Why is it tough to be the new student in school? (top five psychological factors)?…

1. Fear of unknown, we all know from own experience when we have minimal information about the situation it can be anxiety provoking and especially if someone have poor coping skills to deal with the situation. 
2. Children might feel rushed and pressured by the parents for preparation for school year. Parents due to shortage of time might try to do things quickly while children take their time and cannot get ready or think fast or organize them, can create anxiety. 
3. Student might have some bad experience in the past that can trigger anxiety or restless feeling.  If they have, unpleasant experience of being bullied or mal treated at nursery or previous school can trigger fear of same treatment. 
4. Parents may be too busy to prepare the children or not prepare at all. Parents may not be able to understand starting new school or going back to school after few months spending unstructured time and then getting back to routine and face the new challenges in terms of homework attending classes being with same age children is stressful. 
5. Transition from fun activities of vacation time to responsibilities of school and expectations of homework and regularities of daily habits. During vacation time usually family have late sleeping time and fun activities like site seeing,  travelling, visiting family friends is very relaxed time which will be different then starting school and going back to school day routines. 

   How can you cope with them? What advise can we give new students to cope and fit in?

    

1. After a slow summer vacation time, school activities will be a change to busier schedule. So During the latter part of summer and before school opening if parents can help children to start preparing for school like collecting school supplies what is needed and also talking and may be role playing ( for younger children) about the school daily activities. Talking with them how they feel about going back to school? What re their questions or concerns once school is open? Listen carefully and try to answer as much as you can. Be supportive and help them relax don not put pressure or show you are anxious because of them going to school.
2. If there are past experiences which is not good, talk to them and listen to them and try to address, ( Do not hesitate even if you need professional help)
3. Improve communication with children. Teach them this is ok to talk about their difficulties and you are ready to listen and will not be judgmental.
4. Follow the queues if they hint toward something, which is bothering them try to listen and talk about it, and answer honestly to the best of your knowledge if you do not know tell them you do not know.

Some of the students we spoke to said the pressures they faced include other students already being part of their own group. So it was difficult to be an outsider, which caused them to be self conscious.  Some said they were teased for being new students.

As the Child grows there is need to successfully complete each (age specific) developmental task (Social, Educational, ETC) from infancy to Childhood, to latency, to preadolescent, to Adolescent and early Adulthood and so on so forth. ADHD can be a big obstacle in the way of achieving this success.

ADHD Symptoms usually appear between 3 year old to 6 year old and can continue later if not treated. (More common in Boys than girls)

Inattention part of ADHD can compromise the learning process, maintaining good school grades, following directions, hence leading to frequent negative feedback from the parents, teachers, and in other social settings.

Hyperactivity part of ADHD can lead to moving too much, not able to sit where it is required, jumping from place to place, may have minor frequent injuries or falls, resulting negative feedback can lead to many psychological issues, ranging from low self esteem, lack of confidence, poor school performance, and anxiety and depression. (Symptoms’ of Children having ADHD may varies)

Impulsive part of ADHD can lead to impulsively acting out with out prior thinking, making mistakes and get embraced, or suffer injuries.

Good news is it is treatable and in good hands it has very positive treatment outcome.

Facts about ADHD

Approximately 3-7% of school-aged children have the disorder. Prevalence rates seem to vary by community, with some research indicating that larger cities may have rates as high as 10-15%.

General Symptoms

Failure to pay attention or  failure to retain learned information

Fidgeting or restless behavior

Excessive activity or talking

The appearance of being physically driven or compelled to constantly move

Inability to sit quietly, even when motivated to do so

(Seems like driven by a motor)

