Mainstreaming Vs. Special Education

Mainstreaming refers to the integration of children with special needs in a regular/ traditional classroom environment alongside children their age without disabilities. This is in contrast to giving them specialized/ individualized education separated from peers whether that takes the form of separate classes within the school, hospital separate specialized schools, homeschooling or any other segregated arrangement.

Is Mainstreaming for My Child?
Like any other educational option, mainstreaming has advantages and disadvantages. Advocates point to the unrestricted access to general education that mainstreaming provides. Children with disabilities can avail themselves of the same curriculum offered to other kids their age. Specialized educational opportunities, on the other hand, can be so expensive that they are out of the reach of many parents.

Another benefit of mainstreaming put forth by advocates is that it helps children with disabilities feel part of the whole; it promotes diversity and equality in the classroom. Feelings of normalcy and acceptability are enhanced when a disabled child is welcomed into the community of “normal” children. By contrast, when children with disabilities are given special classes, there’s a risk that they will feel ostracized and isolated.

There are those, however, who feel that mainstreaming does more harm than good. Instead of making children with disabilities feel that they can lead normal lives, mainstreaming may actually make these children feel “different” – self-conscious of their challenges and handicaps. Of course, some children with disabilities mix better than others, depending on their disability. For instance, “invisible disabilities” like learning and perceptual disorders, may be more mainstreaming-friendly than, say, a behavioral condition like Attention Deficit Hyperactivity Disorder (ADHD) or Asperger’s Syndrome.

Furthermore, there is the issue of qualified teachers and disability-compatible teaching tools and methodologies. Not all teachers in traditional schools are sensitive enough, knowledgeable enough or skilled enough to work well with children with disabilities. Specialized instruction in more appropriate settings may sometimes provide superior learning opportunities more targeted to the child’s special needs.

Considering all these factors, it is clear that the decision to mainstream must always be an individual one, based on considerations such as financial resources, the child’s unique personality, the nature of his or her disability, the suitability of the mainstreaming institution and its resources, and the qualifications of available educators. The question is not “is mainstreaming preferable?” but rather, “is mainstreaming preferable for MY child?”

What If I Do Decide to Mainstream My Child?
If you do decide to mainstream your child, it’s important that you constantly monitor your child’s adjustment. Depending on the child, increased socialization with peers without disability can be a good or bad thing. Some may feel challenged – and indeed mainstreamed kids do report being motivated to do better in a mainstreaming school – but others may just feel additional stress. Some may develop lasting friendships, others may get bullied, teased or ostracized.

But there are many things parents can do to prepare their children for mainstreaming. Enhancing their self-esteem and self-worth is a good start. If kids are raised confident of their person, they are less likely to bow down at the face of adversity. Parents must also emphasize that their children have their constant support and love.

On the technical side, parents must exert effort to educate the administrators, instructors and classmates in the mainstreaming school about the child’s disability – unless it is the deliberate choice of the child to keep it hidden, which is their right. If the people around a child with disability are aware of what are the child’s special needs, they would better be able to make reasonable accommodation.

Night Terrors

Does your child wake up screaming during the night? Sometimes nighttime screams are triggered by a nightmare, but sometimes they happen for no apparent reason. If your child is waking in fear or hysteria, always talk to your pediatrician. Allergies, health conditions, trauma and other issues may trigger nightmares. It is also possible that the child is suffering from Night Terror Disorder. We’ll look at this latter condition in more detail in this article.

What is Night Terror Disorder?
Night Terror Disorder may be diagnosed when a youngster awakens from sleep with a loud scream, intense fear, rapid breathing and sweating – without any recollection of a dream. The child will seem confused as to where he is, what time it is and what is happening in the present moment. The child usually has no memory of the frightening dream. He is unresponsive to attempts to comfort him, although he may “return to himself” a few minutes later.

Children experiencing Night Terror Disorder may get out of bed and act as if they are fighting. During an episode of night terror, children are not fully awake and it may not be possible to awake them. The average bout of night terror usually last less than fifteen minutes. People with night terrors usually only have one episode a  week.

Night terrors are much more common during childhood than in adulthood. Night terrors usually begin sometime during the age of 4-12 and most often disappear sometime during adolescence. This disorder is more common in boys than it is in girls and is not associated with any psychological disorders in children.

Treatment of Night Terrors
As long as sleep terror is not interfering with the child’s life then there may be no need for medical treatment – your doctor will advise you. Simply waiting quietly with the child for the terror to pass is usually the best intervention. For instance, a parent can lie down beside the child until the child is calm again and falls back to sleep. Although parents may feel distress seeing their child so distressed, it’s helpful to keep in mind that the child will actually have no recall of the event the next morning! Sometimes just giving the child a few days of extra rest (early bedtimes) and a calming routine is enough to end a cycle of Sleep Terrors. However, if sleep terror disorder persists and is interfering with the child’s life there are some steps that are suggested for parents to take such as: rearranging bedroom furniture to avoid injuries, taking the child for some for of psychotherapy or play therapy and, if so inclined, looking into alternative treatments that may be helpful. For instance, some children have responded well to acupuncture in the treatment of their Night Terrors.

Experiment with Bach Flower Remedies
Bach Flower Therapy is a harmless treatment that might be helpful. For instance, during an episode of Night Terror, spray Rescue Remedy into the child’s mouth or drop liquid Rescue Remedy onto his or wrists – it might help calm the child down. Also, see if giving the child a personal Bach mixture might help reduce the frequency of the episodes – if it has no effect, there is no loss apart from a small cost of the remedies. The remedies Agrimony, Cherry Plum, Impatiens and Rock Rose might be especially helpful.

