The Impact of Parental Anxiety on Children

Parents are not only faced with anxiety around their own well-being, employment, mental health, etc., but also around making the correct decisions for, and supporting, their children.  While it is completely natural to experience anxiety, it is vitally important that as parents, we do not transfer our anxieties onto our children.  How can we prevent this from happening?

  • Looking after your own mental health
    • Limit amount of time on social media and news channels
    • Only use reputable sources for information
    • Focus on the things you can control
    • Have a routine
    • Practice good sleep hygiene
    • Eat healthy
    • Hydrate frequently
    • Exercise
    • While working, follow the 55-5 rule (55 min seated working, 5 min walking around)
    • Have a dedicated work space separate from a leisure space
    • Plan for what you can
    • Stay connected with loved ones and friends
    • Take time off to do things you enjoy
    • Get into nature if possible
    • Avoid self-medicating (this includes alcohol and other substances)
    • Practice mediation or deep breathing exercises
  • Communicate:
    • At an age appropriate level with your child/ren
    • Be kind and supportive
    • Allow them to ask questions
    • Do not discuss topics with your partner in front of children if these are not age appropriate
    • Work with children to set up rules during home-learning and living
    • Routines and structure are important
    • Discipline in a positive manner (e.g. talk about the behaviour you want to see, rather than focus on the negative / undesirable behaviour)
    • Normalise their fears around safety and reflect that you are being extra cautious to do everything possible to protect your family
  • Spend Time:
    • Quality time interacting is important (e.g. family games, walks, playing)
    • Spend meaningful time on screens (e.g. read stories together)
    • Ensure that they spend time connecting socially not only learning on screens
    • Time and communication with extended family members and friends is important
    • Spend time together while helping others (e.g. making sandwiches for the needy, knitting squares to make blankets)
  • Access to Technology:
    • Ensure parental controls are in place on all devices
    • Ensure that privacy settings are on
    • Educate children around safe technology use (e.g. never provide your address or personal information to strangers, do not send photo’s to people you do not know)
    • Monitor them when being online – be aware of any secretive behaviour
    • Limit screen time during times when you can engage with your child
  • Model & Encourage Healthy Online Habits
    • Encourage children to maintain their manners as if they were face-to-face in class
    • Be kind and respectful on video/voice calls
    • Be mindful of what they wear and where they use the device (e.g. if they need to go to the toilet, not to take the device with them)

Where parental anxiety is transferred to children, we will typically see:

  • Heightened anxiety
  • Difficulty sleeping
  • Regression to behaviours that they had already outgrown
  • Becoming more clingy / show separation anxiety
  • Have difficulty regulating their emotions
  • Not be able to self-sooth
  • Acting out behaviours
  • Attention-seeking
  • Wanting parents to be involved continuously
  • Inability to play on their own
  • Concentration difficulties
  • Defiance
  • Not wanting to engage in online learning
  • Increased conflict between parent-child and siblings

If you see any of these signs or other incidents that concern you for an extended period, you should contact a Psychologist to help you and your child.  Children from the age of 2 until 12 will engage in play therapy, while older children and adolescents engage in “talk” therapy.

Supporting Children Returning to School during Covid-19

The South African Government has announced the phasing in of learners returning to face-to-face teaching. This has caused two camps to rise: those for children returning and those against children returning to school. I am not going to choose sides, rather focus on how to support children as they go back to school.

Firstly, we need to be aware that many individuals may struggle with anxiety and fear on returning to school. We also need to realize that while children may not show signs of difficulties initially, these may arise as they are faced with new processes on entering schools and interacting with peers and teachers through physical distancing – this is going to be particularly difficult for younger children. As children get used to their new realities during Covid-19, as well as the uncertainty of it’s duration, the prolonged effect may well give rise to an increase in mental illness.

So how do we support all children as we ourselves learn to navigate the waters of our new (hopefully temporary) reality (while managing our own anxieties and fears)? How do we support children who may have, or who may be at risk of mental illness?

  1. Clinically vulnerable children should not return to school but should be supported through online learning.
  2. Children who live in homes with vulnerable individuals should only attend school if strict hygiene and physical distancing is practiced. The child needs to be old enough to be able to understand these practices and be able to carry them out.
  3. Age-appropriate education around Covid-19 is important. This should be implemented in the home as well as the school environment.
  4. Children should be taught good hand hygiene practices at home before returning to school.
  5. Educate children about physical distancing and physical contact and the spread of Covid-19.
  6. Teach children to wear masks independently where a child is able to put on or remove a mask without assistance. For young children, a face mask may be considered – the use of these should also be practiced prior to going back to school.
  7. Talk to children about their thoughts and feelings around returning to school. Normalize their feelings and offer support.
  8. Explain the changes they can expect on returning to school (most schools are providing parents with the procedures that will be implemented).
  9. Keep having conversations with children about their experiences and feelings as the days and weeks after returning to school progress.
  10. Good communication with your child’s teacher is key.

