‘Labelling a child’ is the term used to describe the process where a psychologist or psychiatrist assesses a child, resulting in a diagnosis or ‘label’. The diagnosis is based on a set of criteria defined in the Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV).

About 10% of children and young people will have a mental health problem. The most common diagnoses for children include anxiety disorders; attention-deficit and disruptive behavior disorders; autism spectrum disorders; and eating disorders (for example, anorexia nervosa).

If you suspect your child may have a mental health condition, chances are you’ve wondered if it’s beneficial to obtain a professional opinion and perhaps a diagnosis. While professionals were traditionally hesitant to diagnose pre-adolescents with DSM-IV conditions, diagnoses have been on the rise since the 1980s, partly as a result of greater research into child mental health.

What is a diagnosis?

A reputable mental health professional will not give a diagnosis without a thorough evaluation of a person’s symptoms, behaviours, and developmental history. In the case of a child, specialists will usually consult with several other sources (for example, parents, teachers, and family doctors) before confirming a diagnosis.

What are the advantages of a diagnosis?

An accurate diagnosis will give parents and their child a clear and realistic sense of the limitations and challenges the child may face as a result of the disorder. Following a diagnosis, you should also have a good sense of what treatment plans are available, their pros and cons, and how effective they are. This knowledge can provide tremendous peace of mind for families who are struggling.

Other advantages of a diagnosis include:

• An accurate understanding of your child’s strengths and how to best harness them.
• Individual support from Specialists at your child’s school (for example, regular hours with a Learning Support teacher or funding for resources or appropriate training for teachers).
• Subsidized help for the family (for example, home-based intervention such as ABA for children with autism spectrum disorders).
• Effective collaboration between health professionals. For example, a Speech Pathologist, Occupational Therapist and Psychologist can work together to give your child comprehensive treatment.

What are the disadvantages of a diagnosis?

Most professionals agree: forming a diagnosis can be difficult. A child’s behaviour can change depending on their environment, their food intake and the people around them, which can impact the assessment process.

The disadvantages of a diagnosis may include:

• Stigma from other parents or peers.
• Difficulties reversing the diagnosis should behaviour change or improve.
• Children need support when discussing a diagnosis.
• Some families might find a thorough assessment and Diagnostic Report costly.

Finding more support:

Quirky Kid has offices in Sydney and Wollongong,

If you are concerned as to whether or not obtaining a diagnosis for your child is right for your family, you may find it helpful to talk through the decision with a professional yourself. Ask your health care provider about counselling or support services in your community or contact Quirky Kid on +61 2 9362 9297.

You can share your experiences and discuss the benefits or disadvantages of a diagnosis with other parent on our parenting forum, the Quirky Kid Huddle.

Parents may find useful resources at the Quirky Kid Shoppe.

—

Sources:

National Institute for Mental Health in England (2008). The Mental Health Act: Essential Information for Parents and Caregivers.

Harakavy-Friedman, Jill M (2009). Dimensional Approaches in Diagnostic Classification: Refining the Research Agenda for DSM-V. American Journal of Psychiatry 166, 118-119

Kimberley O’Brien (2011). Interview on the advantages, disadvantages, benefits and challenges of diagnosing children.

The Cleveland Clinic (2005-2009). “Attention Deficit Hyperactivity Disorder.” http://my.clevelandclinic.org/disorders/Attention_Deficit_Hyperactivity_Disorder/hic_Attention-Deficit-Hyperactivity_Disorder.aspx. Retrieved September 24, 2011.

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Children often sleep alongside parents or siblings as they are growing up. This practice is termed “co-sleeping”, and typically, it occurs on a nightly basis for an extended period of time: weeks, months, or in some cases, years. Many families find co-sleeping a good way spend time together and bond as a family, or to reduce their child’s stress around falling asleep or waking during the night. It is also popular among breastfeeding mothers during their child’s infancy.

