Important Information Regarding Autism & Health Insurance

WEBSITE SERVICES HEALTH PLAN TYPE RESOURCES CONTACT US

Stay Connected

Like us on Facebook View our profile on LinkedIn

March 30, 2017

ACA is Safe for Now!

As most of you know by now, on March 24th, the Republicans pulled America’s Health Care Act (aca Trumpcare) from being voted on by the house, due to lack of enough votes for passage.

As a general matter, the ACA and its incorporation of the Federal Mental Health Parity Act, has been very helpful to people with autism and mental health issues. To those of you who wrote or called your congressional representatives, attended town halls, and shared your stories, congratulations and keep staying active and involved. Your voices were heard!! In the meantime, let’s think of ways that we can encourage our congressional reps to make premiums more affordable.

Is it possible to put caps on how much premiums can be raised in a given period, especially in areas where there is competition? Can we focus the press to report on huge profits earned by the insurance and pharmaceutical industries? Can the non-profit sector be incentivized to become more active in this arena? Do we want a public option, especially in states where there is no competition? We know it takes a long time to develop health care policy, continue to think and share ideas!!

What to Watch in Sacramento

On the California front, we are closely watching SB 399 by Senator Portantino. This bill revises the prior CA autism mandate, makes it that health plans cannot deny behavior services based on time of day, setting, location or parental participation, and allows a wider range of qualified providers to train staff and provide behavior treatment to people with Autism. It would prevent health plans from making medical necessity determinations more frequently than every six months.

MHAIP is also watching SB 374 by Senator Newman. This bill extends the Federal Mental Health Parity and Addiction Equity Act to the small group market. In the event that health care reform is repealed and the Federal MHPAEA remains intact, those in groups smaller than 50 employees may no longer be covered. This bill would create a CA law that would extend mental health portections to this population.

Mom gets her San Francisco Bay Area Employer to Adopt the ABA Benefit

We recently met Nicole at an autism conference, where she shared her story of navigating the insurance waters to help get her son the care he needed.

In the Fall of 2015, her son, who was just under 3 years of age, was diagnosed with autism. Nicole immediately started researching how to get him the care he needed, including looking at her own insurance plan issued through her employer. She found out that her employer did not offer an ABA benefit for autism. She spent much of 2016 working with her company, advocating for adding the benefits to the insurance plan. She worked tirelessly, referring to herself as ‘The Squeaky Wheel’ to educate her CEO and other top executives to ensure the plan would include benefits in 2017.

She was delighted that her company was receptive and not only added the benefits for 2017, but offered to take on the additional costs she had incurred during 2016. She had reached out to MHAIP shortly after her son was diagnosed, — we had advised her to purchase a plan on the health exchange in the short term, and educate her employer on adopting a benefit in the long term.

It is great to hear stories like Nicole’s and to know that the work that we do makes a difference in the lives of families.

Presentation for ABA provider agencies

MHAIP has developed a presentation for ABA provider organizations, explaining the most important things they need to know about working with insurance, including what to put in reports to maximize the likelihood of coverage, how to handle problems with billing and collections, how to respond to denials, and more. The workshops designed to work with clinical supervisors and billing staff during a one hour lunch or can be expanded to a multiple hour session, during staff training sessions. Contact us if you’re interested in a presentation.

MHAIP Outreach Events

Karen Fessel (left), MHAIP executive director, and Patricia Gish, MHAIP insurance advocate, spoke on insurance and autism at the Support for Families Annual Resource Fair.

MHAIP board member Feda Almaliti brought the house down in Santa Rosa last month, when she delivered a comedy routine at the “Autism in the Family” conference, sponsored by the Anova School.

Upcoming Events:

Saturday April 8th, Los Angeles, CA

Dr Karen Fessel, MHAIP’s executive director, will be speaking on ” I Feel Like a Tennis Ball! Understanding the Role of Private Health Insurance, Regional Centers and Medi-cal Coverage for Behavior Health Treatment,” on Saturday, April 8 at the upcoming Tools For Transformation Conference, at the Susan Miller Dorsey High School, 3537 Farmdale Ave, Los Angeles.

Tuesday April 25, Portland, OR

Dr Karen Fessel will present a poster “Working with Insurance: The Tricks of the Trade” at Association of Children’s Residential Treatment Centers (ACRC) 61st Annual conference in Portland, OR on April 25th, at the Marriott Portland Waterfront.