Lockdown Level 3 Services Available Online or Face-to-face

Caring for Covid Carers

I have the privilege of being able to be part of an amazing initiative called #Caring4CovidCarers. After a fantastic 2 hours of connecting with colleagues through training this morning, I am reminded again of the need to support those on our front line. I am also reminded that those on the front line may not be aware of my previous offer of support during this pandemic and through reminders such as this one, word can be spread that no one is alone in this.

If you need to reach out, please do not hesitate to contact me. I am still offering pro bono counselling sessions during the Covid-19 pandemic to all health care workers (doctors, nurses, allied health care providers on the front-line, hospital administration staff, and even staff working in hospitals in procurement and storage, cleaners, etc.). It will not only be our doctors and nurses needing support in the coming weeks and months.

Thank you for all that has been done to date, and all that you will still do.

(T): 076 562 8271

(E): megan@edpsychologist.co.za

(W): www.edpsychologist.co.za

A Parent’s Guide to Play Therapy


 

For further information, please contact Megan Clerk, Educational Psychologist.

Contact Number: 076 562 8271

Email: megan@edpsychologist.co.za

The benefits an Educational Psychologist can offer you, your children and family throughout their learning and development

Educational Psychology focusses on an individual’s functioning within the domain of learning and development. With this domain spanning across a number of years as children grow, it can’t be argued that Educational Psychology is a diverse field offering a range of services to suite each stage of development. Educational Psychological support is also not only limited to children, parents and families, but is also available to teachers and communities where parental and teacher workshops provide in-depth information on various topics.

In development, working with parents of younger infants within the Sensorimotor stage of Cognitive Development (Birth to 2 years), Parental Support and Guidance is provided. Play Therapy with children as young as 2 to 3 years old is also initiated, where clients are able to start their journeys in learning and development with the assistance of an Educational Psychologist from early on. One of the keys to success is identifying difficulties as early as possible, in order to assist clients in overcoming and adapting to their individual circumstances.

Within the Pre-Operational stage of Cognitive Development (2 to 7 years), Educational Psychologists provide support through Developmental Assessments; Behavioural, Social & Emotional Assessments and Support; School Readiness Assessments; Psycho-Educational Assessments – as well as Play Therapy and continued Parental Support and Guidance. All assessments are conducted with the aim of assisting parents, children and teachers in dealing with identified difficulties.

The third stage of Cognitive development is the Concrete Operational stage (7 to 11 years) where children start to think logically with regard to concrete objects and events, begin to use classification, understand mathematical concepts and to achieve. Educational Psychological support again includes Psycho-Educational assessments to identify any learning, social or emotional difficulties that may impact on children’s abilities to achieve to their maximum potentials. Identification of Learning Difficulties such as ADHD/ADD; Dyslexia; Dysgraphia; Dyscalculia; Reading & Comprehension, Slow Processing Speed; Poor Working Memory (to name a few) are assessed. Support in the area of Learning Support as well as Study Skills & Methods are offered by some Educational Psychologists.  Individual therapy is introduced during this stage to assist with emotional, social and behavioural difficulties which may further impact performance. Typically the well-known areas of anxiety, divorce, family/relationship difficulties, grief, trauma, bullying, emotional/social difficulties and various disorders can be supported through therapy.

In the Formal-Operational stage (11 years and beyond), adolescents can explore logical solutions to concrete and abstract concepts, understand and reason by analogy, metaphors and hypothetical thinking. Here Educational Psychologists offer additional assessments to assist in future planning and education. Subject Choice Assessments are typically conducted in Grade 8 to assist children in choosing subjects that they will carry through to the end of their High School education. These are based on aptitudes, interests and personality. Similarly, Career Guidance and Assessments are conducted with children in Grade 11/12 to assist in tertiary education decision-making. Within this phase of education (Senior and FET phases), children who struggle with specific barriers to learning (e.g. ADHD/ADD; Emotional Difficulties; Medical Conditions which affect scholastic performance – Hearing, Sight, various Health Conditions – require Concession and Accommodation Assessments. These assessments aim at providing children with an equal opportunity to perform to their full potential and do not provide an additional advantage over others. Typical concessions/accommodations include additional time, rest breaks, medication/food breaks, separate venues, enlarged text and computerised examinations (to mention a few). Individual Therapy is also an option for support throughout this stage of development and is commonly utilised by adolescents adapting to change, struggling with relationship difficulties and various emotional and social challenges. Where families require support as a unit, Family Therapy is offered across all stages of development to assist in various needs of the family unit which may be in crisis, suffering loss or struggling to manage individual difficulties that members of the family may be faced with e.g. managing behavioural, emotional, social or educational difficulties.