While sharing a bed might ease pressures on families while children are very young, the habit of co-sleeping can pose problems as children mature. By the time their children are 2 – 2 1/2 years old, most parents will be eager to have them sleep easily through the night in their own beds.

Why should my child learn to sleep alone?

Encouraging independent sleep in children as they mature is important for several reasons:

• Extended co-sleeping can discourage children from achieving what’s known as “night time independence”. Children with night time independence are confident that they can fall asleep on their own, and know how to comfort themselves if they are stressed or anxious around sleep – key steps in healthy emotional development.

• Frequently, pre-school and school-aged children have fitful sleep cycles. Having a child kicking, tossing and turning in their bed can interrupt parents’ sleep, leading to exhaustion and stress throughout the day.

• Parental intimacy is often compromised when their children sleep with them. This can have a detrimental effect on a couple’s relationship, affecting communication and physical closeness.

How do I break the cycle of co-sleeping with my school-aged child?

If your child refuses to sleep alone, or wakes up crying during the night, and only stops when you are near, he might be experiencing separation anxiety at night. This pattern is also known as “night-time separation anxiety”. Night-time separation anxiety is common among children up to 3 years old, but older children can experience it as well.

Here are some things you can do to ease night time separation anxiety and help your child sleep alone:

• Develop a regular daily routine. The same waking, nap time, and bedtimes will help your child feel secure, which can help them fall asleep more easily. Have a bedtime routine – for example, bath followed by story time and a brief cuddle. Consistency and clear communication is key.

• Keep lights dim in the evening and expose your child’s room to light, preferably natural, as he wakes. These light patterns stimulate healthy sleep-wake cycles.

• Avoid putting your child to sleep with too many toys in his bed, which can distract him from sleeping. One or two “transitional objects”, like a favourite blanket or toy, however, can help a child get to sleep more easily.

• Don’t use bedtime as a threat. Model healthy sleep behaviour for your child, and communicate that sleep is an enjoyable and healthy part of life.

• Avoid stimulants like chocolate, sweet drinks, TV and computer use before bed time. Children ideally need to relax and “wind down” for at least 1 hour before bed time.

Some other strategies to reduce your child’s dependence on co-sleeping include:

• Wean your child from your bed over time. For example, you might plan to spend part of the night on a mattress on the floor of your child’s bedroom or sleep with him for a few hours in his bed before returning to your own.

• Use a baby monitor to help a child who wakes at night communicate with you or your partner. This will also reduce the likelihood of him walking to your bedroom. If your child communicates to you through the monitor, visit him in his bed to reduce disturbance.

• Use rewards, such as The Quirky Kid Tickets to measure improvements in your child’s independent sleeping. For example, a partial night spent in his own bed will earn him a yellow ticket, while a full night sleeping alone will get him a red one. The child might collect tickets to exchange them for a prize.

We offer a range of services, workshops and individualized consultations to support children with sleeping difficulties. Please contact us for more information.

Parent can also discuss sleeping issues at the Quirky Kid Huddle – our parenting forums.

Recommended Resources:

There are a range of resources we make available for children at the Quirky Kid Shoppe.

—

Sources:

University of Michigan Health System (2011). Sleep problems. Retrieved September 23, 2011 from http://www.med.umich.edu/yourchild/topics/sleep.htm

Brazelton, T. Berry and Joshua D. Sparrow (2003). Sleep: The Brazelton Way. Perseus Books.

Kimberley O’Brien (2011). Interview on Co-Sleeping with children and strategies for parents.

Keller, M. A. and Goldberg, W. A. (2004), Co-sleeping: Help or hindrance for young children’s independence?. Infant and Child Development, 13: 369–388.

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Exam anxiety is a natural reaction to too much pressure and can come from a number of sources including: young people themselves; comparisons with others; wanting to reach too ambitious goals; family members; peers or teachers.

Symptoms of Exam Anxiety

Signs your child may be experiencing exam anxiety include:

• Being cranky and irritable;
• Sleeping difficulties;
• Complaints of chest pains and/or nausea;
• Low self-esteem;
• Losing touch with friends;
• Difficulty getting motivated.

