Resources

001: On-Air Consult Meltdown Mode – Tips to calm a toddler in distress

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Posted on by Dr. Kimberley O'Brien

Tips to Calm a Toddler in Distress : On-air Consultation

Here is the inaugural Impressive Podcast with Dr Kimberley O’Brien. In this on-air consultation, Kimberley discusses  Rigid thinking, Sensitivity to change, Issues with emotional regulation, Meltdowns and toddler development.  Enjoy:

Here are the recommended resources to support a 3-year-olds exhibiting including social stories and visual timetables to introduce more structure.

For parents:

  • https://www.booktopia.com.au/the-highly-sensitive-child-helping-our-children-thrive-when-the-world-overwhelms-them-elaine-n-aron/prod9780007163939.html

For toddlers:

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Gaming Disorders: Detection and Intervention

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Posted on by Freya Gardon

Gaming Disorders in children: what are they, what to do if you are concerned for your child

In a society that is increasingly more technologically focussed, a common question asked at the Quirky Kid Clinic centres on “does my child spend too much time playing video games?” The following article will discuss what Gaming Disorders are, how one is diagnosed with a Gaming Disorder, and what to do if your child is struggling.

What are Gaming Disorders?

Although video games have been entertaining us all for decades, the notion of a Gaming Disorder has only been formally recognised recently. In June 2018, the World Health Organisation (WHO) released their newest revision of the International Classification of Diseases (ICD-11). The ICD-11 lists Gaming Disorders under the section‘ disorders due to addictive behaviours’. Previously, Gaming Disorders were only considered as an area warranting further research in the Diagnostic and Statistical Manual of Mental Disorders (American Psychological Association, 2013).

Characterised by recurrent and persistent game playing behaviour (both online and offline formats), an individual with this disorder would give gaming increasing priority over their daily life, to the extent that it impairs other areas of functioning.

Regarding prevalence, Gaming Disorders are more common in males than females (Wartberg, Kriston, & Thomasius, 2017). Though it can present at all ages, most of the research highlights adolescents and young adults as being more impacted (Wartberg et al., 2017).

How are Gaming Disorders diagnosed?

To be diagnosed with a Gaming Disorder, the following symptoms need to be observed over a 12 month period:

  • Impaired control over gaming practices (preoccupied, withdrawal symptoms when gaming is not possible)
  • Increasing priority is given to gaming over other areas of life, and other interests. (For example, stop engaging in social activities, other hobbies or experiencing sleep disturbances)
  • Continuing to game despite negative repercussions (WHO, 2018).

This is not to suggest that children cannot play video games or shouldn’t enjoy some screen time on the iPad; it can be a useful tool to develop hand-eye-coordination, teach problem-solving skills or relieve stress (Granic, Lobel, & Engels, 2014; Li, Chen, & Chen, 2016). Likewise, it is important to reflect on the changes that have occurred in ‘gaming culture’ over the decades. Typically speaking, games developed today are not just more interactive and complex, but also more accessible for consumers. There is also a social aspect to it; often games can connect players not just to friends but others across the world. When making a diagnosis, a professional will also consider the context for each individual child. 

Awareness around Gaming Disorders is more about making ourselves mindful of what too much focus could lead to. As a parent, listen to your gut instinct in these situations. Ask yourself, has my child’s mood changed negatively from continuous play? Do you feel like they need to cut down the time/frequency of play? Are they losing social connections? Is their school work suffering without other explanation?’

Seeking Intervention

While only a small proportion of individuals who engage in gaming activities will go on to develop a disorder, it is important to check in with your child as to how much time they are investing in their gaming. Rather than telling your child, they cannot play (in turn making it more desirable), you may want to check in and see whether they feel in control of their gameplay.

If gaming appears to be having a significant effect on your child’s mental health and/or other areas of life, it is important to start intervention as soon as possible rather than waiting for a major incident to occur. Evidence-based intervention for Gaming Disorders recommend a cognitive behavioural approach, including monitoring time spent gaming while simultaneously addressing the thoughts that maintain game play (King, Delfabbro, & Griffiths, 2010).

Gaming Disorders may also be a potential warning sign for other areas requiring intervention (anxiety, depression, bullying, etc).

