A Child’s Brain

Parents there is something you can do that can make your life as a parent much easier. You can remember that your children are children not little adults. Many parents expect their children and teenagers to be able to function as little adults. When they don’t, parents often get mad and then we have an argument.

Remember when a baby is born their brain is still placid. What this means is their brains is still developing. Just like the “soft spot” in a baby’s skull. When they are born all of the bones in a baby’s skull have not grown together. They are still developing.

This placidly is there usually until a child is around 18 years old. If any of your children have had a head injury around age 9 or 12 and the physician tells you their body can compensate, this is what they are referring to. Since their neurological system is not completely developed, if there is an injury, their neurological system can find away to bypass the injury.

This is a wonderful thing for children considering how often they are injured. However, there is a cost to this developing neurological symptom. Children’s frontal and prefrontal cortex do not fully develop until the age of 18.

What does this mean to you as a parent? It means that you cannot expect your child to reason as an adult would reason. Children and teens typically have concrete reasoning skills until their brain is fully developed. When the brain is fully developed then they have abstract reasoning and can think a head about consequences. Until such time their ability to do so is limited.

If parents will remember this fact and adjust to it, you can decrease your stress. This is why I recommend contracts and agreements. They reduce the need for a child or teen to have to do abstract thinking right on the spot. When you make agreements and contracts with your teen you assist them with and model abstract reasoning. You also increase the likelihood that they will make a good choice versus a poor choice.

Also if you remember the limitations your child is dealing with, if they make a mistake you can respond in a more appropriate manner. If you expect them to reason like an adult and they make a mistake, you are going to be more stern in your reaction. If you remember that they cannot handle abstract reasoning yet, your response and consequence you set will be more appropriate. Also your teen will learn more.

Remember, we are always telling kids you will have to wait until you are an adult. Therefore, when they make a mistake even if they are 15, we need to remember they are not an adult yet and respond in that manner.

Dr. Michael Rubino specializes in treating children and teenagers. He has over 18 years experience working with teens. For more information about Dr. Michael Rubino or his private practice visit his website at http://www.rcs-ca.com or Facebook page at http://www.facebook.com/drrubino3.

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We don’t have drive by shootings in Walnut Creek

I have spoken to a number of schools in the Pleasant Hill, Concord and Walnut Creek area about showing the documentary, The Mask You Live in, and about providing anti-violence and anti-gang education. The common response I receive is, “we don’t have those problems here.” Well tonight in an upscale neighborhood in Concord an 8 year old boy was shot in a drive by shooting. The boy is currently being treated at Children’s Hospital, Oakland. Unfortunately, this proves my point. We do have these issues in Pleasant Hill, Concord and Walnut Creek.

I hear very often from teenagers and kids in middle school that they need to take a weapon with them to school or when they are downtown for protection. They tell me they are afraid of getting jumped. When I point out that if they have a weapon, such as a knife, with them at school or downtown that they can be arrested, they respond that is a risk I’m going to have to take. If I say that by having a weapon they are increasing the odds that they will be hurt, I hear, “if I don’t have one I will get hurt any way. So what’s the difference?”

What is the difference? We have 6th graders willing to take a chance of getting killed because they believe the odds are high enough that they will be severely hurt by someone taking the chance of being killed is not a big risk. What are we doing to help are kids? Nothing, because we don’t live in Oakland or Richmond.

We need to wake up. The shooting tonight is not the first one. A few years ago a teenager was shot in Danville standing outside his front door. There are many kids who regularly carry knives to school or with them to downtown Walnut Creek and Pleasant Hill. These are not black teenagers or Mexican teenagers. These are Caucasian teenagers from families that make well over One hundred thousand dollars a year. It could be your son or daughter, you are saving. Yes girls are carrying weapons too.

What do we do? First we stop hiding behind a stereotype. These problems do not just exist in East Oakland, Richmond and Pittsburg. We need to admit that these issues do exist in Pleasant Hill, Concord, Walnut Creek, Lafayette and Danville. No one is immune from these issues any more. The next thing we need to do is to start to deal with the issues facing our teenagers. Drug overdose, violence, such as shootings, and suicide are at an epidemic rate in teenagers. These are the primary ways teenagers are dying today. They have a better chance of dealing with cancer than they do with these other issues.

Therefore, we need to educate ourselves. Ask your schools or churches to get a copy of The Mask You Live In and watch it. Ask professionals to come speak to your parent groups about these issues and how to help your teenagers. We have two fantastic groups which started in the Bay Area and are respected world wide right here. One is Challenge Day and the other is Alive and Free. We cannot help our teens until we are aware of these issues. Teenagers want the help too. They are tired of living in fear and they are beginning to believe that no one cares this is why they are taking matters into their own hands.