Medical Treatment
It is possible that certain breathing disorders may contribute to the development of Sleep Disorder and these should be ruled out by a medical practitioner. When such a disorder is present, treating the breathing disorder will relieve the night terrors. In particularly severe cases of Sleep Disorder, medication may be employed. A common medication for example is diazepam – a sleep-inducing medication that can sometimes prevent sleep terror from occurring during sleep.

Loner or Socially Handicapped?

Is there something wrong with a child who doesn’t like to play with friends? Or, is it possible that the child is just a healthy loner? How would a parent know if and when to intervene?

If you are concerned about your child’s lack of social life, consider the following tips:

Content vs. Discontent?
Is your child playing happily on his own? Is he busy with books, toys, computers, and other resources in the home? Is he building, creating, learning, exploring and otherwise enjoying himself? Is he acquiring new skills or engaging in productive activities? If your child is thriving in his independent activities, he may just be an introvert – someone who is energized by his own personal activities and drained by being with people. Or, it might just be that he’s had enough people for the day, having interacted with his peers at school for 8 hours or longer; now he’s ready to spend time with himself. Not a full-fledged introvert, he just has a lower need for social activity. Adults are like this too – many grownups just want to relax at home in the evening after a day of interacting in the world. In short, if your child is happy on his own, don’t worry about his behavior and don’t push him to be with friends.

Fearful or Comfortable?
If your child would like to have friends but doesn’t know how to make meaningful social connections, he might benefit from some help. Try a bit of bibliotherapy – ask the librarian for age-appropriate books on the subject of how to make friends. Talk about the subject directly or do some role-playing in order to practice various skills: making and accepting invitations, being a host, being a guest, keeping friends and so on. Also consider enlisting the help of professionals – there are social skills classes and trainers and also mental health professionals who can help. If your child actually feels fear at the idea of inviting a friend over or fear at the idea of going to a friend’s house, then accessing the help of a mental health professional is definitely recommended: there are techniques and interventions that can help your child overcome social discomfort and anxiety.

All or Nothing?
If your child has even one or two regular pals, there is no need to worry about his social life. Not everyone wants or needs a big social net. Similarly, if your child has close and warm relationships with siblings, cousins, community members or neighbors, there is no need to worry that he doesn’t have more friends. However, if your youngster has absolutely no one to connect to there is more reason for concern. Having someone to interact with and talk to is an important life skill. Again, professionals are available to help your child learn how to create at least a small social circle.

Tourette’s Syndrome

Perhaps you’ve noticed that your child is blinking excessively, clearing his throat or twitching – or all three. You wonder – is he stressed, nervous or troubled? Does he need therapy? Or perhaps you suspect that he’s just developed a bad habit. Maybe you’ve been nagging him to stop doing it – all to no avail. But here’s the more realistic possibility – your child has a tic disorder. A tic disorder is a repetitive sound and/or movement that is performed compulsively without a person’s conscious intention. If a person makes a sound (like throat clearing or coughing), the action is called a tic disorder. Similarly, if a person makes a movement (like shrugging his shoulders or turning his head to the right), it is also called a tic disorder. However, if a person make both repetitive sounds and movements, then it is called Tourette’s Disorder.

What is Tourette’s Syndrome?

Also called GTS (Gilles de la Tourette’s Syndrome, named after the French doctor who first described the condition), Tourette’s Syndrome is a kind of tic disorder. Tics are involuntary, repetitive and usually non-rhythmic movements or vocalizations. Persons with Tourette’s suffer from frequent and unintentional motor actions, such as blinking, nodding, shrugging or head jerking and they are also prone to unintentional productions of sounds such as barking, sniffing, grunting, or the repetition of particular words or phrases (including, in some cases, vulgar expressions – see below).

In some cases, Tourette’s Syndrome causes coprolalia — a compulsion to shout obscenities. There are also occasions when persons with Tourette’s engage in movements that may cause harm to their selves, such as involuntary slapping or punching of one’s own face.

Is Tourette’s Syndrome Common?
Tourette’s Syndrome, and tics in general, are more common than most people realize. It is estimated that 15 to 23 % of children have single or transient tics (tics that last a year or so and then stop), although not all cases progress to Tourette’s Syndrome. According to the National Institute of Neurological Disorders and Stroke, about as many as 200,000 Americans have the severe form of Tourette’s, while as many as 1 in every 100 experience more mild symptoms.

Tourette’s usually begins in childhood, with onset between the ages of 2 to 14 years-old. Episodes of Tourette’s wax and wane, and patients may experience long periods of time when they don’t have active symptoms. In general, symptoms are worse during late adolescence, and then gradually taper off towards adulthood.

Tourette’s is often found along with Attention Deficit Hyperactivity Disorder (ADHD) and/or Obsessive Compulsive Disorder (OCD).

What Causes Tourette’s Syndrome? 
The exact cause of Tourette’s Syndrome is not yet identified, but it’s worth noting that the condition tends to run in families. This implies that Tourette’s may be organic in origin, although environmental causes are not being discounted. The roots are traced to some abnormality in the brain structure as well as the production of brain chemicals that regulate voluntary motor behavior. Tourette’s syndrome also seems to be affected by stress, worsening during periods of stress and improving during vacations and other low stress periods.