Here at The Quirky Kid Clinic, our experienced team of Psychologists are more than happy to meet with you to discuss any concerns you have in relation to your child’s development and behaviour.

We always start with a parent only consultation to ensure that we get a thorough understanding of your child’s developmental history and a sense of your families identity, history and cultural dynamics. From here we provide an individualised case plan dependent on your child and families needs. Please don’t hesitate to contact our friendly reception on (02) 9362 9297.

References

American Psychiatric Association. (2001). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Granic, I., Lobel, A., & Engels, R. C. (2014). The benefits of playing video games. American psychologist, 69(1), 66. doi: 10.1037/a0034857

King, D. L., Delfabbro, P. H., & Griffiths, M.D. (2010). Cognitive behavioural therapy for problematic video game players: Conceptual considerations and practice issues. Journal of CyberTherapy and Rehabilitation, 3(3), 261-273.

Li, L., Chen, R., & Chen, J. (2016). Playing action video games improves visuomotor control. Psychological science, 27(8), 1092-1108. doi: 10.1177/0956797616650300

Wartberg, L., Kriston, L., & Thomasius, R. (2017). The Prevalence and Psychosocial Correlates of Internet Gaming Disorder: Analysis in a Nationally Representative Sample of 12- to 25-Year-Olds. Deutsches Ärzteblatt International, 114(25), 419–424. doi: 10.3238/arztebl.2017.0419

World Health Organisation (2018). International Classification of Diseases, 11th Revision (ICD-11).  Retrieved 21 August, 2018, from https://icd.who.int/browse11/l-m/en

 

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Early Signs of Autism Spectrum Disorder (ASD) in infants

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Posted on by Freya Gardon

Autism Spectrum Disorder

A common question new parents ask us at The Quirky Kid Clinic is ‘What do we need to look out for in relation to an Autism Spectrum Disorder (ASD)?’. The following article will discuss what ASD is, the diagnosis of ASD, and what to look out for if you have developmental concerns for your child.

What is ASD?

ASD is a developmental disability characterised by marked differences in social interactions, deficits in verbal and nonverbal communication skills, restricted and repetitive interests/behaviours, and sensory sensitivities. It appears in infancy and the symptoms and severity differ from individual to individual.

The severity of an ASD presentation can range from ‘Level 1 requiring support’, through to ‘Level 3 requiring very substantial support’. When ASD is diagnosed it includes the inclusion or exclusion or an accompanying intellectual disability (American Psychiatric Association, 2013, p. 52).

There is no known cure for ASD, and there is no current consensus amongst medical professionals on the precise cause of ASD. However what is clear is that quality individualised early intervention will support children to increase skill development, communication abilities and develop flexible adaptive behaviours (Dawson et al., 2010).

How is ASD diagnosed?

ASD has shown to be reliably diagnosed in a child as young as 18-24 months old (Charman et al., 2005). However, historically children have been more likely to have received a diagnosis closer to school age than during their toddler years (Mandell et al., 2005; Moore & Goodson, 2003).

Howlin & Moore (1997), who conducted a study of 1200 participants in the UK, reported that whilst the average age parents had any developmental concerns for their child was approximately 18 months old, for the majority of participants studied, the diagnosis did not actually occur until closer to the child turning 6 years old.

In response to ongoing research in the area of ASD diagnosis, in the United States, the American Academy of Pediatrics has now recommended that all children be screened for ASD at approximately 18-24 months old (Johnson & Myers, 2007).

In Australia, Williams et al. (2008) have concluded that currently, we have not matched initiatives occurring in other countries, such as the United States, in relation to early ASD diagnosis and early intervention support initiatives. However, the Autism CRC under the guidance of Professor Andrew Whitehouse and colleagues are currently developing a National ‘Best Practise’ Guideline document for the diagnosis of ASD within Australia. Whilst the document has not yet been finalised the draft submission cites the reliability of an ASD diagnosis for a child of 2 years old by a qualified professional. Although, it is still most common in Australia for children to receive a diagnosis between the ages of 3 and 5 years old (Whitehouse et al., 2017).

A reliable diagnostic process involves identifying the child’s strengths and weaknesses via a comprehensive formal assessment which includes a child observation, such as the Autism Diagnostic Observation Schedule (ADOS-2), a parent interview, such as the Autism Diagnostic Interview-Revised (ADI-R), and cognitive / developmental testing such as an IQ test or a general developmental assessment, completed by an experienced practitioner (Charman, 2010; Whitehouse et al., 2017).

