Welcome to the fourth episode of Impressive. Doctor Kimberley chats with Amanda Berlin, a former corporate publicity strategist and currently helps business owners with her expertise on PR. In this on-air consultation, Amanda seeks advice on how to deal with the frustrations when her five-year-old daughter is having a meltdown when trying to learn new things. Enjoy:
Learning patience while encouraging kids
How co-parenting works in separate households
Decisions of a new mom when finding the business suitable for starting a new chapter in her life
Impressive is a weekly podcast that sheds a new light on the world of parenting. Join host, Dr Kimberley O’Brien PhD, as she delves into real-life parenting issues with CEOs, global ex-pats, entrepreneurs, celebrities, travellers and other hand-picked parents.
In an approachable on-air consultation style, she listens to some of the smartest, kindest parents share theit latest parenting challenge with their incredible kids. Together they brainstorm solutions and Kimberley offer handy tips and valuable resources to help bring out the best in toddlers, teens and in-betweens. Drawing mostly on two decades of experience as a child psychologist, Kimberley also shares her personal insights as mother of two and entrepreneur with a passion for problem-solving.
Feeling sad is normal but how can you know if your child’s sadness is indicative of a disorder? The following article discusses what childhood depression is, how it is diagnosed, and what to look out for if you have concerns for your child.
What is Childhood Depression?
Just as in adulthood, children experience a full range of emotions; from happiness and excitement to anger and sadness. According to a recent Australian government survey, 2.8% of children between 4-17 years met criteria for a major depressive disorder (Lawrence et al., 2015). Prevalence rates were higher in the 12-17 years age group, affecting more females than males (5.8% and 4.3% respectively; Lawrence et al., 2015).
Depression is a mood disorder characterised by periods of low mood for most of the day, most days for a period of two weeks (American Psychiatric Association [APA], 2013). How it presents and the severity in which it is experienced varies from individual to individual. In children, depression can present itself more like irritability than typical sadness (Australian Government, 2018).
There is no exact way to predict who is more at risk of developing a depressive disorder. It is a likely combination of biological predisposition (i.e. the child tends to focus on the negatives of a situation) and life circumstances. In children, key social stressors focus on pivotal times of change, including family conflict, friendship trouble and difficulties at school (Siu, 2016).
How is Depression diagnosed?
Diagnoses can be made by psychologists and psychiatrists using clinical interviews and observations in context to the Diagnostic Statistical Manual of Mental Disorders or the International Classification of Diseases (DSM-5 and ICD-11 respectively; APA, 2013; World Health Organisation, 2018). Screening questionnaires like the Depression, Anxiety and Stress Scale (DASS; Lovibond & Lovibond, 1995), may be a useful tool to help discern whether an individual is experiencing clinical depression.
To be diagnosed, at least five of the following symptoms need to be observed over a minimum two week period. At least one of the symptoms is either depressed mood or loss of interest/pleasure (APA, 2013). Other symptoms include significant weight changes, sleeping difficulties, psychomotor agitation or slowing, fatigue, feeling worthless or guilty unnecessarily, reduced concentration, and/or thoughts of suicide. These symptoms need to be having a significant impact on different areas of your child’s life (e.g. socially, at school, at home).
Presentations will vary and an initial consultation between the child and psychologist and the parent would best determine whether they are expected to meet the criteria.
Early Signs to look out for
Identifying characteristics of depression in a child 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.Consider seeking help if your child is demonstrating the following behaviours (Australian Government, 2018):
Weight gain or loss
Difficulty sleeping (too much or little), nightmares
Saying negative comments about themselves or the world around them
e.g “I am not good at anything”
Feeling tired, lethargic. Hard to get your child motivated. E.g. ‘dragging their feet’
Trouble at school; with friendship groups or concentrating in class/grades slipping
Gives up easily, hopelessness e.g. “what is the point in trying, I won’t be able to do it”
Deliberate harm to self
No longer enjoying games or activities e.g. wanting to drop out of the soccer team. Avoids social interaction
Changes to eating
Sensitive to rejection or being told no
Poor memory forgets details or doesn’t seem to listen
Jumpy, cannot settle
Risk-taking behaviours particularly in adolescence e.g. drug taking
Following diagnosis, recommendations for treatment are provided and they are tailored to each unique needs. Typically, the most common treatment for depression involves a cognitive behavioural approach (Australian Psychological Society, 2018). In addition to working directly with the child, treatment considerations may include working with the parents/carers and family systems to provide strategies to assist at home.
