Another School Shooting, When Will We Stop Them?

Another School Shooting, When Will We Stop Them?

I ran this article a while ago, but due to the school shooting in Kentucky today, it makes sense to run it again.

Again we have another senseless shooting at a school campus, what are we going to do? What answers do we give to the parents or families of the victims that will ease their pain? What would you do if it was your child? Unfortunately, the current President is ignoring the facts that teenagers need access to mental health resources and we need gun control. An interesting point, no guns were allowed anywhere near the Republican Convention even though caring guns were legal in the state. It appears the government is selective how laws are imposed. The main point is again there is another school shooting and more deaths, when do we act and stop these killings? Also it is important to note that the ABC show 20/20 did a story about school shootings. In their story they noted the increase in school shootings is significant. The number of people killed in school shootings was more in 2017 than all of the 17 years of previous school shootings. So we have a serious problem. The sad fact is this shooting barely made the news and we are accepting school shootings as part of our daily lives.

In regards to the mental health issue, many people feel uncomfortable discussing mental health and being around people who are mentally ill and therefore the mentally ill are usually ignored. However, the number of school shootings or people shooting others in movie theaters or other public places has increased significantly. In fact, this number is increasing every year, it is not decreasing, as I noted above. Given this fact, when will we as a society act and when will we demand that our government act? Most of these killings could have been stopped if we listened to family members asking for help because they were afraid a family member might hurt others. Also a majority of these teenager shooters have provided evidence in their behavior that they were having problems and needed help.

The killings that occurred in the Santa Barbara shooting show a family crying out for help for their son and the fact that he needed help emotionally were basically ignored. The result was another senseless killing. One of the victim’s fathers made a statement “no more.” It would be nice if this were the case, but if we do not change our attitudes regarding mental health and the laws, there will be more killings. The parents called for a welfare check on their son for help. The police went to his front door and asked if he was alright, he said yes so by law they left. The boy wrote in his journal, “if they only had stepped into my apartment it would have been over.” The parents told the police he was having mental problems but because he said “I am alright”, the police did nothing and innocent people died.

I have this happen very often where parents are saying their teens need help and the teen tells me they feel suicidal. Therefore, I call the police to have the teen hospitalized. This is the legal procedure. The officers arrive and ask the teen if they feel suicidal, if the teen says no the police may leave and ignore my professional assessment that the teen is a danger to self or others and ignore what the family is saying about the teenager being a danger. They do so because this is how the law is written.

No one wants to take rights away from any one but a person who is feeling like killing themselves or others is not the person to ask “are you alright?” They know if they say yes, the police will stop their plans so of course they say no. Also police officers have not had the training that mental health professionals have had and the officers are put in an awkward position.

As I stated, the number of school shootings is up significantly and shows no signs of declining. Parents come into my office all the time concerned about their teenagers and they have a right to be. However, the teen refuses to come to therapy and the teen is too big for the parents to force them to come in for therapy. If they never come in I never hear anything that permits me to have the teen hospitalized. So we are stuck in a position were we have to sit and wait until the teen does something such as self-mutilating (Cutting), suicide or kill someone else. As a practitioner this is a terrible position to be in and for the parents it is a nightmare.

I am not sure what the right answer is for this situation. I do know that what we are doing is not working. We cannot ignore mental illness and we cannot keep pretending that teenagers in our society do deal with mental illness. Parents, mental health providers and our State Senators and Representatives need to sit down together and discuss this public health problem and we need to do it quickly. If we don’t, it is only a matter of time before their are more killings. The life you save may be your own or someone in your family.

Also we need to address gun control too. We need to make it more difficult to buy guns at a gun shop, show or via the internet. The NRA always states we can’t do anything because people have a legal right to own a gun. This is true, but they don’t need automatic weapons. The lack of gun control laws is another part of the problem of school shootings and as such events as the Las Vegas shooting. We really need to look at this problem and the number of lives be lost and decide, what will we do?