Following diagnosis, access to individualised early intervention with the aim of increasing developmental deficits, and decreasing challenging behaviours can make a huge difference in your ASD child’s developmental pathway.

Early Signs to look out for in infants

Identifying characteristics of ASD in a child younger than two years old can be difficult. Concerns may arise due to the ‘absence’ of behaviours considered to be ‘normal’ development and the ‘presence’ of behaviours considered to be ‘abnormal’ development.

Developmental milestones occur across age ranges so your child may be ahead or behind their peers with respect to milestones such as crawling, walking, and early verbal and nonverbal language development.

Listen to your ‘gut instinct’ as a parent. Consider seeking help from your Child Psychologist or Paediatrician if your 12-month-old infant is not demonstrating the following behaviours, either as an emerging skill that is continuing to progress, or once learnt, does not demonstrate these behaviours consistently across multiple environments (Boyd et al., 2010; Charman, 1998):

  • Responding to their name, or to the sound of a familiar voice, by turning their head and referencing the person who spoke or the direction from where the voice came from;
  • Referencing a familiar person with eye contact, such as smiling in reciprocation to being smiled at, at times such as feeding, and or when playing ‘peek a boo’ like games;
  • Demonstrating joint attention, such as referencing a favourite toy or food, then referencing a familiar person, then looking back towards the item of interest as if to say, “pass it to me”, or “can I have more”;
  • Babbling or making noises to get a familiar adults attention;
  • Developing an imitation repertoire such as waving and clapping, and or including the imitation of a familiar person’s facial expressions and movements;
  • Demonstrating reciprocal interest and enjoyment in play, such as tickles, ‘peek a boo’ like games and cause and effect toys, coordinating eye contact to indicate “more”;
  • Tracking objects or familiar people visually around the room and or following a familiar person’s gestures, such as pointing to an object;  
  • Coordinating gestures in order to communicate, such as pointing at an object to initiate a communication, or waving goodbye;
  • Positively responding to cuddling, and or reaching out to be picked up.

Remember that your child may, like all individuals, experience good days and bad days. Your child’s development will occur in spurts and patterns, and it is best to evaluate your child’s development by considering the consistency and frequency of these emerging skills.

If you feel a particular skill is lacking spend the time to practise the behaviour with your child, ensuring that you are providing attention and praise for your child’s attempts at demonstrating the behaviour. If the skill does not start to develop or your child responds negatively to your attempts to model and teach the skill then seek help from your Child Psychologist or Paediatrician.  

Seeking Intervention

Commence an individualised early intervention program as soon as possible. Whether your child has a formal diagnosis or not it is advisable to start intervention as soon as you suspect that your child’s development is not progressing at the level expected for their age rather than following a wait and see approach.

Here at The Quirky Kid Psychology Clinic, our experienced team of Psychologists are more than happy to meet with you to discuss any concerns you have in relation to your child’s development and behaviour.

We always start with a parent only consultation to ensure that we get a thorough understanding of your child’s developmental history and a sense of your families identity, history and cultural dynamics. From here we provide an individualised case plan dependent on your child and families needs. Please don’t hesitate to contact our friendly reception on (02) 9362 9297.

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References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Boyd, B. A., Odom, S. L., Humphreys, B. P., & Sam, A. M. (2010). Infants and toddlers with autism spectrum disorder: Early identification and early intervention. Journal of Early Intervention, 32, 75-98.

Charman, T. (1998). Specifying the nature and course of the joint attention impairment in autism in the preschool years: Implications for diagnosis and intervention. Autism, 2, 61-79.

Charman, T. (2010). Developmental approaches to understanding and treating autism. Folia Phoniatrica et Logopaedica, 62, 166-177.

Charman, T., Taylor, E., Drew, A., Cockerill, H., Brown, J. A., & Baird, G. (2005). Outcome at 7 years of children diagnosed with autism at age 2: Predictive validity of assessments conducted at 2 and 3 years of age and pattern of symptom change over time. Journal of Child Psychology and Psychiatry, 46, 500-513.

Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., & Varley, J. (2010). Randomized, Controlled Trial of an Intervention for Toddlers With Autism: The Early Start Denver Model. Pediatrics, 125(1), e17–e23.

Howlin, P., & Moore, A. (1997). Diagnosis in autism: A survey of over 1200 patients in the UK. Autism, 1, 135-162.

Johnson, C., & Myers, S. (2007). Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120, 1183–1215.

Mandell, D. S., Novak, M. M., & Zubritsky, C. D. (2005). Factors associated with age of diagnosis among children with autism spectrum disorders. Pediatrics, 116, 1480-1486.

Moore, V., & Goodson, S. (2003). How well does early diagnosis of autism stand the test of time? Follow-up study of children assessed for autism at age 2 and development of an early diagnostic service. Autism, 7, 47-63.

Whitehouse, A.J.O., Evans, K., Eapen, V., Prior, M., & Wray, J. (2017). The diagnostic process for children, adolescents and adults, referred for assessment of autism spectrum disorder in Australia: A national guideline (Draft version for community consultation). Autism CRC Ltd.

Williams, K., MacDermott, S., Ridley, G., Glasson, E. J., & Wray, J. A. (2008). The prevalence of autism in Australia. Can it be established from existing data?. Journal of Paediatrics and Child Health, 44, 504-510.

 

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Building Social and Emotional Learning during the School Holidays

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Posted on by Leonardo Rocker (Quirky Kid Staff)

child inside a backpack. social and emotional skills for kids

The school holiday period can be a great time to reflect on the last term, prepare for upcoming changes and review skills that need to be improved.

Returning to school is typically experienced with mixed emotions. For some parents, it is a welcome relief after what feels like a very long holiday. For others, the return to school signals the end of a carefree, relaxing break and there can be feelings of sadness and/or anxiety associated with the return to routine and the academic and social demands associated with the school.

Children and young people equally experience a range of feelings about the return to school. For some, there is great excitement about starting a new school, seeing friends or perhaps finding out who their new teacher will be. For others, there may be sadness about the end of the holidays or anxiety about a raft of possible concerns such as making friends in their new class or coping with the work/homework requirements.

A tried and test way to prepare for changes and transitions is by focusing on your child’s social and emotional adjustment.

Tips to Help Your Child Settle Into Term 3

Whilst a lot of focus is placed on the academic tasks associated with school, paying particular attention to a child’s social and emotional adjustment over the coming weeks/months is also critical. Below are 3 tips to get you started:

  • Make time to check in with your child about how they are feeling and coping with the school year so far. It’s important to really listen to what your child is saying. To do this, begin by just repeating back or paraphrasing what your child is telling you. Where your child is experiencing uncertainty try to normalise this and remind your child that it can take a few weeks to really settle in. It is not uncommon for children (and parents) to express disappointment about a new teacher they may have been assigned or about the discovery that they don’t have as many close friends in their class. Rather than jumping to solve the problem for your child, build resilience by encouraging your child to come up with some ideas about ways to help themselves cope in such a situation.
  • It can often be a good idea to make time to check in with your child’s teacher as soon as terms resume. Whilst you will, of course, wish to discuss their educational strengths/weaknesses, also address how your child is feeling about their progress and to highlight anything (e.g. camp, homework) that may be worrying your child.  Make sure you also discuss your child’s social skills with the teacher. If they are struggling with friends, ask your child’s teacher how the school can help in facilitating friendships. If your child has had any ongoing incidents of bullying/teasing it is critical to mention this again and ask how they can help to ensure that such incidents don’t occur again during the next terms. Equally, if your child has a history of seeking attention from others in a class by misbehaving, check on how this is been handled at school. Teachers will undoubtedly find your insights into what works and what doesn’t work at home very useful.
  • Encourage friendships and further consolidate social skills in by organising playdates or outings with any new classmates made throughout the term. Whilst children often request existing friends, it can be worthwhile trying to extend friendship networks by inviting new children over. This is not only good for your child but can also help to expand social support networks for you as a parent. In secondary school, it is equally important to encourage friendships by providing opportunities for your son/daughter to have friends over or by offering to drive them to a movie etc. This not only helps foster friendships but also gives parents valuable insights into the type of friendships that your child is building.