Remember that your child will experience good days and bad days. If you are concerned your child may be depressed, talk to them, and check in on anything that may be troubling them. This can be difficult as they may not know how to verbally communicate the issue. Be supportive and remember, what you might be able to cope with, your child may be finding difficult.
Strategies for Parents
Whether you are worried about your child exhibiting some of the aforementioned childhood depression symptoms, or you are looking to help prevent the onset of childhood depressions symptoms, the following strategies may be used to support your child:
Keep your child active. Research indicates that children that participate in regular physical activity are more likely to exhibit fewer depressive symptoms in later years (Zahl, Steinsbekk, & Wichstrom, 2017).
Ensure a good diet. Changes to eating patterns is a key sign of depression (APA, 2013). Ensuring your child is well nourished with a balanced diet with limited refined sugar has been shown to foster better mental health in children (O’Neil et al., 2014).
Develop a good parent-child relationship. Parent rejection has been shown to have a strong relationship with childhood depression (McLeod, Weisz, & Wood, 2007). A parent that is actively involved in presents as interested and encouraging will help your child develop a healthy sense of self.
Social and emotional learning. Teaching your child to recognise different emotions and label them as they are being experienced can help them to better manage experiences of overwhelming emotion (Durlak, Weissberg, Dymnicki, Taylor, & Schellinger, 2008). It can also help your child to develop better social connections.
Whether your child has a formal diagnosis or not, you know your child best. Start intervention as soon as you suspect that your child’s mood is detrimentally affecting their daily functioning.
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.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Australian Government. (2018) Depression. Retrieved September 3rd, 2018, from https://www.kidsmatter.edu.au/mental-health-matters/mental-health-difficulties/depression
Australian Psychological Society. (2018). Evidence-based interventions in the treatment of mental disorder: A review of the literature. Retrieved from https://www.psychology.org.au/About-Us/What-we-do/advocacy/Position-Papers-Discussion-Papers-and-Reviews/psychological-interventions-mental-disorders
Durlak, J. A., Weissberg, R. P., Dymnicki, A. B., Taylor R. D., & Schellinger, K. B. (2011). The impact of enhancing student’s social and emotional learning: a meta-analysis of school-based universal interventions. Child Development, 82(1), 405-432. doi: 10.1111/j.1467-8624.2010.01564.x.
Lawrence D., Johnson S., Hafekost J., Boterhoven De Haan K., Sawyer M., Ainley J., & Zubrick S. R. (2015). The Mental Health of Children and Adolescents. Report on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Canberra, Australia: Department of Health.
Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales. Sydney: Psychology Foundation.
McLeod, B. D., Weisz, J. R., & Wood, J. J. (2007). Examining the association between parenting and childhood depression: A meta-analysis. Clinical Psychology Review, 27(8), 986-1003. doi: 10.1016/j.cpr.2007.03.001
O’Neil, A., Quirk, S. E., Housden, S., Brennan, S., L., Williams, L. J., Pasco, J. A., … Jacka, F. N. (2014). Relationship between diet and mental health in children and adolescents: A systematic review. American Journal of Public Health, 104(10), 31-42. doi: 10.2105/AJPH.2014.302110
Parenting Strategies (2018). Preventing depression and anxiety. Retrieved from https://www.parentingstrategies.net/depression/
Siu A. (2016). Screening for Depression in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine, 164(5), 360-366. doi: 10.7326/M15-2957
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
Zahl, T., Steinsbekk, S., & Wichstrom, L. (2017). Physical activity, sedentary behaviour, and symptoms of major depression in middle childhood. American Academy of Pediatrics, 139(2). doi: 10.1542/peds.2016-1711
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
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.
We all recognise the benefits of reading. At the Quirky Kid Clinic, we’ve put our pens to paper and compiled a list of all the subtle social, emotional and language boosts a simple ‘bedtime story’ can have. We also prepared a step-by-step guide on how to build a healthy and manageable reading routine for your family!
The Benefits of Reading
Reading is a bonding experience. Reading with your child helps to nurture your relationship with them. It’s an opportunity to spend exclusive time together without distractions or external pressures. Richardson et al. (2015) found that reading with your child helps them to feel more secure and bonded with their parent as well as helps children absorb new information faster.