Educational Psychologists are not limited to working with children only. Career Guidance and Assessments, as well as Concession and Accommodation assessments are also offered to students within tertiary settings, or to those aiming to study further, as well as to adults wishing to make a career change. Support for teachers and parents can also be provided through Talks/Information Evenings and Workshops on various topics e.g. ADHD; Learning Disorders/Difficulties; Concessions & Accommodations; Bullying, as well as a variety of topics according to specific needs within a school or community.

Lastly, some Educational Psychologists have furthered their training and expertise to include working within, for example, Child & Family Mediation where they assist parents in divorce/separation scenarios to draw up Parenting Plans in the best interest of the child – an element required as part of the legal documentation in Divorce. Others have entered into Medico-Legal and Forensic Assessments to assist in claims of personal injury and loss, and placement and emotional assessment in legal matters where children are concerned.

The benefits of enlisting the services of an Educational Psychologist are extensive.  As a parent, it is important to know that you do not have to be alone in struggling to deal with difficulties.  Lastly, certain medical aid plans also cover the costs of assessments in part/full depending on the specific plan. Early identification and intervention is key to assisting any individual with difficulties.

By: Megan Clerk

Behavioural Considerations Associated with Traumatic Brain Injury

As professionals we always remain academics in our quest to understand and assist our clients in the difficulties they face.  Within the field of Medico-legal assessments which I have found an increasing passion in over the past 2.5 years, this is especially relevant with the changes and advances in medical knowledge.

The following article speaks to the behavioral changes, as well as, the effects on development where Traumatic Brain Injury has taken place in young children.

http://www.brainline.org/content/2008/07/behavioral-considerations-associated-traumatic-brain-injury_pageall.html

Happy reading.

Suicide in Young Children – What are the signs?


There are several warning signs that someone may be at increased risk of suicide, and they are:

  • suicide notes — these should always be taken seriously
  • threatening suicide — direct or indirect
  • previous attempts of suicide
  • depression, particularly in the presence of thoughts of helplessness and hopelessness
  • risk-taking behavior, particularly anything involving gun play, aggression, or substance abuse
  • making final arrangements — this might involve giving away prized possessions
  • efforts to hurt themselves, such as self-mutilating behavior and self-destructive acts
  • inability to concentrate or think rationally
  • changes in physical habits and appearance, such as insomnia or hypersomnia (sleeping far too much), sudden weight gain or loss, disinterest in basic hygiene
  • great interest in death and suicidal themes — it might manifest in their journal, school papers, drawings
  • sudden changes in friends, personality and behavior, or withdrawal from family and friends
  • increased interest in things dealing with suicide — a sudden interest in guns or other weapons, pills, or even alluding to suicidal plans
  • vulnerable teens and young adults swayed by media reports of celebrity suicides, or the romanticized representation of suicide in movies and television
  • low levels of communication between parent and child — family discord has not been decisively shown to be a major risk factor for suicide, but it further exacerbates other problems such as depression, alcohol and drug abuse
  • being bullied or victimized, or being a bully

What is ADHD?


Attention deficit hyperactivity disorder (ADHD) is a psychiatric disorder or neurobehavioral disorder characterized by significant difficulties either of inattention or hyperactivity and impulsiveness or a combination of the two. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), symptoms emerge before seven years of age.

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Signs and Symptoms

Children with ADHD tend to get distracted from schoolwork rather easily, and they often behave disruptively.

Inattention, hyperactivity, disruptive behaviour and impulsivity are common in ADHD.  Academic difficulties are also frequent.  The symptoms are especially difficult to define because it is hard to draw a line at where normal levels of inattention, hyperactivity, and impulsivity end and clinically significant levels requiring intervention begin.  To be diagnosed with ADHD, symptoms must be observed in two different settings for six months or more and to a degree that is greater than other children of the same age.

The symptom categories yield three potential classifications of ADHD — predominantly inattentive type, predominantly hyperactive-impulsive type, or combined type if criteria for both subtypes are met:

Predominantly inattentive type symptoms may include:

  • Be easily distracted, miss details, forget things, and frequently switch from one activity to another
  • Have difficulty maintaining focus on one task
  • Become bored with a task after only a few minutes, unless doing something enjoyable
  • Have difficulty focusing attention on organizing and completing a task or learning something new or trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities
  • Not seem to listen when spoken to
  • Daydream, become easily confused, and move slowly
  • Have difficulty processing information as quickly and accurately as others
  • Struggle to follow instructions.

