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Eating Disorders among Children and Young People

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Posted on by Leonardo Rocker (Quirky Kid Staff)

Eating disorders are among some of the most serious and challenging mental illnesses that affect  children and young people. Eating disorders are characterised by the presence of unhealthy or extreme views of one’s weight and/or shape, which lead the young person to engage in dangerous eating and/ or exercise behaviours. These behaviours severely impact on the young person’s life, affecting their ability to function at school, home and in their relationships.

In 2012, it was estimated that around 4% of the Australian population suffered from an eating disorder, with females making up more than half the total (The Paying the Price Report). Estimates suggest up to 75% of adolescent girls perceive themselves as overweight or want to lose weight (www.nedc.com.au). Real prevalence rates may be even higher due to the secrecy, shame and guilt often associated with eating disorders in children and young people.

Watch our Info graphic on Eating Disorders

While eating disorders in children and young people can start at any age, youth between the ages of 13-18 years appear to be most at risk (TPTPR). The Mission Australia’s Youth Survey, 2012, demonstrated that body image remains to be one of the top three issues concerning Australian young people. The age at which children are starting to think about body image and dieting appears to be reducing (American Academy of Pediatrics, 2003). Children as young as five years have identified the desire to be slimmer (Hamilton, conference) and around a quarter of our teenagers are experimenting with dangerous dieting behaviour (eg. taking laxatives, engaging in excessive exercise) (Hutchings,Conference). Australian research suggests that the prevalence of disordered eating behaviours have increased two-fold between 1995 and 2005 (TPTPR).

In light of this, knowing how to identify the signs of an eating disorder and knowing how to help your child are essential.

What are the types eating disorders?

There are several types of eating disorders in children and young people, with the most recognised being Anorexia Nervosa and Bulimia Nervosa.

  • Anorexia Nervosa is characterised by significant weight loss, below what would be expected for the person’s age and height, with an accompanying intense fear of gaining weight or becoming ‘fat’. People with Anorexia Nervosa see their bodies in a distorted way, typically believing they are fat even when they are extremely underweight.
  • Bulimia Nervosa is characterised by seemingly uncontrollable episodes of eating to excess, followed by behaviours aimed to rid the body of the calories ingested, such as undertaking excessive exercise, taking laxatives and vomiting. People with Bulimia have a preoccupation with their weight and shape and typically feel a great sense of guilt and shame, often meaning they go to great lengths to hide their behaviours.

While Anorexia Nervosa and Bulimia Nervosa are typically the most recognised eating disorders, the most common eating disorder is  Eating Disorder Not Otherwise Specified (EDNOS), which affects more than half of those with a diagnosed eating disorder. A person experiencing EDNOS typically presents with a distorted view of their weight and shape, an intense fear of gaining weight and disturbed eating patterns. While a person with EDNOS will share but not meet all the criteria for Anorexia Nervosa and Bulimia Nervosa, the disorder is by no means any less significant or serious.

 

What causes eating disorders?

Two significant risk factors for developing an eating disorders to be aware of are:

  • disordered eating eg. dieting, fasting, avoiding food groups. Australian and New Zealand research indicates that engaging in moderate dieting behaviour puts young people at a six-fold risk of developing  an eating disorder and that engaging in extreme dieting puts young people at an 18-fold risk (www.nedc.com.au).
  • body dissatisfaction eg. feelings of shame and anger over one’s body shape, preoccupation with body shape, distorted  body image (TPTPR).

While there is no one cause of eating disorders, genetic vulnerabilities (eg. a parent with restrictive eating behaviours), psychological factors (eg. low self esteem, perfectionists traits), cultural factors (eg. a culture that promotes thinness and dieting) and stress (eg. bereavement) all appear to play a role in the development of eating disorders.

How can I tell if my child may be developing an eating disorder?

Below are some signs that your child could be developing an eating disorder. Of all the signs, disordered eating, such as restrictive dieting, fasting, limiting food groups, binge eating, laxative use, self induced vomiting and using diet pills, is the most significant indicator that your child may be developing an eating disorder.