CASES WE HAVE WON

WILDERNESS PROGRAMS:

21 year old youth from San Mateo County, CA

We assisted the family of a 21 year old man from San Mateo with severe opioid addiction and depression obtain complete coverage for his 81 day stay at a Wilderness facility in Oregon. The family received over $40,000 in reimbursement from Blue Shield/Magellan. Blue Shield initially approved treatment but denied after three days, alleging that he had made sufficient progress to benefit from an intensive outpatient program. MHAIP appealed that continued care was medically necessary, and he had tried intensive outpatient previously without success. Our case went to the CA Department of Managed Health Care, where it was overturned in his favor.
16 year-old boy from Santa Cruz county, CA

MHAIP assisted the family of a 16 year-old boy from Santa Cruz county get nearly 75% of costs reimbursed for his 83 day stay in Wilderness therapy. When we called for pre-approval, we were initially told that this was not needed and services would be covered. We got a tracking number for the call. Later, when HealthNet denied for failing to pre-authorize, we were able to cite this phone call and provide the family with relevant arguments regarding the Mental Health Parity Law, which they used in an appeal with the CA Department of Managed Health Care. The DMHC agreed with our position, and the family was reimbursed:

“Ultimately, my wife and I filed a complaint with the California Department of Managed Care, which found that the insurance company had processed our claim improperly and that their response to our claim was not consistent with California law. When the State indicated that our claim was not handled property, the insurance company decided to make an administrative exception on a one-time basis and reimburse us on an out of network basis. This resulted in us getting about $75% of our costs reimbursed. We can’t thank MHAIP enough for their assistance in achieving this result. Most importantly, our son benefited greatly from his time in wilderness.”

-Father, Santa Cruz County, CA.
Recovered unpaid claims for ABA provider

We helped an ABA provider recover over $40,000 of unpaid claims for services provided to a 10 year old client with autism from Mesa, AZ. Blue Cross Blue Shield of Arizona alleged that the denials were due to the provider’s late filing. The provider had actually submitted their claims on time, but the BCBS AZ had delayed payment, lost documents, and failed to respond for over a year. We appealed to the Arizona Department of Insurance and BCBS AZ agreed to pay. So far, the provider has recovered $31,640 with more claims still under review.

Six-year-old girl from Los Angeles County

A six-year-old girl with autism from Los Angeles County had been receiving 36 hours per week of ABA therapy. Although she had responded very positively to her treatment, she continued to face challenges with emotional regulation, functional communication, age-typical play, and self-help skills. Nevertheless, with no warning to her family, her insurance plan (Anthem) cut her services by nearly one half, from 36 to 20 hours per week. In attempting to justify this decision, Anthem noted that the girl had made progress, but ignored evidence that she still struggled with many issues that required intensive treatment.

The girl’s family turned to MHAIP for assistance, and we filed an expedited appeal on her behalf with the California Department of Managed Health Care (DMHC). The DMHC agreed that her 36 hour per week program continued to be medically necessary and instructed Anthem to resume coverage of her full program and to reimburse her family for the portion of her treatment it had refused to pay.

Five-year-old boy from Los Angeles County

A five-year-old boy from Los Angeles County had been prescribed occupational therapy to treat his autism. Unfortunately, his health insurance provider network did not have any occupational therapists (OTs) available to treat him. His mother found an OT outside of the network, but the family’s insurance plan, Aetna, refused to pay for that OT. MHAIP filed a complaint with the California Department of Managed Health Care (DMHC) on his behalf, explaining that Aetna must pay for the out-of-network OT because its own provider network was inadequate. The DMHC agreed and instructed Aetna to pay for the treatment provided by the boy’s out-of-network OT.

Five year old boy from San Mateo County

We helped the family of a five year old boy from San Mateo County with ASD get occupational therapy reinstated from Kaiser. Kaiser came forward and provided services without requiring appeal or regulatory intervention:

“We recently worked with AHIP to have our son’s Occupational Therapy (OT) services reinstated after receiving a denial for continuation by our insurance company. After a year of OT, in which our son met most of his goals, our insurance company pulled OT services due to a re-evaluation that took place in their offices. With pressured testing, our son did not “perform” in office, as most of our sensitive children do not. However, I knew that OT was helping him and was determined to get these services back. After filing two grievances, as well as a courtesy call, I planned to file an Independent Medical Review.

I called Karen Fessel at MHAIP. Karen reviewed our case and placed one phone call, which was all it took to get the ball rolling again. We went from experiencing a brick wall in communication to a dialogue again with our insurance company. After one call with an OT at our insurance company, who reevaluated our case, we received an apology and had our son’s OT services reinstated within a week. Thank you to MHAIP for helping us resolve this within weeks after we were getting nowhere on our own for months! And, it opened up the channel of communication again, hopefully helping us avoid this issue in the future.”