What is the Treatment for Tourette’s Syndrome?
As with many conditions, prognosis is best when one employs a multi-disciplinary approach. Because of the link of symptoms with stress, training in stress management, as well as counseling and therapy is a good start for people with the condition. Some people have found alternative treatments helpful as well, such as Bach Flower Therapy, herbal supplements, and nutritional supplements. Any therapy that helps foster relaxation and well-being may be helpful or at least supportive in this condition. Support groups, for those with the condition, as well as their loved ones, are also helpful. When symptoms are severe, or if they cause the individual significant distress, there are psychoactive medications that can help manage Tourette’s symptoms.

For a professional diagnosis and treatment plan, it’s best to consult a neurologist, psychiatrist, and/or a clinical psychologist.

Worries

Worrying is a common human activity which everyone engages in. While children and teens have specific worries at various times – such as worry about school, doctors, robbers, dogs, or friendships – some children tend to worry about almost everything! When worry is frequent or across the board, it can become a serious source of distress in your child’s life. Moreover, your child’s intense worrying can also have an impact on you as you spend endless hours trying to offer reassurance and inspire greater confidence.

If your child worries a lot, consider the following tips:

Worry is a Form of Stress
In its mildest forms, worry is a stress-inducing activity. Worry involves thinking about stressful events like something bad happening, something going wrong or some disaster occuring. Such thoughts send stress chemistry through the body. Some people say they worry in order to prevent something bad from happening. Their logic is that it is not “safe” to be too sure of a positive outcome and believing that things will work out just fine can actually cause them to go awry. Interestingly, no spiritual or religious discipline advocates such an approach; on the contrary – every spiritually oriented philosophy encourages POSITIVE thinking in order to help positive events occur. Nonetheless, many people claim that worrying is somehow helpful to them. Some say that it prepares them in advance for disappointment so that they won’t be crushed if things do turn out badly. Like the superstitious philosophy above, this really makes no sense. Suffering in advance only ADDS a certain number of days or hours of pain to the pain of disappointment of something not turning out well. It would be better to be happy in advance and just feel badly at the time something actually goes wrong. Besides, most of the things that people worry about actually turn out O.K. which means that they have suffered many hours for no reason whatsoever! In short, there is really nothing that we can recommend about the habit of worrying. It is simply a bad habit that wears us down.

Because worrying is a habit, the more one does it, the more one will be doing it in the future. In this way, worrying is just like playing piano – practice and more practice makes it easier and faster to play the (worry) song. The worry habit builds up a strong neural pathway in the brain. However, once a person stops worrying, the neural pathway shrinks from lack of use and more productive thoughts will more easily and rapidly occur. But how can one stop worrying? And how can one help his or her child stop worrying?

How to Stop Your Own Worry Habit

  • As soon as you are aware that you are worrying, start thinking about something else – anything else. For instance, look at what is right in front of you and describe it. This breaks up the worry activity and interrupts the automatic habit, sort of “blowing up” the worry pathways in the brain.
  • Set aside 2 periods each day to specifically worry about a problem that you have. Allow five or ten minutes for each period and worry all you want. If you find yourself worrying at any other time of the day, STOP and remind yourself that it is not your worry period. Be sure to worry during your scheduled times.
  • Learn “mindfulness meditation.” This technique can help you release worries as well gently. (See more information about related techniques below).
  • Take the Bach Flower Remedy (see below) called “White Chestnut” for general worries (especially those that keep you awake at night) and “Red Chestnut” for worries about your close family members like parents, spouse and kids.

How to Help Your Child Stop the Worry Habit
When your child expresses a worry, name his feelings and don’t try to change them. For instance, if your child says, “I’m so afraid I’m going to fail my test.” you can say, “I understand Honey. You’re afraid you won’t pass.” Or, if your child says, “What if no one at the new school likes me?” you could say, “Yes, it’s scary to think that the kids won’t like you.”  The main part of this technique is NOT trying to talk the child out of his or her worry (i.e. “Oh don’t worry about it, you’ll be fine!”). If you refrain from offering reassurance, your child will begin to reassure HIMSELF! It’s not much fun worrying out loud when no one tries to reassure you. This discourages the child from thinking so negatively – or at least, cuts it very short. Also, by naming and accepting the worry WITHOUT trying to change it, your child learns to be less fearful of his or her own feelings. Rumination (worry) is much less likely once the original feeling has been acknowledged. When you are in the habit of acknowledging and accepting the child’s fear or concern, the child learns to accept his or her own feelings as well and this causes them to release quickly.

Help Your Child Access Positive Imagination
Children often have wild imaginations. This imagination is commonly used to conjure up thoughts of bad things happening (i.e. robbers breaking in, a dog attacking him/her, etc…). Teach your child how to imagine good things happening instead. Show him how to imagine guardians, angels, friendly lions or knights etc. Imagination can be a powerful tool. For a young child, make up stories that employ protective images. If you are raising children within a faith-based framework, draw on this resource. Consult the teachings of your faith and pass these on to your child. Research shows that people of all ages who draw on their faith actually do much better emotionally, suffering less worry and stress in the long run.

Techniques to Calm the Mind
Breathwork and other forms of meditation can help retrain and calm a worried mind. Teaching a child to focus on his breath for even three minutes a day is a very powerful way to introduce him to the idea that he has some control over his thought process. By paying attention to the “in” breath and the “out” breath for just a few minutes, the child can have a mini-vacation from worry. He can turn for that vacation as part of his daily routine AND whenever he is feeling stressed from his own worrying process.For instance, instruct your child to think the word “In” when he’s breathing in and to think the word “Out” when he’s breathing out. Focusing on the breath in this way for even three minutes, produces powerful anti-anxiety chemistry in the brain.