Show them you care by doing something to educate yourself and stop this cycle of violence and abuse teenagers are living with daily. Also I am on the national Alive & Free Board and I am available to work with teenagers and parents. I am one of the few therapists who runs an anger management group for teenage boys in this are and we deal with all these issues. In fact, I had just decided yesterday to start another group. If you have questions, contact my office.

This may sound scary, but if we all work together we can help our teenagers and ourselves.
Dr. Michael Rubino is an expert in this area and has been works with teenagers and these issues for over 18 years. For more information on Dr. Rubino or his private practice groups visit his website http://www.rcs-ca.com, his Facebook page at http://www.Facebook.com/Drrubino3 or follow him on Twitter @RubinoTherapy.

The Scary Reality of Middle School

As a therapist who works with adolescents, I am very familiar with what is happening on High School and Middle School campuses. Often when I mention to parents who have a child going into middle school or a child in middle school, if they have spoken to their child about drugs and alcohol, I am told no.

I hear these parents say every day that they don’t need to worry about drugs or alcohol with their child in middle school because their child is too young for that right now. Well the reality is these parents are wrong. Drugs and alcohol are just the tip of the iceberg. Children that are in the age group of middle school are now involved in very adult activities.
To begin with, most campuses are better pharmacies than your pharmacy. I have had middle school kids say they can get Vicodin, Concerta, Ecstasy and of course weed and alcohol on the campus. Some kids use at school and some use after school and on the weekends. More and more middle school kids are deciding to experiment with drugs and alcohol due to the pressure to succeed and fit in with friends.
Also many middle school kids are sexually active, but they don’t think they are sexually active. They think because they are not engaging in intercourse and they are engaging in oral sex that it doesn’t count. The kids say they are just messing around with each other and do not consider this sex. They also have no idea about sexually transmitted diseases or how to protect themselves. However, the number of middle school kids engaging in oral sex and intercourse has increased significantly over the last few years. The rate is now high enough that some middle schools, such as the San Francisco School District, are disrupting condoms to middle school kids.

Another common issue in middle school is bullying. However, we are not just talking about one kid teasing another kid at school. Often there is a group of kids teasing one kid and it is not just at school. Now kids are using Facebook, Twitter, Instagram and texting by phone to tease and harass other kids. And as many of you may recall there have been a number of kids who have committed suicide due to the teasing at school. Also a number of middle school students have been arrested for photos they text and for harassment. Texting a photo of a child in middle school means the middle school child violated child pornography laws. Something many parents are not aware of is that when a child texts a nude photo of a middle school age student it violates child pornography laws and the child who text it and received it can both be arrested.

Also many kids in middle school, especially boys, don’t feel safe and are afraid of someone trying to beat them up before or afraid school. They say they have to fight because other kids are recording it and posting it on YouTube. If they don’t fight the other kids will think they are a “whimp” so they have to fight. Due to this fear many middle school students carry knives, metal pipes, guns or anything they can think of to protect themselves. This is very sad kids have to live in fear for their safety. Also parents and students don’t realize, if a student is caught with any of these items on campus they can be removed from their entire school district and required to go to continuation school. In addition, the school can have the student arrested. Due to terrorist activities, schools take anyone possessing items that can severely hurt someone very seriously.

These are just a few of the issues that are occurring at all middle schools and they are very serious. Your child is not going to come to you to ask about these issues or tell you about them because they feel embarrassed and they are afraid of getting in to trouble. So parents even though you may feel embarrassed or awkward discussing these issues with your 11 year-old child, please do so. If you notice anything about your child’s behavior that seems different to you and you feel a sense of concern, ask your child about what is happening at school and with friends. Mention they are getting older so are there issues regarding drinking, sex or being teased that they need to talk about. You may be saving their lives because they are dealing with things they know nothing about and these things can kill or have life long effects.
Here is a YouTube video that might help:

Dr Michael Rubino is an expert dealing with adolescents and adolescent issues. He has over 18 years experience treating adolescents. For more information about Dr. Michael Rubino’s practice check his web site http://www.rcs-ca.com or his profile on LinkedIn.