Dr. Michael Rubino is a psychotherapist in Pleasant Hill who specializes in treating teenagers. Dr. Rubino has over 20 years experience treating teenagers. He has appeared on national and local television and radio shows regarding this topic. To find out more about Dr. Rubino’s work or his private practice visit his website www.RCS-CA.com.

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Mental Health and Sleep

Mental Health and Sleep

Sleep has a strong impact on our mental health and physical health. In fact, sleep deprivation can cause a person to have a psychotic break or if the depreciation is really severe it can even result in a person’s death. I recently received some very good information regarding sleep and mental health. It was provided by Jenny Thompson who is associated with www.bettermattressreviews.com. I think it is valuable information for everyone so I have provided it below.

Mental health and sleep are closely related. Sleep problems frequently accompany mental illness, and can even be the first warning sign of a disorder. In turn, lack of sleep worsens mental health symptoms, creating a vicious cycle.

Mental illness is common, with almost 20 percent of Americans suffering from at least one mental health disorder. While only 10 to 18 percent of the general population experience sleep issues, as many as 50 to 80 percent of people with mental illness have trouble sleeping.

Mental health disorders are the largest cause of insomnia. 40 percent of insomniacs and over 46.5 percent of hypersomnias have a comorbid mental health disorder. On the other hand, only 16.4 percent of people have a mental health disorder without any kind of sleep issues.

Sleep problems are closely correlated with ADHD, anxiety disorders, bipolar disorder, depression, and schizophrenia. Below we’ll review how sleep affects several mental health disorders, and provide tips for getting better sleep.

Schizophrenia and sleep

Schizophrenia affects 1 percent of people, or 3 million Americans. Onset often occurs in late adolescence or the early 20s. Individuals with schizophrenia suffer from psychoses such as delusions and hallucinations, and experience difficulty focusing their thoughts and expressing themselves.

Up to 80 percent of people with schizophrenia have sleep problems, including:

Irregular sleeping hours. They may fall asleep anytime during the day or night rather than during the typical overnight sleep period of most people. They may have consistently delayed melatonin release that shifts their sleep pattern later than normal, slowly shift their circadian rhythm later and later each day, or follow no consistent sleep-wake patterns at all.

Irregular sleep quantity. They may get too much (hypersomnia) or too little (insomnia) sleep, as a result of medication side effects, fear or anxiety due to hallucinations (which may cause them to sleep more to escape, or conversely to be afraid of nightmares), or the irregular sleep hours cited above.

Sleep apnea. Individuals with sleep apnea literally stop breathing during the night, due to blocked airways or a miscommunication between the brain and the breathing muscles.

Less refreshing sleep overall. Due to the issues described above, people with schizophrenia experience less refreshing sleep overall because they have trouble getting sufficient amounts of REM sleep.

For many people with schizophrenia, an onset of sleep problems can be a warning sign that psychosis is starting or returning.

A 2012 study of mice found that abnormalities in the SNAP-25 gene are linked to schizophrenia as well as disrupted sleep-wake cycle, suggesting that resolving sleep issues may less or resolve schizophrenia symptoms.

Anxiety disorders and sleep

Generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, social phobias, and PTSD are all associated with having anxious thoughts while trying to fall asleep at night and related insomnia.

Source: The National Academies Press

Panic episodes may waken an individual with panic disorder from sleep, thus disrupting their overall sleep quality. Likewise, individuals with PTSD are prone to vivid re-experiencing traumatic nightmares which heighten their bedtime anxiety and also cause interrupted sleep.

Individuals with mood and anxiety disorders may be prescribed various medications such as antidepressants and mood stabilizers which can further interfere with sleep.

Insomnia not only accompanies anxiety; it can cause it. When individuals experience chronic sleep deprivation, it disrupts their serotonin and gamma-Aminobutyric acid neurotransmitter levels, which can result in anxiety. One study found that having insomnia increased one’s risk to have yet another mood or anxiety disorder one year later.

Depression and sleep

Insomnia is one of the biggest risk factors for depression. Lack of sleep worsens mood, and the effect is even worse for individuals with a mood disorder. Depressed people with sleep issues have a higher risk of suicide than depressed individuals without sleep problems.