Predominantly hyperactive-impulsive type symptoms may include:

  • Fidget and squirm in their seats
  • Talk nonstop
  • Dash around, touching or playing with anything and everything in sight
  • Have trouble sitting still during dinner, school, and story time
  • Be constantly in motion
  • Have difficulty doing quiet tasks or activities

and also these manifestations primarily of impulsivity:

  • Be very impatient
  • Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences
  • Have difficulty waiting for things they want or waiting their turns in games

Some children, adolescents, and adults with ADHD have an increased risk of experiencing difficulties with social skills, such as social interaction and forming and maintaining friendships.  About half of children and adolescents with ADHD experience rejection by their peers compared to 10-15 percent of non-ADHD children and adolescents. Training in social skills, behavioural modification and medication may have some limited beneficial effects.

The most important factor in reducing emergence of later psychopathology, such as major depression, criminality, school failure, and substance use disorders is formation of friendships with people who are not involved in delinquent activities.  Adolescents with ADHD are more likely to have difficulty making and keeping friends due to impairments in processing verbal and nonverbal language.

Handwriting difficulties seem to be common in children with ADHD.  Delays in speech and language as well as motor development occur more commonly in the ADHD population.

Management

The management of ADHD involves either psychotherapy or medication therapy alone or a combination of the two.  Medications used in the treatment of ADHD include stimulants, noradrenergic agents, adrenergic agonists and certain antidepressants. Medications have at least some effect in about 80% of people.  Dietary modifications may also be of benefit.

Psychosocial

The evidence is strong for the effectiveness of behavioural treatments in ADHD.  It is recommended first line in those who have mild symptoms and in preschool-aged children.  Psychological therapies used include psychoeducational input, behavior therapy, cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), family therapy, school-based interventions, social skills training, parent management training, neurofeedback, and outdoor activities.  Parent training and education have been found to have short-term benefits.  There is a deficiency of good research on the effectiveness of family therapy for ADHD, but the evidence that exists shows that it is comparable in effectiveness to treatment as usual in the community and is superior to medication placebo.  Several ADHD specific support groups exist as informational sources and to help families cope with challenges associated with dealing with ADHD.

Medication

Stimulant medications are the medical treatment of choice.  There are a number of non-stimulant medications, such as atomoxetine, that may be used as alternatives.  There are no good studies of comparative effectiveness between various medications, and there is a lack of evidence on their effects on academic performance and social behaviours.  While stimulants and atomoxetine are generally safe, there are side-effects and contraindications to their use.  Medications are not recommended for preschool children, as their long-term effects in such young people are unknown.  Research into the long-term effects of stimulants in ADHD have come to conflicting conclusions with one study finding benefit, another finding no benefit while another finding evidence of harm.  The current research has methodological problems and more robust research has been recommended. Any drug used for ADHD may have adverse drug reactions such as psychosis and mania, though methylphenidate-induced psychosis is uncommon.  Regular monitoring of individuals receiving long-term stimulant therapy for possible treatment emergent psychosis has been recommended.  Stimulant therapy is recommended to be discontinued periodically during protracted therapy to assess for continuing need for medication.  Tolerance to the therapeutic effects of stimulants can occur, with rebound effects occurring when the dose wears off. Therefore due to the risk of discontinuation/rebound effects abrupt withdrawal of stimulants is not recommended.

People with ADHD have an increased risk of substance abuse, and research studies have found that stimulant medications reduce this risk or have no effect on substance abuse.  Additionally, stimulant medications approved for treating ADHD have the potential for abuse and dependence.  Atomoxetine due to its lack of abuse potential may be preferred in individuals who are at risk of abusing stimulant medication.

Deficiency in zinc has been associated with inattentive symptoms of ADHD and there is evidence that zinc supplementation can benefit ADHD children who have low zinc levels.  There is also some evidence that zinc supplementation leads to a significant reduction in the dosage of stimulants required for ADHD.

(Obtained from the Web)


My journey as an Educational Psychologist


My journey as an Educational Psychologist began by completing my undergraduate degree at the University of Johannesburg.  I then went on to complete my PGCE (Post Graduate Certificate in Education), followed by my Honours and Masters degrees In Educational Psychology at the University of Johannesburg. I have gained experience in working at the Centre for Psychological and Career Development (PsyCaD) where I completed my Internship Training and worked as an independent Psychologist.  I have since worked in the Medico-Legal field assessing and assisting clients and attorneys in Road Accident Fund claims.

 

I have an interest in hypnotherapy, specifically ego-state therapy, as well as in positive psychology.  My other area of interest lies in Cognitive Behavioural approaches and Neuropsychology.  I enjoy assisting my clients to reach their full potential through individual therapy, group interventions, psycho-educational workshops, and assessments.

 

I have a great passion for the field of Educational Psychology and wish to further my experience and my training continuously to broaden my own knowledge to best assist the clients that I work with.