Twirls Hair

Children (and adults!) have “nervous habits.” These are often little useless movements or actions like rubbing the forehead, cracking knuckles, nibbling at fingernails, shaking legs back and forth, rocking back and forth and so on. Hair-twirling – taking a strand of hair and wrapping it around a finger – is a popular nervous habit from infancy onward.

If your child engages in hair twirling, consider the following tips:

Nervous Habits Reduce Feelings of Stress
Those who understand the human energy system can often describe how a nervous habit contributes to feelings of soothing and comfort. For instance, when people bump into something, they’ll often instinctively rub the injured part of their body. This is because humans are wired to help themselves heal without even knowing how or why they are doing it. They rub the injury instinctively – not because they’ve been told to do it. The rubbing activity brings increased blood circulation to the area and also brings energetic healing to the wound. Indeed, the whole business of “hands on healing” has to do with the energy stored within our bodies that can be transferred through hands to another part of our own or another’s body. In a similar way, rubbing the head, nibbling fingers and so on, initiates energetic healing that reduces stressful feelings and increases calm.

Children and teens engage more in their favorite nervous habit when they are more stressed. This increased stress may be due to outside pressure like school exams or internal pressure like fatigue. Tired children will often curl up on their mother’s lap and twirl their hair. The twirling activity acts like a pacifier, calming their internal agitation, exhaustion or fear.

Hair-Twirling is Not Hair Pulling
Some children will not only twirl a strand of hair, but then they will pull it out of their head. This habit is called trichotillomania. It is a mental health disorder which is a type of impulse disorder. Hair-pulling is a compulsive activity – one that is very difficult to stop without professional assistance. Hair-pulling, like hair twirling, occurs more often when a child is experiencing stress, but it’s real purpose is to reduce anxiety.  In other words, hair-pullers have more internal pressure than simple hair twirlers have. Moreover, hair-pulling leads to feelings of helplessness and shame when left untreated. Hair-twirling usually doesn’t bother the person who does it. Hair-pulling is best treated by a child psychologist.

Helping Your Child Stop Hair-Twirling
Toddlers frequently engage in hair-twirling and as they become a little older, they just as frequently grow out of the habit. Therefore, the best thing to do for young hair twirlers is NOTHING. However, if your child is still twirling her hair when she is six or older, you can help her in a few ways. Nagging is not one of them. Besides being detrimental to the parent-child relationship and to the child’s development, nagging is also completely ineffective as a deterrent to hair twirling! What helps more, is reducing the child’s stress and re-directing her behavior.

Stress-reduction for children and teens can often be accomplished with Bach Flower Therapy – harmless vibrational remedies (water) that are available at health food stores. The Bach remedy Agrimony is particularly helpful for those who have bad habits. However, a consultation with a Bach Flower Therapist can be most helpful – read up on the descriptions of the 38 remedies to pick the ones that most fit the profile of your child (you can find more info online and on this site). Up to 7 remedies can be mixed together in one “treatment” bottle and used until the twirling subsides. If twirling begins again, start giving the remedy mixture again. Continue off and on in this way until the twirling has stopped completely.

Anything you can do to reduce stress in the house will be helpful in a general way. Quiet parenting techniques and a happy relationship with your spouse can only help. However, a child’s hair twirling can certainly happen even in a very low stress environment and even when she is very emotionally secure. It’s really more a matter of personal stress style, inherited tendencies and so on.

You might try giving your child something to hold in her hands when you notice she has been twirling. The hands, as discussed above, have energy centers that can help regulate stress. Holding or playing with something in the hand is a more socially acceptable soother than hair twirling. You can get your child a worry stone (a smooth stone for rubbing) or a fidget toy of some kind. Always give her something to DO with her hands instead of just asking her to stop playing with her hair.

In order to break the habit, you can also give your child a hairstyle that makes twirling very hard to do – tight braids or very short hair. It takes about 21 days to break a habit, so after that period, you can probably go back to her old hairdo. However, NEVER give a child a hairstyle that she doesn’t like as this can actually be traumatic for her.

If the hair twirling won’t stop and it bothers you or the child, consult a psychologist. A professional can offer techniques that are used for more intense issues like trichotillomania but that will also help with hair twirling.

Nail Biting

So, your child bites his nails. (The technical term for the compulsion is onychophagia.) Don’t worry, there’s more than one way of weaning him out of the habit— and none of them involves chili peppers! If your child can’t seem to leave his nails alone, consider the following suggestions:

Start with Increasing Awareness
Nail-biters are rarely aware of what they are doing, until someone directs their attention to their action. So before you issue your child a reprimand, consider the possibility that he may just be acting out of instinct, and has no idea that nail-biting is an undesirable behavior.