Engaging in activity without thinking before hand

Constantly interrupting others or changing the subject

Poor peers relationship

Difficulty sustaining focused attention

Distractibility, Forgetfulness or absentmindedness

Continual impatience

Low frustration tolerance

When focused attention is required, it is experienced as unpleasant

Frequent shifts from one activity to another

Careless or messy approach to assignments or tasks

Failure to complete activities

Difficulty organizing or prioritizing activities or possessions

Inattention during infancy can include

Symptoms of Inattention

Difficult to soothe

Less babbling speech the first year

Poor sucking or crying during feeding

Smiles less often

May not enjoy soft touch

Symptoms of Hyperactivity during
infancy can include

An aversion to being cuddled or held

Strained/negative mother /child relationship

More frequent crying

Symptoms of Impulsivity during infancy can include

Frequent crying and colic (painful bowel problems)

Frequent infections, more allergies, etc

Inattention during Pre school years can include

¨     Strong will; unresponsive to discipline

¨     Some language difficulties

¨     Difficulties with structured play

¨     Toilet training problems

Symptoms of Hyperactivity during
Pre school years can include

¨     Higher activity levels than peers

¨     Problems noticeable in structured play

¨     Aggressive behavior

¨     Difficulty going to sleep

¨     Motor restlessness during sleep

¨     Strong will, “difficult to manage”

¨     Causing family disorganization and parents feeling overwhelmed

Symptoms of Impulsivity during Pre school years can include

¨      Extreme excitability

¨      Gross/fine motor difficulties (awkward, clumsy)

¨      Fearlessness, may endanger self or others

¨      Low frustration tolerance

¨      Peer problems begin

Inattention during elementary school years can include

¨     Failing to pay close attention to details or making careless mistakes while doing schoolwork or other activities

¨     Trouble keeping attention focused during play or tasks

¨     Appearing not to listen when spoken to

¨     Failing to follow instructions or finish tasks

¨     Avoiding tasks that require a high amount of mental effort and organization, such as school projects

¨     Frequently losing items required to facilitate tasks or activities, such as school supplies

¨     Excessive distractibility

¨     Forgetfulness

¨     Procrastination, inability to begin an activity

¨     Associated problems such as low self-esteem, depression, or anxiety

Symptoms of Hyperactivity during
elementary school years can include

¨     Diminished need for sleep

¨     Fidgeting with hands or feet, or squirming in seat

¨     Leaving seat often, even when inappropriate

¨     Running or climbing at inappropriate times

¨     Difficulty with quiet play

¨     Frequent feelings of restlessness

¨     Excessive speech

Symptoms of Impulsivity during elementary school years can include

¨     Social immaturity

¨     Frequent arguments with parents and peers

¨     Disregards socially-accepted behavioral expectations

¨     Requires more supervision than average

¨     Inconsistent with responsibilities and chores

¨     Continually striving to be the center of attention

¨     Answering a question before the speaker has finished

¨     Failing to await one’s turn

¨     Interrupting the activities of others at inappropriate times

¨     Poor peer relationships

Inattention during adolescence can include

¨     Frequently shifting from one uncompleted task to another

¨     Difficulty organizing activities

¨     Serious academic inconsistencies

¨     Ongoing underachievement

¨     Difficulties with household activities (cleaning, paying bills, etc.)

¨     Often viewed as lazy or disinterested

¨     Associated mood or behavior problems become more pronounced

Symptoms of Hyperactivity during
adolescence can include

¨     Increased hyperactivity

¨     Pronounced feelings of restlessness

¨     Low self-esteem

¨     Intense need to stay busy and/or to do several things at once.

¨     Discipline problems

¨     High-risk behavior

Symptoms of Impulsivity during Adolescence can include

Continued poor peers relationships

¨     Low self-esteem

¨     Discipline problems

¨     Continued frequent arguments

¨     Drug and alcohol abuse

¨     Risk-taking behavior

¨     Impulsive spending, leading to financial difficulties

Treatment options:

Currently available treatments focus on reducing the symptoms of ADHD and improving functioning. Treatments include medication, various types of psychotherapy, education or training, or a combination of treatments

Psychotherapy:

Behavioral therapy aims to help a child change his or her behavior in positive direction.

It involves practical assistance, such as help organizing tasks or completing schoolwork, or working through emotionally difficult events.

It teaches a child how to monitor his or her own behavior.

Praising or rewarding for acting in a desired way, such as controlling anger or thinking before acting.