Why social-emotional learning is so important

The importance of focusing on the social and emotional well being of children is becoming increasingly acknowledged. In the current climate of increasing rates of mental illness in young people and concern over youth suicide rates, the NSW government has reportedly decided to tackle the problem more aggressively by proposing to adopt a more preventative approach in addressing such issues. The Government’s decision to begin at the grassroots level and start better-educating school-aged children (from Kindergarten) about mental health issues is welcome news to everyone here at Quirky Kid.

The changes to the Personal Development, Health, Physical Education (PDHPE) syllabus which are apparently due for implementation from 2020 include a more comprehensive effort to address social-emotional learning and mental health issues from primary school onwards. Beginning in Kindergarten, it is proposed that children will begin with simple social-emotional concepts such as feelings and building relationships with others, but as they progress to higher grades the aim will be to address important issues such as coping with success and failure, overcoming adversity, grief and death, coping with controlling behaviour in others, domestic violence, and substance abuse.

Helping Children to Build Important Social-Emotional Skills

Equipping children to cope with the social and emotional demands of school fosters increased coping and resilience skills. The evidence suggests that well developed social and emotional skills are both protective and helpful. Strong social and emotional skills in children not only predict fewer behavioural problems in the classroom but they are also related to positive academic outcomes and improved school performance  (Myles-Pallister, Hassan, Rooney, & Kane, 2014; January, Casey & Paulson, 2011; Durlak, Weissberg, Dymnicki, Taylor, & Schellinger, 2011)

The government and other mental health agencies hope that by tackling such topics in school and by better-educating children about mental health, steps will be made to not only demystify such issues but will crucially equip children with a more effective toolkit for managing difficult feelings. It is further hoped that lessons learned at school will have a lasting impact as children become adults.

How Can Quirky Kid help develop your child’s social-emotional learning skills?

At The  Quirky Kid Clinic, we are strong advocates for prevention and early intervention when it comes to children’s mental health issues. Prevention, is, of course, the preferred approach. In our experience, providing intervention to children and families before problems become too entrenched can often be the key to success. Where issues have been developing for some time, it can be much harder to address problems and for both the child and family such situations can feel insurmountable.

The Best of Friends® gives children the knowledge skills and confidence to understand and manage emotions, set and achieve positive goals, develop and maintain friendships and make good decisions. Designed for children aged 7 to 11, the program teaches these critical skills to children in an age-appropriate and practical way.

So embrace this potentially challenging time with your son/daughter and remember children tend to take the lead from their parents. With this in mind, try to model calm, brave behaviour whilst at the same time keeping the doors of communication wide open. By adopting these strategies your child should feel a little braver about adapting to their new classroom, teacher and school expectations.

Term 3 Social and Emotional Learning Programs for Children

If you are looking for a more extensive approach to preparing your child for Term 3, book now for our The Best of Friends® holiday and Term 3 Programs.

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References:

Durlak, J.A., Weissberg, R.P., Dymnicki, A.B., Taylor, R.D., & Schellinger, K.B. (2011).  The Impact of Enhancing Students’ Social and Emotional Learning: A Meta Analysis of School-Based Universal Interventions.  Child Development, 82(1), 405-432

January, A.M., Casey, R.J., & Paulson, D. (2011). A Meta-Analysis of Classroom-Wide Interventions to Build Social Skills: Do They Work?.  School Psychology Review, 40(2), 242-256

Myles-Pallister, J.D., Hassan, S., Rooney, R.M. & Kane, R.T. (2014).  The efficacy of the enhanced Aussie Optimum Positive Thinking Skills Program in improving social and emotional learning in middle childhood.  Frontiers in Psychology, 5, 909.

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Breaking Bad News to Your Children

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Posted on by Freya Gardon

Breaking Bad News to children

Allied health professionals, such as psychologists, can undergo years of training and practical experience to build their communication skills to deliver difficult news sensitively. They quickly learn that, when it comes to delivering bad news to children, it is essential to be prepared.

Parents, however, may need to learn as they go. At some point, all parents will have to communicate difficult or unpleasant situations to their children. Whether it’s the death of a family pet, moving away, separation/divorce, or harder still, the passing of a loved one – children and parents will need help navigating their emotional responses and behaviours through these tough times.

Clearly, this is a daunting task for anyone as we may feel inadequate to handle such situations. Research and experience tell us that the key is to let children know you are available to answer all questions and to provide as much support as needed. 