If this is the case, then simply start by explaining that nail-biting is not a hygienic habit, and can cause germs to travel to the mouth (talk of tiny little worms is recommended at this point — which is not a lie! Some worms are microscopic, and may be found in the dirt under one’s fingernails). Explain to your child that you would like to help him avoid nail-biting as much as possible. More so, you would like him to stop immediately once he catches himself biting his nails. Putting the responsibility of managing behavior onto your child is a good beginning education in self-regulation.

(In the meantime, cut the child’s nails short so he or she won’t have much to bite!)

Ring the Bell on Nail-Biting
As mentioned, nail-biting can be an automatic behavior, often done outside of a person’s awareness. If you want to remove an automatic habit, you have to increase consciousness. You have to make the action as obtrusive as possible.

Bracelets with loud bangles can be used as a warning device for nail-biting. As the child raises her hand to bite her nails, she will be notified by the jingle of the bracelets. This may be enough to stop her mid-track.  A consequence when caught nail-biting, such as reciting a poem or song (the consequence need not be unpleasant; simply “obtrusive”) may also be implemented. It can be enough to break-up the automatic sequence in the brain. When the child is slowed down by any consequence following biting, the brain registers this slightly aversive activity and tries to avoid it by stopping the precursor – the nail biting itself.

Consider Nail-Biting as a Symptom of Stress or Tension
It’s possible that kids nail-bite to release tension or manage insecurity. If this is the case, the best thing to do is address the cause of their unease. Otherwise, other nervous habits might just replace nail-biting and you’ll be back at square one again.

So try to be observant. When do your kids nail bite? Where do they nail bite? What situations trigger the behavior? Which people seem to reinforce it? Gathering this information can help you discover sources of stress or tension in a child’s life. For kids, plain, old-fashioned boredom can trigger stress that triggers nail-biting. Nail-biting may also be a general self-soothing activity that follows conflict in the home, studying for exams, worrying about something or some other tension. Giving kids effective stress-release tools can diminish or stop the habit of biting. For instance, stress can be relieved by Bach Flower Therapy (see a practitioner or learn more about this harmless form of stress relief on-line), daily physical exercise, relaxation training (meditation or yoga for kids) and EFT (Emotional Freedom Technique). Some kids will benefit from professional counseling or specific therapies for breaking habits. A child specialist (art therapist, child psychologist or other mental health professional) can be very helpful.

Or Just Let it Be…
While nail-biting is a common habit among children, it’s not a serious one. It also tends to go away on its own, so no intervention may just be the intervention that you need. If the habit persists for several months, or if it’s so intense that it causes bleeding in the nails, then a physician or a child psychologist should be consulted. Keep in mind too, that some adults still bite their nails. Early intervention can prevent a lifelong habit.

Habits and Nervous Behavior

Everyone has some bad habits. And everyone engages in their bad habits more often when they are feeling tense or nervous. For instance, a teenager or adult may have taken up the “bad habit” of smoking cigarettes. The smoker will almost always be smoking more often when feeling anxious. Younger children can have habits like picking their nose, biting their nails, or twirling their hair. (You can learn more about these bad habits and how to help them by reading articles under the category Nervous Habits on this site). Some kids crack their knuckles, chew their pencils, or nibble on their shirt cuffs. Some rock back and forth in their chairs. In fact, there is hardly a limit to the type of bad habit that a child can “invent!”

If your child has some bad habits or nervous behaviors, consider the following tips:

Nervous Behavior Means the Child is Nervous!
Whether it is pacing back and forth, pulling out hairs, or shaking one’s leg, the purpose of a habit is to release some nervous tension. If you can address the tension directly, the habit will most likely go away (or at least diminish) all by itself. Instead of telling your youngster to stop shaking his leg, offer him something for his “nerves.” Now this doesn’t mean that you should offer him a stiff drink! (That’s a bad habit that a lot of adults are into!). There are plenty of healthy, child-safe “stress busters” that you can offer your child. For instance, your child might be calmed by the right herbal tea. A herbalist or naturopath might be able to prescribe a herbal mixture that reduces your child’s overall level of tension or “nerves.” Herbs can be prepared as bedtime tea’s or they can be taken as syrups or even lollipops when they are made by a professional herbalist. Some herbs are available in tincture or tablet form from your local healthfood store. All herbs are medicinal so make sure that you consult a professional before giving your child herbal medicine. Less medicinal than herbs are essential oils. These, too, are available at healthfood stores. Aromatherapy – the use of essential oils to calm nervous tension – is less medicinal than herbal medicine, but still a little medicinal (for example, some oils need to be avoided in pregnancy or when someone has epilepsy). Therefore, it is adviseable to check with a professional aromatherapist before preparing oils for your child. However, once you learn which oils are safe and how you can prepare them for your child, you will find essential oils to be a delightful way to calm your child’s stress, help him sleep and reduce his nervous habits. A calming treatment that is not medicinal in any way is Bach Flower Therapy. The Bach Flower remedies are essentially water. They do not affect the body – rather, they affect the emotions. They help a child feel less upset, worried, angry or sad. They can help with excess nervous energy, anxious feelings or other “nervous” symptoms. You can read descriptions of the remedies on-line and choose the ones you think are most appropriate for your child or you can consult a professional Bach Flower Therapist. Always include Agrimony in your Bach Remedy mixture when you want to treat a nervous habit; Agrimony is the remedy that helps reduce nervous behaviors. In addition to natural therapies (and these are only a few of the treatments that are available), you may find that psychological counseling can help reduce your child’s anxiety and stress. Obviously this intervention is most important when your child is really stressed and nervous. However, your child who is just “the nervous type” (not very, very anxious), may benefit from psychological interventions as well. Most appropriate for the average child is EFT (Emotional Freedom Technique), mindfulness meditation for children, CBT (cognitive-behavioral therapy) self-help workbooks and other psychoeducational tools. Exercise is another great way to reduce nervous energy: enroll your child in active sports, gymnastics, yoga, swimming – make sure your child is physically active daily!

Refrain from Telling Your Child to Stop His Habit
Telling a child to stop doing whatever he’s doing not only DOESN’T help, but it also hurts. Your child isn’t trying to be “bad” when engaging in a nervous habit. It’s almost like it is happening outside of his conscious awareness. Rather than telling him to stop, simply re-direct him to another activity. Interrupting habits helps to break up the strong neural pathway that is beginning to develop. For instance, suppose your child is sitting in a chair wildly kicking one leg back and forth, back and forth, back and forth. Don’t tell the child to stop! Instead, ask him to please fetch you something from another part of the house. This will interrupt his habit and anything you can do to interrupt the pattern will be quite helpful.

Never Humiliate or Mock Your Child for His Nervous Habit
Some people try to “shame” their child out of their nervous habit. Even if you manage to cure a child this way, the cost is way too great. Don’t do it. There are better ways to cure a habit. For instance, if your child has a habit of nose-picking, DO NOT tell him he is disgusting! Instead, follow the steps you’ll find in the “Nose-Picking” article on this site.

Get Your Doctor’s Advice if a Habit is Persistent
Pediatricians have seen it all. Ask your child’s pediatrician for advice on how to help your child with his nervous habit.

Try to Reduce Stressful Events in Your Child’s Life
This can be a hard one. You might really WANT that divorce, even if it causes your child to become unravelled. However, do what you can to limit the stress your child is exposed to on a daily basis and you’ll find that his nervous habits diminish. Refrain from yelling at anyone or engaging in any kind of conflict. In fact, try to stay in a good mood when your child is around.  Nurture your own mental health by taking good care of yourself. This will help you be happier and calmer and this will only be good for your child. Getting help for yourself or your marriage or even your divorce, can be an important step in calming your household and supporting your child’s mental health.

Learning Disabilities and Self-Esteem

Because they have more difficulty in school compared to other kids, children with learning disabilities (LDs) sometimes start to question their own intelligence and competence. Their self-esteem can suffer, despite the fact that they usually have normal or even very high intelligence as measured on standard instruments.  In fact, a learning disability is defined as a SPECIFIC deficit in one or two areas of functioning (i.e. math and reading) despite overall normal (or even higher)  intelligence. However, children typically experience a great deal of failure and frustration before they end up being officially diagnosed with a learning disability. It is often during this period of not knowing what the problem is that kids are particularly vulnerable to developing low self-esteem.

However, even after diagnosis there are many threats to the child’s self-concept: there’s the anger, self-pity and a sense of helplessness that comes from having to work harder than peers, or from needing to be isolated in special learning situations (remedial teachers, classrooms or schools), or having to endure after-school tutors and lessons. Despite all the interventions and efforts, many children with learning disabilities will never do as well as their peers in their weak areas. Moreover, some kids with severe learning disabilities will not be able to keep up with or join in certain activities because of their deficits and this exclusion, too, can contribute to low self-esteem.

In addition, not all people are sensitive or affirming when they relate to children with disabilities. Some kids can be downright cruel, teasing children with special needs or even bullying them. Parents and teachers may also unconsciously communicate low expectations, and may unintentionally send the message that they don’t see the child as capable.

A Predictor of Success
However, since healthy self-esteem is a key ingredient for attaining  success in life, it is important that parents do what they can to help their learning disabled child acquire a positive self-concept.