Reading builds language skills. Children who are exposed to a great volume of rich language are given a head start academically and develop stronger language skills (Fernald, Marchman, & Weisleder, 2013). This ultimately impacts not only their learning and cognitive development, but also positively influences a child’s communication skills.
Reading builds coping skills. Setting aside time to read with you child provides a regular forum to contemplate and work through challenges. Reading, looking at pictures and pointing things out provides an opportunity for your child to express themselves as they relate to the characters in the story. This promotes healthy relationships and provides positive ideas and ways to express oneself. For example, a child transitioning to school may benefit from reading a story about another child starting school as walking through the experience in someone else’s shoes can help normalise their own feelings, understand their experiences and build up a set of coping strategies for these experiences.
Reading is relaxing. iPads, TVs, phones, computer games; it is often impossible to compete with the whizzing, whirring, distracting nature of these devices. Finding time in your day to sit down with your child is a crucial opportunity for quiet reflection and mindfulness. Think of it as a way of “tuning in” as opposed to “tuning out”.
Reading teaches empathy. Being able to share and understand the feelings of others is a skill crucial to building our social relationships. A study out of Cambridge University (Nikolajeva, 2013) found that reading books about fictional characters can provide excellent training for young people in developing and practising empathy. Through reading, a child experiences the feelings of another person in different situations, which helps them develop an understanding of how they feel and think. These skills, when nurtured, help the child to show empathy in real life situations.
So, we now know the benefits, but how can we put this into practice? Here are some pointers that our Psychologists here at Quirky Kid recommend for people looking to transition storytime from a rare occasion to an unmissable part of their daily routine.
Building your Reading Routine
Timing is crucial. Set reading time to about 30 minutes before the child’s bedtime. Recommended time for a reading session is between 10 and 30 uninterrupted minutes depending on your child’s age and attention span, but follow your child’s interests.
Get comfy. Make sure your reading space is comfortable and that your child can see, hear and respond easily. Limit the distractions available around you.
Be prepared. For kids who have trouble sitting still, provide things to keep their little hands busy. Providing paper and crayons to draw with or toys to look at can help, whilst still listening to the story.
If you don’t like it, ditch it. Select a captivating text that will keep both you and your child engaged. Don’t insist on reading something that you or your child are not enjoying. Everyone tastes are different after all!
Encourage discussion at every turn. Start with the cover: what do they think the book will be about? At each page: what do they think might happen next? After the book: what happened here? So many lessons can be learned from these mini-recaps!
Let them try. If your child has begun school, help them to sound out words phonetically and occasionally point to some sight words that they may recognise.
Don’t try to compete. Very few children, given the choice of watching cartoons, playing games or reading a book, are going to choose books – at least, not until they’ve developed a love of reading. Set a cut-off time for technology and give the child the choice of hearing a story or reading aloud.
Make it fun. Be as animated as you can whilst reading. This will add to the enjoyment and imagination that goes along with reading, especially for the younger children. Adjust your pace, tone and volume to the story.
Fostering a positive reading environment in the home can provide many benefits for you, your child and your family. Reading with your child not only develops their language and literacy skills, but also helps them develop many foundational skills that will support them throughout their life, including resilience and empathy skills. Setting aside thirty minutes a day to make storytime a regular and enjoyable part of your family routine is one of the best and most valuable times to raise a reader and connect with your child.
[00:00:00-00:00:32]Dr. Kimberley O’Brien introduces strategies for parents to help kids cope with traumatic news.
Hello Bonnie. It’s Dr. Kimberley O’Brien here. I’m auto-recording in Japan, so I hope there won’t be any background distractions. I’ll talk for five minutes on strategies to help kids cope when they’ve seen a tragedy, or had some sort of unfortunate event. I’ll have some tips for parents as well – I’ll fill you in on that towards the end of the interview.
[00:00:33-00:02:27] Parents shouldn’t shield children from all forms of adversity. Instead, teach them coping strategies for stressful events, since those are an inevitable part of life.
The first thing you said was about helping kids to deal constructively with bad news, rather than sweeping it under the carpet. I agree that it’s a healthier approach, because it’s really setting them up for life. It’s giving them the skills to overcome adversity, without feeling like a parent is required to shield them from something that’s not appropriate for kids to hear.