Treatment is also complicated. While antidepressants boost mood and alertness to help treat depression, that same alertness makes the insomnia persist – and not addressing the insomnia can make individuals less responsive to treatment. But certain prescription drugs for insomnia, like Rozerem, may worsen depression. The key is to find a treatment plan that helps both issues, but not at the expense of either.

Depression and sleep issues are bidirectional. That means the problems of one can worsen the other. The good news is, that also means the improvement of one often fixes the other. For example, 35 million Americans suffer from mild depression (dysthymia). For many, their comorbid insomnia goes away once they begin taking antidepressants.

Bipolar disorder and sleep

Bipolar disorder affects 3 percent of Americans, or 6 million adults. In addition to severe changes in mood, behavior, and energy levels, individuals with bipolar disorder may also experience the following sleep problems:

Insomnia, or difficulty falling or staying asleep

Hypersomnia, or oversleeping, especially during depressive episodes

General sleeplessness, where individuals feel fine even when they’ve had significantly less sleep, although this abnormal sleeping pattern eventually catches up with them

Delayed sleep phase syndrome, where the individual has a delayed circadian rhythm, causing them to naturally start to fall asleep or wake up later than others and experience excessive daytime sleepiness as a result

Irregular sleep-wake patterns from manic episodes and related hyperactivity at night

REM sleep issues like vivid nightmares

Sleep apnea affects one-third of individuals with bipolar disorder, resulting in less restful sleep overall and excessive daytime sleepiness

For individuals with bipolar disorders, different sleep issues may arise depending on when they are in a manic or depressive state.

In fact, for 75 percent of individuals with bipolar disorder, sleep problems are one of the biggest warning signs that they are about to experience a manic episode. For example, sleep loss from chronic sleep deprivation or even a night of jet lag can induce a manic episode. Manic periods are so arousing that individuals can go for days without sleep, or sleep drastically less amounts than usual and not feel tired. However, that lack of sleep makes its mark in other ways, as they’ll still experience the other symptoms of sleep deprivation felt by everyone, including increased irritability, trouble focusing, reduce judgment, depressed mood.

As they enter depressive episodes, bipolar people may experience insomnia or hypersomnia, both extremes which cause further imbalances in mood and increased anxiety.

In between manic and depressive episodes, individuals with bipolar disorder experience poorer quality sleep, occasional insomnia, and interrupted sleep.

Sleep tips for individuals with mental health disorders

There are various psychotherapies that treat mental illness, sleep therapies for sleep problems, and other behavioral changes that can help individuals with mental health disorders sleep better at night.

1. Practice good sleep hygiene.

It all starts with good sleep habits. Good sleep hygiene includes keeping the bedroom cool, dark, and quiet, and limiting stimulating activity before bed, such as watching television, using the computer, or engaging in heavy exercise. Heavy meals, as well as alcohol, drugs, and caffeine, should be avoided in the early evening and late night hours.

2. Be careful with napping.

For individuals with excessive daytime sleepiness, power naps of 20 minutes can help give a sense of refreshment. However, naps longer than 20 minutes should be avoided as they can contribute to insomnia later that night.

3. Try sleep therapy.

There are various psychotherapy options that assist individuals with mental health disorders. There are also many specific therapies designed to treat comorbid sleep problems.

Cognitive behavioral therapy (CBT) has proven very effective for treating insomnia. CBT first helps the patient recognize their harmful or disruptive thought patterns and habits. Then, they learn to replace them with positive thoughts and better ways to cope so they can calm anxieties surrounding sleep as well as the rest of their lives. One study in particular found that six 20-minute sessions of CBT resulted in a nearly 50 percent decrease in insomnia, 20 percent decrease in depression and anxiety, and 25 percent decrease in paranoid thoughts, and 30 percent decrease in hallucinations.

