SOLVING BEHAVIOUR

Identify behaviour disorders and view available program plans
 
+ SOLVING SOCIAL EMOTIONAL BEHAVIOUR CONCERNS

Social Emotional Behaviour Disorder (SEBD) is an inability to build, understand, and maintain interpersonal relationships with peers and school staff. Children with SEBD may lack the ability to understand social cues, display a pervasive mood of unhappiness, have a tendency to distort minor problems into something more severe, or display consistent inappropriate behaviour and feelings in normal conditions.

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Behaviours may include but are not limited to:

  • Lack of impulse control

  • Aggression

  • Avoidance

  • Refusal or defiance

  • Anti-social behaviours

  • Attention seeking

  • Personal space issues

  • Lack of empathy

  • Dishonesty

  • Inflexible thinking

  • Hiding or running away

  • Self harm

For further reading specifically on SEBD, the California Department of Education offers an excellent resource for understanding social-emotional development in children with their Social-Emotional Development Domain.

Defining Emotional Behavioural Disorder (EBD)

  • As an Inability to learn, which cannot be explained by intellectual lack, sensory issues, or known health factors.

  • As an Inability to develop or maintain interpersonal relationships.

  • Exhibits inappropriate behaviors or feelings

  • Exhibits a pervasive mood of unhappiness or depression…eyore like.

  • Shows physical symptoms (somatic) or fears associated with personal issues or school problems.

 

You will note an established pattern of

  • Withdrawal and/or anxiety, depression, challenges with mood regulation, and/or self esteem issues.

  • A disordered thought process with unusual behavior patterns and communication styles.

  • Forms of aggression, hyperactivity and/or impulsivity that are developmentally/age inappropriate.

Characteristics of EBD

 

  • Internalizing

  • Externalizing

  • Cognitive

  • Academic

What are internalizing behaviours? Common traits

 

  • Withdrawn/isolated from both people and activities.

  • Somatic complaints – body aches, particularly stomach and head.

  • Depression/anxiety based behaviours.

  • Self-harm/mutilation or injury.

  • Eating disorders/issues.

  • Over compliance.

  • Social awkwardness/ineptness – peer anxiety.

  • Perfectionism

  • Cognitive Rigidity: (difficulty in changing expectations).

  • Obsessive thought patterns.

  • Frustration around unmet expectations.

  • Frustration around changes in routines.

  • Disengaging from aspects of life.

 

What are Externalizing behaviours? Common traits

  • Acting out.

  • Defiance toward authority and/or refusals to follow routine or instruction.

  • Aggression, (verbal and/or physical) toward staff, peers, family, pets.

  • Bullying of peers/staff or family members.

  • Task refusals, (non-compliance around non-preferred tasks).

  • Purposeful disruptive behaviours.

  • Forms of self-harm, (self- harm can be performed for both internal or external behavioural needs).

  • Property destruction including work of other students or staff.

  • Raging.

  • Lying, cheating and/or stealing.

  • Refusal to accept consequences or perform repair work, (apologies etc.).

  • Arguing and interrupting.

  • Chronic non-compliance.

  • Attempts to gain control over those in charge, peers or activites.

  • Inability to form or build long lasting positive relationships with peers.

 

Significance of EBD on Cognitive and academic abilities

 

Academic Achievement:

  • Most students with emotional and behavioural disorders tend to perform one or more years below grade level. Many of these students, your will find, exhibit significant deficiencies in both reading and math goals. This limits their ability in all other areas. In addition to the challenges to learning caused by their behaviours, many students with EBDs, also have learning disabilities and/or language delays, which compound their challenge in mastering and achieving academic goals.

 

  • There is a strong correlation between low academic achievement and behavioural challenges. The disruptive and defiant behaviour of students with EBDs commonly leads to academic failure or lack of achievement in meeting goals. This in turn may predispose them to further “antisocial conduct”.

 

Cognitive Abilities:

  • Many children with emotional and behavioural disorders score lower on psycho-educational assessment than their peers.

  • On the basis of his review of research related to the intelligence of children with emotional and behavioural disorders, Kauffman (2005) concluded that “although the majority fall only slightly below average in IQ, a disproportionate number, compared to the normal distribution, score in the dull normal and mildly retarded range, and relatively few fall in the upper ranges”.

  • Whether children with EBDs actually have any less real intelligence than do children without disabilities is difficult to say. Does the behaviour cause the inadequacy in learning ability or does the inadequacy cause the behaviour?

  • Assessment measures how well a child performs certain tasks at the time and place the test is administered. It is almost certain that in most cases, the child’s inappropriate behaviour will interfere with testing and will have interrupted past opportunities to learn many of the tasks included on the tests. Off task/avoiding behaviours have a huge impact on learning.

Solve for specific Social/Emotional Behavioural Disorders (SEBD):

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“I am perpetually torn between grace and violence.”

- B. pumpkin

Always remember, this is not about you, it’s about them. Take nothing said or done personally. This will be one of the most challenging behavioural students/child you will ever have. Do not be hard on yourself. We always do the best we can.

Intermittent Explosive Disorder (IED) is part of a cluster of diagnoses called the disruptive, impulse-control, and conduct disorders, which include:

  • Oppositional Defiant Disorder

  • Intermittent Explosive Disorder

  • Conduct Disorder

 

These disorders are marked by the presence of challenging, explosive, aggressive, and/or antisocial behaviour often associated with physical or verbal injury to the self, others, or even objects or through violation of the rights of others.

IED is characterized by reoccurring behavioural outbursts lacking in any kind of self-regulation or control. There is markedly low frustration tolerance evidenced by disproportionate rage at small annoyances. The behavioural outbursts can manifest as:

  • Verbal aggression (temper tantrums, rages, tirades, escalated arguing)

  • Physical aggression (property damage or destruction including classrooms, animals or other individuals)

 

The amount of aggression expressed during these recurrent outbursts is completely out of proportion to the provocation or to any antecedent psychosocial stressors. These recurring outbursts are not premeditated or planned in any way, nor are they performed to gain a tangible reward, power, or intimidation.  

The child or adolescent feels immense tension prior to the outburst and experiences pleasure, gratification or relief during or following the rage. Like letting the air out of a balloon. These outbursts have a very rapid onset (0-100 in seconds) and typically, though it varies by child, last for less than 30 minutes.

Intermittent explosive disorder is a chronic disorder that can continue for years or the lifetime of the child without intervention, although the severity of outbursts may decrease with age. Treatment involves medications, self-regulation training and mental health therapy.

The typical pattern consists of:

  • Frequent, less severe outbursts such as tantrums, tirades, arguments, which don’t do any physical damage.

  • Followed by less frequent, more severe episodes that do cause injury to people or animals or damage to property.

 

IED have a huge impact on a child’s family life as well as social relationships and academic achievement.

If you have ever had a child or student with true IED you will have noticed that once an episode has run its course the child will typically be quite lethargic, many fall asleep and dependent upon any co-condition, often remorseful about the event.

 

Working with IED is about teaching the child to recognize when they are about to have an episode and the strategies to stop it in its tracks or reduce it’s effect and in the future prevent it all together. Teaching other ways to deal with life’s annoyances and to get their needs met.

“You’re not the boss of me!”  The mantra of the ODD challenged child.

Always remember, this is not about you, it’s about them. Take nothing said or done personally. This will be one of the most challenging behavioural students/child you will ever have. Do not be hard on yourself. We always do the best we can.

All children are occasionally oppositional or defiant. Most of us have suffered through the terrible twos! They may argue at random, talk back, disobey, and defy those in charge. Some oppositional behaviour is a normal part of development for two to three year olds and early teens.

ODD, however, is another matter. Openly uncooperative and hostile behaviour becomes a serious concern when it is chronic, frequent and consistent. When it stands out comparatively to peers of the same age and developmental level and when it affects a child’s social, family and academic life.

Children with Oppositional Defiant Disorder (ODD),display an ongoing pattern of uncooperative, defiant, and hostile behaviour toward most authority figures that seriously interferes with their day to day functioning. These behaviours often carry over to peer exchanges.

Characteristics of ODD may include:

  • Frequent rages and/or tantrums.

  • Excessive arguing with adults – attempts to control the situation with adults and peers.

  • Often questioning rules or directions.

  • Complete defiance and refusal to comply with adult requests and rules.

  • Deliberate attempts to disrupt, annoy or upset those around them.

  • Blaming others for their own mistakes or inappropriate behaviours.

  • Unwillingness to accept consequences or do repair work. Deny responsibility.

  • Easily and often frustrated.

  • Frequent bouts anger and resentment.

  • Negative verbalizing when upset or frustrated.

  • Often display a lack of emotional connection.

  • Spiteful, vindictive and revenge seeking patterns.

  • Defend their behaviours or see them as reasonable.

  • Leaving without permission.

Severity:

Mild – behaviours occur only in one setting, such as only at home, school, work or with peers.

 

Moderate - behaviour’s occur in at least two settings.

Severe – behaviours occur in three or more settings.

 

Solving behavioural challenges is no easy task it takes time, energy, consistency and effective program planning. In most cases, with the appropriate proactive measures, children can be successful members of the classroom and community but what happens when everything you have tried is not enough?

 

At that point, the questions to ask are:

  • Have I truly tried everything?

  • Have I given my programs enough time?

  • Have I been consistent?

  • Are my expectations too high?

  • Have I truly put teaching behaviour before teaching curricular goals?

It is important to remember for school staff, foster parents, and outside caregivers, that if you are fighting against a tide of what is happening outside of school, or what has happened in the past, it is extremely difficult to change the outcome in the short space of time we have with these guys. Not impossible but difficult. Our hands are tied in many ways and we are already starting at a disadvantage.

If you are a parent and working at undoing what has already been done you have the time that those of us in the field do not. Never give up on your child. No child is ever truly lost.