Here are some other top tips for delivering –  and dealing with the aftermath – of delivering bad news to your children.

1# Be honest

Lay out the facts at a level that is developmentally suited to the age of the child. Younger children may need help to understand the implications of the bad news and what it means for them. For example, approaching the topic of death or loss may result in a conversation about what death really means. Use words they understand and avoid saying things in such a way that might leave children confused about what you’re really saying.  Speak clearly.

For teenagers, it is particularly important not to “sugarcoat” or limit details of the information, as this is often perceived to be dishonest or patronising. A study of young adults revealed that if they viewed their parents to be hiding something, or later found out that the parents had not been entirely truthful, the response was negative.

2# Be prepared to answer their questions

Children want their questions answered.

In fact, a survey of young adults revealed those who had access to the information they wanted from their parents in times of crisis were much more satisfied than those who were told  to ask “no questions.” It is essential to schedule a time when there is enough opportunity for children to react and to think about what they want to ask, and for you to have time to respond calmly.

Avoid having difficult conversations immediately before school or work as this may be met with stress and anxiety without the chance to address these feelings appropriately.

Additionally, be prepared for awkward or tricky questions and be ready to answer them if you can. If you can’t answer a particular question, it is okay to admit you don’t know, rather than over-complicate an explanation.

3# Respect their ability to cope with the news, and their right to hear it

Respecting children’s developmental stage and maturity is essential. No one likes to be talked down to. Children whose parents speak to them as ‘equals’ feel respected and trusted, and are likely to respond with more maturity in a problematic situation.

In a research study by Donovan, Thompson, LeFebvre, and Tollison (2017) early adult respondents who perceived that their parents discussed tough issues with them more as peers, reported higher ratings of disclosure quality and in turn, greater relational closeness following the disclosure.

4# Provide reassurance

It is an essential role of parents to provide comfort and reassurance to children in stressful or distressing times. Let them it is ok to feel whatever they are feeling (e.g. sadness, anger). Confirm that these emotions are entirely valid responses to the situation.

Reassure them that you will be available to answer any questions or talk about this situation again at any time. Reassure them that they are loved.

5# Model good self-care

Share how you feel. Experiencing difficult situations, as well as talking about it with others, can be exhausting. Taking care of your own emotional well-being is essential and being honest is part of it.

Besides, it is perfectly okay to let your kids see that you are sad, angry, upset, etc. This gives them a chance to see how emotions affect other people and to learn how to regulate them effectively.

Parents are emotional role models, especially in times of crisis, and your children will inevitably look to you to assess what is an appropriate response in these times. Be natural and talk about it.

6# Seek help for yourself and your child(ren) if needed

This all being said, it is essential to reach out for help when needed; both for yourself, and for your child.

Calling on your support network and sharing how you feel or what do you need, can help everyone to cope better.

Additionally, if you’re feeling overwhelmed or the kids seem to be having an especially hard time coping, find a child psychologist who can work with your family. Child psychologists can assist you in developing an appropriate strategy for moving forward. You can contact the  Quirky Kid.

References

Brott, A.(2014, September 29) 9 tips for breaking bad news to kids[Blog post]. Retrieved from: https://www.huffingtonpost.com/knowmore-tv/9-tips-for-breaking-bad-news-to-kids_b_5623488.html

Donovan, E. E., Thompson, C. M., LeFebvre, L., & Tollison, A. C. (2017). Emerging adult confidants’ judgments of parental openness: disclosure quality and post-disclosure relational closeness. Communication Monographs, 84(2), 179-199. doi:10.1080/03637751.2015.1119867

Levetown, M. (2008). Communicating With Children and Families: From Everyday Interactions to Skill in Conveying Distressing Information. Pediatrics, 121(5), e1441-e1460. doi:10.1542/peds.2008-0565

Livoti, N.(2013, June 30)Honesty and reassurance is key when talking to kids about bad news[Blog post]. Retrieved from: http://www.pennlive.com/bodyandmind/index.ssf/2013/06/honesty_and_reassurance_is_key.html

Marshall, L.B.(2016, July 8). How to break bad news to your teen. Retrieved from: http://www.quickanddirtytips.com/business-career/communication/how-to-break-bad-news-to-your-teen