Studies have consistently shown that if kids with LDs consider themselves as capable and confident, they do better in all areas of life. Moreover, they are less likely to fall into mental health issues associated with LDs, such as depression or anxiety.

Define the Term “Learning Disability”
A learning disability is a condition, not a trait. In this way, it is similar to diabetes or asthma. Helping your child know that he or she is normal but has a condition, can go a long way to keeping that youngster’s self-esteem intact. There are books for children that explain learning disabilities; seeing the condition described in a book can also help kids realize that this is something outside of themselves that they must deal with, but it does not define all of who they are. Children often misunderstand the term “learning disabilities,” thinking that it means that they can’t learn! This erroneous idea can affect their performance across the board. Instead of just having difficulty in one or two areas, a child with this misconception can do poorly in every area simply because he believes he is intellectually handicapped. It is very important for parents to spell out the specific disability and to highlight the child’s learning strengths. For instance, a parent might say, “your brain has trouble recognizing and remembering letters (this is called ‘dyslexia’)and so you have to work harder to be a fast reader. But in every other way, your brain works perfectly and you are actually very smart. So this means that you should find it easy to do your arithmetic, art, gym, music, science and most of your other subjects. You can can also be awesome on the computer and in sports. And because you’re so smart, you will be able to figure out how to help your brain remember the letters and you will become a good reader – it will just take a bit of work. But we’re going to provide you with extra help so it will be even easier.”

In addition, parents should focus on their child’s areas of natural strength and competency. If the child is a talented musician, artist, cook, computer whiz or whatever, parents can highlight the child’s gift and smarts in these areas. Parents can try to expose their child to as many different activities as possible in order to help the child find areas of competency. For instance, if you don’t invite the child into the kitchen to prepare dessert for the family, neither you nor the child will ever know that cooking is his natural talent! In addition to skills, LD kids also have commendable traits such as determination, compassion or courtesy. Giving positive feedback to character and behavior is another way to boost the child’s self-esteem.

Let Them Contribute
Assume that the child is competent unless the child proves otherwise. Therefore, treat your learning disabled child as a full fledged member of the family with all “voting” privileges and responsibilities. Parents can help their child feel normal by holding them to normal expectations and standards. Offer compensation only when the child’s LD is actually affecting task performance. For instance, kids with learning disabilities can fold laundry as well as anyone else, so don’t let them off the task. However, a particular child with LD may have more trouble running errands due to the difficulty of handling money. This doesn’t mean that the child shouldn’t be allowed to go to the corner store. It might mean, however, that you help him with this task by explaining what to expect in the way of change, showing him what the financial transaction is going to look like or otherwise “tutoring” him through the task.

Use Emotional Coaching
By naming a child’s feelings, parents can help boost the child’s self-esteem and overall emotional intelligence. Naming a feeling lets the child know that he is O.K., his feelings are normal and acceptable and he has emotional support. Thus, when the child is struggling with a difficult task, a parent can acknowledge “It’s hard! It’s frustrating to try that again and again and still not get the answer!” It is hard to believe how powerful a simple acknowledgment of the child’s feelings can be. Moreover, a large body of research shows that just naming feelings helps the child do better academically, behaviorally, socially and emotionally.

Child Speaks Loudly

Do you have a child who tends to shout out what he wants to say, or speak louder than necessary?  It can be so frustrating! No matter how many times you ask your child to speak more quietly, he pops up the next time just as loud as ever.

If your child speaks too loudly, consider the following tips:

Have Your Child’s Hearing Checked
Speaking too loudly can be a sign of a hearing problem or difficulty in processing sounds. We all tend to adjust our volume based on cues in the environment, and if your child has difficulty hearing you, he or she might speak louder to compensate. Consult your pediatrician or a hearing specialist as soon as you can. Many hearing issues can be corrected with early intervention.

Check the Noise Level in Your Home
A child may speak louder as a reaction to an environment that has a lot of background noise. Is the radio on high in your home? Is there machinery in the yard that needs to be shut down? Perhaps you can adjust the volume of these distractions so that your child can quiet down. Or maybe you have a large and boisterous family and your child has to compete to be heard over the din.  You may not be able to get everyone to lower their voices but you can try. Most importantly, be aware of your own voice and check whether YOU are raising your voice in order to be heard as well. You might be inadvertently providing the loud model. If so, work on lowering your volume. See what you can do to get people to listen to you when you are talking in a normal tone and volume (consider reading Raise Your Kids without Raising Your Voice by Sarah Chana Radcliffe for tips on this subject).