That being said there is a small percentage of children who we just cannot help with the limitations available to us in the home or school setting. These children, as Dr. Bruce Perry (childmind.org) pointed out, leave us few options; restraint in highly volatile situations, suspension or expulsion and placement into specialized settings. We know that in these settings the child is more likely to receive the intensive care and treatment they require to move forward to a successful future. They and others will be safe.

 

We as educators, caregivers and parents must always bear in mind, not only the target child but the safety of all children associated with this child. We can only do our best to serve and meet them where they are in this moment and attempt to lift them to a greater future.

We cannot see it as failure if we do not succeed. Know that every skill that we taught, the time and care we offered is within the child’s knowledge base and someday he/she will access it. We have left them with valuable teaching. We have done the very best that we can, what more can be asked of us? What more can we give?

Attachment disorder is a general term created to describe disorders of mood, behaviour, and social relationships which have arisen from a failure to form normal, bonded attachments to primary care givers in early childhood.

“What cannot be communicated to the [m]other cannot be communicated to the self.” 
― John Bowlby

What is attachment?

 

Attachment is the connection developed and established between a child and the caregiver. This attachment profoundly affects the child's development and their ability to express appropriate emotions and develop healthy relationships.

 

Parents of a child with an attachment disorder may find themselves exhausted simply from trying to connect with the child. A child with an insecure attachment or an attachment disorder lacks the necessary skills for building meaningful, healthy relationships. It is possible, however, to repair attachment challenges though it takes enormous work, love, commitment and patience.

What are the causes of Reactive Attachment Disorder (RAD) and other attachment disorders?

Attachment disorders can occur when:

  • A baby cries or is upset and no one responds or offers comfort.

  • A baby is hungry or wet or otherwise in need, and is not attended to for hours.

  • The baby receives no stimulation or connection from the care-giver: no one looks at, talks to, or smiles at the baby. The baby is left to feel alone.

  • A young child gets attention only by acting out or displaying other extreme behaviours that disrupt the care-givers or force them to respond.

  • A young child or baby is mistreated or in an abusive situation.

  • Sometimes the child’s needs are met, by the caregiver and other times they are not leaving the child to never know what to expect.

  • The infant or young child is hospitalized for longer period or separated from caregivers.

  • A baby or young child is moved from one caregiver or home to another, the result of adoption, foster care, or the loss of a parent.

  • The caregiver is emotionally unavailable because of a mental health issue, an illness, or a substance abuse problem.

 

As you can see, sometimes the situation is unavoidable but unfortunately it can leave the child feeling alone with a lack of trust. The world is unsafe. More often the situation is one of neglect, abandonment and/or abuse.

Warning signs and symptoms of Insecure Attachment:

 

Attachment problems range from mild, easily addressed issues, to the most serious type, known as reactive attachment disorder (RAD).

As we have mentioned, it is never too late to tackle treating and repairing attachment difficulties such as reactive attachment disorder but the earlier you notice the first symptoms of insecure attachment and take steps to repair them, the better. With early detection, it is possible to avoid a much more serious problem. Caught in their infancy, attachment problems can be easy to correct with help and support.

What to watch for in infants:

  • Baby avoids eye contact.

  • Does not smile at you or newcomers.

  • Does not reach out to be picked up.

  • Will not allow your efforts to calm, soothe, and/or connect.

  • Does not appear to notice or care when left alone.

  • Cries inconsolably (different than colic).

  • Does not coo or gurgle or make sounds that content babies do.

  • Does not track you with his or her eyes.

  • Shows no interest in playing interactive games or playing with toys.

  • Tend to spend a lot of time rocking or comforting themselves – self soothing.

Important note: The early symptoms of insecure attachment are very similar in nature to the early symptoms of other issues such as ADHD and autism. If you notice any of these warning signs, make an urgent appointment with your paediatrician for a professional diagnosis.

 

Warning signs and symptoms of RAD:

 

Children with reactive attachment disorder have been completely disrupted in early life. This leaves their future relationships also impaired and in jeopardy. They have serious difficulty relating to others on a human level and are often developmentally delayed. Reactive attachment disorder is common and often seen in children who have been abused, chronically moved about in the foster care system, lived in orphanages or group homes, or taken away from their primary caregiver after already establishing a bond, this includes foster or adoptive families.

 

What to watch for in RAD:

  • The child may have an aversion to touch and/or physical affection. Children with reactive attachment tend to respond to touch and affection as a perceived threat. Their reactions are unusual.

 

  • The child may have control issues. Most children with reactive attachment disorder go to great lengths and will do almost anything to remain in control and avoid feeling helpless. They are typically disobedient, defiant, and argumentative as they work to always have the upper hand.

 

  • The child may have anger problems. Anger may be expressed externally in tantrums or acting out, or through seeming manipulative, passive-aggressive behaviour. An example may be hiding their anger in socially acceptable actions such as giving a high five that hurts or hugging/squeezing someone too hard

 

  • The child may have difficulty showing genuine care and affection/empathy. For example, children with reactive attachment disorder may act inappropriately affectionate with complete strangers, almost precocious while displaying little to no affection towards their caregivers.

 

  • The child may have an underdeveloped conscience – lacking in empathy. Children with reactive attachment disorder may appear like they don’t have a conscience and can fail to show guilt, regret, or remorse after behaving inappropriately or harming another.

 

What happens as these children age?

 

As these children grow they can develop either an inhibited or disinhibited pattern of Attachment disorder.

 

Inhibited Attachment Disorder (IAD):

These children are often very withdrawn, emotionally detached and distant. They are resistant to comforting and often react very poorly to direct praise. They are often hyper-vigilant – overly aware - but do not react or respond. They may push others away or respond with aggression or violence when others attempt to get close.

 

Disinhibited Attachment Disorder (DAD):

 

These children do not prefer their own caregivers over others. They seek attention or comfort from anyone without discretion. They are highly dependent, emotionally/mentally young for their age and can be or appear to be highly anxious.

 

It is extremely important if you notice these signs to take the child to a medical professional for diagnosis and support. Schools should pull in any outside resources they have for assessment and support in working with these very special souls. Healing is a life long journey but it is possible with help and commitment. If you are a foster parent remember that these behaviours are not the child’s fault and are all they know in how to cope. It is not about you.

Always remember, this is not about you, it’s about them. Take nothing said or done personally. This will be one of the most challenging behavioural students/child you will ever have. Do not be hard on yourself. We always do the best we can.

 

“You’re not the boss of me!”  The mantra of the CD challenged child.

 

Understanding Conduct Disorder

 

Conduct disorder (CD) is a mental health disorder diagnosed in childhood or adolescence that presents itself through a repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate norms are violated. These behaviours are often referred to as "antisocial behaviours."”  (Internet Mental Health)

 

What Is Conduct Disorder?

Conduct disorder is a group of behavioural and emotional deviations that typically begin during childhood or adolescence. Children and adolescents with CD will have a difficult time following rules and behaving in a socially appropriate way. They may act out in aggressive, destructive, and deceitful behaviours that often violate the rights of others. Adults and other children may perceive them as “bad”, delinquent, or a threat, rather than as having a mental illness. 

“Conduct disorder is a severe condition characterized by hostile and sometimes physically violent behaviour and a disregard for others. Children with CD exhibit cruelty, from early pushing, hitting and biting to, later, more than normal teasing and bullying, hurting animals, picking fights, theft, vandalism, and arson. Since childhood and adolescent conduct disorder often develops into the adult antisocial personality disorder, it should be addressed with treatment as early as possible; the earlier treatment starts, the better the outlook.”

One of the most noted components of conduct disorder is a seemingly callous disregard for societal norms and the rights, feelings, and personal space of others. Children and adolescents with CD seem to revel in causing disruption and harm. To them, aggression, deceit, coercive behaviours that result in a power shift are utterly gratifying. Picking fights, trespassing, lying, cheating, stealing, vandalism, raw destruction and emotionally or physically abusive behaviour, including weapons or forced sexual encounters are all signs that an older child may have CD. Signs of the disorder in younger children may be harder to see differentiated from normal acting out, but are similarly coercive: relentless bullying, aggression (biting, hitting, kicking, pushing) lying for the sake of lying, consistently blaming others, stealing items of no value just because. They often say things like: “I wanted it, why shouldn’t I take it.” “I liked it.” (The Child Mind Institute)

As all kids and adolescents act out from time to time, experts caution that we are looking for a persistent, consistent pattern of this sort of behaviour in evidence before CD is considered. Professionals will also attempt to determine if the behaviour is a “negative adaptation” normalizing the abnormal, to a troubled environment, a “learned” behaviour,  it was modelled, or if the gratification that comes from aggression seems to originate from within…intrinsically based. Were they born this way? Which is quite rare.

 

Types of Conduct Disorder:

There are three types of CD. They’re categorized below according to the age at which the onset of signs/symptoms occur:

  • Childhood onset occurs when the signs/symptoms of conduct disorder appear before age 10.

  • Adolescent onset occurs when the signs/symptoms of conduct disorder appear during the teenage years.

  • Unspecified onset means the age at which conduct disorder first began is unknown or undetermined.

Some children will be diagnosed with CD with "limited pro-social emotions." This type of conduct disorder is often described as the child who is callous and unemotional – lacking in empathy. They can appear to be quite cruel.

What are the signs/Symptoms of Conduct Disorder?

  • Children who have CD are often difficult to control and unwilling to follow rules of any kind.

  • They can act impulsively without considering the consequences of their actions. A danger even to themselves as well as others.

  • They also lack the ability to take other people’s feelings into consideration. They do not understand or hold empathy. A complete disregard for others.

A child may have CD if they persistently/consistently display one or more of the following behaviours:

  • Aggressive or violent/threatening conduct. (biting, hitting, kicking in young children)

  • Deceitful behaviour. Lying and theft, blaming others.