Refocus Attention
Worriers focus on the negative – all the things that can go wrong. The worrier eventually builds up a strong negative tendency in the brain, automatically looking for worst case scenarios at every opportunity. To help counter this brain development, teach your youngster  how to notice the good in his or her life. For instance, institute a dinner time or bedtime ritual that acknowledges all the things that are going right in life, all the ways things are good, all the prayers that have been answered, etc.  A few minutes of this practice each day can be enough to stimulate a new direction of neural development in the  brain. Self-help techniques like EFT (emotional freedom technique) can be very helpful for people who worry.

Use Bibliotherapy (read stories)
Ask your local librarian for suggestions for age-appropriate books and movies that highlight children’s abilities to courageously and effectively face challenges and solve problems. Such stories can help reduce a child’s sense of helplessness and vulnerability.

Talk about Resilience
If your child worries about terrorism, war and other threats to personal safety, address the worry directly. Keep in mind that with all the forms of media available today, it has become increasingly hard to shield a child from disturbing news and images. Therefore, trying to protect your child from such things should not be your goal. Instead, focus on giving your child the information he needs to feel reasonably safe and secure and then acknowledge that there is no absolute guarantees that bad things won’t happen. You can convey that people have always been able to “step up to the plate” and handle what comes their way. People can face adversity with courage. If you know some examples in your family life or in your community, share them with your child. You can also look to the larger world and select some heroes who have clearly demonstrated the human capacity to cope with challenge and difficulty. This approach is more helpful and calming than making false promises that nothing will ever go wrong in your child’s life.

Consider Bach Flower Therapy
Bach Flower Therapy is a harmless water-based naturopathic treatment that can ease emotional distress and even prevent it from occurring in the future. For worries, you can give your child the flower remedy called White Chestnut. White Chestnut helps calm a “noisy” brain. If your child experiences specific worries, such as a fear of that someone will get hurt or fear of illness, you can offer the remedy Mimulus. For vague or unclear fears (i.e. scared of the dark) you can use the remedy Aspen. Walnut is used for those who are strongly affected by learning about bad things happening in the media or other places. You can mix remedies together and take them at the same time. To do so, you fill a one-ounce Bach Mixing Bottle with water (a mixing bottle is an empty bottle with a glass dropper, sold in health food stores along with Bach Flower Remedies). Next, add two drops of each remedy that you want to use. Finally, add one teaspoon of brandy. The bottle is now ready to use. Give your child 4 drops of the mixture in any liquid (juice, water, milk, tea, etc.) four times a day (morning, mid-day, afternoon and evening). Remedies can be taken with or without food. Continue this treatment until the fear or worry has dissipated. Start treatment again, if the fear or worry returns. Eventually, the fear or worry should diminish completely.

Worry as an Anxiety Disorder
When a child’s worry does not respond to home treatment or when it is causing significant distress or interfering with the youngster’s functioning at home or school, assessment by a mental health professional is important.  The child may have a mental health disorder that can benefit from treatment. For instance, excessive and chronic worry is a symptom found in Generalized Anxiety Disorder (GAD). In GAD, worry symptoms are often accompanied by a variety of physical symptoms, such as shortness of breath, fatigue, restlessness, and trouble sleeping. In other words, the worry habit can also make child feel physically unwell. A mental health professional can assess and effectively treat excessive worry, helping your child to enjoy a healthier, less stressful life.

Motor Tics (Twitches and Jerks)

Motor tics are repetitive, involuntary movements. They are like an itch that just must be scratched – a person may wait or delay the urge to tic, but in the end, just has to do it. A tic can manifest as eye-blinking, shoulder shrugging, head bobbing, upper body jerks, knee bending and any other repetitive movement. Some include head-banging and picking at one’s skin in this category as well, although these behaviors are technically disorders in their own right.

If the tics last less than a year and cause distress during that time, they may be diagnosed as “transient tic disorder.” If they last more than a year and are never absent for more than three consecutive months, and they cause some distress, they may be diagnosed as “chronic tic disorder.”

If motor tics occur along with vocal tics (grunts, barks, coughs, words, mental words and so on), causing significant distress, then “Tourette’s Syndrome” might be diagnosed. Only a doctor or clinical psychologist can provide an accurate diagnosis. All tics are thought to have a biological basis and some medications can “unmask” (trigger) a latent tic condition. Medications for ADD/ADHD, for instance, have been known to trigger tic disorders in vulnerable individuals. The term “nervous tic” does not pertain to motor tic disorder. One needn’t be nervous at all to have a tic disorder. In fact, tic disorders are thought to be inherited and related to other brain disorders such as obsessive-compulsive disorder (OCD) and ADHD. Indeed, many kids have all three disorders together.

Helping Your Child with Motor Tics
Although “causing distress” is part of the diagnostic criteria of a motor tic disorder, it is a fact that PARENTS might be more distressed by the child’s movements than is the child him or herself. In fact, the  parent may feel anxious or very annoyed by them. There can be a definite urge to scream “STOP DOING THAT!”  However, tic movements are outside both the realm of the parent’s control and the child’s control. This lack of control can  also cause distress to the child. Children may find their movements to be embarrassing in public situations. For this reason, they may strive to hold back an urge to tic while out of the house, only to “let loose” once in the privacy of home, “tic’ing” with a vengeance. It’s like having an itch that you stall until you get home and then you scratch madly to address the build-up of the tension.

