Does My Child Have ADHD?

School will be starting soon and many parents will receive reports from their child's teacher that will cause them to ask, "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 and needs medication.

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 by a professional who specializes in ADHD. 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. Many parents take their child to their pediatrician, however, many pediatricians are not trained in diagnosing ADHD. I would suggest having your child evaluated by a mental health clinician trained in working with children and in assessing for ADHD.

As I stated above, 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. There are other treatment options besides medication, so do not rush to medicate your child either. Consider all the treatment options.

Dr. Michael Rubino specializes in treating children and assessing children. He has over 20 years experience treating and assessing children and teenagers. For more information about Dr. Michael Rubino's work visit his website at www.rcs-ca.com or his Facebook page http://www.Facebook.com/Drrubino3.

The Reality of Middle School in The 21st Century

As the school year is starting many parents are focused on their children’s transition into High School or Kindergarten. However, there is another important transition for children. Beginning Middle School is a major transition for pre-adolescents. As a psychotherapist who works with adolescents, I am very familiar with what is happening on High School and Middle School campuses and how big the transition is into Middle School. However, some parents are not aware of what happens in Middle School today. One example, 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 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 that Middle School Students are drinking, using drugs and having sex. Many parents are unaware of what is happening in Middle Schools these days. Drugs and alcohol are just the tip of the iceberg. Children that are in the age group of middle school are now involved numerous dangerous activities such as selling drugs.

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 their school 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 feel successful as a teenager and so they 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 for STDs or getting pregnant. 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. Yes, Middle Schools are giving condoms to children in the sixth grade. These kids are only 11 years old.

Another common issue in middle school is bullying. However, we are not just talking about one kid teasing another kid at school anymore. Today there is for a group of kids teasing one kid and it is not just at school. Now kids are using Facebook, Twitter, Instagram, Snapchat and texting by cellphone 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. I recently wrote an article about a middle school girl who committed suicide and in her obituary she left a note to the other students just asking them to be nice to each other. Another issue with teasing, is that a number of middle school students have been arrested for photos they text and for harassment. Besides teasing, texting a nude photo of a student in middle school means the middle school child violated child pornography laws. Something many parents and students are not aware of is that when a child texts a nude photo of a middle school student, who is under 18 years old, it violates child pornography laws and the child who texts 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. Boys are bragging about their fights on YouTube and comparing how many people have watched their fight with their friend’s fight. Therefore, boys feel they must fight, otherwise 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 that kids have to live in fear for their lives and safety at school. 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 the issues in their lives and mention drinking, sex or being teased and ask if they need to talk about it. 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 20 years experience treating adolescents. For more information about Dr. Michael Rubino’s practice check his website http://www.rcs-ca.com or his Facebook page http://www.Facebook.com/Drrubino3.

High School Creates Changes for Teenagers and Parents

Over the next few weeks, many teenagers will start High School. There will be many changes for them and for you as a parent. As your teen enters high school they are also starting to enter the adult world. This is now a time for them to start to take on new responsibilities and to consider the reputation they are creating for themselves. As parents your responsibility is to help guide them, not tell them exactly what to do. It is important that the teen develop life skills on their own. You will not always be there as the parent to help.
The first step is for you to allow them to earn your respect. Explain that they are no longer little kids, that they are now young adults, and part of being an adult is earning people’s respect. You also have to be prepared to respect them and allow them to be young adults and not treat them like little children. This does not mean you are giving up control. Your teen still needs you for money, permission to do things at school and to sign the consent for the all important driver’s permit. So relax, you still have all the control you need.

The first place to start with respect is their rooms. Allow them to have their rooms as their own private space. Do not worry if it is dirty or if their are clothes all over, it is their space and they have the right to live in it how they choose. Set the limits that as long as you can close the door and there are no odors coming from their room, you will respect their privacy. If these agreements are broken, then you have the right to go in and clean as you like. You also have the right to inspect the room if there are obvious signs of drug use. As a parent you have to balance your teen’s right to privacy, but at the same time you need to ensure their health and safety.

Homework is another big area of concern. Make your life easy. Set a minimum GPA such as 3.0 or 2.0 based on your teen’s ability and then allow your teen to manage their homework. If they ask for help, obviously help them. If they do not, let them handle their homework until progress reports and grades come out. You need to have an agreement as to what will happen if they fail to maintain the minimum GPA set and they never ask for help. If they fail to maintain the minimum GPA, then the consequences you agreed to are implemented. The consequences occur not because you are being mean, they occur because the teen failed to live up to their part of the agreement – they made the choice. This is important to reinforce so you are not labeled the bad guy and the teen learns a lesson in making choices.