Teach Your Child about “Indoor” and “Outdoor” Voices
Expect kids in the playground to be noisy — after all, being as loud as you can is one of the perks of playing outside! When your child has been playing outdoors for awhile, it’s not impossible that he or she will get used to high volume when speaking. Gently but firmly explain that there is a difference between acceptable volumes when inside the home and outside the home — the indoor and outdoor voice. You can even make a game out of it!

Consider if Your Child is Struggling with Speaking
When a child is first learning to speak, or to socialize with family and friends, it’s not unusual for some awkwardness in execution to exist. Your child may be unintentionally speaking too loudly; he or she may simply be struggling with getting the right volume out. If this is the case, training your child on speaking in different volumes can help. You can act out each voice — soft whisper, conversational tone, and shouting from across the room. With constant practice, kids will eventually learn how to adjust their own volume.

Take Your Child to a Speech Therapist
Speech therapists can assess and treat excessive loudness. They teach kids how to breath properly so that they don’t need to shout to get their message heard. They can help kids whose voices have become hoarse from shouting. They teach kids to be more aware of how they use they voice and they show them how to gain control over it.

Consider Anxiety
If you’ve asked the child to speak more quietly and you’ve tried speech therapy and there is still a problem, the child may have a psychological issue that requires attention. Sometimes speaking too loudly, especially if your child used to speak in a level tone before, may be a sign of anxiety. Perhaps your child is trying to get your attention; maybe he or she doesn’t think you’re listening. It’s also possible that he or she is afraid and nervous, and is trying to keep a brave front by speaking louder than usual. If this is the case, it’s best to surface what it is that’s stressing your child, so that it can be addressed. Either try chatting with the child one-on-one to see if anything is bothering her or take her to a child psychologist for an assessment and if necessary, treatment.

Talks Excessively

We love our kids and usually enjoy listening to their stories, thoughts and feelings. But when our kids talk too much – they ask too many questions, share far too many stories, explain things in way too much detail or just seem to want to engage parents in conversation 24/7 – then  we can get frustrated even annoyed. People only have so much attention span and patience (even parents). Constant chatter at home, in the car or while we are talking to others can grate on our nerves so much that we sometimes just want to yell “stop talking already!”

If you have given birth to a chatterbox, here are some tips for you:

Decide Who has the Problem
Interestingly, your child’s “excessive talking” may not be his or her problem – it might be YOURS! Parents can find their child’s talking annoying because they are stressed, distracted, depressed or just plain exhausted. When a parent has a lot on his or her mind, the chatter of a child can be hard to bear. Considering that it is perfectly normal for small children to enjoy talking (especially those in the pre-school set), parents may have to change themselves rather than the child. Perhaps a parent needs to lighten his or her schedule to make room for a few more minutes of daily listening time, or maybe a parent needs a more effective way of relieving personal stress so that more mental space is available for listening to children. Sometimes a parent’s difficulty in listening stems from his or her introverted personality; social interchange drains introverts while it stimulates extroverts. If that is the case, the parent may have to work around the introverted tendency, stretching a bit to accomodate the child’s normal need to talk. On the other hand, if you feel you have normal tolerance for children’s conversation but one of your kids just talks way past that point of tolerance, then you may need strategies to help the child cut back.

Explain the problem. Your child doesn’t realize that he or she is placing a burden on listeners. The child is just doing what comes naturally – enthusiastically sharing thoughts, ideas, stories, information and so on. You need to explain that people have fairly short attention spans and can only listen in “bites.” Most excessive talkers are actually terrible listeners, so it will be easy to demonstrate to your chattery child just how hard listening can be: ask the child to listen to you describe something in great detail (i.e. pick a topic that is unlikely to be particularly interesting to your child and talk for 3 to 4 non-stop minutes, explaining every tiny detail that you can). Your child will get a real experience of how frustrating it can be to have to listen and actually pay attention to someone who is talking. You can then use this experience to remind him or her when he or she is overloading your circuits. A gentle, respectful reminder is all that is necessary. You might even develop a code-word for the problem like “overload” or “maxed-out” or something that the child picks. Eventually the child will have a better idea of how many words the average listener can tolerate before the work of listening becomes too hard. This will be useful information for your child’s social functioning.

Call for a Time-Out
If the talking is excessive, call for a time-out. For example, you may say “I love to hear all about your day, sweetie, but daddy is a bit tired from work and needs a few quiet moments to rest. Let’s talk about it later when we’re having dinner, O.K.?” If you do it gently but firmly enough, your child will eventually respect the boundaries you set. And if your child generally has trouble holding his thoughts and questions in, get a timer or an alarm clock and tell the child to come back when the buzzer goes off. When kids can track when time out starts and when it ends, then they can be able to hold their stories for later.