-Mother of five-year old boy, Redwood City, CA

Six year old boy from the San Francisco peninsula

We recently helped the family of a six year old boy from the San Francisco peninsula get ABA reinstated through Kaiser. The child’s ABA had stopped because there were no providers available, and he was regressing to the point of hitting other children in the classroom. He was at risk for getting expelled from his private school.

“We are back on track as of early January. I am in touch with the supervising therapist and he was assigned a person for every day. The supervisor is awesome and is in touch about the tools she is implementing in therapy. My son has stopped hitting his peers and is being responsive with applying the tools.

We are very grateful and will be donating to your organization this year. Thank you very much! I have also spread the word to other parents that have children on the spectrum.

Thank you for helping our family! You have made a difference in our lives.”

-Claudia, Mom to six year old boy with ASD, SF peninsula.

SUPPORT MHAIP to Help Families!

Your donation helps us to field calls from the community and provide advice to low income families. Donate through through the Pay Pal link below or on our website.

OTHER WAYS TO SUPPORT MHAIP

CA state employees may donate here through the CA state campaign, or with our code 29208. We are also a recognized cause through the corporate employer-matching philanthropic site Benevity (as Mental Health and Autism Insurance Project).
AMAZON: When you shop on Smile.Amazon.com, you can select our organization to receive a small percentage of the purchase price by using this link. All donations made to MHAIP are tax-deductible. We appreciate your support!
EBAY:

Support us through the EBAY Charities Program-click here for more details
Thank you to our generous donors

Thank you so much to the following families who generously donated to our year end campaign:
$200 or more

Sally Levy Albert

Bette-Ann and Norbert Fessel

Todd Goldman

Matt Panuwat

Kam Patel
$10-199

Jane Bermont

Helen Bernett

Kathleen Cooper

Kathryn Duclo

Mary Jane Dyer

Nea Hanscomb

Sally Kirk

Timsi Malhotra

Peggy Orlin

John Park

Tara Perkins

Alison Rowland

K Alexander Shangraw

Amy Weinstock
We so appreciate your support!

Wishing you a Happy Spring!
Sincerely,

Karen Fessel

Executive Director & Founder

Mental Health & Autism Insurance Project

Mental Health & Autism Insurance Project | | karen@autismhealthinsurance.org

Text | Link

346 Rheem Blvd

Suite 207 D

Moraga CA 94556

SafeUnsubscribe™ drmike@rcs-ca.com

karen@mhautism.org

Update Profile

About our service provider

Sent by karen@mhautism.org in collaboration with

Constant Contact

Try it free today

Dr. Michael Rubino treats children and teens with Autism. For more information regarding Dr. Rubino visit his website http://www.rcs-ca.com.

How Teens React to Terrorism

In light of the terrorist attack on London yesterday and the threats against Jewish Community Centers, it makes sense to remind parents how children and teenagers are being impacted. I have been seeing more and more teenagers who are complaining of anxiety and depression. Many of these teenagers are also afraid to go to school too. I have also been seeing more teenagers being placed on home/hospital for school. This means a teacher comes to the house once a week instead of the teenager going to school. This is an alarming trend.
I have also been hearing more teenagers talking about needing to carry a knife with them for their own safety. They tell me you never know when someone might try to attack you. These are not juvenile delinquents or gang members, these are average teenagers. They come from healthy families and are doing well in school and not involved in drugs. This need they feel to protect themselves is an alarming trend.

However, if you take a step back and look at what these children have seen over their lives it makes sense. Most of these teenagers were very young on 9/11 when the United States was attacked. Since 9/11 they have also seen two wars and heard on the nightly news about terrorist alerts or attacks around the world.

In addition to terrorism, this is the first generation growing up with mass shootings. According to ABC News from 2000 to 2015 there have been 140 mass shootings and since January 1, 2016, there have been more mass shootings than the previous 15 years. According to the statistics on mass shootings every day 36 people are killed in the United States by a gun. This does not include suicides. For the group we are discussing, suicide is the third leading cause of death for children between 10 and 18 years old and using a gun is one of the most popular methods of suicide.

Now, in addition to these facts stated above, think about what these children see on the news and the video games they play. Anytime there is a shootings incident in the United States there is pretty much 24 hour news coverage of the event for days. Also when there are bombing or shootings in Europe there is 24 hour news coverage for days. And now we have moved on to covering funerals. When the officers were killed in Dallas the memorial was televised nationally. If we look at the video games these kids are playing most have to do with killing and death. And since computer graphics have significantly improved, many of these games look real.