Sometimes taught as part of CBT, meditation and deep breathing exercises can soothe anxious thoughts and help relax the body for sleep. You can find audio files of guided meditation and relaxation exercises on the MIT Medical website.

Sleep restriction therapy involves setting a strict bedtime and waketime, and only staying in bed for that allotted amount of time, regardless of how much sleep the individual actually enjoys. Eventually the body gets used to the new sleep-wake cycle and begins to sleep and wake at the proposed appropriate time. A small 2013 study found that sleep restriction therapy improved sleep and reduced symptoms of insomnia for patients with bipolar disorder.

Chronotherapy works similarly by gradually adjusting the bedtime and waketime. It’s a newer therapy and the research is still bearing out.

Bright light therapy helps reset a person’s circadian cycle and make them feel more awake in the morning. Exercising outside in the morning in areas of bright sunlight can provide a similar effect.

4. Explore natural remedies.

Melatonin supplements help kickstart melatonin production in the brain. These can be helpful for insomnia or anyone who has difficulty falling asleep due to a period of mania or delayed sleep-phase syndrome. Valerian root can also help induce sleep. Both melatonin supplements and valerian root are widely available at pharmacies.

5. Keep a sleep diary.

If you’re concerned you may have a comorbid sleep disorder, a sleep diary can help you track your sleep habits. Note when you fell asleep and when you woke up, the total amount of time you were asleep, and anything abnormal that happened during your sleep, such as nightmares or snoring. If you find you’re not getting enough sleep, you can meet with a sleep specialist for a diagnosis and share your diary with them.

You may also want to consult a mental health professional for an evaluation and/or your primary care physician.

Dr. Rubino has 20 years experience as a psychotherapist treating children and teenagers. Many have sleep problems. For more information regarding Dr. Rubino’s work or private practice visit his website http://www.rcs-ca.com.

Risks Associated with Legal Marijuana

Risks Associated with Legal Marijuana

Marijuana is now legal for medical and recreational use in California. However, the United States Attorney General is trying to make recreational use illegal based on Federal law. Regardless of the US Attorney General, many people, especially teenagers, are happy that recreational use is legal and that it is legal to buy marijuana. However, the marijuana that is currently legal to buy and use recreationally may pose some serious problems. It may pose some very serious health problems that could be deadly.

The problem is that the state of California is not prepared for the new law making recreational marijuana legal to buy and use. Before any marijuana is sold from a dispensary it is supposed to be tested for mold, fungus and pesticides. The way marijuana grows it can be contaminated with mold and fungus. The mold and fungus are dangerous to people. In fact, the U.C. Davis Medical Center had a person die from a lung infection created by a fungus. They tracked the fungus back to some marijuana the person used.

The form of the marijuana doesn’t matter. The mold and fungus can be in marijuana you smoke or eat. You can get sick from either form. People may assume if pesticides are used to kill the mold and fungus as the marijuana that will make the marijuana safe. After all, we use pesticides on the food we eat all the time with no problem. However, fruit and vegetables can be washed and the pesticides removed. Marijuana cannot be washed. Therefore, the pesticides remain on the marijuana. Some of the pesticides turn into cyanid when they are burned. Therefore, a person smoking recreational marijuana can also be taking in cyanid which can be deadly.

The reason this problem exist is because there are not enough labs in California to test the marijuana being sold for recreational use. There are only approximately 18 labs in California approved to test recreational marijuana. These labs cannot keep up with the demand.

The solution is to have more labs approved to test recreational marijuana. The State of California is currently working on getting more labs approved for testing. However, it is projected that it will take until July 2018 in order for the State to have enough labs approved and prepared to test recreational marijuana.

Therefore, in the mean time, when you go to a dispensary to buy recreational marijuana if it has not been tested, there will be a sticker on it saying it has not been tested. If you have a doubt, ask before you buy and ask to see the documentation. If the marijuana has been tested, the dispensary will be able to provide this information. If the dispensary hesitates about providing documentation, then the marijuana has not been tested. Remember, currently all recreational marijuana which has not been tested should have a warning label stating it has not been tested. However, some sellers may not disclose this information and therefore the marijuana may not have the warning label. So for your own safety, if you buy recreational marijuana before July 2018, ask for the documentation that it has been tested for mold, fungus and pesticides.