Parents and teachers also can give positive or negative feedback depending upon the behavior.

In addition, clear rules, chore lists, and other structured routines can help a child control his or her behavior.

Teaching children social skills, such as how to wait their turn, share toys, ask for help, or respond to teasing.

Learning to read facial expressions and the tone of voice of others, hence modify ones’ behavior.

Learning how to respond? Appropriate to certain situation.

Children with ADHD need guidance and understanding from their parents and teachers to reach their full potential in their life.

Medication:

Medication treatment if needed is safe and can be discussed with Child Psychiatrist.

Discuss the risk/benefits of taking the medications.

Know about the side effects and pre requisite to start the medications. (like ECG, Labs etc)

Usually medications used called (stimulant medications) Like, Ritalin, Concerta, Adderal, vyvance,Methylephenidate, Pristique  and Focalin to name a few.

In group of ADHD Children who can not tolerate (stimulant medications) can benefit from medications (non stimulant), Like Tenex, Strettera, Wellbutrin and Clonidine ETC.

Research Shows Combination treatment (psychotherapy and medications) is superior to individual treatment approach.

Medications does not cure ADHD but it treat the symptoms.

Reference

1. DSM-IV-TR workgroup. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision.Washington,DC: American Psychiatric Association.
2. Mick E, Biederman J, Faraone SV, Sayer J, Kleinman S. Case-control study of attention-deficit hyperactivity disorder and maternal smoking, alcohol use, and drug use during pregnancy. Journal of the American Academy of Child and Adolescent Psychiatry, 2002 Apr; 41(4):378-385.
3. Khan SA, Faraone SV. The genetics of attention-deficit/hyperactivity disorder: A literature review of 2005. Current Psychiatry Reports, 2006 Oct; 8:393-397.
4.      www.nimh.nih.gov.

If the child appears to have inattentive/hyperactive symptoms, it could be due to ADHD.

2- Disorganization/forgetting and losing things can be part of ADHD.

3- Kids having ADHD symptoms, show some deficits in social skills due to the fact that they miss out the information and quos given by others and can “miss the boat” while other kids without ADHD get that quickly, hence influence their interaction. By correcting these Symptoms and social skills training, this problem can be helped.

4-Learning can be affected by co morbid condition like learning issues plus inattention symptoms. On the other hand inattention can be worsened by learning issues so both can impact each other.

5- Self esteem issues can arise due to the fact that child feels insufficient or incapable of keeping up with academic and social areas and may lead to depressive feelings and prefer to be alone and solo player.

6- In some kids due to these problems behavior issues arise especially oppositional behavior.

Treatment strategies:

Of course first try the behavior modification plan but using medication can be helpful, if needed. It needs further discussion and labs test and EKG if plan is to start the medications.

Behavior modification Plans:

A- Improving the communication by:

a- Ask the child to stop what he/she is doing, and

b- Make eye contact.

c- Then tell him/ her instructions.

d- Ask him/her to repeat what is being said.

e- If he/she follows through the command, give him/her reasonable proportional reward immediately upon completion of the task.

B- Improving the behavior by:

a- Set a goal and educate fully what will be the reward upon successful completion of task and should be given the reward immediately as agreed.

b- Suggestion for rewards can be few. For example short term reward to be given immediately. Long term reward like earning over period of time, You can design plan like, If she/he does homework on time for 3 days everyday she will collect a star and 3 stars value of something which he/she likes and is reasonable ( Avoid Candy, Junk food, and aggressive video games etc as rewards).

C- Improving self esteem and learning by:

a- Praise him/her for any good behavior, (no false praises).

b- Minor achievements should be highlighted and encourage him/her to do more like that.

c- Let him/her have friends who are more friendly and tolerant then who are not.

d- Limit the use of screen electronic gadgets like computer, video games and etc.

e- Have him/her read short stories in free time and then asks her to tell the story followed by positive encouragement and rewards.

f- Short assignments followed upon by the retrieval of information and positive encouragement after successful task.