  • Destructive behaviours.

  • Violation of rules – an inability to comply.

  • A complete lack of disregard for others. Little to no empathy or remorse.

Aggressive conduct can include:

  • Intimidating, threatening or bullying others. (hitting, biting, kicking, pushing in younger children)

  • Verbal abuse, racial slurs.

  • Physically harming people or animals on purpose.

  • Committing violence against others including rape.

  • Using a weapon.

Deceitful behaviours can include:

  • Lying

  • Breaking and entering.

  • Stealing/theft – the value is often irrelevant.

  • Forgery

  • Blaming others for their own acts. 

 

Destructive conduct can include:

  • Arson

  • Vandalism

  • Other Intentional destruction of property.

  • Destroying a classroom or home because they felt like it.Violation of rules can include:

Violation of rules - inability to comply:

  • Skipping school

  • Refusing to follow directions in the classroom or at home.

  • Disruptive, antisocial behaviours.

  • Running away from home

  • Drug and alcohol use.

  • Sexual behavior at a very young age.

 

Note: Boys who have CD are more likely to display violent or aggressive and destructive behaviour than girls. Girls are more prone to, though not in every case, deceitful, promiscuous and rule-violating behaviour.

 

The symptoms of conduct disorder can be mild, moderate, or severe:

Mild symptoms display little to no serious behaviour problems in excess of those required to make the diagnosis. Conduct concerns cause relatively minor harm to others. Common challenges can include lying, truancy, and lack of compliance to parental or school rules.

Moderate symptoms display numerous behaviour challenges. These conduct issues will have a mild to severe impact on others. The problems may include vandalism, bullying, verbal and physical aggression, threatening, lying, truancy, lack of compliance, theft, a lack of regard for societal rules, violence, a disregard for others.

Severe symptoms display behaviour problems in excess of those required to make the diagnosis. These conduct challenges cause considerable harm to others. The problems may include violence, arson, rape, use of a weapon, complete disregard for others, or breaking and entering.

What Causes Conduct Disorder?

 

Genetic and environmental factors that may contribute to the development of conduct disorder.

 

Potential Genetic Causes:

Damage to the frontal lobe of the brain has been linked to conduct disorder. This part of your brain regulates important cognitive skills, such as problem-solving, memory, and emotional expression as well as your personality. The frontal lobe in CD may not work properly, which can cause, among other things:

  • A lack of impulse control.

  • A reduced ability to plan future actions – see consequence.

  • A decreased ability to learn from past negative experiences and use this in future events.

The impairment of the frontal lobe can be genetic, or inherited, or it may be caused by damage due to a brain injury.

Environmental Factors:

The environmental factors that are associated with conduct disorder include:

  • Child abuse/neglect. (trauma)

  • A dysfunctional family situation.

  • Parental abuse of drugs or alcohol.

  • Extreme Poverty.

 

Who Is at Risk for Conduct Disorder?

The following factors may increase the risk of developing conduct disorder:

  • Being male 

  • Living in poverty.

  • Having a family history of conduct disorder.

  • Having a family history of mental illness.

  • Having other psychiatric disorders.

  • Having parents who abuse drugs or alcohol.

  • Having a dysfunctional/harsh home environment.

  • Having a history of experiencing traumatic events.

  • Being abused or neglected including abandonment.

How Is Conduct Disorder Diagnosed?

By a mental health professional. For a conduct disorder diagnosis to be made, there must be a consistent pattern of displaying at least three behaviours that are common to CD. The child must also have shown at least one of the behaviours within the past six months. The behavioural problems must also significantly impact your child socially or at school.

How Is Conduct Disorder Treated?

Children with conduct disorder who are living in abusive homes may need to be removed from parental care. If abuse isn’t present, a mental healthcare provider will use behaviour therapy or talk therapy to help the child learn how to express or control their emotions appropriately. The mental healthcare provider will also teach and train parents in how to manage the child’s behaviour. If there is another mental health disorder, such as depression or ADHD, the mental healthcare provider may prescribe medications to treat that condition as well.

It takes time to establish new attitudes and behavioural patterns, therefore, children with CD usually require long-term treatment. However, early intervention may slow the progression of the disorder or reduce the severity of negative behaviours.

These are the children that typically most annoy classroom teachers, caregivers and even parents, strangely, even more so than more violent, disruptive, or even explosive behaviours. These we seem able to understand. Neediness, however, is insipid and constant; it’s more difficult to emotionally escape.

It is through trial and error that growing children discover what makes adults give them attention and what drives them away. As they are dependent upon us, children do everything they can to get the love and nurturing they require. Typically their early experiences show them that when they are appropriately behaved, when they learn new skills, and when they are happier, adults most enjoy their company. When adults react with interest, affection and approval, children will strive to please, to grow in their social skill and practical skills, and work to find a positive place at home and in their classroom. These children are intrinsically motivated through love and nurturing.

Unfortunately, when children consistently are unable to get a response, the attention they need, they become desperate and seeking. Abandonment, neglect, withholding of attention, threatens a child’s emotional well-being and physical survival. If lacking enough positive interaction, a child will develop negative seeking tactics to engage adults. Being yelled at, nagged, reminded, and even punished is far better than being ignored. By seeking ways to be recognized by an exasperated, frustrated or angry adult, the child knows that at least he isn’t forgotten.

Few parents purposely set out to deprive their children of enough nurturing through parental contact. However, many parents are overscheduled, working too hard, or in distress and chronic crises themselves. Parents who weren’t parented well themselves, may not be able to appreciate how much their children need their time and attention and even what nurturing looks like.

Sometimes, though not often, it’s just a matter of temperament. Some children just need more positive interaction than others. They are sensitive souls. This can be especially challenging to a parent or teacher who by their own nature, does not need as much connection as the child does. It makes it difficult to reach out or understand the child.

How to Solve an Attention-Seeking Child’s behaviours:

Attention seeking children have a legitimate need. It’s our job to teach them how to get what they need in an appropriate way: How to use their words.

As a parent:

The first question to ask is whether the child has a point? Is he/she showing this behaviour because we are not involved enough? It’s so easy to get so caught up with work, chores, activities, and responsibilities that we don’t spend nearly enough time interacting with our children. We sit them at the IPAD or in front of the TV and go about our business. They go to daycare at 6 AM from there to school, from school back to daycare where we pick them up at 5 or 6 PM. 

If that’s the case, the child doesn’t need behaviour help so much as the parents need to find a way to reorder priorities and make a clear set time daily to spend with their child. Children require our affection, they need to be played with, talked too, read too, and tucked in at night to be emotionally secure and strong. They need to be able to share and feel a sense of their parents’ pride in their accomplishments. This creates emotionally secure, attached children. This can be challenging with our busy schedules but it is not impossible. The most important job we have and the only one that truly matters is raising our children.

On the flip side, when children are getting plenty of nurturing but are still misbehaving, they have somehow misunderstood what they need to do to engage others, for whatever reason the message of what it takes to gain attention has been misread.

As a teacher:

Ask yourself, have I engaged with this child? What have I done to make this child feel like he/she belongs? What buttons is this child pushing in me? Why am I so affected by the behaviours? What is this triggering for me? Am I aware of this child’s history? Is there any kind of trauma, especially in needy kids, neglect or abandonment? Are there learning difficulties? Are there combined issues, PDD, ADHD….Does culture play a hand?

Recognize that you may be spending more time with this child than their parents.

 

Solve neediness in simple compassionate ways:

Catch them being good. Only provide attention for appropriate behaviour. Look for opportunities to make a positive comment, to connect, to share an activity, to offer a leadership role and to have a conversation. Fill up that attention-seeking hole with positive reinforcement as many times a day as you can.

  • I like the way you….

  • Thanks for getting in line.

  • Thanks for bringing me your plate.

  • I love that you….

  • It makes me happy when…

  • It’s awesome that you walked the dog for me.

  • I appreciate that you helped John with his math.

 

Use planned ignoring:

  • Ignore the inappropriate behaviour but not the child!

  • Engage only with the positive target behaviours. 

  • When the child acts out, resist the temptation to lecture, nag, scold, yell, or punish.

  • Negative reactions only continue and further the negative interaction going.

 

Have a plan when ignoring and recognizing positive behaviour is not enough: 

 

At home:

  • Tell the child that their body/behaviour is showing you they need a break. (no more than one minute per year of age).  

  • Have an appropriate calming/break space for the child to go to. The less talking about the negative behaviour, the better.

  • Go over what appropriate behaviour looks like. Teach the words to use to get what they need.

  • When the time is up, invite the child back to join the family/classroom.

  • Give reassurance that you know the child will behave appropriately.

  • Choose a motivating way to engage with the child positively for at least a few minutes before moving on. Play a game, chat for a few minutes, read a book.

  • Use the same principle for older children.

  • If they won’t take a break, remain calm!  Withdraw yourself, take a breath, and make a rational decision about appropriate consequences.

    • Removal of free time.

    • Removal of technology for a period.

    • Removal of a currency they value.

 

At school:

  • Use the steps above.

  • Use positive reinforcement to motivate.

  • Create a visual that lists the target behaviours you wish to see: (purchase or order visuals here)

  • Have the visual also show what the child is working toward…the reinforcer.

  • Choose three to five of the target behaviours that are most important to you. Do not make it too difficult at first!

  • Choose a motivator that you know the child values – with needy kids that is typically adult time.

    • You could plan to have lunch with this child once a week or monthly if their behaviour is on track.

    • You could plan a small gathering with friends and a favoured staff member.

    • A board game or basketball game.

    • whatever that child enjoys is the reinforcer.

 

Be consistent. Always follow through!

  • It’s the only way children know we mean what we say, 100% predictability.

  • Never threaten…be true to your word.