Give Them Something to do When you Need Quiet and Peace
The chronic talker is really a chronic interacter. This kind of child depends on constant social stimulation. However, this obviously puts a strain on other people. Help your child develop other sides of his brain by re-directing him or her to tasks and activities that will encourage introspection or self-directed play. Point them to storybooks, puzzles, train sets, crafts, art projects, computer programs, physical exercise, TV programs or audio books. When kids know ways to enjoy themselves even if they don’t speak a word, then they are less likely to talk excessively.

Teach your Child Social Skills and Manners
Sometimes, firm rules on what is acceptable and unacceptable behavior is a good way to help a child who talks excessively. For example, teach them that it’s okay to share, but not okay to interrupt when someone else is speaking. Or that it’s okay to ask questions, but not when mom or dad is driving. Most importantly, teach them to take turns in a conversation, allowing the other person to speak for an equal number of minutes. Your child has to learn balance and restraint. You can introduce the notion of conversation sharing that works like a see-saw: the people alternate back and forth in a fairly equal exchange. If the other person talks only briefly, your child needs to do the same. Otherwise he or she is “hogging” the conversation, taking more than his or her rightful share.

Consider ADHD
Excessive talking is often found in those who have ADHD (attention deficit hyperactivity disorder). It may be related to troubles with impulsivity (controlling and limiting behaviors). Particularly if your child also has other symptoms of ADHD like problems attending to boring tasks and subjects, disorganization, fidgeting, interrupting, trouble waiting his turn and so on, you should consider getting a psychoeducational assessment. Ask your doctor for a referral to a psychologist who can diagnose your child. The psychologist can determine whether the excessive talking is part of a syndrome or whether it is just a feature of personality.

Daytime Accidents

You thought that you and your child already passed the stage of toilet training. You child has been dry 24/7 for months now and has learned to consistently let you know when he needs to go to the bathroom. You have already happily excluded diapers from your weekly grocery list. It’s frustrating then to find out that your child has had an “accident.”

Dealing with daytime accidents, purchase when a child already finished the toilet training process, can make a parent feel like a failure. However, parents need to realize that accidents are a normal part of the extended toilet training process and occur long after earlier stages of toilet training have been completed. In other words, toilet training is a longer term process than most parents realize. A period of consistent dryness is routinely followed by periods of frequent “accidents.” Accidents often happen simply because the child is distracted with other things. Patience and consistency are what’s required from parents at this point, so that the lessons learned during earlier toilet training can be reinforced.

The following are some tips for parents dealing with daytime accidents:

Gently Remind Your Child About the Need to Go to the Bathroom
When you notice that your child is “dancing” or squirming, ask him or her to take a timeout to the bathroom. If your child’s underwear is already wet, or you’ve seen the puddle on the floor, gently accompany your child to the toilet. Your child may already be done urinating, but the visit can be a helpful reminder that no time will be saved by not going to the bathroom; the child must go anyway. This helps the child to realize that time is actually SAVED by going to the bathroom before urinating since there will not need to be washing up and changing clothes.

Don’t Get Mad
As with all the stages of toilet training, don’t get upset at your child for the accident. Don’t punish him or her for it either. Urination is a natural body process and sometimes difficult for a child to control. You don’t want to embarrass or shame a child for something he or she can’t help.

Establish Regular Bathroom Habits
Daytime accidents can be prevented by having regular bathroom habits. Invite your child to go to the toilet immediately after waking, around two hours after breakfast and two hours after lunch. They don’t have to go if they don’t need to, of course, but making it a part of the day can help them keep their toilet training in mind until they do it automatically.

Watch Out for Signs That They are Trying to Hold it in
Kids often hold in their urine when they are distracted, e.g. they are watching a good show on TV and they don’t want to miss anything. Watch your child for signs that they might be holding it in. These signs can include fidgeting or crossing legs. When you see the signs, remind them that they need to go to the toilet. Holding urine in is not healthy.

Consider Underlying Medical Conditions
If your child’s daytime accidents persist for weeks despite your interventions, consider consulting your pediatrician. There are many conditions that can cause frequent daytime accidents, including diabetes and urinary tract infections. Pharmaceutical interventions are also available to relax the bladder.

Be Patient During Transitions
Your child may already have mastered toilet training, but current stress in their life can cause the lesson to be temporarily forgotten. If they are undergoing stressful transitions, e.g. a move to a new house, then just be patient. The day time accidents can be merely an emotional reaction, and will go away once the child feels more secure.