Above strategies are usually help full with or without medication depending upon the severity of illness.

To make an appointment please contact me

Respecting Privacy is one of the most important aspects to gain trust of your child, but at the same time you don’t want your child to take major risks due to ignorance.

Although Parents have seen the child growing and have changed and clothed him/her. Child starts getting annoyed If you become intrusive. Child needs privacy and to master it.

Privacy Signal given by Children:

Asking verbally for private space.  When the child starts saying they need privacy. You being parent have no right to stay close or in the shower with child if he/she is yelling “go out”. Give them space and never reason that you are his/her parent. Give them time alone if they are requesting, such requests should be taken very seriously.

Asking for own room:

When Child requests his/her own room. This is the time when it should be given if possible. Now they start realizing the need for separate space for changing and hiding underwear.

When they start asking to knock before you enter. Respect their request and never spy on them.

Children deserve the increased privacy as they grow to the adolescent years.

Following are helpful hints about the Privacy and how to handle it.

Accepting new role:

Grade school children might start hiding while changing and this may appear as a new behavior. While before they would care less. These changes are due to physical and mental changes.  Don’t get annoyed if child shut the door.  And never tease saying that “ I have seen you before”.

Don’t Grant total Privacy:

While in the public bathroom child should be supervised. Child should be educated that you may be examined by the pedriatition. Random asking about privacy rules and occasionally Doctor or the parents have to look at their body.  Sometime child themselves ask you to be there while they are using the bathroom, as a parent you should be available like staying close and may be reading paper or doing some other activity nearby.

Teaching the skill of changing:

Teach the child how to change in Public bathrooms (changing while towel is warped around the waist), Never go to the Public bathroom alone. Help them understand the safe and unsafe places to change and be there.

Expect Inconsistency and that should be respected:

Sometime children will ask to be with them while they are using restroom at other times they don’t like. Respect their wish and be available if they say so. Extreme behavior should be interpreted with caution.

Change in Behavior:

Some time children starts behaving differently and become too embarrassed or exposing themselves too much, Both situation should be taken cautiously. There might be something to look for, but never the less behavior can be due to being with very modest friend or otherwise. Don’t jump to conclusions and don’t respond prematurely by saying something must had happened.

Teaching good Habit:

This is also time to teach children healthy hygienic habits, Cleaning the private parts, and practice good behavior. Educating them about the body changes and changes in feelings with opposite sex preferences and how to handle those feelings. Answer there question and never say no.  If you don’t answer somebody else will and you don’t know how that person will respond. Establish trust with your child and use it to guide and educate the child.

Practice good habits of covering up:

If you walk in home semi naked children will feel embarrassed initially and later they might get used to it and start copying the behavior. Usually 7-9 year old children either hide if you are wearing improperly or they may giggle while seeing you.

It is good practice to knock before you enter the Child’s room and respect their privacy.

Bath robe is helpful to help them feel secure because at times towel might fall off while they are coming out of the shower/bathroom.

If Child is waiting outside the bathroom for you, always come out while Towel or robe is covering you.

Always lock the bather room and shower door and set rules for privacy.

Don’t do’s

Never Post anything on your children’s Face book or any other media account wall.

Don’t be friend with your child on social Media.

Don’t friend with your child’s friend even if you know them before on social media.

Never ever look at their shoulder while they are texting.

Same sex parent should educate about the sexual issues.

Never spy and make judgments about your own suspicions about the child.

The survey in Sharjah asked 193 Emirati pupils aged 11 and 12 what they thought was their exposure to various types of abuse.

The most significant finding was that more than 40 per cent said that they felt neglected, said the researcher Ahmad Alomosh, professor of applied sociology at the University of Sharjah.

But Dr Muhammad Tahir, the head of psychiatry at Health Call Clinic in Dubai, said it was important to remember that the survey gathered children’s impressions.

To read this complete article, follow this link:

http://www.thenational.ae/news/uae-news/emirati-children-say-they-feel-neglected

Child Mental Health Perspective

Children are assets for any society. Society has bilateral/two way role in providing for the children and in turn children give back as productive members of the society. Impact of the society on growing children is enormous and helps shape the future of the individual.