 

Repeat:

  • ​Repeat until the child stops the behaviour.

  • Repeat when negative behaviour is more than a momentary lapse.

  • Do it until it becomes a pattern that the child can predict 100% so it is no longer worth pursuing the negative behaviour.

 

Remember: It’s normal to need/seek attention from others in society.  Children secure in the knowledge that the adults in their lives are interested in them, love them and value them, don’t need to act out consistently. They are intrinsically motivated.

PTSD and C-PTSD: Cause and Effect:

Visit Dr. Bruce Perry's website to grow your understanding of trauma in children. Dr. Bruce Perry is the leading expert on trauma based brain research.

 

Not every person/child who is abused or is a witness to disaster or violence will develop PTSD - or a more debilitating chronic pattern of PTSD. Natural resilience plays a key factor in the development of ongoing PTSD.

 

Complex post-traumatic stress disorder (C-PTSD; also known as complex trauma) is a mental health disorder similar to post traumatic stress disorder (PTSD). It is the result of repetitive, multiple events, prolonged or chronic emotional and/or physical trauma over which the victim has little or no control and from which there is little or no hope of escape, such as in the case of children, the ultimate victims.

Post-traumatic stress disorder (PTSD) is a mental illness involving exposure to trauma from single events such as death or the threat of death or serious injury - abuse. PTSD is also be linked to ongoing emotional trauma.

The following are excerpts from the National Center for PTSD:

How many children develop PTSD in the USA?

The National Comorbidity Survey Replication- Adolescent Supplement is a nationally representative sample of over 10,000 adolescents aged 13-18. Results indicate that 5% of adolescents have met criteria for PTSD in their lifetime. Prevalence is higher for girls than boys (8.0% vs. 2.3%) and increase with age. Current rates (in the past month) are 3.9% overall. There are no definitive studies on prevalence rates of PTSD in younger children in the general population.

From the US department of Veteran’s affairs.

 

Understanding Complex – PTSD:

What types of trauma are associated with Complex PTSD?

During long-term, ongoing and chronic traumas, the victim is generally held in some form of “captivity”, be it physically or emotionally. Dr. Judith Herman – trauma research and treatment explains. In these situations the victim is under the control of the perpetrator and unable to get away from the danger.

 

Examples of such traumatic situations may include and are not limited to: 

  • Long term exposure to crisis conditions.

  • Concentration camps 

  • Prisoner of War camps 

  • Prostitution brothels 

  • Long-term domestic violence 

  • Long-term child physical/emotional abuse 

  • Long-term child sexual abuse 

  • Organized child exploitation rings 

  • Entrapment or kidnapping.

  • Slavery, forced labour.

  • Long term imprisonment and torture

  • Repeated violations of personal boundaries.

  • Long-term objectification.

  • Long-term exposure to inconsistent, alternating behaviours, violence and love.

  • Long-term care and responsibility of mentally ill or chronically sick family members.

 

What other symptoms may be seen in Complex PTSD?

A person who experienced a prolonged period of chronic victimization/abuse under the complete control of another may also experience the following challenges – children have little choice or escape:

  • Emotional Regulation (dysregulation) . This may include ongoing sadness, suicidal thoughts, explosive anger, or inhibiting anger. 

  • The conscious state.  Can include forgetting traumatic events, reliving traumatic events on their own or through triggering, or having episodes of dissociation – the person feels detached from their own mind or body – dissociative state.

  • Self-Perception. This may involve feelings of helplessness, shame, guilt, stigma, low self-esteem or self-loathing and a sense of being completely different from other human beings, not belonging.

  • Distorted perception of the abuser. This may include attributing complete power to the perpetrator, becoming engrossed with the relationship to the abuser, or preoccupied with revenge, idealizing the relationship or thinking it is special. Acceptance of the perpetrators belief system – we all know something of Stockholm syndrome.

  • Relationships.  Isolation may happen, distrust, or a chronic search for a rescuer. Repeated failures at self-protection.

  • Systems of belief. It is my belief that this piece in itself may be the largest factor in determining resilience This may involve a loss of sustaining faith or a sense of hopelessness and despair – there is nothing better. When we are able to sustain belief and hope that things will improve, that all events happen to purpose, with or without outside help we can maintain resilience – I know this from personal experience.

C-PTSD Characteristics

 

Over time C-PTSD can manifest itself in myriad of issues including, eating disorders, depression, substance abuse, school problems, promiscuity, co-dependent or unbalanced relationships and more violent types of behaviours such as theft, vandalism and destruction of property, aggression and a desperate need for control. The list is long.

 

What are the risk factors for PTSD?

 

Three factors have been shown to raise the chances that children may develop PTSD.

  • How severe the trauma is

  • How the caregivers react to the trauma

  • How close or far away the child is from the trauma

 

As you would expect, children and teens experiencing the most severe traumas tend to have the highest levels of PTSD symptoms. PTSD symptoms may be less severe if the child has some family or outside support and if caregivers are less upset by the trauma and are not the perpetrators.

 

Other factors may also affect PTSD. Events, which involve people hurting people; such as rape, assault, and abuse are more likely end in PTSD than other types of traumas. Also, the more traumas a child faces, the higher the risk of getting PTSD. Statistically, girls are more likely than boys to get PTSD.

Symptoms of PTSD in children:

 

Primary school age (ages 5-12)

Young children, while not necessarily having the issues of flashbacks or problems remembering parts of the trauma, as adults with PTSD often do, may instead put events in the wrong order. They may also believe that there were noticeable signs that the trauma was going to happen, which may lead them to believe that they will see these signs before another trauma perhaps allowing them to avoid future events.

 

Children of this grouping can display signs of PTSD in their play. They often repeat a part of the trauma. These “games” do not diminish their stress or anxiety.

 

What we may notice at school and home:

  • recurring nightmares 

  • sleeplessness 

  • fatigue

  • fearfulness /anxiety

  • neediness/tearfulness

  • irritability 

  • agitation 

  • hyper-vigilance 

  • avoidance 

  • separation anxiety 

  • change in school performance 

  • emotional numbness 

  • social withdrawal/isolation

  • loss of interest in activities 

  • angry, explosive outbursts 

  • attempts at control

  • difficulty concentrating 

  • guilt 

  • worry for others 

  • physical complaints 

 

Teens (ages 12-18)

PTSD symptoms in teens can begin to look similar to those of adults. One significant difference is that teens are more likely to display impulsive and aggressive behaviours and well as continue many of the listed behaviours above. 

What are the other effects of trauma on children?

Besides PTSD, children and teens having experienced trauma, often have other challenges. Some of the issues that we can see in traumatized children/teens.

  • Fear, worry, sadness, anger/rage, emotional dysregulation, feelings of aloneness and separation from others, low self-worth/esteem, and lack of trust.

  • Behaviours such as aggression, inappropriate sexual behaviour, self-harm, and abuse of drugs or alcohol, attempts to control.

 

Understanding Anger and Trauma

 

Why is anger a common response to trauma?

Anger is at the core of the survival response in human beings. Anger provides us with the energy to cope with life's stressors and to keep going in the face of strife.

 

On the flip side, anger can create major problems in the personal lives of those who have experienced trauma, especially those who suffer from PTSD.

 

When we think of anger as our most basic natural survival instinct, it becomes easier to understand. When humans or any animal, are faced with extreme threat, anger is most often the response. Anger assists the person in survival by shifting the focus from fear to rage. The person then focuses all of his or her attention, thought, and action toward survival. Fight or flight.

 

Anger is also a typical response to events that seem unfair or where you have been made a victim or betrayed. This may be most often seen in cases of trauma that involve exploitation or violence.

 

Trauma and shock of early childhood abuse often affects how well the survivor/victim learns to control emotions. Problems in this area lead to frequent outbursts of extreme emotions, including anger and rage.

How can anger after a trauma become a problem?

Sometimes in PTSD our response to perceived threat and our ability to discern the level of threat becomes stuck – meaning we cope as we did during the trauma. We respond to all stimuli in survival mode. This is an automatic brain response of irritability and anger in those with PTSD and it can create serious problems at school, in the workplace and in family life. It may also affect feelings of self worth and ones’ role in society.

How is PTSD treated in children and teens?

 

PTSD symptoms may go away on their own after a few months time for many young people. Others, depending on the length and severity, show symptoms for years if they do not get treatment. There are many treatment options.

  • Cognitive-Behavioural Therapy (CBT)

  • Psychological First Aid (PFA)  

  • Eye movement desensitization and reprocessing (EMDR)

  • Play therapy

  • Medication to manage, anxieties, depression, regulation issues.

  • Self-regulation training.

  • Counselling

  • Compassion and love

Research articles on child trauma: ChildTrauma.org

ACES - Adverse Childhood Experiences

I have seen many studies and though most have the same 10-12 ACEs others include experiences that I know from my own work to be just as damaging. The lists that hold up to 15 resonate the most with what I have seen in my work and in my life. As the studies continue, our understanding of trauma will continue to grow offering us greater opportunity to prevent and support.

The tally of how many adverse childhood experiences have occurred in childhood is known as the ACE score. The higher the ACE score, (multiple or continuous trauma) the greater the impact on behaviour and life development, (physical health, at risk behaviours, substance abuse and mental health).

Abuse:

  • Physical

  • Emotional/verbal

  • Sexual


Neglect:

  • Physical

  • Emotional

  • Abandonment


Household Environment:

  • Domestic violence

  • Substance abuse

  • Mental health illness

  • Parental divorce

  • Caregiver separation/death/prolonged illness

  • Family member incarceration

  • Witnessing abuse of another family member (for some children this can include loved pets)


Environment

  • Continued bullying

  • Witnessing violence(war, gang, etc.)