Suggestions for managing exam stress

• Effective Study habits: Effective study and learning habits can help to reduce exam stress in students of all ages. The Quirky Kid Clinic runs a study skills program to help students learn these skills

• Diet: Ensure your child is eating regular healthy meals throughout the exam period, drinking lots of water, and that they are monitoring their caffeine or sugar intake.

• Lifestyle: Encourage your child to keep up leisure activities such as seeing friends, exercising, or even watching television, as these activities give the brain a much-needed break from studying, which will allow for more effective study in the future.

• Sleep: Encourage your child to stop studying at least one hour prior to going to bed, in order to help them unwind and have a more restful sleep.

• Relaxation: Relaxation techniques such as breathing and muscle exercises can help your child calm down and manage their stress symptoms in a range of environments and situations. Child Psychologists at the Quirky Kid Clinic can help your child with relaxation exercises in an individual consultation or during our Why Worry workshop.

Please contact our clinic to make an appointment if you believe your child would benefit from some assistance in dealing with exam stress.

____

Information for this fact sheet was taken from Kimberley O’Brien, Child Psychologist, ReachOut .com, ParentLine and Kids Help Line

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Most children require some  “warm up” time to familiarise themselves with new people, environments and experiences, after which they relax and behave as they usually would. When children show an ongoing difficulty with normal social interchanges such as greetings, making requests or responding to questions, it can be important to investigate and make a decision about the need to intervene about this constant social anxiety.

Where can parents start:

Track where and when the “shyness” occurs and whether it is transient or ongoing. However, when children experience any challenges with normal social interchange it is important to remove any pressure for communication to take place. Instead a small step approach is most effective for increasing comfort and participation in social interchange.

Well intentioned statements such as “I feel sad when you don’t say hello”, through to punishment and negative consequences will reduce the likelihood of the communication occurring.

For example lets have a look a Stella’s behavior:



when she arrives at preschool she will not look at or greet her carers even when prompted, and instead hides behind her parents. After a short period of time however Stella is chatty and social with both adult carers and peers, makes spontaneous requests and answers questions without hesitation. Her social anxiety has been managed by her.

Now, lets look at Jack’s behaviour, for example:

Although his arrival looks just like Stella’s, Jack however does not appear to warm up after settling in and continues having difficulty responding to questions or communicating effectively with adult carers, but is quite happy playing and chatting with his peers. His social anxiety has not been well managed by Jack.

Here are some  suggestions to manage social anxiety

1. Discuss with your child what they are doing currently, for example hiding and not looking and talk to them about being brave and doing just a little bit more!
2. Think about what a little step might look like, such as holding hands instead of hugging a leg and try and engage your child to give it a go.
3. Before you get to pre-school try practicing the new step at home. Have toys and other family members play the role of staff and other children and don’t forget to have fun!
4. Use rewards such as praise, stickers and stamps when children are able to try the new step in “real time”. Talk to preschool staff to let them know what you are up to, so they can notice and praise the child.
5. Remember that some children love “over the top” praise, where as others prefer more low-key noticing. When a step has been mastered, renegotiate with your child to move up to the next step. Monitor progress and review regularly.

Steps to manage social anxiety should follow a progression from non communicative behavioural changes such as clinging becoming hand holding to non-verbal communication such as looking, smiling, waving or nodding, then indirect communication such as whispering to a parent to say hello to a carer, or showing a movie saying hello on a parent’s smart phone, and lastly direct communication from one word greetings through to talking freely.



Keep encouraging positively and remember this is a carrot only approach, sticks will only exacerbate the problem!