Additionally, children in the fourth and fifth grades are telling me they are worried about our election results. They have heard what Trump has said and they are afraid other countries might attack us or Trump may start a war. Also Hispanic children who are legal citizens are afraid that they will be deported. This is a great deal for a nine or ten year old child to worry about.

Looking at all of this it begins to make sense why I am seeing more depressed and anxious teenagers who fear for their lives. These teenagers are being traumatized. They may not be experiencing the trauma personally but they are experiencing vicarious trauma. With all of the pictures on television and news reports and realistic video games these teenagers are playing, they are being traumatized vicariously. We have never had a generation of children grow up with the amount of trauma that these children are growing up. Even children growing up during World War II didn’t experience this amount of trauma. We didn’t have instant access to news nor did we have the graphic videos being shown by the news media.

The question now becomes, what do we do? Well we can not change the world unfortunately. However, we can monitor how much exposure our children are receiving to mass shootings when they occur. We can monitor the video games they are playing and limit access to games that focus on violence and killing. We can demand that the Congress pass gun control laws that make sense. No one needs an assault weapon to hunt a deer. We can also listen to what our children are saying and talk to them about their concerns. When a mass shooting occurs we can ask them how they are feeling, ask if they have any concerns and reassure them that you are there as their parents to protect them.

Finally, if you start to notice a change of attitude in your child that you are concerned about have them assessed by a psychotherapist. There is nothing to be ashamed of if a child needs therapy. We are exposing children to situations that most adults have problems dealing with themselves. You may find it very upsetting to talk to your child about these incidents. For these reasons and many more, if you feel your teenager has been traumatized vicariously make an appointment with a psychotherapist who specializes in treating teenagers and victims of trauma. Our kids have had to deal with a lot. We can help make it easier for them growing up in this time by providing the help they need.

Dr. Michael Rubino has over 20 years experience treating children and teenagers and dealing with victims of trauma. For more information about his work or private practice visit his website at http://www.RubinoCounseling.com or on Twitter @RubinoTherapy

Necessary Emotional Skills for Middle School Students

The world has changed a great deal. Children use to be able to go to school and the biggest fear was being teased or getting into a fight. Today children need to worry about being seriously hurt or killed. Many 6th graders that I work with carry knives with them to school. They tell me they need the knives for self-protectin.

Yes we are living in a different world. Today children have to worry about being seriously hurt physically or even being killed. This is a lot for a child who is only 10 years old. They also have grown up seeing school shootings occur on a regular basis.

Due to these facts children in middle school today are having to develop new coping skills. Part of these new coping skills are new emotional skills. Physills Faggosis, a school counselor, out lined some of the new emotional skills that middle school children need in order to survive in today’s world.

Top 10 social emotional skills for middle school students
1. Make good friend choices. This typically comes on the heels of making some questionable choices. Kids figure out quickly which friends instill a sense of belonging and which ones make them feel uncomfortable. It can be helpful to ask your children these questions: Do you have fun and laugh with this person? Can you be yourself? Is there trust and empathy? Common interests are a bonus.

2. Work in teams and negotiate conflict. I don’t think many students get through middle school without feeling like they had to carry the load on at least one group project. Maybe they didn’t delegate and divide the work effectively at the onset. Perhaps they chose to take ownership to avoid a poor grade. Help them understand what happened and consider what they might have done differently.

3. Manage a student-teacher mismatch. Unless there is abuse or discrimination, don’t bail them out by asking for a teacher change. Tell them they still can learn from a teacher they don’t like. Let them know it’s a chance to practice working with someone they find difficult. Remind them that if they can manage the situation, they won’t feel powerless or helpless the next time. Focus on concrete barriers to success in the class, not the interpersonal conflict. Is it miscommunication? Study skills?

4. Create organization and homework systems. Make sure they are the architects of this process. Encourage them to come up with solution-oriented plans and tweak them as needed. Do they need to use their planner? Create a checklist? Their motivation will come from ownership. If they say they don’t care, remind them that they don’t have to be invested in a particular outcome in order to change their behavior. People who hate exercise can still choose to lift weights.

5. Monitor and take responsibility for grades. If you care more than they do about their grades, why should they worry? Let them monitor their own grades, and if they don’t do well, don’t step in to advocate for assignment extensions or grade changes. Let them carry the burden and experience the connection between preparation, organization and grades. Conversely, if they are perfectionists, they will learn they can survive and manage the disappointment of a low grade.

6. Learn to self-advocate. By middle school, they should be learning how to ask teachers for help or clarification. This may be in person or through email. When students bond with teachers, they connect more intimately with the material, too. Unless there is no other option, try not to reach out on their behalf.