  • Discrimination

  • Homelessness

  • Natural disaster

  • War


Child health

  • Chronic illness

  • Serial hospital stays

  • Serious illness

The long term effects of adverse childhood experiences (trauma):

ACE pyramid jpeg.001.jpeg

If you are unsure what you are facing, lack an official diagnosis, or do not wish to purchase a program plan - the Strategies to Use and Behaviour Insights pages have information and techniques which are essential in managing challenging behaviours.

 
+ SOLVING FOR MENTAL HEALTH CONCERNS

“Chronic anxiety is a state more undesirable than any other, and we will try almost any manoeuvre to eliminate it. As a German saying puts it: 'Better an end with terror than a terror without end.” 

― Robert E. NealeThe Art of Dying

Read more...

Solve for specific Mental Health Disorders:

A child with generalized anxiety disorder (GAD) has persistent worries that cause distress about a myriad of everyday things – eeyeore syndrome fits here almost as well with chronic depression - including doing well in school or sports.

 

A key distinguishing factor in GAD is that the anxiety is focused not on external events like social interaction or germs, but internally.

 

GAD may make the child feel:

  • Restless

  • Fatigued

  • Tense

  • Irritable

  • Difficulty concentrating or sleeping 

  • GAD is more common in adolescence

  • More prevalent in girls than boys.

 

The anxiety can significantly impact a child’s quality of life and the ability to participate fully in social activities and school.

 

What to Look For

 

A child may have GAD if there is pervasive worry about everything, but particularly performance in school or other activities, or the ability to meet expectations. These children often seek reassurance in an attempt to assuage their worries. This stress can lead to physical symptoms such as fatigue, headaches and stomach-aches. The worries in GAD are exaggerated but they do tend to focus on tangible, real-life issues and events. (Child Mind Institute)

 

Differing from social anxiety disorder, they’re focused the child’s own sense of perfectionism rather than what others will think of the child. It is challenging for children with GAD to immediately recognize that their fears are exaggerated. Differentiating between anxiety disorders can be challenging and should only be diagnosed by a mental health professional.

GAD Risk Factors

 

Genetic factors do have a place in developing generalized anxiety disorder (Mayo Clinic). Children who develop the disorder are more likely by nature to be avoidant and tend toward inhibited behaviours and negative temperaments. .

External signs of childhood anxiety

When anxiety is expressed externally, a range of signs and symptoms arise, which often complicates diagnosis.

  • Kids may have difficulty sleeping or complain about stomachaches, headaches or other physical problems.

  • They may appear or become avoidant and clingy with parents or caregivers.

  • They may have trouble being attentive in class or be very fidgety – which can mimic ADHD.

  • They may become aggressive or have explosive outbursts that appear oppositional in nature, when their fight-or-flight mechanism is triggered. This is where observation is key – what’s driving the behaviour?

 

The words we use to describe our own anxiety can also confuse. People use a lot of different words to describe what they’re feeling or the way they may feel. They may inform you that they are feeling self-conscious, shy, apprehensive, worried, or afraid. These words capture the moment and what they are struggling with, but may distract the listener from the fact that anxiety is the root cause.

 

“There are many different kinds of anxiety, which is one of the reasons it can be hard to detect in the classroom. What they all have in common,” says neurologist and former teacher Ken Schuster, PsyD, “is that anxiety “tends to lock up the brain,” making school hard for anxious kids.” (Child Mind Institute)

Children can struggle with

  • Separation anxiety: When children are worried about being separated from their caregivers they may have a difficult time at school drop-offs and throughout the day.

  • Social anxiety: These children are excessively self-conscious, making it challenging for them to participate in class and socialize with peers.

  • Selective mutism: This happens when children have a hard time speaking in some settings, like at school around the teacher yet can talk fluently at home.

  • Generalized anxiety: When children worry about a vast array of everyday things. Kids with generalized anxiety often worry particularly about school performance and can struggle with perfectionism. They can be completionists.

  • Obsessive-compulsive disorder: Like adults this happens when children’s minds are filled with unwanted, repetitive and stressful thoughts. Kids with OCD tend to try to alleviate their anxiety by performing compulsive rituals like counting or washing their hands.

  • Specific phobias: Children, like adults, can have an excessive and irrational fear of particular things. 

(Child Mind Institute)

Recognizing Anxiety at School

  • Inattention and restlessness which can mimic ADHD.

  • Attendance issues, late arrivals and clingy kids.

  • Disruptive behavior – mimicking other behavioural disorders.

  • Difficulty answering questions in class – being called on.

  • Frequent trips to the bathroom, office, nurses area.

  • Problems in certain subjects – fear based may or may not involve a learning disorder.

  • Not turning in homework

  • Avoiding socializing or group work – refusals to participate.

Great reads for kids with anxiety:

As teens we start to become more aware of what other people think of us. There seems to be a “right” or “wrong” in everything we do. There also seem to be things that you just shouldn’t do—things that could be socially embarrassing, or lose you points with friends. This social stress can lead to social anxiety

(Child Mind Institute).

 

Social anxiety is diagnosed when children worry so much about how they may appear to others, that they stop doing the things they need to (and want to) do for fear of embarrassment or judgement by peers.

 

This disorder typically arises between the ages of 8 and 15. At first, children are usually able to conceal social anxiety disorder. Their parents and teachers may not notice that anything is wrong, especially as kids are often ashamed to admit how anxious they are about things that don’t seem to bother others.

Social anxiety is more than being shy – it is a feeling of terror of what others will think of you. Shy kids warm up over time in social situations but those with social anxiety do not. Because kids with social anxiety disorder are afraid of doing anything that is embarrassing or socially awkward, they can be experts at concealing how they actually feel. On the flip side it can make them act out in a situation where they may be embarrassed and act out as an attempt to avoid.

Great reads for kids with anxiety:

OCD  typically arises between ages six to nine though can manifest as early as five. Young children experience the disorder differently than adolescents and adults do. Young children may not recognize that thoughts and fears are exaggerated or unrealistic. They may not be fully aware of why they feel compelled to perform a ritual only that it provides a “just right” feeling of being safe in the moment.  It is between the ages of 9-12, that it evolves into a magical thinking pattern and grows more superstitious in nature.

 

The OCD child will respond to anxiety in a way that is very rigid and rule-bound and interferes with normal daily functioning.
 

Signs of OCD

  • Repeated hand washing, locking and relocking doors or touching things in a certain order, turning lights off and on, lining up pencils in a certain way, systematically arranging and checking the desk in a structured routine.

  • Extreme or exaggerated fears of germs, family members being injured or harmed or doing harm themselves.

  • Magical thinking  - “If I touch everything in my room, Mom won’t be killed in a car accident today.”

  • Repeatedly seeking reassurance about the future – all will be well.

  • Intolerance for certain words or sounds.

  • Confessing to thoughts that are or violent in nature.

 

OCD can be overlooked

 

Signs of OCD are not always obvious. Compulsions may not be noticed as they can appear subtle or be misread by caregivers and teachers. The fact that the child is performing a ritualistic compulsion may not be clear to others or can be invisible, such as counting to a certain number, in the head.

 

As children grow and age, they realize that some of their fears are nonsensical, or their behaviours are unusual in comparison to peers This may lead them to go to greater efforts to conceal their OCD symptoms from others. Children with OCD can also sometimes manage to suppress their symptoms in certain situations. They may mask them at school only to explode at home because of the tremendous effort it took to get through the school day or vice versa.

 

OCD can also be mistaken for other disorders. Many children with OCD are so distracted by their obsessions and compulsions that it interferes with their ability to pay attention in school. A teacher or staff member may notice a child struggling with focus and assume an ADHD role, as the OCD isn’t apparent. And it can also be overlooked when a child with OCD develops depression. Children with

OCD are at a greater risk for depression, especially without treatment. Also look to your mental health professional for a correct diagnosis

 

For children who have obsessive-compulsive disorder, functioning in school is often highly challenging. As the teacher, it can be easy to misread the symptoms of OCD as ADHD or a more oppositional behaviour.

 

Recognizing OCD in the classroom

 

  • Frequent requests to go to the bathroom: This could be to complete the compulsion to wash hands.

  • Triggering situations: someone near the child was coughing or sneezing, wiping their nose or if the child touched something that was perceived as contaminated in any way. It can, as with other behaviours, be a desire to escape, get out the classroom and get away from others - respite.

  • Constant reassurance seeking: This can take the form of repetitive questions. “Are you sure that’s right? Could you tell me again? Did you hear what I said? Can you repeat the instructions?” (Child Mind Institute​) It can also manifest in ritualistic behaviours: checking doors, windows, lockers, desks - over and over and over again.

  • Getting “stuck” on tasks – the completionist:  Children with OCD often will need to finish something to completion, or understand it to completion, before they’re able to move on (Child Mind Institute​). This can cause explosive outbursts and outright refusals to transition and again look oppositional. Say a child is working on completing a writing task, and the teacher says, “Now let’s line up for library,” the child not going to be able to shift gears. The first task must be completed.

  • Retracing: If a child leaves the classroom and worries that something was left behind, the desire to go back into the classroom and check will be overwhelming. If it was a bad thought as the child went through the doorway, the thought pattern might have to “fixed or changed” by going back through the doorway again while saying a good word even if it means being late for a next class or being chastised by adults.

  • Obsessive erasing: A child could be erasing a lot or crumpling up work and starting over because the work has to look perfect. Or it could be that the child may have used a word that is disturbing. An example of this would be, if there is a fear of vomiting and he/she has written the word vomit, that child might not be able to stand seeing that word, so it’s erased. These kids wear away their erasers and end up with holes in the paper from repeated erasing or piles of crumpled up attempts at their feet. Words may even be written all over the back of the page.

  • Distraction: When a child is busy thinking that if “she” doesn’t turn to page eleven and count backwards eight times then her mom is going to get sick, she’s not going to be paying attention in class. And if the teacher calls on her to answer a question or perform a task, her distraction might look like ADHD.