Refuses to Go to a Mental Health Professional

In an ideal world, consulting a mental health professional would be as easy as consulting a medical doctor – and as stigma-free. Unfortunately, many people still feel an element of shame, embarrassment or other type of awkwardness about going to a psychological professional. Some people still think that mental health professionals only deal with people who are “crazy” and understandably don’t want to be an identified member of such a population. In fact, in the “olden days” mental illness was poorly understood and derogatory terms such as “crazy” were used to describe people who we know know were suffering from various biological disorders such as schizophrenia, manic-depressive disorder or delusional disorders. Psychiatrists and clinical psychologists can now help mentally ill people feel and function better than ever before. Moreover, modern mental health professionals assist not only those who are suffering from true mental illness, but also those who are completely mentally healthy. They help almost everyone to function in less stressful, more productive and happier ways, helping  them achieve their full potential in every area. People who access mental health services in order to feel and achieve their best, tend to be more emotionally sophisticated, open-minded and growth-oriented than those who do not. In other words, it is often the most mentally healthy people who consult mental health pofessionals today.

Although YOU may know all this, your child may not. In fact, your child may have the old misconception that going to a mental health professional means that there is something wrong with you. As a result, he or she may not want to see a mental health professional, even though you know that this is exactly what is needed.

If your child refuses to go to a mental health professional, consider the following tips:

Explain to your Child what Mental Health is and what Mental Health Professionals Do
As previously mentioned, there are many misconceptions that float around regarding the mental health profession — and even young children could have heard of them through playmates and peers. It’s important then that you explain carefully that mental health is just one aspect of our health. Emphasize that healthy people access mental health services in order to learn new skills, improve relationships, reduce stress and emotional discomfort, feel better physically, and achieve more in school or life. Be specific too – talk about the various tasks that mental health professionals perform such as psycho-educational assessments, mental health assessments, family counseling (to reduce conflict or help cope with stress), remove and/or manage fear, anger or sadness, and much more.

Your child may not recognize or agree that he or she has an issue that requires intervention. As a parent, you are in charge of your child’s well-being. If your child had an infection, you would insist on medical attention. Similarly, if your child needs help for an emotional problem, it is up to you to arrange it. If the child in question is a teenager, you might have to deal with resistance – be prepared. First try to motivate the youngster with reason – explain the possible benefits of assessment and treatment. If the child still refuses to cooperate, let him or her know that, privileges will be removed. For example, “No you don’t have to go to see Dr. Haber, but if you decide not to come, you will  not have the use of my car until you change your mind.” Think of whatever consequences might help motivate your adolescent to cooperate.

Tell children what to expect at their first session. If there will be art or music or toys, let your child know that the session should be very enjoyable, even while the therapist is learning about the child’s issues and learning how to be help. If it will be a talking therapy, tell the child how the therapist might open the conversation, what sort of questions might be asked and how the child might approach the conversation. Tell the child how to handle tricky situations like not wanting to talk or open up too much or feeling not understood or being fearful. In other words, prepare for everything!

Gently but Clearly Explain Why you are Referring Them to a Mental Health Practitioner
Tell your child why you have scheduled a mental health consultation. Explain that the consultation is meant to help the child and is not some sort of negative consequence! Kids who are caught breaking the law, or even family rules, are often scheduled for counseling in order to find out the reason for the misbehavior. Children who do not do well in school are referred to educational psychologists for assessment of learning disorders or other causes. Depressed or anxious teens may be sent to psychiatrists or psychologists for treatment. If you are having relationship difficulties with your youngster, make sure to participate in the counseling process in some way, either having joint sessions with the child or having individuals sessions just like the child is having, or both.

Negotiate Confidentiality Boundaries Beforehand
A tricky issue for children in therapy is confidentiality. It’s common for some kids to have hesitation talking to a mental health professional. For them, counselors are just their parents’ spies — a way parents can gather information about them. It’s important that parents (and maybe the mental health professional him or herself) clarify beforehand that all issues discussed within sessions are confidential, and that only the generic nature of issues discussed would be revealed to parents. Similarly, the mental health practitioner can specify what will remain confidential and what sorts of information cannot remain confidential, giving the child the opportunity to share or withhold information knowing the limits of confidentiality.

Tell your Kids that They can Terminate a Consultation Anytime
It’s important that kids actually enjoy their therapy experiences. Negative therapy experiences may affect them negatively throughout life as they refuse to get much needed help because of traumatic memories of therapy in childhood! Therefore, make sure that your child LIKES going to therapy or change the therapist, or the type of therapy, or even consider stopping therapy for the time being and trying again later. Usually, mental health professionals are good at establishing rapport with their clients and child and adolescent specialists are particularly skilled at making kids feel comfortable. Nonetheless, if your child remains uncomfortable after a couple of meetings, end the therapy. Adults also need to feel comfortable in therapy in order to benefit and they, too, have the right to “shop around” for a compatible therapist or therapy approach. Since there are so many different types of treatments and so many therapists, there; they will do their best to get your child feeling at ease before they start an actual intervention. But many factors can cause your child to be uncomfortable with a mental health professional. It’s helpful then that your child knows that you are at least willing to consider enlisting a different professional, or terminating sessions if there are significant concerns.