Dealing with Your Teenager & the Prom

Yes it is that time of year again — Prom Season. Along with the prom come the concerns of who will I go with? What will I wear? How much can I spend on a dress? and a number of other issues. Hopefully, you and your teen have already discussed the issues around dating and have agreements regarding dating. If not, Prom may be a harder issue because now you have to deal with issues regarding dating and Prom.

As a parent, the first thing to do is to contact your teen’s High School and see what rules and guidelines the school has already established. Many High Schools have rules regarding who can attend, such as only students of that high school can attend, a dress code and some high schools require you to inform them if you are going and your date’s name and the telephone numbers for both set of parents. They do this so if your teen fails to arrive by the designated time or if there are any problems at the Prom, they know who to call.

Another reason to contact the school is to find out where the Prom is being held. Due to the number of drunk driving deaths, deaths due to drugs and due to the costs being so high, a number of high schools have the entire Prom on the school campus. They serve dinner and have the dance at the school. Once you have the details then it is time to discuss with your teen what your expectations are regarding the Prom. This is also the time where you will set the rules for the Prom and make your agreements with your teen.

Assuming the Prom is not being held at the campus and instead being held at a Hotel, there are a few items to discuss. The first issue is price. Most teens want to go to an expensive dinner, hire a limo for the night and for the girls there is the Prom dress. I have seen teens spend over $2,000 on their Prom dresses. A limo for the night can cost $800 and dinner can cost $200. If you have this money and are willing to indulge your teen then there is no problem. Most parents don’t have this extra money so you need to agree on a budget. For example, a limo is not a necessity for the Prom. As a parent you may feel safer with a limo because your teen is not driving. Also there is a new law and limos cannot carry liquor when they are driving for Proms and they must card anyone consuming alcohol in the limo. You can bring the price down by having your teen split the cost of the car with 2 to 3 other couples. However, you will want to talk to the parents of your teen’s date and any friends they are going with to ensure all the parents agree.

Another option is letting your teenager pay for part of their prom. There is nothing wrong with expecting them to contribute to the limo, pay for the dinner and for girls, they can pay for part of their dress. This is a good way to start teaching your teen about saving money and how much things really cost.

If you have a daughter you need to negotiate the cost of the dress or consider renting a dress. In my opinion she does not need to spend $500 on a dress or more to look good. The same rule goes for her hair. She does not need to spend $300 on styling her hair for one night.

You also need to talk with your teen regarding your expectations about consuming alcohol, using drugs and sexual activity on Prom night. Many teens plan After Parties for their Proms. Quite often at the After Parties is where the drinking, drug use or sexual activity occurs. This is another reason why it is important to know who your teen will be going with to the Prom and their parents. You should never allow your teen to go to an After Party where there is not adult supervision. If the party is at a friend’s house with adult supervision and you have spoken with the adult, there should be no problem. If your teen wants to rent a hotel room so their date and their friends can have a party, this is a huge problem and should never be allowed. There are too many incidents where teens overdose, drink to the point of alcohol poisoning, get pregnant or trash the hotel room. Most hotels will not rent a room to someone under 18, but many teens find away around this rule and some parents will rent the room for their teen. Another reason to know you teenagers friends and parents.

Another issue to discuss is curfew. Yes it is their Prom and you want them to have a good time, but there is no reason why they need to stay out the entire night or for the entire weekend. If there is adult supervision the entire time it may work. If there is not adult supervision it is a recipe for disaster.

Finally, you need to have a discussion with your teen regarding acting responsibly and self-respect. The Prom is a major event and it is another step that your teen is taking into the adult world. They need to remember if they want to act like adults, they have to be willing to accept being treated like an adult. So if they violate the rules that their school has established for the Prom, they may be giving up their right to graduate with their class. The Prom should be a happy event that you and your teen both remember for a long time. If you discuss the issues before the Prom and come to agreements that you both accept then it should be a safe, happy event for all. Good luck!

Dr. Michael Rubino specializes in working with teenagers, their parents and high schools. For more information on his work visit his website at http://www.rcs-ca.com or follow him on Twitter @RubinoTherapy.

Divorce, Children & Parenting

When parents get a divorce they can stop being husband and wife, but they cannot stop being parents. I often see parents forget that a divorce doesn’t stop the need for them to work together as parents. You may not like each other and you don’t have to, but you have to figure out how you are going to co-parent together.

Often I am working with children who are being placed in the middle. The child is expected to pass messages back and forth between the parents. So for example, dad well say don’t forget to tell your mother about baseball practice. It is not the child’s responsibility to relay messages. As parents you must communicate with each other. If you have a difficult time talking in person or by telephone use email. If you are having problems with your personal emails where someone said they never received an email. Many counties now have a program called “The Family Wizard” and it tracks emails and you can allow professionals to monitor the emails if you wish. The most important thing is you find a way to communicate.