  • Slowness on exams and papers and tasks: Sometimes when kids take a long time to do what others can do in much less time, they’re struggling with the perfectionism of needing to do things the right way. This can mimic learning problems, or inattention, but it isn’t.

  • Avoidance: We may notice a child who doesn’t want to sit on the floor, or pick things up that touched the floor or others touched, or get the hands dirty in art class, or sticky from glue. A lot of playground activities may be avoided, as kids with germ-phobic fears will look at the playground the way you might look at handrail in a busy mall, it’s filthy.

  • Tapping and touching patterns: If a child sits down and accidentally kicks the chair next to “her” with her right foot, she’s going to then have to kick it with her left.  Again this may look oppositional, or fidgety.

  • Complaints of fatigue and fear (anxiety):  Children with OCD are using their brains a lot with all their ritualistic processes and when you couple that with anxiety you get exhaustion. It’s common for kids with OCD to want to come home and take a nap after school (Child Mind Institute).

Children and teens can, like adults, experience a range of mental illnesses like depression. It can be difficult for adults to understand how challenging children’s problems are to them because we look at their issues through adult eyes and perception/perspective. The pressures involved in growing up can be very troublesome for some children. Others have many challenges outside of the classroom – or home.

 

It’s important to remind ourselves, as educators and caregivers, that while their problems may seem trivial to us, they can feel and are often overwhelming to the child. We must take depression in young people very seriously. Even very young children commit or attempt suicide. I myself had the experience of working with a ten year old who had attempted suicide.

 

Depression is form of mood disorder. Mood disorders affect the way you feel about yourself, your life, and your circumstance, which in turn affects the way you think and act. In depression, you may feel down or low, hopeless, or very sad and find that you can’t enjoy things you used to like. Many people who experience depression feel quite irritable or angry, others report an ever-present feeling of numbness (Canadian Mental Health Association).

 

Recognizing depression in children and youth can be more difficult than in adults because young people experience so many changes naturally. You may wonder what is ‘normal’ and what might be a cause for concern. Is your teary teen hormonal or depressed? Also, many children and teens may not want to talk or do not talk about their feelings, or may have their own explanation for their what they are experiencing. Always use the resources of a mental health professional.

What to Watch for

 

Changes in usual demeanour: The child may show signs of being unhappy, worried, guilty, angry, shameful, fearful, helpless, hopeless, lonely, or rejected. They may begin to isolate themselves and withdraw from peers and family members (Canadian Mental Health Association).

Changes in health: The child may start to complain of frequent headaches or stomach aches - general aches and pains that you can’t explain. They complain of feeling tired all the time or have problems eating (too much or too little) or sleeping. The child may unexpectedly gain or lose weight.

Changes in thinking: The child may say things indicative of low self-esteem, self-dislike or loathing or self-blame. Negative talk – negative future outlook. They may have a hard time concentrating. In some cases, they may show signs that they’re thinking about suicide or even talk about it. They may begin to talk frequently of death or draw pictures of it.

Changes in behaviour: The child may withdraw from others, cry easily and/or often, or show less interest fun activities that they normally enjoy. They might over-react and/or have sudden outbursts of anger or tears over small incidents that they could normally cope with.

 

Please note that some of these changes may also be signs of other mental health disorders.

 

It’s important to consult a professional and to look at the bigger picture: how intense the changes are, how they impact the child’s life, and how long they last – is it cyclic or constant? It’s particularly important to talk to they child and seek outside help if you’ve noticed several changes lasting more than two weeks. Or repetitive, episodic periods of sadness. (Canadian Mental Health Association)

Who is at Risk?

 

Depression typically manifests between the ages of 15 and 30, but it can affect anyone— including younger children (Canadian Mental Health Association). While we don’t know exactly what causes depression, many known factors are involved. These include and are not limited too: family history, personality, life events, and body changes. Certain medications and physical illnesses can also contribute to depression.

 

What can I do About it?

 

Depression is very treatable. Children, teens, and adults all can recover from depression and lead healthy lives. For children and teens, early treatment is very important allowing them to get back to their life goals as quickly as possible (Canadian Mental Health Association). Seek outside help through your community or school. Counselling, medication, social communities are all available in the detection and treatment of depression.

Bipolar disorder in children, also known as paediatric bipolar disorder, occurs in children and teenagers. In the latest version of the Diagnostic & Statistical Manual of Mental Disorders (DSM-5), it is no longer referred to as “bipolar disorder,” but rather as Disruptive Mood Dysregulation Disorder [(DMDD)], however, these are one and the same (Psych Central).

 

Differing from most adults with bipolar disorder, children are characterized by:

  • Abrupt mood swings

  • Periods of hyperactivity followed by lethargy

  • Intense temper tantrums (rages)

  • Frustration and defiant behaviour (mimicking oppositional)

  • Chronic irritability due to rapid and severe mood cycling with few clear periods of peace between episodes.

 

The criteria for DMDD are similar to that of adult bipolar disorder (Psych Central). 

 

The child or adolescent needs to meet at least four or more of the following:

 

  • Severe temper outbursts (explosive rages) verbal or aggressive in nature and toward objects or others.

  • Rages occur 3 or more times per week and are inconsistent with the child or teen’s age level.

  • Expansive or irritable mood.

  • Extreme sadness or lack of interest in play.

  • Rapidly changing/altering moods lasting a few hours to a few days. Extreme highs and lows.

  • Explosive, lengthy, and often destructive rages.

  • Separation anxiety.

  • Defiant behaviours.

  • Hyperactivity, agitation, and distractibility.

  • Sleeping too little or  too much.

  • Bed-wetting and night terrors – inconsistent with age. (Night terrors are different than nightmares, the child will appear awake may even get out of bed or have open eyes but still be in the terror and asleep).

  • Strong and frequent cravings, often for carbohydrates and sweets.

  • Excessive/over involvement in multiple projects and activities.

  • Impaired judgment, impulsivity, racing thoughts, the need to keep talking.

  • Dangerous or adrenalin behaviours (such as jumping out of moving cars or off roofs).

  • Inappropriate or precocious sexual behaviour

  • Grandiose belief in own abilities that defy the laws of logic  - like superpowers.

 

Please note that many of these behaviours alone are not indicative of a possible disorder and can be characteristic of normal development (Psych Central).

Childhood bipolar disorder is characterized by at least four of these symptoms together, and indicated by rapid/altering mood swings and hyperactivity. These symptoms will cause significant distress in the child or teen, and will occur in more than one setting and last for at least two weeks. It is best to seek the support of a mental health professional who has experience with childhood bipolar disorder as it is easily misdiagnosed. Treatment consists of medication and psychotherapy.

Selective Mutism is a complex childhood anxiety disorder characterized by a child's inability to speak and communicate effectively in “select” social settings, such as school (Selective Mutism Center). These same children are able to speak freely and communicate in settings where they are comfortable, secure, and relaxed – feel safe.

 

Selective mutism is a debilitating and painful challenge for a child – it is the actual fear of speaking and of social interactions where there is an expectation to speak and engage. Unfortunately even nonverbal communication can be affected, leaving the child shut down and withdrawn.

 

Different variations:

  • Some children may be completely mute, unable to speak or communicate to anyone in any social setting.

  • Some may be able to talk to a select group or perhaps even whisper.

  • Some children may freeze, expressionless – leaving them socially isolated.

  • Those less severely affected may appear relaxed, able to socialize with one or a few children but are unable to speak directly and effectively communicate to teachers or most/all peers.

What causes a child develop Selective Mutism?

 

Most children with Selective Mutism have a genetic predisposition to anxiety – an inherited tendency (Selective Mutism Center). These children often show other signs of severe anxiety, such as separation anxiety, frequent tantrums and crying, moodiness, inflexible thinking, sleep problems, and extreme shyness beginning in infancy. There are ties to multi-lingualism and language processing disorders.

Some children with Selective Mutism have Sensory Processing Disorder (DSI) meaning it is difficult for them to process sensory information – such as sounds, lights, touch, taste and smells. Some children have difficulty controlling sensory input and this in turn can affect their emotional responses. This type of processing disorder may cause a child to simply misinterpret environmental and social cues leading to inflexibility, frustration and anxiety. The following anxiety may cause a child to shut down, avoid and withdraw or it may cause the child to act out in negative behaviours.

There is a small percentage of children with Selective Mutism who do not seem to be shy (Selective Mutism Center).  They often seek attention but use only nonverbal language. There is limited understanding of this and there are several theories – in the end they are simply stuck in the nonverbal stage of communication.


There is no evidence that the cause of Selective Mutism is related to abuse, neglect or trauma (Selective Mutism Center).

Selective Mustism VS Trauma induced mutism

Selective Mutism speak children speak in at least one setting, they are rarely mute in all settings their mutism is a way of avoiding the anxious feelings brought on by expectations and social encounters.

Children with traumatic mutism typically develop mutism suddenly, after a traumatic event, in all situations. They are unable to process the event and become mute (My Aspergers Child).

Characteristics

  • blank facial expression is common

  •  never seem to smile

  • Can have stiff or awkward body language when in a social setting and appear uncomfortable or unhappy.

  • They turn their heads away, chew or twirl their hair, avoid eye contact, or withdraw from the group seemingly more interested in playing alone.

  • The less avoidant may play with one or a select few children and be very participatory in groups. These children will still be mute and/or barely communicate with most peers and teachers.

  • Some may appear out going but be completely nonverbal.

  • Typically timid, cautious – separation and social anxiety

  • May have co-existing conditions such as a sensory processing disorder or language delay.

  • May present physical symptoms tied to anxiety

If you are unsure what you are facing, lack an official diagnosis, or do not wish to purchase a program plan - the Strategies to Use and Behaviour Insights pages have information and techniques which are essential in managing challenging behaviours.