Anxious and Stressed Teens

Anxiety is an unsettled, restless, uncomfortable state of mind that can affect people of all ages. Anxious teens may feel worried, stressed or panicky and can experience anxious feelings occasionally or frequently, mildly or intensely. Teenagers who have a lot of anxiety – the kind that interrupts their sleep, interferes with their functioning or causes them intense stress – should be seen by a mental health professional for assessment. Anxious feelings range all the way from normal levels of stress and worry that most people experience, all the way to symptoms of bona fida anxiety disorders – it takes a professional to determine what is going on when anxious feelings are anything more than minor and occasional.

What Triggers Teen Anxiety?
The teenage years are times of high stress, hard decisions and strong emotions. Teen anxiety can be triggered by many events in the teen’s life such as a broken relationship, a parental divorce or academic pressure in school. In addition, teenagers are living in a fast-paced, constantly changing world which creates its own pressure – there is no time to be still and settle in. Social pressures are particularly intense for this age group: kids worry about fitting in, feeling accepted, developing relationships, handling peer pressure and more.

What Parents can Do to Help?
Parents can be part of the problem or part of the solution. For instance, parents can put excessive pressure on teenagers by being too disapproving, too critical or too punitive. On the other hand, they can help relieve stress by being both accepting and gently guiding. They can offer encouragement, praise and validation, keeping the parent-child relationship primarily positive in the ideal 90-10 ratio that is healthiest for this age group (see Raise Your Kids without Raising Your Voice by Sarah Chana Radcliffe for details about building a positive relationship with teenagers). Empathetic listening, ready humor and general acceptance go a long way to helping teens feel confident and emotionally secure.

Moreover, parents can guide teens toward activities that provide stress relief such as sports, drama clubs, volunteer work, and even part-time jobs. Parents can also encourage downtime, family fun (board games, outings, hobbies) and even cooking! A short vacation or even a few hours out of the house for some one-on-one quality time can often work wonders with an adolescent. Parents can even play some relaxing music in the house to help set a calm mood. Of course, reducing family stress (no yelling, fighting, marital battles, etc.) will also help reduce teen anxiety. If parents are experiencing stress of their own, they shouldn’t share it with their teens but rather with other supportive adults.

Warning Signs
There is a difference, however, between normal levels of worry and stress and levels that would be best treated with professional help. If a parent notices the following symptoms of anxiety, he or she should discuss them with a doctor and/or ask for a referral for to a  mental health professional (preferably and adolescent specialist) for assessment:

  • Inability to follow through with usual routines  (like getting to class on time, doing homework, doing one’s household chores, keeping one’s room cleaned, grooming oneself properly and so on)
  • Compulsive thoughts (inability to stop thinking about/worrying out loud about certain topics)
  • inability to make a decision without excessive input from others
  • Peculiar habits (i.e. arranging things, checking things, excessive washing, lengthy praying, repeating words or phrases, needing excessive rituals, refusing to touch certain things, wearing gloves inappropriately, and any other strange behavior
  • Agitated behavior (shaking, inability to settle down, stay still, sleep)
  • Disturbed sleep patterns (insomnia, early waking, nightmares)
  • Strange or excessive fears or worries
  • Refusal to go certain places (like malls or parties) or be with certain people or engage in age-appropriate social activities due to anxious feelings
  • Chronic unhappy or irritable mood
  • Addictive behavior (may stem from anxiety)
  • Self-harm such as cutting oneself, picking at one’s skin (may stem from anxiety)
Anxiety Disorders
There are several different types of anxiety disorders, all of which are thought to have biological roots. GAD (generalized anxiety disorder) is a state of chronic worry about everything and anything. Panic Disorder is a focused type of anxiety that may involve panic attacks with or without fear of leaving home unattended. Simple Phobia can involve any intense fear of any one thing like fear of needles or heights or flying. Social Phobia is a type of anxiety that involves fear of being judged negatively by others. PTSD (post-traumatic stress disorder) is an anxiety disorder that is triggered by experiencing or witnessed a life-threatening event. OCD (obsessive-compulsive disorder) can occur spontaneously or after a strep infection and involves anxious thoughts and compulsive rituals. Often teens with anxiety have other disorders as well – depression, ADHD, eating disorders and addictive disorders among others. Fortunately, all anxiety disorders respond well to treatment. Today there are many treatments besides medication that are quite effective – therapies, stress-management training, meditation-based interventions, alternative treatments and more. The sooner you get help for your anxious teen, the sooner your teen will enjoy peace of mind.