7. Self-regulate emotions. Children often need assistance labeling strong emotions before they can regulate them. Help your kids identify any physical symptoms that accompany their stressors. This may help them know when to take a breath or hit the “pause” button before reacting. In real time, point out when they handle an emotional situation well. Discuss the strategy they implemented-maybe they took a break or listened to music. Also, help them make connections between their thoughts, feelings and behaviors. Are they stuck in all-or-nothing thinking? Are they consistently self-critical?

8. Cultivate passions and recognize limitations. When your children are fired up about something, run with it and encourage exploration. Seize the opportunity to help them go deep. Get books, go to museums and be supportive even if the subject does not excite you. In the process, you will help them figure out what drives them. On the other hand, it is OK if they struggle in a specific area. That, too, is useful information. No one needs to be good at everything.

9. Make responsible, safe and ethical choices. Teach them to respect their bodies, and to make safe and healthy decisions. It is equally important to talk about how to avoid putting others at risk. Have open conversations and discuss plans for different scenarios they may encounter. Try not to be overly reactive if they ask shocking or distressing questions. Keep the lines of communication open.
10. Create and innovate. Our changing world needs imaginative creators and divergent thinkers. It also can build confidence to think independently and outside the box. As your kids do their homework, read required texts and take standardized tests, remind them that these benchmarks are not the only ways to measure success. Encourage them to make connections across material from different classes, and to build, write, invent and experiment.

Dr. Michael Rubino is an expert at treating children and teenagers and he has been doing so for over 20 years. For more information about Dr. Rubino’s work or private practice visit his website at http://www.rubinocounseling.com or follow him on Twitter @RubinoTherapy.

Information Parents Need about Teenagers and Concussions

Parents school will be starting soon. Besides getting kids prepared to a school schedule versus a summer schedule there are things such as buying new clothes and school supplies. In addition, in a high school there are tryouts of sport teams. In fact many of your sons may already have started tryouts for the school football team.

We now know with sports come concussions. Research is showing that all it may take is one concussion to have a long term impact on someone. Also after a concussion many people suffer Post Concussion Syndrome characterized by mood swings and difficulty with concentration.

Therefore parents it is important to learn the basic signs of Concussions in teenagers and how to respond. Especially since concussions are more common in teenagers than we once believed. A concussion can cause physical impairment such as not being able to walk or emotional issues such as a teenager suddenly having anger problems or depression.

We have been hearing more and more about concussion in professional sports in recent years. We have also seen professional athletes walk away from their careers because they are not willing to risk the after effects of multiple concussions. A fact that some in professional sports do not want to be publicized. Will Smith stared in a movie regarding a professional football player and how his life significantly changed after several concussions. The National Football League tried to stop this movie from being made and shown, but they lost.

However, we do have examples. Mohammad Ali is the most notable example of how multiple concussions can change a person and leave them disabled. Also a news anchor for ABC News documented how his life changed after receiving a traumatic brain injury while covering the war in Afghanistan.

Concussions and Traumatic Brain Injuries also occur in teenagers. Teen athletes such as football players routinely suffer concussions. Many of these athletes suffer permanent brain damage such as difficulty remembering things or emotional issues such as mood swings. Also a number of high school athletes do die from concussions every year.

High school athletes are not the only teenagers at risk for concussions. Teens in general are at risk because teens are willing to engage in risky behavior such as jumping off something or racing cars. Many teens feel they are safe. They hear about these issues but think it would never happen to them. However we never know who it will happen to. Therefore, parents you need to educate and monitor your teenager’s behavior. If you have a teen athlete, you may need to make the decision to stop them from playing a sport if they have suffered a couple concussions. This is not easy but you must think of their lives after high school.

I have included a link to a YouTube video where a physician describes the basic information about what happens to a brain during a concussion and the process of recovery from a concussion. This is a must see for any parent https://youtu.be/zCCD52Pty4A.

In addition to this video I have included a fact sheet from the CDC regarding information about concussions for you to review http://www.cdc.gov/headsup/pdfs/schools/tbi_factsheets_parents-508-a.pdf.

Dr. Michael Rubino has over 18 years experience working with teenagers and their families. For more information on Dr. Rubino or his work please visit his website at http://www.rcs-ca.com or follow him on Twitter @RubinoTherapy.

Financial Parenting Issues after Divorce

Financial Parenting Issues After Divorce

by Dr. Michael Rubino, Rubino Counseling Services <http://www.rcs-ca.com>, Pleasant Hill, CA

When you get a divorce you can stop being husband and wife, but you can never stop being parents. I often meet parents who forget that a divorce does not change the need for them to work together. You must figure out how to co-parent, and finances are a large part of that conversation.