 
+ SOLVING FOR COMPLEX NEEDS

What is a Global Developmental Delay (GDD)?

 

Global developmental delay refers to a cognitive/intellectual developmental disability typically characterized by a lower than average intelligence coupled with considerable limits in at least two other areas/milestones of development. It is mainly diagnosed in those under the age of five years.

What are Pervasive Development Disorders - PDD?

 

The Following disorders are included under the banner of PDD:

  • Autism

  • Asperger's syndrome (now considered autism spectrum disorder)

  • Childhood disintegrative disorder:  This is rare condition. Children begin typical development in all areas, physical, emotional and intellectual, then, at some point, typically between 2 and 10 years of age, the child begins to lose many of the social and language skills developed. A child with disintegrative disorder may also lose control of other bodily functions, including bowel and bladder.

  • Rett's syndrome: Children with Rett’s symptoms associated with a PDD also suffer problems with physical development. They typically suffer the loss of some/many motor or movement skills and develop poor coordination. It is a condition mainly of girls.

  • Pervasive development disorder not otherwise specified (PDDNOS)

Read more...

Solve for specific complex needs diagnoses:

Global developmental delay refers to a cognitive/intellectual developmental disability typically characterized by a lower than average intelligence coupled with considerable limits in at least two other areas/milestones of development. It is mainly diagnosed in those under the age of five years.

 

It is typically a temporary diagnosis for those too young to be assessed leading to a confirmation of intellectual disability in older, school aged children. Intellectual disability refers to children diagnosed after the age of five and under the age of 18 – dependent upon Country location.

Diagnostic Statistical Manual (DSM-5) criteria for Intellectual disability

The following three criteria must be met:

  • Deficits in intellectual functions, such as reasoning, problem-solving, planning, abstract thinking, judgment, academic learning and learning from experience, and practical understanding confirmed by both clinical assessment and individualized, standardized intelligence testing.

  • Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility. Without ongoing support, the adaptive deficits limit functioning in one or more activities of daily life, such as communication, social participation, and independent living, and across multiple environments, such as home, school, work, and recreation.

  • Onset of intellectual and adaptive deficits during the developmental period.

(Tassé, M., 2013

Signs of GDD/Intellectual Disability

 

Typical signs of GDD include but are not limited to:

  • Delayed attainment of milestones (sitting up, crawling, walking)

  •  Limited reasoning or conceptual/abstract abilities

  •  Weak social skills and impaired judgement

  •  Aggressive behaviour used as a coping skill

  • Communication complexities.

 

Intellectual delay can be diagnosed as mild, moderate, severe or profound (Tassé, M., 2013).

 

GDD has a myriad of known risk factors affecting the function of the central nervous system including:

  • genetic (such as Fragile X syndrome)

  • metabolic

  • prenatal (such as rubella or birth trauma)

  • perinatal (premature birth or as the result of a childhood injury or infection)

  • condition cause can also be “undetermined”.

 

Children do not outgrow Developmental disabilities, though they can progress and learn on their own terms and at their own level (Amanda Morin, Understood). Some conditions that may cause a developmental disability include:

  • Down syndrome

  • Angelman syndrome

  • Autism

  • Fetal alcohol spectrum disorders (FASD)

  • Brain injury.

Developmental delays on the other hand, may be short-lived, such as in the case of a speech delay brought about by hearing loss from ear infections or a physical lag from a long hospitalization. These delays may also be the early warning signs of learning and/or attention issues. It may not be clear what is causing a delay but getting early intervention is key.

Children develop skills at their own pace. Some babies may start walking as early as 9 months, while many others don’t take their first steps until 15 months. Please note that both of these children sit within the range of typical development (Amanda Morin, Understood). However, a developmental delay is more than just being “little behind or a little slow.” This child is continually behind his/her peers in skills by developmental age.

Developmental Milestones (Amanda Morin, Understood)

Typical physical milestones for children by age one – gross-motor:

  • Siting up without leaning on anything for support or being held up

  • Belly crawl, bum scoot or crawl on hands and knees

  • Pull themselves up to standing holding on to furniture and move

Typical physical milestones for 12 and 24 months:

  • Stand up alone and walk while holding on to your hands

  • Assist in getting dressed and undressed by holding our limbs (ie: arms up in the air to put on a shirt)

  • Walk without assistance

  • Begin to walk up stairs

 

Typical fine motor skills toward age of 2:

  • Drink from a child’s sippy cup (or regular cup with help)

  • Use a spoon to eat – this may be awkward still

  • Pick up small objects in a “pincer grasp” (thumb and one finger)

  • Point, poke, pinch

  • Place toys or objects into a container and pull them out again

  • Scribble with a thick crayon or marker

 

Typical cognitive milestones, 12-24 months-(the way in which the child learns to think, explore, and solve problems):

  • Know the use for everyday objects (such as a spoon, phone)

  • Developing the ability to follow simple directions, (“blow me a kiss” or “sit down”)

  • The early beginnings of imaginative play

  •  Be aware of own body parts and be able to point to them - head, eyes, ears, nose or mouth

  • Drawing connections between a word spoken and a picture in a book

  • React to familiar songs and stories – things enjoyed

  • Begins to test cause and effect, learning to predict outcomes: such as what happens when a plate is thrown on the floor

 

Typical language Milestones between 12 and 24:

  • Babble sounds that appear conversational or as in a response to the speaker

  • Recognize names of attached people and words for common items (dog, ball, shoe, cup)

  • Raise arms to be picked up, point at things desired and shake the head indicating no

  • Understanding of basic commands such as stop

  • Speak some easy beginning sound words such as, no, mama, dada

  • Express emotions (happiness, sadness and frustration) with different sounds or cries

 

Typical Social and Emotional Milestones by 1 year:

  • Engage by smiling and/or laughing in reaction to someone else or when playing

  • Cry in reaction to someone nearby being upset

  • Be able to exploring the room/area when a caregiver is nearby

  • Show affection to familiar/known people

  • Display minor temper outbursts when frustrated

  • Be nervous/shy with unknown people and clingy with caregivers

 

Please note that kids develop at different rates. A child might meet some of these milestones a little earlier than peers or a little later. But if the child isn’t meeting most of them, an evaluation may be in order.

Physical Milestones related to kindergarten (Amanda Morin, Understood)

 

Children at this age are quite active and can typically accomplish the following by the age of 5:

 

Gross Motor Skills

  • Walk heel-to-toe a well as tip toe

  • Successfully jump rope and pump legs to move the swing alone

  • Hop on each foot

  • Catch a ball – softball size

  • Coordination to move the body in different ways simultaneously, (swim, bounce a basketball or dance)

 

Fine Motor Skills

  • Chose a dominant hand – prefer one over the other

  • Hold a pencil using a tripod grip (two fingers and a thumb)

  • Cutting skills - basic shapes with scissors; some may be able to cut a straight line

  • Easily manipulate eating utensils

  • Be able to wipe and wash themselves after using the bathroom

Typical Cognitive Milestones related to ending of kindergarten:

  • Recognize and name colors and basic shapes

  • Know the alphabet letters and their letter sounds

  • Provide their name, address and phone number

  • Understand basic concepts about print/reading

  • Understand that stories have a beginning, middle and end

  • Count objects in groups up to 10 and recite numbers to 20

  • Attend to an activity for 15 minutes and finish a short project

  • Make plans/decisions around how to play, what to build or what to draw

 

Typical language Milestones:

  • Use sentences including 5 – 8 words

  • Use words correctly to argue and/or reason with people, (because is a word that may often be used in explanation)

  • Use most plurals, pronouns and tenses correctly

  • Tell/make up stories, jokes and riddles there may be an understanding of simple puns

  • The use language to talk about and describe opposites and compare things (“That black dog is bigger than the white one.”)

  • Talk about future events as well as things that have already passed

  • Follow simple multi-step directions

 

At kindergarten end, typical children can recognize common words, such as the and me, and are able to begin reading three-letter words, like cat.

 

Typical Social and Emotional Milestones:

  • Begin to understand right from wrong

  • Express feelings and make friends

  • Have an interest in behaving/being like their friends and desiring their approval

  • Begin to prefer same-gender friendships and may become jealous of other people spending time with “their” friends – or favoured teachers

  • Tend to follow the rules most of the time when understood and may criticize those who don’t

  • Enjoy receiving attention and may be silly to get attention (this depends on a child’s nature however)

  • Desire approval and to be taken seriously

  • Begin to understand the concepts of sharing and how it relates to them

 

Please note that children develop, at their own pace and this list is not limiting. If a 5-year-old, however, hasn’t met a number of these milestones, you may want discuss it with the teacher and your health provider.

It is advisable that parents seek the advice of their health professional as to community resources and programs to assist them on their journey with their child.

 

 “The most interesting people you’ll find are ones that don’t fit into your average cardboard box. They’ll make what they need, they’ll make their own boxes,”

Dr. Temple Grandin

 

Dr. Grandin’s Story – a lesson in hope

 

As seen on her site:

Dr. Grandin did not talk until she was three and a half years old.  She was fortunate to get early speech therapy.  Her teachers also taught her how to wait and take turns when playing board games.  She was mainstreamed into a normal kindergarten at age five.  Oliver Sacks wrote in the forward of Thinking in Pictures that her first book Emergence: Labeled Autistic was “unprecedented because there had never before been an inside narrative of autism.”  Dr. Sacks profiled Dr. Grandin in his best selling book Anthropologist on Mars.

Dr. Grandin became a prominent author and speaker on both autism and animal behavior.  Today she is a professor of Animal Science at Colorado State University.  She also has a successful career consulting on both livestock handling equipment design and animal welfare.  HBO made an Emmy Award winning movie about her life and she was inducted into the American Academy of Arts and Sciences in 2016.