Recommended Reading
 For Parents:


• I ‘m Shy: http://therapeuticresources.com.au/i-am-shy
• I’m Worried: http://therapeuticresources.com.au/i-m-worried
• What to do when you worry: http://therapeuticresources.com.au/what-to-do-when-you-worry
• Helping your anxious child: A step by step guide for parents
by Ronald Rapee, Ann Wignall, Susan Spence, Vanessa Cobham and Heidi Lyneham

If this is still not working…

If your child is showing an ongoing difficulty with normal social interchange and communication at preschool or outside the home, despite having normal speech development and speaking and communicating freely at other times, it is a good idea to consult your GP,  pediatrician or a developmental psychologist and to look into a referral for intervention.



Social anxiety is best treated early by a qualified and experienced psychologist, particularly when it involves impairment in communication.

Discuss it on the Quirky Kid Huddle:

Other parents can help you by sharing their experience, visit our parenting forum the Quirky Kid Huddle: http://childpsychologist.com.au/forum/

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Other pre-schoolers are already little thinkers, able to anticipate future separation thus increasing their anxiety surrounding the morning’s pre-school drop-off.  This child may ask the night before “is it a school day tomorrow?” and then display challenging behaviour from early in the morning in an effort to avoid the anticipated separation.

Here are a few options for managing this tricky issue of separation anxiety for pre-schoolers and parents alike.

• Begin by learning more about your child’s day by having a conversation with the staff at the pre-school. Questions to ask include:

- How long does he or she take to settle? – How are his or her play and social skills developing? – How well is he or she communicating?

• Pre-school staff provide valuable feedback around issues such as how well your child is able to do things like share, take turns and manage frustration with peers. If there are significant issues occurring in these areas, difficulty separating from parents and caregivers can reflect your child’s distress at entering an environment where they are having consistent negative experiences. If this is the case, it is important to target the skills and behaviours which are less developed and causing difficulty as a first step

•  If pre-school staff report that your child settles quickly and is reaching normal developmental milestones around play, communication and social skills, you can then target the issue of separation and assist your child to learn to cope with this process.

If your child happily gets ready for school and appears quite relaxed until the actual moment when you are leaving, we recommend:

1. Keep drop-offs short and your actions consistent e.g. Spend a period of time settling your child by engaging them with a carer and/or activity. It may help if you narrate your actions so your child is clear about what is happening “ Let’s take you over to (carer) or Let’s go and set you up with the blocks…. It’s time to say goodbye now. Mummy will come and collect you at (time). OK Mummy is going now, (kisses/hugs) bye.
2. Stay calm and make sure to also use your face to communicate, e.g. I know you are sad when mummy goes (show sad face) but you have a great time with (carer/ friend’s name) (show happy face)

If your child is a “little thinker” and anticipates separation well before the event, we recommend:

1. Create a ‘days of the week’ chart so your child is aware of school days and the weekly routine.
2. Normalise the anxiety or worry by validating your child’s feelings e.g. “You’re a bit worried about going to school and being apart from mummy. It’s OK to feel worried”
3. Encourage your child to persevere even though they are worried by reflecting on their past experiences. e.g. “You were worried about leaving mummy last week but you were very brave and went to school and then you had lots of fun”, “you were worried when we went to the party on the weekend but then you settled in and had a great time”
4. Create some catch phrases with your child to assist them to manage. Use these phrases on multiple occasions and have your child repeat them back to you. e.g. “I just need to play some games then I’ll get used to it”, “Even though I miss my mummy, I’m OK and my mummy is OK”, “I will have a lot of fun today and mummy will pick me up soon”.
5. Praise your child for being brave and doing things even though they are worried.

Be aware of supporting your child’s worry by allowing him or her to avoid attending pre-school or a feared event as a way of managing their anxiety. This usually exacerbates your child’s anxiety rather than diminishing it.

If all the above fail, the Quirky Kid clinic runs a popular anxiety workshop called ‘ Why Worry? for children aged 3 and above. You can also consult one of our psychologists individually to discuss other strategies.

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This was an interesting conversation and you can listen to the podcast by clicking below:

You can further participate on the discussion by visiting our Forum – The Quirky Kid Huddle - http://childpsychologist.com.au/forum

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Following disasters such as the recent floods in Queensland and Victoria, parents are often left wondering how best to address these  traumatic natural disasters events with their children.