I also see children being put in the role of therapist or best friend. Parents feel overwhelmed or are angry about the divorce process or results and that start talking to their child about “what your mother or father did.” This is not a child’s role. Furthermore, all divorces have an order not to discuss the issues with the children. If you need someone to speak to try going to therapy. If your child is asking questions, simply say that is an adult issue and they don’t need to worry about it.

Another major issue I see working with children in therapy is financial. Who is going to pay for baseball sign ups, Boy Scouts or Girl Scouts etc. often father’s feel they don’t need to pay because they pay child support. Don’t put your child in the middle of these arguments. Your child is the one who gets hurt and they will choose to stop doing outside activities because they don’t want the argument. The are points on both sides, but remember you want to do what is best for your child. While you are going through the divorce process it is a good idea to discuss these financial issues and decide how to handle them. Also come up with a plan for how you will discuss financial issues that come up after the divorce that you have not thought about during the divorce. If you are already divorce and having these issues, look at going to a therapist that specializes in co-parenting. This therapist will be familiar with these issues and can assist you work through these issues. The main point is you don’t want to put your child in the middle and you want to do what is best for your child.

Remember, when you get a divorce you stop being husband and wife but you don’t stop being parents to your children. If you don’t want the divorce to have a negative impact on your children then you must learn how to co-parent. This means the two of you work together to make parenting decisions and you don’t put your child in the middle. The goal is that your child is not even aware of these tensions. It is not easy, but there are professionals that can help. Don’t be afraid to ask for help.

Dr. Michael Rubino has over 18 years experience working with people dealing with high conflict divorces. For more information about Dr. Rubino’s work or private practice visit his website at http://www.rcs-ca.com

Does My Child have ADHD?

Does my child have ADHD? I hear this very often and do many assessments on children to determine if a child has ADHD. Yes ADHD is a really disorder, but too many teachers and schools rush to the conclusion that a child has ADHD.

According to statistics by the American Psychological Association, five percent of children in the United States have ADHD. It is also more common in males and it does tend to run in families. However, not every child who has ADHD requires medication. Many children can be treated with psychotherapy and behavior modification. Therefore, if your child is diagnosed with ADHD do not rush to medicate your child. There are different subtypes of ADHD and different severities of the diagnosis.

If you feel your child may have ADHD or their school suggests the idea make sure you have your child appropriately assessed. In the past schools would often diagnosis children with ADHD. Schools are no longer supposed to make this diagnosis. If they feel a child might have ADHD, they are supposed to have your child evaluated.

If you are going to have your child evaluated for ADHD, make sure you take your child to a mental health clinician who specializes in children and in doing assessments. The assessment for ADHD is not very difficult and an appropriate evaluation by an appropriate mental health clinician should cost around $250 depending on where you live. I have seen some parents who have spent thousands of dollars getting CT scans, MRIs and PET scans. You do not need an expensive scan of your child’s brian to diagnosis ADHD.

The DSM V, the diagnostic manual that mental health clinicians use, list the criteria needed for the diagnosis. I am including a link to the Center for Disease Control which list the criteria for the diagnosis and other information about ADHD, http://www.cdc.gov/ncbddd/adhd/diagnosis.html. Typically the diagnosis can be made by a clinician interviewing the parents, having a play session or two with the child and observing the child at school or consulting with the teachers. However, remember if you are going to have your child evaluated for ADHD, you want a mental health clinician who specializes in treating children and assessing children for ADHD. Your child’s pedestrian should be able to refer you to someone or if you call your insurance they will probably have referrals.

Before you rush to have your child assessed, remember some basic facts. Most children between the ages of two to five are very active. They also have very short attention spans. Sometimes you need to give a child some time to mature especially if you have a boy. Remember boys mature slower than girls and tend to be more active than girls. It is important to keep these facts in mind when you are wondering if your child has ADHD.

Now if you child is more hyperactive than other kids his age or his attention span is shorter than most kids his age, there might be an issue. Also if there is a strong family history of ADHD in the family such as his father had ADHD as a child and paternal and maternal uncles all had ADHD as children, there might be an issue. Also if your child was born premature or there were complications during the pregnancy or child birth, there might be an issue. Premature babies or babies with a difficult pregnancy or birth are more likely to have ADHD and learning disabilities.