Asking the child to refrain from doing his or her tic DOES NOT WORK and may even lead to an  increase in  tic activity because of the stress that the demand induces. When children feel watched or rejected for making movements, they’ll actually make MORE movements!

Although chronic tic disorders are considered to be really chronic –  lasting a lifetime –  many people do experience spontaneous remission. That is, the tics just disappear on their own at some point. Sometimes neurological or psychotropic medications can help and may be an appropriate intervention when motor tics are severe and having a negative impact in the child’s life.  Speak to your doctor about these possibilities. Sometimes behavioral therapies can help (find a psychologist who is experienced in the treatment of tic disorders). Bach Flower Remedies have helped many people with tic disorders (consult a practitioner for an individualized, appropriate formula for your child) and some people have benefited from homeopathic treatment and other alternative treatments. EFT (emotional freedom technique) may help some people with tic disorders. In fact, any form of alternative medicine that reduces physical and mental stress, may have a beneficial effect on the course of a tic disorder – one must experiment in order to find out if a particular treatment will help his or her child. And, as stated previously, some children and teens just “grow out of them” over time.

Vocal Tics (Sounds and Noises)

Some children (and adults) make repetitive sounds that serve no communicative or health purpose. These sounds are called “vocal tics.” A vocal tic can be a cough, much like the cough one has when one has a cold, except that in the case of a tic – there is no cold and consequently no need to clear the passages of mucous! Sometimes the doctor will mistake this kind of cough for post-nasal drip – a small irritant in the throat. However, a true vocal tic is more like a bodily habit without a physical cause; there is no post-nasal drip. In addition, the cough does not stem from “nerves” or nervousness and therefore, it is also inaccurate to call it a “nervous habit.” A vocal tic is a biological disorder that is usually inherited. Calm people can have tics just as easily as anxious people. Nonetheless, stress does tend to aggravate tics, resulting in a temporary increase in symptoms.

Coughs are only one kind of vocal tic. A person can make any sound, including words. There are barks, hisses, grunts, sniffles, clicks and other noises. There are words or phrases that are repeated and in one kind of vocal tic (corprolalia), there are expletives (swear words) or “dirty words” that seem to jump out of nowhere.

If a child has both vocal tics and motor tics (repetitive, non-purposeful movements like jerking, bobbing, twitching and so on), he may have Tourette’s Syndrome. If he has only one kind of tic for less than a year, he may have transient tic disorder. Chronic Tic Disorder is the name given to tics that last longer than one year. Some children with tic disorders also have other disorders such as ADHD, OCD, mood disorders, anxiety disorders and conduct disorders. Many children, however, have simple tic disorders that improve with treatment or even on their own over time.

What Causes Tics?
Brain abnormalities can cause tics. Both structural changes in the brain and biochemical changes have been found in those who have tic disorders. Tic disorders run in family trees. Tic disorders commence before the age of 18. Sometimes they begin after taking a medicine (i.e. Ritalin, antidepressant medication, Cylert and Cocaine can all trigger tics in sensitive individuals). Sometimes tics may begin after a strep infection (in a similar way to PANDAS – the post-viral form of Obsessive-Compulsive Disorder). Sometimes injuries or other health conditions (even a common cold) can trigger the development of a tic. In all cases, the environment is thought to trigger a gene that is present in the child.

Although more tics occur when a child is feeling stressed or anxious, neither stress nor anxiety cause tics. Emotional distress worsens or aggravates a tic disorder temporarily. Stress reduction techniques bring tics back under control. The condition waxes and wanes – sometimes throughout life, but very commonly only until the end of adolescence when the tics may just disappear by themselves.

What Helps Tics?
Some medications can be helpful for tics – speak to your doctor or psychiatrist about this approach. Behavioral therapy can also be very helpful in reducing the tendency to tic. A psychologist can create the proper intervention for this kind of therapy. In addition, some alternative treatments have been found to be helpful in treating tics. For instance, nutritional interventions such as abstaining from coffee, pesticides, certain chemicals and so on, can sometimes help. Bach Flower Therapy (especially the remedy called Agrimony) has been very helpful for some children and teens with tics – consult a Bach Flower Practitioner for best results. Homeopathy and acupuncture might also be helpful. In fact, any intervention that helps reduce stress can help reduce the tendency to tic. Experimenting with several different healing modalities will help parents assess which one or ones have a positive effect on the course of the disorder.

Asking a child to stop making noises is NOT helpful and in fact, may lead to more tic behavior as the request itself induces stress. Tics are not done on purpose and they CANNOT be resisted. A child can delay a tic, but not stop it. Therefore, the youngster needs parental understanding and tolerance. The tic is not the child’s fault; rather, he or she is suffering from a disorder of the brain. Fortunately, tic disorders can be relatively mild, they can remit spontaneously and even when they do persist, they do not tend to interfere with academic performance or other normal functioning.

Extreme Misbehavior – Conduct Disorder

Even before stepping into high school, John had already accumulated a laundry list of offenses. He had been involved in bullying, vandalism, fire setting, stealing, and fighting, among other aggressive or illegal activities. As if these antisocial behaviors weren’t enough, John also had other issues like abusing alcohol and prescription drugs, and threatening his parents with violence.  At 14, he was arrested for assault, and placed in a juvenile correction facility.