The journey starting at birth has many dimensions and children are influenced by everything they come across and mix it with qualities (gene and environment) they are born with. Studies have shown that environment plays a big role in expressions or suppressions of the innate genetic qualities of an individual.

Initial few years of life are marked with accelerated growth of body and brain and are crucial for the normal development.

Children are born with a brain like an empty disc, waiting for the programs to be written, future progress and quality of life depends immensely upon the quality of programs (teaching and training) and the timing. However these programs are influenced by genetic loading of the child (if there are mental health issues or not), economic status, parenting skills of the parents/caretaker, neibougher hood, school system, religious believes, social/cultural values, and other variables to name few.

Among Negative attributes are the mental health issues, poor physical health, poor parenting, inadequate schooling, and rough social environment, unstable socioeconomic status of the family, poor services, and many more.

Still among those some variables are hard to modify while others are modifiable to an extent with an effort and hard work in the right direction.

Early detection and intervention is a key to positive change in the individual’s life. In this current fast pace world, focused and pertinent identification of the problem and remedial intervention are of prime importance for lasting success.

In this regard there are some universal problems, like( known mental illnesses, social and occupation issues due to new developments when not used rightfully, Like imitating and copying the culture which is totally opposite to individuals own values resulting huge conflict among different age group family members, like use of computer excessively and inappropriately “computer addiction have been noted and resulting in declining performance of the individuals”,  etc) still other problems which are culture specific.

Utmost important is the need to deal with these issues within the frame work of acceptable cultural and religious beliefs.

In order to achieve success, it is of immense value to know the problem in depth and modifiable causative factors, and knowledge to deal with these problems (treatment). There need to be short term objectives and long term goals going side by side to help make difference in this area.

Short Term objective:

Organize and prepare the team of mental health professionals to render support and services using the available tools and manpower toward the identifiable mental illness among school going children.

Few suggestions,

1) Parent education and discussions groups for the high risk group of children as pointed out by the parents, teachers and primary care physicians.

2) “Teacher education” about the common mental illness and how to identify and when to refer for more thorough evaluation.

3) Scheduled mental health screening events in the school with prior parent’s informed consent. (Parents trust and confidence is very important in this regard for full cooperation)

4) Appropriate referral and further evaluation/treatment of high risk individuals.

5) Arrangement for mental health school nurse who can render services to children in need including but not limited to dispensing medications if needed.

6) Self help support groups at school and community level to help deal with identifiable mental illness and overcome stigma associated.

Long term Goals:

Goals can be achieved by the recruitment of mental health professional/educational experts having them credentialed appropriately and training them to do the following task.

A)    Achieve better results by initial training workshops for the teachers to indentify the common mental illness there presentation and the way to handle these problems in school setting.

B)    Annual mental health Screening surveys to indentify children who need full psychiatric evaluation and appropriate referral to the mental healthcare professional

C)    Coordination and collaboration of reports and record from the psychiatric provider to parents and additional services recommendations’ if needed to the school.

D)   Idea of having resource rooms for the children having minor issues and need some support to finish their assignment within the same class.

E)     If needed special education classes with fewer students more teachers to help remedy the special need children who need accommodation.

F)     Arrangement for the test accommodations for the special need children.

G)   Ongoing research to develop innovative techniques to improve the systems. (including feedback from the parents and educational professional to help develop efficient system)

H)   Establishment of chain of out-patient clinics with defined catchment area, coupled with day programs and in-patient psychiatric units for acute emergencies.

Mental health support and services is ongoing process which needs to be evaluated from time to time for its effectiveness and need for adding the services or modifying implementation coarse depending upon the need.

Above mentioned programs may exist in any society and there is always room for improvement and task specific research can help in upgrading the system. This is essentially a work in progress even in very developed societies. It is never enough the effort we can put in this area.

“Children are assets for any society. Society has bilateral/two way role in providing for the children and in turn children give back as productive members of the society.”