Finally, you and your teen need to sit down a draw up a contract concerning the house rules, school performance and your expectations regarding their behavior in general. If you have it in black and white and there is a conflict then all you need to do is refer back to the contract and the problem is resolved. It is very important that you abide by the contract too. So you cannot increase a consequence, if you agreed to something else already with your teenager. It is essential that you honor your word. If you want your teen to be responsible, you must be responsible.

One last thing – no one is perfect. If you make a mistake, model appropriate behavior and apologize. If your teen makes a mistake and comes to you right away to apologize, thank them for their honesty and compliment them on their maturity. Remember, they want to know that they are important in the world. By treating them with respect and as maturing adults you are validating the fact that they are important and loved and you are encouraging them to keep trying.

Obviously, it is not always that easy and there are various parenting situations. The above suggestions are a guideline to get started with as your teen enters high school.

Dr Michael Rubino is an expert in providing psychotherapy to teenagers and their parents. He has over 20 years experience working with teenagers. For more information on Dr. Michael Rubino’s work or private practice visit his website at http://www.rcs-ca.com or follow him on Twitter @RubinoTherapy.

Preparing Your Teenager for High School

In about six weeks a number of students will be starting their first year in high school. Parents this is a good time to think back to your first day of high school and how you felt and what you were expecting. This can help you relate to some of the feelings your teenager is having and help you when you talk to them about starting high school. Hopefully this article will be able to provide some tips to make it an easy transition for your teenager and for you.
One common stressor for many teenagers are the stories they have heard about how seniors pick on and tease the freshman students. Another common fear for freshman is that they are going to get lost on the campus and not be able to find their classrooms. Your teenagers are at a point in their life where they want to make a good impression on the other students. At their age image is very important. Therefore the idea of being teased by the seniors or getting lost on the campus can be very stressful and also create a great deal of anxiety for a student starting high school.

As parents, you can talk to your teenagers about your first days days at high school and reassure them that the stories they hear about Freshmen being targets for the seniors are greatly exaggerated. Also you can try to go with them over to the school before it starts and walk around the campus so they can get use to where everything is at their new school. Another thing you can do is remind them that everyone makes mistakes so if they do get lost the first day it is not a big deal. Remind them there will be a lot of other kids starting their first day of school too and there will be other kids getting lost. This is also another opportunity to continue to establish an open relationship with your teenager. The more you talk with each other you increase the likelihood that they feel comfortable coming and talking to you about issues they will have while in high school.

Another issue facing some students is starting all over. In middle school may be everyone knew them and they were in the “popular group.” Now no one knows them and they need to start all over. This may be frightening to them, but remind them there will be many times in life when they will need to start as the new person. Also remind them, if they were able to do it in middle school, they can do it in high school too. However, encourage them to have faith because it won’t happen over night. Now for many students middle school was a nightmare. They may be looking forward to starting over. Again remind them if they have the desire to try they can do it, but also to be patient because it may not happen as quickly as they like.

Also before school actually starts is a very good time to establish what your expectations are regarding grades and after school activities and hanging out with friends. before I school actually starts is a very good time to establish what your expectations are for your teenager regarding grades, homework, after school activities and hanging out with friends. If you establish an understanding between yourself and your teenager before these situations arise you can save yourself a lot of time arguing with your teenager. However as you establish these guidelines you want to have a conversation with your teenager about these issues. Remember your teenager is starting to enter the adult world, if you simply just tell them these are the rules no matter what they will feel that you are being unfair and they will try to find a way around your rules. If you have a discussion with them about the rules they will feel that their opinions are being respected and they are more likely to feel that the rules are fair and are more likely to follow the rules. It is also a good idea to write a contract with all the things you agreed to. If you write the agreements down and there is a misunderstanding you simply need to refer back to the contract. Also this is another opportunity for you to establish a relationship with your teenager where they feel comfortable enough to come to you and discuss any problems they may be having. You are also role modeling to them how to have an adult discussion and how to negotiate fairly and respectfully with other their people.

Of course you also want to take this opportunity to discuss with your teenager the fact that they are going to be faced with making decisions about alcohol, drugs and sex. This is a good time to provide them with the education they will need in order to cope with these situations. Remind them that information they may receive from their friends may not always be accurate. Furthermore, encourage them that at any time if they have any questions or concerns regarding these matters or any other matters you are always there to listen and to talk with them.

One thing to remember is acronym HALT. I teach this often with anger management, but it helps with communication too.

H – hunger

A – anger

L – lonely

T – tired

If either one of you are having these feelings, it is generally not a good time to have a discussion. Also if either one of you is feeling like this and you may not be listening to each other. Therefore, if either one of you are having these feelings or don’t feel like talking, then it’s better to postpone the conversation until you are both ready to talk.

Lastly, remind them that they are starting a brand-new phase in their life and it is normal to feel anxious and stress. Also remind them that these feelings are normal in the beginning but they usually quickly disappear after they have started school.

