticing and understanding social cues such as body language, tone of voice, and facial expressions.

3. Mental Illness Goes Hand-in-Hand with Autism.

It’s fairly common that those who fall somewhere on the autism spectrum often deal with other challenges or mental illness. Symptoms of autism such as feeling uncomfortable in new places or interacting with others may cause anxiety disorders. Sometimes when people with autism notice how they’re different from others around them and feel unable to communicate, they can feel isolated and depressed. Along with anxiety and depression, other challenges people with autism might encounter include eating disorders, aggressive behavior, insomnia, or other difficulties with sleeping.

4. Many Myths Still Surround Autism.

While the general public knows more about autism than they did ten years ago, there are still misconceptions that people believe. A few myths about autism include:​

  • People with autism don’t feel the range of different emotions. People with autism experience the full range of emotion; they just express their emotions differently.

  • Vaccines cause autism. This misconception was widely believed and spread, but scientists worldwide have proven there is no scientific evidence to this claim.

  • People with autism like to be alone and don’t want friends. Most people with autism want to connect with others, but they often have trouble with social communication and recognizing the emotions of others.

5. Parental Support is Just As Important As Professional Support.

Noticing early signs of autism is extremely beneficial for both you and your child. If you recognize any symptoms of autistic behavior in your infant or toddler, it’s recommended to seek a professional diagnosis. Children can be diagnosed accurately at just 18 months of age, and this early intervention can be the key in helping children develop communication skills and manage stressors. 

However, while professional guidance is important, you must never underestimate the importance of supporting your child and helping him to better understand his symptoms. The most important thing for parents to remember is to be open-minded to how their child communicates. Listen to phrases your child may repeat, or focus on nonverbal cues, and then communicate in their preferred way. This can lessen confusion and misunderstanding, and can bring you and your child closer together.

If your child has been diagnosed with autism and you’re unsure of where to turn, Oakville Wellness Center has several resources available. If your child has delayed speech or trouble communicating, it can be helpful to contact a speech-language pathologist. 

If your child is experiencing a major life change, such as entering school, or you fear they might be struggling with an underlying mental illness, there are resources to help your child. 

​
By:  Dr. Syras Derksen
Registered Psychologist
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