John has Conduct Disorder, a mental health condition believed to affect 3-10% of American children and adolescents. Conduct Disorder or CD is characterized by persistent patterns of antisocial behavior, behavior that violates the rights of others and breaks rules and laws. While most kids have natural tendencies towards episodes of lying, belligerence and aggression, children and teenagers with Conduct Disorder exhibit chronic and inflexible patterns of gross misbehavior and violence. Conduct Disorder is a serious disorder of behavior and not simply an overdose of the sort of ordinary mischief or misbehavior that all children get into. It is characterized by repetitive, consistent antisocial behavior that is not responsive to normal parenting interventions.

Conduct Disorder manifests in aggression to people and animals, destruction of property, deceitfulness or theft, and serious violations of rule such as running away, using dangerous weapons, skipping school and classes, ignoring curfews and so on. Symptoms cause severe impairment in the child’s personal, academic or social life. Conduct Disorder occurs more often among males than among females and usually coexists with other mental health conditions such as substance abuse, Attention Deficit Hyperactivity Disorder or ADHD, learning disorders, and depression.

What it’s Like for Parents
Conduct Disorder poses one of the greatest sources of grief and stress among parents. Symptoms can start out looking relatively normal, involving “misbehavior” such as chronic arguments with parents, disobedience and even hyperactivity. But as time goes by the gravity of the symptoms tend to escalate, alongside with their frequency. Temper tantrums can become actual episodes of violence and assault; lying to parents can become stealing from friends and classmates; and lack of respect for privacy at home can become breaking and entering somebody else’s home. Conduct Disorders can lead to cases of rape and sexual abuse, even homicide. If left untreated, Conduct Disorders can evolve into the adult disorder known as Antisocial Personality Disorder.

Receiving calls from teachers, principals and even the local police station, are common occurrences for parents of conduct disordered children and teens. Usually, there are many fruitless attempts to discipline or moderate a child’s behavior. Even counseling is insufficient because the biological nature of the disorder necessitates medical treatment as well. Because kids and teens with Conduct Disorder  suffer from a lack of empathy and emotional responsiveness, parents rarely get through to their child on their own.

What can Parents Do?
The good news is that there is hope for treating Conduct Disorders, and many programs have been found effective in both managing symptoms and restoring functionality. However, treatment is usually slow and complex. Indeed, Conduct Disorder is one of the most difficult behavioral disorders to treat. Recovery generally requires time and a combination of many different treatment approaches including different types of therapy, education, behavioral interventions and medications.

What can Help?
Early intervention helps increase the likelihood of successful treatment, which is why parents should act promptly when they notice antisocial behavior in their children. CD often begins as ODD or Oppositional Defiant Disorder, a condition characterized by lack of respect for authority. Lack of empathy is also a risk factor, alongside a family history of antisocial and/or criminal behavior.

As part of a comprehensive treatment program, traditional counseling and therapy interventions can go a long way, particularly those that aims to teach positive social skills such as communication, empathy and conflict management. Emotional management techniques, such as anger management interventions can also help. Sensitivity training, especially those at residential camps where kids and teens can interact with peers (and sometimes animals like horses), have also been known to be effective.

Parents are also encouraged to join family therapy sessions and Parent Management Training or PMT. Family therapy can surface systemic factors that cause and reinforce antisocial behavior in children. Family therapy can also help parents establish more effective forms of guidance and discipline, and teach parents how to respond to disruptive and defiant behaviors.

Because of the biological factor in Conduct Disorders, getting pharmacological help is important as well. A psychiatrist can help plan the appropriate drug therapy for a child or teenager with Conduct Disorder. In addition, a psychiatrist can help manage the child’s overall program of therapy and specific interventions. Sometimes the best source of help for children with Conduct Disorder is a specialized children’s mental health treatment center where many different types of professionals offer services under one roof and the child’s program can be coordinated through one department. Ask your doctor for a referral to such a center for diagnosis and treatment of your child.

Mental Retardation

Mental Retardation is a condition that is identified by a child’s doctors. It is a disorder that not only affects intellectual functioning, rx but also affects behavior, vcialis 40mg social behavior and emotional states. Mental Retardation is diagnosed when a child’s intelligence test scores fall below 70 AND  the child requires assistance in the tasks of daily living. Children with mental retardation often have difficulty in the following areas; thinking logically, viagra 100mg remembering things, speaking, understanding social behaviours, connecting cause and effect, and solving problems. Some types of mental retardation are associated with behavioral problems such as aggression, impulsivity, self-injury, stubbornness, passivity, hyperactivity, attention problems, depression or psychotic disorders.

Children with Mild Mental Retardation (I.Q. in the 50-70 range) can usually attain a sixth grade level education and learn to work and live within the community with some level of support. Mild Retardation characterizes 85% of all cases of mental retardation. Another 10% of mentally retarded people have Moderate Mental Retardation. Those with Moderate Mental Retardation (IQ in the 30-50 range) can usually learn enough social and language skills to be able to work in sheltered workshops as adults. Those with this level of retardation do not generally live independently. Children with Severe Mental Retardation (IQ in the 20-high 30 range), constituting about 5% of the of the Mentally Retarded population,, may learn some communication skills and may be able to work with supervision, while those with Profound Mental Retardation (IQ less than 25), constituting 1-2% of all those with Mental Retardation, will require lifelong care.