Additional signs include:

  • Physical changes:  for example, significant changes in weight and weight loss, disturbed menstruation in females, general lethargy and looking pale and gaunt, feelings of dizziness, dehydration, sleep difficulties, dental decay.
  • Behavioural changes: for example, frequent weighing of self and commenting on being ‘fat’, secretive eating habits, wearing baggy clothes to conceal weight loss, denying there is a problem, attempting to harm oneself, withdrawing from socialising and family life.
  • Psychological Signs: for example, expressing fear of gaining weight, foods and bodily changes, self loathing, expressions of guilt, changes in mood and loss of motivation and enthusiasm for life.

What do I do if I am concerned that my child has an eating disorder?

Early intervention is best when it comes to treating eating disorders. People with eating disorders commonly attempt to hide their eating behaviours and weight changes from family and friends and so early detection can be difficult. Here are some tips for parents:

  1. be familiar with your child’s eating habits by regularly eating together. This will help you recognise if eating habits change and/ or become restrictive
  2. listen to how your child discusses food – are they talking about dieting, ‘bad’ foods, being fat?.
  3. look at your child – has their mood changed? are they more difficult or secretive at meal times? Are they struggling with getting to sleep and/ or worrying about their body image?

If so, these are warning signs that your child needs help. Given that eating disorders can result in serious medical complications it is advisable that the first step be a visit to your GP.

The good news is, with intervention, support and commitment to recovery, eating disorders are treatable. Treatment for an eating disorder typically involves the help of variety of people including a psychologist, nutritionist, GP, paediatrician, psychiatrist and specialist physician. This ‘team approach’ is aimed to address the eating disorder from a medical and psychological perspective and support all of the child’s needs. While some children may require hospitalisation if they are acutely unwell, treatment typically occurs in a community setting.

Treatments of eating disorders in children and young people typically take a family focus. Families are involved in all treatment phases, for example, in helping their child gain control of disordered eating behaviours and supporting their child in addressing some of the psychological and emotional issues that arise.Treatment involves helping the child/ young person back to a healthy weight range while addressing their distorted attitudes to themselves and food.

Families form an important part of treatment, as children and young people with eating disorders do not always view their eating as and problem and often minimise their problem behaviours. Showing your child that you are concerned about them and available to help is an essential role parents and caregivers have in the recovery process.

Recovery is an individual process that can be lengthy and include many ups and downs. The important thing to remember is that bumps in the road are common, however, should be viewed as learning tools rather than setbacks. Focus on what you and your child have learnt from the experience rather than the negatives and frequently reflect on the overall gains your child has  made.

As a parent and/or caregiver, it is important to reflect healthy ideas about your own body image, avoid looking in the mirror and making negative comments about yourself, share with your child all the things you value about them that are not associated with their weight or shape and remind them of all the positives associated with getting better.

What can we do as a community?

Today’s society can be a challenging one for our children to grow up in. The constant portrayals in the media of super skinny women and muscled men can lead children to measure themselves against ideals which are hard or impossible to obtain.

As a community, some ways to help our young people cope with these influences are:

  1. Discuss with children that media portrayals are typically unrealistic and misrepresented. Media portrayals of models and celebrities are typically airbrushed, photoshopped and reconfigured in such a way, that moves these images dangerously away reality. Help your child critique the images they see and view them for what they really are.
  2. Limit and filter images that you child is seeing in the media and create a space for open discussion when unrealistic images are viewed.
  3. Discuss the uniqueness of individuals. Help children and young people identify unique qualities in themselves and their friends which make them valuable and important members of society. Help children recognise that they are more than what they look like and that being a certain body shape does not bring happiness, success or love.
  4. Be a role model: focus on your own positive qualities and talents, express positive attitudes to your own body, have a healthy and balanced lifestyle that incorporates healthy eating and exercise and focus on healthy-lifestyle goals rather than weight-loss focused goals
  5. Say positive things to yourself and others each day. Children and adolescents form beliefs about themselves from others around them. Being positive and content helps children internalise these attitudes for themselves.
  6. Lobby the media, fashion and advertising industries to adhere to codes such as The Voluntary Industry Code of Conduct on Body Image and Positive Body Image, which support the use of positive body image practices.


References:

The Mission Australia’s Youth Survey 2012
National Eating Disorders Collaboration 2011 
What’s Happening to our Girls? What’s Happening to our Boys? 2012 Booked Out Conference Sydney
http://www.maggiehamilton.org
American Academy of Pediatrics (2003). Policy statement: Identifying and treating eating disorders. Pediatrics, 111, 
204-211

The Paying The Price Report: The economic and social impact of eating disorders in Australia

Headspace: National Youth Mental Health Foundation: Myth Buster: Eating Disorders Fact Sheet

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Family, Society and School: Where do we want to go?