Bottom line, if someone suggests that your child has ADHD don’t rush to the pedestrian seeking medication. Compare your child’s behavior to other children and consider the risk factors. If your child doesn’t have many risk factors for ADHD maybe wait six months and reassess the situation. The most important thing to remember is if you decide to have your child assessed for ADHD, make sure you go to a mental health clinician who specializes in children and ADHD. You want a mental health clinician who specializes in treating children with ADHD and assessing children for ADHD. Also remember you do not need any expensive scans like a CT scan.

Dr. Michael Rubino specializes in treating children and assessing children. He has over 18 years experience treating and assessing children and teenagers. For more information about Dr. Michael Rubino’s work visit his website at http://www.rcs-ca.com or his Facebook page http://www.Facebook.com/Drrubino3

Teens, Heroin and Death

The ABC 20/20 did a very good show last night about the epidemic of heroin use in the United States. If you did not see it, you can probably find it on their website.

According to ABC 20/20, 129 people die every year from a heroin overdose. A majority of these deaths are teens and people in their twenties. Heroin is used by people in the lower income level and by people who are the wealthiest in the country. It is used by whites, blacks, Hispanics basically every ethnic group. It is also used by males and females. Therefore, for the families in Lafayette, Walnut Creek and Danville who say we don’t have that problem here, yes you do. Also for parents and educators who think that if their child is in a private school they are less likely to use, you are wrong too. Heroin crosses all ethnic and economic boundaries. The epidemic is so severe some schools are teaching children in the 6th grade how to use Narcan. This drug can reverse an overdose of heroin if administered in time.

Therefore, parents in the Bay Area, you need to pay attention to this issue and these facts. You might be saving the life of your child or someone else you love.

As stated Heroin use to to be a drug of the past but it is now very popular with teens. Heroin is a cheaper alternative to many other drugs. For $10 a teenager can buy a capsule of heroin. This is much cheaper than other drugs.

Heroin is still mainly snorted or injected. Because it is injected teens are exposing themselves to HIV and Hepatitis C. Both are life threatening conditions with no cure. Also many girls who use heroin get pregnant but don’t realize they are pregnant until the 4th or 5th month. The girls stop but it is too late. The babies will be born drug addicted and if they live through withdrawals, these children will have on going health issues and learning disabilities. In addition to exposing themselves to diseases most teens use Heroin with other drugs such as alcohol. This makes the probability of overdosing on Heroin even higher. Heroin lowers a persons breathing rate and the drugs they are combining it with lower the breathing rate even more making an accidental over dose more likely. The rate of overdosing from Heroin has quadrupled over the years.

Why is Heroin coming back and very popular with teens? Heroin is very similar to the Opioid based pain killers that teens have been using for years. However, with the cost of pain killers rising on the streets and becoming harder to get due to new prescription laws, heroin is easier to get and cheaper. Also teens tend to like the high better. It is not uncommon for someone to get addicted after using heroin one time.

In the last few years heroin use has doubled in teenagers. What teens are at the highest risk? Those who have been using Opioid pain killers, those abusing marijuana and males. Remember it is very common for teens to combine heroin with other drugs and they are unaware of the impact it has on their breathing. They may collapse and not know why and by the time their friends get them to an emergency room it’s too late. Also teens may go to sleep after using and their breathing rate is so shallow they never wake up.

This is a very dangerous drug. If it doesn’t kill when the teen uses it the drug can kill when the teen contracts HIV or Hepatitis C. The rate of teens using this drug has doubled and the amount of people dying from an overdose has quadrupled over the last few years. Again, parents you cannot ignore this issue. Heroin is being used by upper class children and poor children, athletes, and all races. So it is impacting all teens.

The other major issue with this drug is stopping. Someone cannot just go off heroin. People can die from withdraw. However, finding a treatment center that is affordable or with an open space is very difficult. They may have to wait four months to get into a rehab center. This is very dangerous. When someone decides to stop heroin, they need to enter rehab immediately. If they have to wait even 2 days, they may not make it because they cannot stand the withdrawal symptoms.

If we get involved we can hopefully stop teens from using this highly addictive killer. I have attached a link to a handout by the CDC with facts, warning signs and suggestions to help your son if you think he is using heroin. http://www.cdc.gov/vitalsigns/heroin/
http://www.cdc.gov/vitalsigns/heroin/

Dr. Michael Rubino is a psychotherapist who has been working with teens for over 18 years and he is considered an expert in this field. For more information about Dr. Michael Rubino and his private practice visit his website at http://www.rcs-ca.com