Who’s going to pay for baseball signups, Boy Scouts, and Girl Scouts? Often fathers feel they don’t need to pay for these activities because they already pay child support. This results in disagreement and arguments. Heartbreakingly, I have observed that children will often choose to stop doing outside activities in order to avoid parental arguments. When you put your child in the middle of these arguments your child is the one who gets hurt. Even though financial arguments may raise valid points on both sides, ultimately, you want to do what is best for your child.

As you go through the divorce process, discuss child-related 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. Understanding that you decided to divorce for a reason, and that money matters can be a very sensitive topic, don’t be afraid to ask for help, especially if it will help your child. Look into going to a therapist who specializes in co-parenting. A therapist will be familiar with these issues and can assist as you work through disagreements and find solutions that are best for your child.

College tuition is a major financial issue I see with parents who are divorcing. Parents have different opinions about paying for college. Some feel it is their duty as a parent to pay for college while others feel their child can take on student loans and get an afterschool job. A quick solution for this issue is the understanding that you cannot force your spouse to have the same beliefs as you do regarding college. Your child is now an adult, and taking on some financial responsibility is an option you may need to consider.

Whether you’re discussing college tuition, Little League, or money for the prom, always focus on what’s best for your child. Forget he said/she said, forget about alimony or child support. This is not a contest about who will win. If you make it a contest, your child loses. For the sake of your child, if you have to pay a little extra for Little League, isn’t it worth it?

Dr. Michael Rubino has over 18 years experience working with couples in high conflict divorces. For more information about Dr. Rubino’s work or private practice, visit his websites http://www.rcs-ca.com and http://www.drmichaelrubino.com, or on Follow him on Twitter at Twitter.com/RubinoTherapy.

Information about Teenagers and Concussions

Schools are back in session and high school students are either trying out or getting ready for try outs for their sport. Parents are learning that “basic” Concussions in teenagers are more common than people think and can create more problems that people think. A concussion can cause physical impairment such as not being able to walk or emotional issues such as a teenager suddenly having anger problems or depression.

Many teenagers develop Post Concussion Syndrome after a concussion. Teenagers can have violent mood swings, difficulties concentrating and with memory. This can cause problems at school and with family and friends. I have seen teenagers who get so depressed by these changes that they become suicidal. Post Concussion Syndrome can last a year and often physicians do not warn parents or teenagers about this syndrome. This makes matters worse because they feel like they are crazy because they don’t understand why they have the symptoms.

In addition to this video I have included a fact sheet from the CDC regarding information about concussions for you to review http://www.cdc.gov/headsup/pdfs/schools/tbi_factsheets_parents-508-a.pdf.

I have also included this link from the CDC which helps parents, coaches and schools https://www.cdc.gov/headsup/

Dr. Michael Rubino has over 19 years experience working with teenagers and their families. For more information on Dr. Rubino or his work please visit his website at http://www.rcs-ca.com or follow him on Twitter @RubinoTherapy.

Does My Child haveADHD?

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

Suicide Awareness

This week is devoted to suicide awareness and decreasing the number of suicides that occur yearly. I hope the information in this article helps you understand the issue of suicide. To start off with, I have included an article where six people describe their suicidal feelings and the help they need http://linkis.com/huffingtonpost.co.uk/AlJc2.

In today’s society there has been a significant increase in depression, anxiety and suicide among teenagers and children. In fact, suicide is the third leading cause of death in children 10 to 18 years old. Yes 10 year old children are committing suicide.

In my practice I am seeing more and more children and teens reporting they feel depressed, anxious and overwhelmed. One of the main reasons I hear for these feelings is that children feel a great deal of pressure to succeed in school. I have kids in 5th grade and 6th grade worrying about grades. Not because their parents will get mad because if they don’t get As they wont get into a good college and won’t get a good job and won’t be able to afford a house.

This is a great deal for a 5th grader or 6th grader to worry about at their age.

I also see middle school students and high school students involved in several sports and other activities such as Boy Scouts. The kids are feeling pressured to do extracurricular activities not for fun but for their resume. They are again concerned about getting into a good college and being a success. This pressure is not coming from parents either. It is pressure kids are now placing on themselves.

Recent studies are showing a correlation between lack of fun and time to relax with the increase in depression in children and teenagers. A study in Psychology Today discusses this issue. I have included the link so parents can read this study and think about it. Also so you can look at your children and talk with them. See if they are enjoying life or feeling overwhelmed because they need to succeed. Money pays the bills but doesn’t guarantee happiness https://www.psychologytoday.co…

Dr. Michael Rubino is an expert working with children and teenagers. For more information about Dr. Rubino and his work visit his website http://www.rcs-ca.com

How Much Time Should Teens Spend Online?