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Posted on by Dr. Kimberley O'Brien

“Family, Society and School: Where do we want to go? is the theme of the May 2012 Education conference in Sao Paulo, Brazil, attracting 15,000 educators from around the world and as the only Australian speaker, I am nervous! Apparently, I will be fielding questions from the audience pertaining to the cooperative relationship between schools and families, otherwise known as Family-School relations.

Family-School relations differ between schools and between families. Some families are very involved, others are not. Some schools throw their doors open to parent volunteers, others do not. The question of, “where do we want to go?” encourages us to develop an ideal scenario for our children, incorporating the positive input of families, schools and greater society.

The Best Case Scenario

In my opinion, the best case scenario for primary school students is to see their parents regularly interacting with teachers, other parents and students in the school grounds. Similarly, I like the concept of parent volunteers in the classroom for reading support, weekend working bees in the school vegetable garden to generate a sense of belonging at school, as well as open communication between educators and parents on any given day. Younger siblings who feel welcome in playgrounds with parental supervision are more likely to experience an easy transition from home to school upon commencing Kindergarten.

The Reality

In reality, our child psychology clinic commonly receives referrals from frustrated parents seeking support when their children are refusing to attend school, or when both parent and child would like to change schools after months or years of family-school conflict. Other parents report strict school policies limiting parent-teacher contact to avoid a bottle-neck of parental traffic in classrooms before and after school. We also work with the parents of children with diagnosed Learning Disabilities or an Autism Spectrum Disorder (ASD). These families most regularly request classroom or playground observations. Some mothers sing the praises of schools, doing everything possible to increase classroom support for their child and others reports teachers have suggested they seek out another school option to gain more appropriate support.

Inside a Brazilian School

The Quirky Kid Clinic started researching school culture in 2006 as part of the School Days Project. The video below offers insight into what a school in Brazil looks like, through the eye of 10 year old, Riana, a student from Curitiba in Southern Brazil.

 

When parents disengage

A global perspective on Family-School relations suggest many schools are struggling to receive any support from parents. In Northern Brazil, for example, teachers often report minimal involvement from parents despite their attempts to make contact, particularly when there are large sibling groups attending the local school. In some cases, parents are working long hours to support their large families while others with limited educational opportunities in their own childhood, may lack confidence and avoid engaging with teachers.

There are many reasons parents disengage with teachers and this phenomenon is common across all socioeconomic groups. How many time-poor parents in Australia put school activities on the bottom of their agenda? And how many others find the active parent community overzealous and off-putting? Most importantly, how can we reach all parents and teachers in a meaningful way to ensure a common connection in the interest of the student community?

When I ask the young clients I work with about their family’s involvement with the school, they commonly report their parent’s opinion of the school, stating, “Mum wants me to change schools because my teacher won’t tell us anything”. In my experience, when parents have a negative opinion of the school, the teacher or the homework policy; students typically follows suit, with an identically negative opinion. Mental note, never put a teacher down in the presence of a child! Parental opinions count, at least in the eyes of your school-aged children.

Research findings

Educational psychology research emphasizes the importance of consistency between home and school to increase a child’s sense of stability in both settings. A student’s connection to school is increased with parental involvement in activities such as reading support or canteen duty. Students with a sense of stability and connection to school are less inclined to ‘drop-out’ of school or struggle with academic motivation. Parental motivation to become involved in school activities is similarly relevant in this story, as a means of modeling a positive life skill to young people.

Generating change in Family-School relations

School events, such as a disco, fete or sports carnival often generate support from parents when resources are limited. Importantly, parents have the capacity to positively influence the school-family relationship. An active parent community will generate ideas for fundraising or similar and delegate jobs between themselves. Schools soon learn the value of this input. Alternatively, schools wishing to generate more parental involvement would do well to promote the benefits by acknowledging families for their participation while providing diverse opportunities to appeal to a broad range of skills, from gardeners to craft assistants. Parents who volunteer to assist with sports or weeding at school, typically report the benefits of physical activity as well as fostering the parent-child relationship. Being present at school is also an opportunity for parents to observe their child’s friendships; to gain insight into teaching techniques and to gain confidence within the school community.  Making a start on Family-School relations requires both parents and teachers to find traction and build momentum before the results become clear.