A few things you can do on the first day of classes to help with any anxiety are you can get up in the morning with them and have breakfast with them before they go to school. You can also put a note of encouragement in their backpack that they will find when they are at school and this can help reassure them and remind them how much support they have at home. Finally, you can arrange to be at home when when they get home from their first day of high school so you can talk about it with them. Also plan to have a family dinner to discuss everyone’s first day of school and offer encouragement where needed. These are just a few ideas to help with the transition process.

Dr. Rubino has a private practice in Pleasant Hill and specializes in working with teens. To find out more about the work he has done over 20 years visit his web site at http://www.RubinoCounseling.com.

Meet Coco Loco

Coco Loco is the new way teenagers have found to get a high. This product just entered the United States. It is not being marketed as a drug so the FDA has no authority over it. Teens assume it is safe because it is chocolate and natural.
Since this substance is so new, I have included a link that you can look at so you are more familiar with this substance. https://youtu.be/MV6QIsqA_f4

While chocolate is one ingredient it also includes ingredients common in energy drinks so the person feels a burst of energy. What is the problem? Since this is not regulated, there is no way to determine the amount of caffeine or other substances used to increase your heart rate are in it. Therefore, if a teen has been drinking a number of energy drinks and then snorts Coco Loco, they won’t know if they have had too much until it is too late.

Increasing your heart rate can be dangerous. Most people who do cardio exercises take their heart rate to make sure their heart rate is in a safe zone and not too fast. When a person’s heart rate is too fast, they can have a heart attack or a stroke just to mention some of the physical dangers. Also if a person ingest too much caffeine they can cause themselves to have a psychotic episode.

The problem with Coco Loco is since it is marketed as “natural” it does not have to comply with the labeling or health codes that substances considered as medical have to follow. If you go to a store such as GNC that tends to sell products to help lose weight or improve your energy level, you will find many of the items do not list ingredients or health warnings. By law they do not have to.

So the problem is that many teenagers may assume this product is totally safe when it is not. The problem is that they may discover this when their hear is beating 200 beats a minute and their health is at risk or they have had too much caffeine and find themselves waking up in the psychiatric ward of a hospital because they had a psychotic episode.

So parents, take a few minutes and discuss Coco Loco with your teenagers. In fact, discuss it with any of your children who are going to school. There is no age restriction on who can buy it and children may not hesitate to try it because it is chocolate. Explain the difference and the risks so they can make a good choice.

Dr. Michael Rubino has over 20 years working as a psychotherapist treating children and teenagers. For more information regarding Dr. Rubino’s work or private practice visit his website at http://www.RubinoCounseling.com.

Facts about July 4th for Parents

It’s the 4th of July weekend and many teenagers will be involved in various activities. It’s a popular weekend for teenagers to be out drinking and also swimming with friends. Most people assume these are every day activities and everyone will have a good time.
However, this is not reality. Every year 5,000 teenagers are killed in motor vehicle accidents and 400,000 are injured (CDC statistics). These injures may range from cuts and bruises to someone being paralyzed.

Also regarding swimming, there are 3,500 accidental drowning every year. And out of these drownings 1 out of 5 are teenagers (CDC statistics). This is the number who die. It doesn’t include brain injuries due to lack of oxygen to the brain or breaking a neck by diving. A broken neck can result in death, paralysis or being in a Halo Brace for 6 months. Again this is an activity we assume is safe and nothing would happen swimming in a friend’s pool.

With it being the Fourth of July weekend and there are going to be a lot of parties and drinking. There are also going to be a lot of drunk driving accidents, drownings and accidental overdosing. You have no way to know if you or your family might be one of the unlucky families this weekend. It could be your teen who is killed or it could be you.

You never know what is going to happen in life. Especially given everything that is happening all over the world. And if you look at the above statistics, you never know when or if something is going to happen.

A mother experienced this fact when her son committed suicide. Suicide is the third leading cause of death for teenagers. After that she wrote the following poem to her son. She also encouraged all parents of teenagers to remember to say “I love you,” to your teenager. You may not get another chance.

I Love You

How could you?

They asked you,

How could you?

But you could not answer

As you were not here.

Why would you?

They asked you,

Why would you?

But their questions fell onto

The world’s deafest ears.

I loved you!

They told you,

I loved you.

But they told you too late,

Through their tears.

I’ll miss you,

They told you,

I’ll miss you.

And in death now

They hold you more dear.

The point is don’t take the risk. Since you never know what may happen and many teens feel that their parents don’t care, take the opportunity while you have it to express your feelings. Don’t spend the rest of your life regretting I never told him I loved him or wondering if that would have made the difference.

Dr. Rubino is a psychotherapist is Pleasant Hill who specializes in treating children and teenagers. He has over 20 years of working with teens. To find out more about his work or to contact him visit his website at http://www.RubinoCounseling.com.

Dr Michael Rubinio

Understanding Your Teenager

Month: July 2017