A common argument I hear daily in my office is how much time should an adolescent be spending on their laptop or their smart phone. Parents typically believe that their adolescents are spending too much time on their cell phones and laptops. Of course adolescents feel that their parents are being unfair and not allowing them enough time on their cell phones or laptops. Adolescents typically say they need their laptops and cellphones for homework and to communicate with their friends. They feel that their parents don’t understand how the world works today.
Today’s adolescents have grown up with laptops and smart phones their entire lives. Texting is a very common method of communication for teenagers too. However, most parents grew up when laptops could not do as much and cellphones were typically only used for making a telephone call. Therefore, there is a difference of opinion regarding how teenagers should use technology and how their parents have used technology over the years. Especially, because when parents were teenagers themselves technology was not so prevalent.

Besides parents and teens having different views about technology. Parents are worried that their teenager is becoming addicted to their cellphones. Having seen how some teens react to having their cellphones taken away, I can understand why some parents feel their teenager is addicted to their cellphone. However, parents have additional concerns too. Parents are concerned that with all the texting teens do that their teens are becoming anti-social. Other concerns are the amount of bullying that occurs online, the sexual perpetrators that are online and how easy it is for teens to obtain drugs online. Another concern is that their teen may be involved in sexting or sending naked photos of themselves while on line. Sexting is a relatively new phenomenon so we don’t have a great deal of information regarding it.

However, we do have evidence to support parents’ concerns. There are numerous examples of cyberbullying and examples of teens commuting suicide due to cyberbullying. There is evidence of child predators using the internet to prey on teenagers. There is also evidence of teenagers being able to access drugs easier and engaging in sexting and sending sexually explicit photographs of themselves via text.

Therefore, there are reasons for parents to be concerned. While there are research studies which indicate that there are reasons to be concerned about how much teenagers use cellphones and go online, there is also research showing there is reason to be concerned about what teenagers are exposed to online and can access online. Some studies do conclude that teenagers spend to much time daily online and on their cellphones. Some studies indicate that teenagers should be limited to one to two hours per day online. The American Psychological Association has considered including a diagnosis of internet addiction in the Diagnosis and Statistical Manual. However, because the amount of people using cellphones and the internet in numerous ways, there is no agreement about what defines an addiction and what is normal usage. Therefore, parents are encouraged to monitor their teens and use their own judgement regarding rules involving cellphones and the internet.

While, there is research indicating that the internet can pose a danger to teenagers, there is also research showing that there are benefits to the internet and cellphones. The research has shown that teenagers who are depressed, anxious or questioning their sexuality that they can find cites online where they can talk with other teens feeling the same way. Texting has been shown as a way friends have identified other friends who were thinking about suicide and get their friend help. In fact, just this week, Facebook has added additional ways that people can get help for someone especially if they feel their friend might be suicidal. Many teens I work with find it easier to open up to friends or parents via texting or emailing at times. Therefore, while research shows there are reasons to be concerned, there are also studies indicating that cellphones and the internet can provide positive benefits to teenagers.

Therefore, what do parents do? At this point there are no firm answers because this technology is so new. So parents need to pay attention to the news and research studies that are being reported. Furthermore, parents need to have conversations with their teenagers and educate their teens about the risk associated with texting and the internet. Also parents need to use their judgement and set rules regarding cellphones, texting and using the internet that they feel are appropriate. Currently, the accepted amount of time for a teen to be online recreationally so for fun and this doesn’t include homework is one to two hours a day.

Dr. Michael Rubino is a psychotherapist who specializes in treating children and teenagers. Dr. Rubino does treat teens and adults who feel they are addicted to texting or the internet. For more information about Dr. Michael Rubino’s work or private practice visit his website at http://www.RubinoCounseling.com or his Facebook page at http://www.Facebook.com/Drrubino3.

Facts for Parents about Bullying at School

Many kids, despite what they say, really enjoy school. They like seeing their friends, their teacher and learning. However, some kids are not as excited and even worried about going to school. Many of these kids were bullied last year and they are afraid of being bullied again this year.
Often when a child is being bullied they do not say anything to their parents until the bullying is really bad. They are afraid, especially boys, that you will see them as weak. They are also afraid that you will be disappointed in them for not defending themselves. Parents you have not said anything or done anything to create this feeling in your child. It is how our society is today. Children, especially boys, receive messages from television, music, video games about being strong and defending yourself. This is what the documentary “The Mask You Live In”, is trying to address, but that is a different topic.