Summary

So, family, society and school: where do we want to go? My aim is to be part of a supportive, functional and resourceful community where educational aspirations are achieved and dreams are encouraged. Every school could be a microcosm of the same ‘warmth and generosity’, demonstrated by the most committed and kind-hearted teachers and school volunteers. The ones who dig deep within themselves to present all children with a world of opportunities and unwavering stability. But let’s not forget to mention the potential of time-poor working parents, who would love nothing more than to volunteer and see more of their school-aged children! By making the family-school relationship a priority in our society, children not only have the pleasure of recognizing a familiar family face in the school crowd; we also begin to work towards a common goal.

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ADHD and Education

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Posted on by Leonardo Rocker (Quirky Kid Staff)

Recent discussions on education is pointing to the need for re-thinking the way children receive education. Here at the Quirky Kid Clinic, we have long advocated on a child-focused approach where each child receives the most appropriate education strategy or intervention. We work from the child’s perspective, making use of strong creative approaches and make sure parent and child understand each other. To-date, we offer consultancy to a range of educational institutions

The same perspective – on the education system and ADHD – was echoed by creativity expert Sir Ken Robinson. During his presentation, he makes a strong argument against the use of medication as the principal method of treatment with children diagnosed with ADHD. This is also a strong focus of Quirky Kid’s work with children and families experiencing ADHD.

In summary, he indicates that our children are living during the mot stimulating period of our existence and we are penalizing children and demanding they listen to, at times, boring non- interactive classes – by medicating them. There are much more to his presentation, so please watch below:

Please see the video below:

If you would like more information on ADHD interventions at the Quirky Kid Clinic, please contact us.

Educational Revolutions

Recent discussions on education are pointing to the need for re-thinking the way children receive education. Here at the Quirky Kid Clinic we have long advocated on a child-focused approach where each child receives the most appropriate education strategy or intervention. We work from the child’s perspective, making use of strong creative approaches and ensure parent and child understand each other. To-date, we provide consultancy to a range of educational institutions

The same perspective – relating to the education system and ADHD – was echoed by creativity expert Sir Ken Robinson. During his presentation, he makes a strong argument against the use of medication as the principal m

Educational Revolutions

Recent discussions on education are pointing to the need for re-thinking the way children receive education. Here at the Quirky Kid Clinic we have long advocated on a child-focused approach where each child receives the most appropriate education strategy or intervention. We work from the child’s perspective, making use of strong creative approaches and ensure parent and child understand each other. To-date, we provide consultancy to a range of educational institutions

The same perspective – relating to the education system and ADHD – was echoed by creativity expert Sir Ken Robinson. During his presentation, he makes a strong argument against the use of medication as the principal method of treatment with children diagnosed with ADHD. This is also a strong focus of Quirky Kid’s work with children and families experiencing ADHD.

In summary, he indicates that our children are living during the mot stimulating period of our existence and we are penalizing children and demanding they listen to, at times, boring non- interactive classes – by medicating them. There are much more to his presentation, so please watch below:

Please see the video below:

If you would like more information on ADHD interventions at the Quirky Kid Clinic, please contact us.

ethod of treatment with children diagnosed with ADHD. This is also a strong focus of Quirky Kid’s work with children and families experiencing ADHD.

In summary, he indicates that our children are living during the mot stimulating period of our existence and we are penalizing children and demanding they listen to, at times, boring non- interactive classes – by medicating them. There are much more to his presentation, so please watch below:

Please see the video below:

If you would like more information on ADHD interventions at the Quirky Kid Clinic, please contact us.

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Kids and Facebook @ 7 News

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Posted on by Leonardo Rocker (Quirky Kid Staff)

Kimberley O’Brien, our principal child psychologist, discussed the use of Facebook and study time with report Pippa Gardner from Channel 7 . You can find  useful, practical and informative advice about parenting by visiting our resources page, – or discussing it on our forum.

Watch the segment below or visit Channel 7 website.

If you have a story and would like to discuss it with us, please contact us to schedule a time. Kimberley O’Brien enjoys sharing the best of her therapeutic moments with the media. View our media appearances to-date.