From a young age kids are learning how to overcome physical injuries. Like toddlers grazing knees – they hop up and brush themselves off, and then life goes on. They can cope with those sorts of little incidents. And if we do shield the kids from all adversity, then they don’t learn the coping skills they need in certain situations, like if they are not good enough for a sports team, or if they’re excluded from a game at school. Teaching them coping skills is like teaching them life skills that help them to be more resilient. And it gives them confidence to be able to overcome issues moving forward. That’s part of healthy psychological development.
Imagine adults that haven’t learned to overcome adversity. They’re more likely to react negatively, perhaps need a lot more support, and need to take time off work if they haven’t learnt to cope with life’s issues that will come our way. That’s just part of life, isn’t it? Kids will have to change schools, or they may lose a pet or loved one. That stress is a part of living, so it’s something that kids need to learn to cope with.
[00:02:27-00:04:08] Encourage children to express their feelings in words, rather than through actions. Praise them for expressing themselves clearly, and empathise with them verbally. When something bad happens, let kids write down questions in a booklet, so you can answer those questions when you feel prepared to remain calm during the discussion. It’s a way to model good coping skills.
The best way to do this, for parents, is to prepare for question time if it’s something that’s happened for a young person, like the loss of a pet. Have a question booklet that kids can record some questions in. And then make sure you feel prepared emotionally to answer each one of those questions. When I say prepared emotionally, I mean that children often take their cues from their parents. If parents are very emotional, kids will often follow suit and become quite emotional. So being prepared to model good coping skills as a parent is important. Say “these things happen but we will get through it”. Use words to explain those feelings.
Sometimes kids will use actions or behaviour to express their emotions. For example, they may feel disappointed, or upset that they didn’t make the sports team, and they may throw their sports bag across the room. But what we want kids to do is to use their words, and say “I feel so disappointed, I’m so jealous that my best friend was selected and I wasn’t”. Parents should then use verbal praise to say “I’m so glad to hear you express yourself so clearly, now I understand how you feel”. Parents can empathise with young people: “I’ve felt that way before, this must be hard”. Empathising is also part of helping kids to express their feelings in words, rather than in actions.
[00:04:08-00:05:01] When it comes to family trauma, such as a separation or a tragedy, it’s better to get professional help because they can remain objective and provide the family with support.
Just a final point now, for parents on how to help kids through family separation. It’s good to encourage them to see a psychologist, such as someone at the Quirky Kid Clinic or a school counselor, to help them normalize those feelings. Often if parents are involved in situations, like if there’s been a tragedy or trauma within the family, it’s better to get professional help. A professional can remain objective and provide kids and parents with stats on how often these things occur, how long it may take kids to recover, and what the phases of grief and loss may be. It’s good to have an expert when dealing with family separation or similar situations.
[00:05:01-00:05:58] When a tragedy happens, stick to the basic facts when relaying the news to the child. Avoid delving into the causes, or exposing them to distressing images, to avoid more of an emotional response.
And finally, a tip about how to relay the news to a child. Say it was something that happened in the world, like a tsunami. We often get rising referrals when there’s been a trauma, like a tsunami, and kids have seen it on TV. It’s best to switch off the news when there’s lots of visual, distressing images for kids to catch. Parents have more control when they’re giving the news to the young person. Stick with the facts: what happened, how it happened, when it happened. Avoid going into the whys, because that’s often going to trigger more of an emotional response.
[00:05:58-00:06:50] Apart from verbally expressing themselves, it can also be useful for kids to use art or visual props to talk about how they felt before, during, and after an incident.
I’m going to wrap up now. To help kids deal and process emotions, help them to use their words to understand those feelings, or to seek help from a professional. Sometimes kids will express their feelings using art, so give them an opportunity to draw what happened. Or, they can select images, such as from our “Face It” cards, which are feelings cards with a whole bunch of different facial expressions. Children can use them to talk about what they felt before, during, and after an incident. Visual props can be very helpful.
Bonnie, it’s been a pleasure to answer your questions today, and I look forward to talking to you again in the future. I’m Dr. Kimberley O’Brien from the Quirky Kid Clinic. That’s www.quirkykid.com.au. And keep in touch. Thank you.