It is very important to take bullying very seriously these days. It is no longer just one kid calling another kid names. The bullying today occurs at school and may include threats of being killed and it goes beyond school. Now bullies can continue their bullying via text messages, emails, Facebook, Twitter, Instagram and Snapchat. So the bullying becomes non-stop. It can really make someone feel worthless and that they be better off dead. We have an example of this from a 13 year old boy, on the east coast, who committed suicide because he could not tolerate the bullying. He is not the first child to commit suicide due to bullying. Other kids are turning to drugs and alcohol and we are seeing a number of accidental overdosages resulting in death. We assume they were accidents, they could be suicides staged to look like accidents.

Bullying is not just an elementary school issue. It occurs in High School and College too. Remember a few years back a college student committed suicide because his roommate secretly filmed him in his dorm room with another guy having sex. When the tape was posted, the boy was so ashamed because he had not made it publicly known that he was gay. He did not know what to do and ended up committing suicide.

As the rates for bullying, suicide and drug use increase with kids in middle school and now beginning in Elementary school, we must take this issue seriously. I assume it has entered Elementary schools because the third leading cause of death for 10 year old children is suicide according to the CDC statistics.

Also a common problem I see elementary children for in psychotherapy is bullying. Many of these children are embarrassed because they feel they should be able to stop the bullying. They are also embarrassed and often don’t want me to tell their parents because they believe they must of done something to deserve being bullied. I explain to them they do not deserve it and they should not have to stop it on their own.

What should a parent do? One thing is parents should watch for the following warning signs that your child is a victim of a bully:

Avoiding activities they used to enjoy

Loss of friends or avoiding social situations

Problems sleeping

Complaining of stomachaches or headaches

Loss of appetite

Declining grades

Missing or damaged clothing or belongings

Self-destructive behaviors like running away from hom

If you notice any of these or just have a sense something is wrong then talk to your child. However, when you talk to your child reassure them they did nothing wrong, there is nothing wrong with them and you are not upset or disappointed with them. Try to develop a game plan of how you are going to deal with it together and ask how you can be supportive. Also ask your child to promise you if they feel really sad like they want to hurt themselves that they will talk to you before they do anything. You may think this is ridiculous, but I use a no suicide contract with many children that I work with and they honor it. The contract lets them you know that you care about them.

The other thing you can do as a parent is go to your child’s school and ask what is the school’s policy on bullying. You can also ask how the school watches for bullying, how is the policy enforced and what is being done to prevent bullying. You may ask the school or volunteer to contact a group such as Challenge Day. This is an international organization that addresses bullying and they are located in Concord. I have seen their work and it is fantastic and kids love it.

Another thing you can do as a parent is start talking to your child about bullying on an occasional basis. This gives you a chance to let them know it’s not their fault and to develop a plan of action if it does occur. You should also discuss drugs and alcohol at the same time. I work with kids all day long and at times I am still shocked at how young kids are when they are starting to get involved with drugs and alcohol.

Keeping an open line of communication with your child is very important if you want them to come to you. Research still indicates that children are more likely to turn to their friends when they have a problem. This is good that they have this emotional support, but their friends don’t have the answers or solutions that they need. Remember it is best to speak to your child when you are in a calm environment and no one else, such as brothers or sisters, are around. Also remember the word HALT. It stands for:

Hungry

Angry

Lonely

Tired

If you sense your child is experiencing any of these feelings it is not a good time to talk. When you talk with your child you want it to be productive and for your child to feel like they are not being judged. Therefore, sometimes it is better to put off a conversation so you don’t end up in an argument. This is more likely to close the line of communication with your child.

I have mentioned several times that being bullied is not their fault. What I have seen from working with children who are bullies, abusive men and reviewing the research is that bullies really have very low self-esteem. In fact many times they lack a sense of themselves. The only way the feel important or alive is by putting someone else down. They do this because they are afraid the other kids might be able to figure out how lousy they feel about themselves. It is often said the best defense is a good offense. By acting like the big guy on campus that other people will see them as the big guy and they are able to keep their secret. Kids usually do this because it was done to them too.

Therefore, we need to remember the bully is usually a kid who has been abused too and is crying out for help. If we are going to stop the problem of bullying we need programs to help the bullies too. They are only repeating what they have been taught.

Dr. Michael Rubino specializes in working with children and teenagers. He has over 20 years experience working with children and teens especially those who are victims of trauma. For more information about Dr. Rubino’s work or private practice visit his website at http://www.rubinocounseling.com or his Facebook page at Facebook.com/drrubino3.

Dr Michael Rubinio

Understanding Your Teenager

Month: March 2017