The three most common inborn causes for mental retardation are: Fragile X syndrome, fetal alcohol syndrome and Down syndrome. Brain damage, chemical effects, metabolic issues, chromosomal abnormalities, disease, birth trauma, and malnutrition are also causes of mental retardation before birth. Mental Retardation acquired after birth can be caused by infections, lead poisoning, brain trauma, and environmental deprivation at critical periods.

Treatment of Mental Retardation
As of now there is no cure to this disability. However, there are many things that can be done to optimize the development of children with mental retardation. Medical treatments improve the mental and physical conditions that often accompany this diagnosis. Psychological and behavioral treatments can help as well.  Every day, new teaching tools are being developed that can help stimulate learning and communication skills. Accessing support resources in the community can help the family and child function optimally. There are many non-profit or for-profit schools in North America as well as government-run establishments that cater especially to children and adults with mental retardation

ADD/ADHD – Attention Deficit Disorder

You’ve always considered your son to be an active child; even as a toddler he was always on the go. He gets bored quickly if there isn’t structure or if he doesn’t like the activity (like homework!) and he prefers to do several things at once. He often interrupts people when they speak, but you’re confident that he can outgrow the behavior. However, his inability to sit still during dinnertime is increasingly annoying and of even more concern is the trouble he’s been getting into in school for calling out answers and leaving his seat without permission. You’re wondering – could he have ADHD (attention deficit hyperactivity disorder)?

Most children are first considered for formal assessment when their school performance is suffering. However, ADD/ADHD can occur in children of every intellectual level (from intellectually challenged all the way to intellectually gifted). The brighter the child, the longer it may take for teachers and parents to become concerned, since the child’s academic performance may not be as quickly or as severely affected by his disorder. Nonetheless, a child who has to work extra hard in order to counteract the effects of ADD/ADHD is usually feeling stressed, exhausted and irritable. These behavioral symptoms should be taken seriously – not just the child’s grades. In fact, no matter what the child’s grades are like, behavioral disturbances at home should also be taken seriously. Sometimes these are a result of parenting style, but sometimes they are caused by conditions inside the child. A proper assessment may lead to a diagnosis of ADD/ADHD or some other developmental condition or simply stress that the child has not been able to express to his parents. Parents should also seek assessment when their child seems to have trouble following instructions, remembering to do what he is told, taking turns, waiting patiently, organizing his schedule and belongings or sitting for age appropriate lengths of time. Don’t assume that a child doesn’t have ADD/ADHD just because he can spend hours sitting quietly in front of the T.V. or computer screen. The disorder only interferes with “boring” activities, not activities that stimulate the child. That is because ADD/ADHD is a brain condition that is essentially understimulated. In fact, medicinal treatment consists of stimulant drugs. Although normal people can tolerate boredom fairly well, those with ADD/ADHD have zero tolerance for boredom because their brains are stimulant hungry – boredom is actually painful for them. This is also why kids with ADD/ADHD tend to get into trouble when left in unstructured situations. They will create activity by getting into mischief. Highly structured programs help prevent this problem.

What is Attention Deficit Disorder?
Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder or ADHD, are behavioral conditions characterized by an inability to maintain focus for a long time and/ or an inability to keep still. These difficulties in managing attention and activity are more than what is expected developmentally from kids of the same age. The symptoms tend to also persist across all situations, thus a child with ADD or ADHD tends to be inattentive or disruptive, not just at school but at home as well.

ADHD affects somewhere between 5 and 10% of schoolchildren, depending on measurements utilized. Symptoms of ADD or ADHD are never the same with any two people. People with attention deficit disorder may not be able to sit still, plan ahead, finish things, or pay attention to what’s going on around them. Symptoms for ADD may include: having difficulty remaining in one place, difficulty waiting one’s turn in groups, blurting out answers before the question is complete, poor organizational skills, losing things, shifting from one uncompleted task to another, talking excessively, not listening to what is being said, being easily distracted, entering situations without thinking, having difficulty following instructions, fidgeting with hands and feet, squirming while seated, interrupting people often and forgetting things that are necessary for a task or activity.

Kids with ADD/ADHD may also have additional symptoms such as problems with anger, poor social skills, poor fine or gross motor skills, anxiety, sleep disturbances and mood issues. Sometimes ADD/ADHD occurs alongside other disorders such as Tic Disorders, Obsessive-Compulsive Disorder, depression and social phobia. Attention Deficit Disorder has an early onset, and usually manifests itself before a child turns 7 years old.

Symptoms for attention deficit disorder are broken down into three groups: Type 1: Inattentive. This group of ADD sufferer have symptoms of attention deficit – i.e. being easily distracted, daydreaming, losing focus. Type 2:  Hyperactive/Impulsive. This group of people with ADHD show symptoms of overactivity (fidgeting, running or pacing where inappropriate, always “on the go”) and impulsivity (acting without thought, interrupting others, calling out). Type 3 is Mixed Inattentive and Hyperactive/Impulsive, where the person has a mixture of symptoms across both categories – that is, a mix of ADD and ADHD symptoms. Diagnosis is generally not made until the person concerned has eight or more of the above symptoms, and the symptoms have remained the same for at least six months.