The type and amount of information you provide your child after a natural disasters is dependent on their age. However, simple explanations that reassure children that they are safe and let them know that you are there caring for them will help.

Tips for Parents

• Try to keep routines. If they have been disrupted,  help re- establish routines as soon as possible, as these are essential for children to grow and develop typically.
• Limit exposure to the media, and adult conversation about the natural disaster. Children are very much influenced by the responses and feelings of parents and other adults. Seek support for yourself of friends and colleagues
• Answer any questions that your child may have about natural disasters. Be honest without giving a lot of detail.
• Talk about the events related to the natural disasters if your child brings it up, don’t try to change the subject. It’s important to correct any ‘false’ ideas young children may have.
• Give children a chance to discuss their experiences of the natural disaster, and to share their fears. This will assist them in their ability to move on.
• Be available and reassuring.
• Help children gain a sense of self control by allowing them to make choices, that are age appropriate.

It can take weeks, months, sometimes years, for children to fully recover from the stress they may have experienced during a natural disaster. Each child is different. The more consistent children’s daily routines are and remain after a disaster, the better they will be able to adjust and move forward.

Recognising stress in children after a Natural Disasters

Young children

• sleep problems,
• going backwards in their development, e.g. wetting the bed, clinging and behaviour problems.

School aged children

• not wanting to go to school,
• nightmares,
• behaviour problems,
• physical symptoms, e.g. headaches or tummy aches.

Young Adults

• Withdrawn,
• Appear depressed,
• React aggressive under stress.

If you notice that your child’s reaction to stress or trauma due to a natural disaster is not lessening over time, or is becoming worse, it may be beneficial to seek some professional advice. For more information on how the Quirky Kid Clinic can help, or to schedule an appointment please contact us.

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Information for this fact sheet was taken from an interview with Child Psychologist Kimberley O’Brien, the Raising Children Network website and the following article.

Foulks, D. (2005). Nurturing Children After Natural Disasters. A Booklet for Child Care Providers, National Association of Child Care Resource and Referral Agencies. Arlington, Virginia, 1-16.

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The Likes of You{th} is a  Tool to Boost Social and Emotional Well–being for Adolescent Boys.

The Likes of You{th} Kit is a set of 12 Picture Cards, 24 Questions Cards and a User Manual written by Child Psychologist, Kimberley O’Brien. The LoY Kit has been developed to help boys (10–16 years) through the often turbulent transition to young adulthood. With an emphasis on self-awareness and coping strategies. The Likes of You{th} Kit empowers young boys to improve their social and emotional well-being through collaborative activities and discussion.

Covering themes such as Authority and Rebellion, Motivation and Depression, Confidence and  participation, Freedom and Escape, Study stress and conflict, Girls, rumours and sexuality, Screen Addiction and boredom, Companionship and loyalty, Independence and Identity, Pa rents and Responsibility, Self esteem and style, Gangs and aggression this resources is perfect to complement the practice of those working with young people.

>> Download a Flyer or Buy Now

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The highest you ever climbed! – The furthest you ever swam! – The fastest you ever ran! -

Children love stories, especially true stories describing adventure and emotional extremes. Often they will ask to hear our stories but how often do they get to tell theirs?

The TMAS cards invite young people to recall and retell their own memorable moments of extremity (Luckiest! Loneliest! Bravest!), as they rediscover a sense of pride in their own achievements. The story topics have been carefully chosen to appeal to young storytellers, with the capacity to engage listeners of all ages.

The TMAS cards are a useful tool for parents and professionals working with young people to facilitate communication, highlight strengths, give praise and boost self-esteem.

The TMAS collection is designed for young people and adults, (aged 6 years and above). We all have stories to tell and the TMAS cards provide a forum for all people to share their experiences, children and adults alike. The cards have been tried and tested with individuals and small groups, throughout a number of different contexts.

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