When she was young, she was considered weird and teased and bullied in high school.  The only place she had friends was activities where there was a shared interest such as horses, electronics, or model rockets.  Mr. Carlock, her science teacher, was an important mentor who encouraged her interest in science.  When she had a new goal of becoming a scientist, she had a reason for studying.  Today half the cattle in the United States are handled in facilities she has designed. 

 

What are Pervasive Development Disorders - PDD?

 

The Following disorders are included under the banner of PDD:

  • Autism (in depth discussion to follow)

  • Asperger's syndrome (now considered autism spectrum disorder)

  • Childhood disintegrative disorder:  This is rare condition. Children begin typical development in all areas, physical, emotional and intellectual, then, at some point, typically between 2 and 10 years of age, the child begins to lose many of the social and language skills developed. A child with disintegrative disorder may also lose control of other bodily functions, including bowel and bladder.

  • Rett's syndrome: Children with Rett’s symptoms associated with a PDD also suffer problems with physical development. They typically suffer the loss of some/many motor or movement skills and develop poor coordination. It is a condition mainly of girls.

  • Pervasive development disorder not otherwise specified (PDDNOS)

 

Understanding Autism

 

Autism is considered a “spectrum disorder” as there is a wide range of variation in how people are affected; each child is unique in symptoms and abilities. What all children with autism have in common, however, is some degree of challenges with social interaction, empathy, communication, and flexible/thinking behavior. These combinations of symptoms and level of disability vary immensely from person to person – two children having the same diagnosis may look very different from one another when it comes to their behaviors and abilities/skills.

Signs of Spectrum Disorders

 

Basic social interaction challenges:

  • Unusual or inappropriate body language, gestures, and facial expressions (such as avoiding eye contact or using facial expressions that don’t match what he or she is saying – difficulty reading facial expressions)

  • Lack of interest in other people’s doings or in sharing interests or achievements (showing a work of art, pointing to a dog)

  • Unlikely to approach others or to pursue social interaction; typically comes across as standoffish and detached; spends much time in isolation - prefers to be alone

  • Difficulty understanding other people’s feelings, reactions, and nonverbal cues – facial expressions, body language

  • Resistance to being touched

  • Difficulty or failure to make friends with peers the same age

 

Speech and language comprehension issues:

  • Long delay in learning how to speak (after the age of two) or doesn’t speak at all

  • Speaking in an unusual tone of voice, or with an odd rhythm or pitch

  • Repeating words or phrases over and over without communicative intent

  • Difficulties in starting a conversation or keeping it going

  • Difficulty with communicating needs or desires to others

  • Doesn’t appear to understand simple statements or questions – can’t follow simple multi-task instructions

  • Inability to see irony, sarcasm or humour – too literal

 

Play behaviours that may be noticed:

  • Repetitive body movements (hand flapping, rocking, spinning) and/or moving constantly

  • Obsessive attachment to odd objects (rubber bands, keys,)

  • Preoccupation with a limited topic of interest, often involving numbers, schedules or symbols (trains, maps, license plates, statistics)

  • A strong need for routine and order (follows a rigid schedule). Tends to get upset by changes in routine or environment.

  • Odd movement - clumsiness, abnormal posture

  • Fascination with spinning objects, moving pieces, or parts of toys

  • Hyper- or hypo-reactive to sensory input

  • Tendency to be less spontaneous and curious

  • Often lacking in imaginative play or peer play

Related signs of Autism Spectrum Disorder

  • Sensory issues – Often children with ASD either underreact or overreact to sensory stimuli (sound, touch, taste)

  • Emotional regulation difficulties – Children with ASD may have trouble regulating emotions or expressing them in appropriate ways.

  • Uneven cognitive abilities – Though ASD occurs at all intelligence levels many children have unevenly developed cognitive skills, such as verbal skills weaker than nonverbal or rote or immediate memory tasks over abstract.

  • Savant skills – these typically show up in art, math, music or memory ability.

 

Diagnosis

 

Diagnosing ASD is often difficult and time-consuming. This has much to do with concerns around labeling or even incorrectly diagnosing the child. As a parent if you’re concerned that your child may have ASD, it’s important to seek out a health care professional with knowledge in this area and/or reach out to your child’s school if applicable. Look into treatment options and understand everything you can about it by talking with your local ASD communities. Early intervention is extremely helpful in ASD.

Resources

Autism Canada

Autism Society of America

 

Determining whether or not a child has autism spectrum disorder or another developmental condition, involves clinicians looking carefully at the child and the way the child interacts with others, communicates, and behaves (Help Guide). Diagnosis is based on these patterns of behavior once observed.

 

As we mentioned, diagnosis takes time and depending upon your child’s symptoms and their severity, the assessment may involve several modes including:

 

  • Speech

  •  intelligence

  •  social, sensory processing

  •  motor skills testing.

 

Understanding PDD-NOS

(Pervasive Developmental Disorder – Not Otherwise Specified)

 

As in all forms of ASD, PDD-NOS can occur in concurrence with a wide range of intellectual ability. The features that define it are as having significant challenges in social and language development.

It’s typically seen as the diagnosis for a child who has mild or some but not all of the characteristics of autism. As an example, a child may have significant autism symptoms in one area such as social deficits, but mild or no symptoms in another. There is much debate around PDD-NOS.

An important thing to note is that some professionals refer to PDD-NOS as “atypical autism”. Diagnosis usually happens in these situations:

  • The child is high-functioning as in Asperger syndrome but is experiencing mild cognitive issues and/or language delay that would prevent the Asperger diagnosis

  • The child is similar to a person with Autism but his/her symptoms began at a later age

  • Well the child has many symptoms of Autism there are fewer perseverative behaviours than in those with an Autism diagnosis

 

The current criteria (very minimal) from the DSM-5 is as follows:

 

Experts say this category should be used when there is severe and pervasive impairment in the development of reciprocal social interaction associated with impairment in either verbal or nonverbal communication skills or with the presence of stereotyped behavior, interests, and activities, but the criteria are not met for a specific Pervasive Developmental Disorder, Schizophrenia, Schizotypal Personality Disorder, or Avoidant Personality Disorder. An example of this category includes “atypical autism” – all presentations that do not meet the criteria for Autistic Disorder because of late age at onset, atypical symptomatology, or subthreshold symptomatology, or all of these.

PDD-NOS is characterized by:

  • Delays in the development of socialization and communication skills.

  • Communication difficulties - using and understanding language

  • Difficulty with social behaviour

  • Difficulty with changes in routines or environments

  • Uneven skill development (strengths in some areas and delays in others)

  • Unusual play with toys and other objects

  • Repetitive body movements or behaviour patterns

  • Difficulty with transitions

  • Perseveration – including on ideas/thoughts

  • Increased or decreased sensory sensitivities (touch, smell, taste, sound)

 

Again, early diagnosis and intervention are to key to optimizing outcomes which includes success in inclusive classrooms and as an adult. However, it is never too late to begin any treatment

If you are unsure what you are facing, lack an official diagnosis, or do not wish to purchase a program plan - the Strategies to Use and Behaviour Insights pages have information and techniques which are essential in managing challenging behaviours.

 
+ SOLVING FOR FETAL ALCOHOL SPECTRUM DISORDER (FASD)

Fetal Alcohol Spectrum Disorder (FASD) is a complex and not easily explained disability. The term - Fetal Alcohol Spectrum Disorder - refers to the range of effects that can occur in children, youth or adults who have been prenatally exposed to alcohol (FASD Support Network of Saskatchewan Inc.).

Read more...

Effects range from mild to severe and can include:

  • a small head

  • a smooth ridge between the upper lip and nose, small and wide-set eyes, a very thin upper lip, or other abnormal facial features

  • below average height and weight

  • hyperactivity

  • lack of focus

  • poor coordination

  • delayed development and problems in thinking, speech, movement, and social skills

  • poor judgment – difficulty anticipating consequence of actions.

  • problems seeing or hearing

  • learning disabilities

  • intellectual disability – cognitive delays

  • heart problems

  • kidney defects and abnormalities

  • deformed limbs or fingers

  • mood swings

  • behaviour issues – outbursts, tantrum, aggression

 

FASD is an injury to the brain for which there is not cure and is a life-long condition.

Critera for Diagnosis (Canada)

  • Information proving the birth mother drank during pregnancy

  • Characteristic facial features

  • Below normal weight, height and small head

  • Problems with learning and /or problems with behaviour

If you are unsure what you are facing, lack an official diagnosis, or do not wish to purchase a program plan - the Strategies to Use and Behaviour Insights pages have information and techniques which are essential in managing challenging behaviours.

 
+ SOLVING FOR ATTENTION DEFICIT (HYPERACTIVE) DISORDER (AD(H)D)

ADHD exists when a child has pervasive and persistent difficulties focusing and keeping their body still and interferes with every aspect of their life: home, academic, and social. Early childhood ADHD may be associated with depression, mood or conduct disorders and substance abuse (CHADD).

 

Children with ADHD may have symptoms of inattention (formerly ADD), hyperactivity/impulsivity, or both.

Read more...

​With inattention (ADD) symptoms may include and are not limited to: 

  • Often make careless mistakes or not pay attention to detail

  • Be easily distracted

  • Appear not to be listening (zone out)

  • Have difficulty concentrating

  • Have trouble following instructions, getting organized, and starting or completing activities

 

With hyperactivity/impulsivity symptoms, the child may:

  • Often fidget or seem constantly "on the go"

  • Run around when it is not appropriate – leave the classroom or home

  • Become easily frustrated when asked to take turns – or wait

  • Interrupt others

  • Make noise at inappropriate times

If you are unsure what you are facing, lack an official diagnosis, or do not wish to purchase a program plan - the Strategies to Use and Behaviour Insights pages have information and techniques which are essential in managing challenging behaviours.