Below is a summary of the common symptoms of ADD:

  • Short attention span, mind tends to wander
  • Frequent  forgetfulness
  • High rate of unfinished projects
  • Gets painfully bored when task isn’t interesting or when there is a lack of structure
  • Makes careless errors in schoolwork
  • Is easily distracted
  • Doesn’t follow through on chores or instructions, appears not to listen
  • Disorganized; loses and misplaces things frequently
  • Difficulty in concentrating on tasks, a high rate of unfinished projects
  • Excessive activeness or excessively high energy levels

Common symptoms of ADHD include:

  • Constantly being on-the-go
  • Frequent fidgeting and running about
  • Impulsive behavior like blurting out answers in class
  • Trouble waiting in-line or other slow-moving situations
  • Talks excessively and interrupts others

There are no laboratory tests that can measure ADHD; as a behavioral condition, psychologists and medical practitioners rely mainly on observation, interview and teacher reports to get a clear picture of the patient’s state. Diagnosis can be made by a paediatric specialist (a medical doctor who specializes in the diagnosis and treatment of ADD/ADHD or by a psychologist whose speciality is assessment and diagnosis). Sometimes the family doctor can make a diagnosis as well. Teachers cannot diagnose ADD/ADHD although they may suspect its presence and they are also a vital source of information for those who provide the assessment. Teachers can often refer parents to those who can diagnose. Finally, friends and relatives CANNOT diagnose ADD/ADHD – specialized tests and measurements are required in order to make a diagnosis in addition to behavioural data collected from parents, teachers and others.

What Causes ADHD?
The exact origins of ADHD are still under debate, and many controversies surround the different theories being pushed forward by various research groups and experts. The most accepted explanation so far is that ADHD is a neurological condition related to both the lack of specific chemicals in the brain, and brain structural issues that inhibit attention and self-control. This biological basis is most favored, as ADHD appears to be a genetic condition that begins as early as infancy. However, many researchers also believe that diet, lifestyle and environmental conditions have a lot to do with the symptoms of ADHD. They argue that ADHD is a fairly recent phenomenon, and the condition was rarely reported 50 years ago. ADHD is also rare in poor and developing countries, suggesting that there is something in the way we approach life today that promotes symptoms of inattention and inactivity. In particular, some scientists blame the high sugar content of the modern diet, as well as the rampant used of preservatives and artificial ingredients for ADHD. Excessive use of  technology, such as the television, computer and gaming consoles have also been considered as culprits. Additionally, poisonous chemicals in the air, water and food products are also believed to cause neurological impairment.

How is ADHD Treated?
Once a diagnosis is obtained, parents have a variety of treatment options that they can consider. Both behavioral and biological interventions are usually recommended.

Psychostimulants such as Ritalin have been found to be effective in increasing an ADHD child’s attention span and improving performance at school. Some parents prefer to try alternative treatments such as homeopathy, herbal medicine and nutritional supplements. Some parents will try the natural approach for some months and, if results are not satisfactory, then try psychotropic medication.

Cognitive-Behavioral techniques are used to help manage inattention and impulse control. Children and adult ADHD sufferers can be taught specific techniques to help reduce symptoms and enhance functioning.

When making a decision as to which form of treatment to employ, consultation with the following people is recommended: a behavioural optometrist for a developmental vision evaluation, an allergist regarding possible allergic reactions, a child psychologist who can devise a behaviour modification program, a medical doctor who can assess the need for and prescribe medication and an occupational speech therapist with expertise regarding sensory processing problems. Other professionals to consider are special education tutors who can provide specialized supplementary education when necessary and naturopaths who are experienced in the alternative treatment of this syndrome. Although the treatment team seems large, it is also comprehensive, helping to create the most thorough and effective intervention for those children who have ADD/ADHD.

Bringing Out the Best in the ADD/ADHD Child
Raising a child with ADD/ADHD requires superb parenting skills. Being “Average-Joe-Parent” just won’t do with this population. For a set of easy-to-acquire top parenting skills, see Raise Your Kids without Raising Your Voice by Sarah Chana Radcliffe. While your doctor and other members of the professional team are addressing your child’s symptoms, you as a parent can keep the following points in mind:

  • The ADD/ADHD child is not purposely disobedient or unruly. He is dealing with inner compulsions and forces; he would like it if he could be easier going, more flexible, happier and relaxed, but he just can’t get there.  He needs your love, support, patience and understanding.
  • Keep expressions of anger to an absolute minimum with this population. They lack the ego-strength (self-confidence) to handle anger and often react with depression, withdrawal, aggressiveness, acting out and other forms of intense emotional turmoil and dysfunction. Learn how to discipline without using anger at all.
  • Your child might benefit from reading self-help books on ADD/ADHD – there are now many available, written for children and teenagers.
  • Consider experimenting with Bach Flower Therapy as a treatment for ADD/ADHD. Bach Therapy has no side-effects of any kind, yet can often effectively reduce many of the symptoms of ADD/ADHD such as impulsivity, immaturity, hostility, depression, anxiety, restlessness, lack of concentration/attention and more. (You can find more information on the Bach Flower Remedies online and throughout this site.) Your naturopath may also recommend other alternative and dietary interventions.
  • Consider enrolling your child in social skills or anger management programs providing sheltered group activities or individual activities that will build personal confidence and self-esteem such as karate lessons, drum lessons, art lessons, cooking classes etc. These needn’t be formal classes – if you can provide extracurricular activities yourself at home (like teaching your child to cook or sew) – that’s great! ADD/ADHD children often grow up to be adults with exceptional creativity and unique gifts. As long as their self-esteem remains intact and they develop ways of working around their deficits, they are capable of being highly successful professionally and personally.