Parents it is important to explain this information to your teenagers. Before marijuana was legalized the major concern was could the marijuana be laced with another drug such as LSD. However, now besides making sure it is not laced if you buy it off the street, you also need to check if it has been tested. Parents you may feel safe because legally you have to be 21 years old in order to buy marijuana. However, we all know that teenagers can find someone to buy it for them. Therefore, teenagers need to be aware of the health risks associated with buying marijuana from a dispensary now.

Dr. Michael Rubino has 20 years experience working with teenagers and children. For more information about Dr. Rubino’s work or private practice visit his website www.RubinoCounseling.com or follow him on Twitter @RubinoTherapy.

Risks Associated with High School Sports

Risks Associated with High School Sports

Many high school students are currently busy practicing their sport or playing games. Typically most people look at the fun and the positive experience it provides for students. However, high school athletes do get hurt, sometimes seriously. High school athletes do suffer broken arms and legs, but they also suffer concussion, traumatic brain injuries and spinal cord injuries. Parents are now 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. Unfortunately we had another example a week ago, when a wrestler from College Park High School suffered a spinal cord injury and is paralyzed from the neck down.

As a result of these head injuries, 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. Also these symptoms can create problems at school that the student may need accommodations for in order for the student to understand the classes.

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, Traumatic Brain Injuries and Spinal Cord Injuries also occur in teenagers. Teen athletes such as football players routinely suffer concussions, traumatic brain injuries or spinal cord injuries. 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.

A new research study from Boston University released shows that boys who play football before the age of 12 years old are more likely to have memory problems and problems making decisions as adults. This study also shows that boys who play football before age 12 are three times more likely to develop clinical depression as an adult. The study suggests the reason this occurs is because around the age of 12, a child’s brain is undergoing a great deal of development at this age. Robert Stern, one of the authors of the study, explained that “the brain is going through this incredible time of growth between the years of 10 and 12, and if you subject that developing brain to repetitive head impacts, it may cause problems later in life.”

Another MRI study, by the Wakes Forest School of Medicine, conducted last year showed that boys between the ages of 8 years old to 13 years old who played even just one season of football showed signs of diminished brain function.

High school athletes are not the only teenagers at risk for concussions or other serious injuries. 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.

Also boys are not the only ones at risk for concussions. Girls are at risk for concussions and other serious injuries. In fact, some studies show that cheerleaders are at a higher risk of getting a concussion than football players. Cheerleaders do not use helmets and have no head protection. Also many people assume a child needs to be knocked out in order to sustain a concussion. This is not true. You can sustain a concussion without losing consciousness. So football players are not the only one at risks. Any high school athlete is at risk – boy or girl. Anything that causes a jarring of the head can cause a concussion. Our brain sits in fluid in our skull. Therefore any jarring force can cause the brain to hit the side of the skull and cause a concussion. This is why all high school athletes are at risk for concussions.

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.

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

Parents need to talk to their teenagers’ school and coaches regarding making sure that they use the latest safety equipment for their sport. Parents may even want to research what the latest safety equipment so if your teen’s school is not using the latest safety equipment, you can inform the school. The ultimate goal is we want high school sports to be fun and safe for high school students.

Dr. Michael Rubino has over 20 years experience working with teenagers and their families. For more information on Dr. Rubino or his work please visit his website at www.rcs-ca.com or follow him on Twitter @RubinoTherapy.

Facts about Vaporizing and Hookah Pens

Facts about Vaporizing and Hookah Pens

Many teenagers have heard it is illegal for them to use marijuana. Therefore, many teenagers have found away that they feel is legal and safe. Teenagers are using vaporizers or Hooka pens. Unfortunately, many parents don’t know a great deal about this new way to smoke

Vaporizing is the new things teens are using. They use it when the use an E cigarette and they use vaporizers for using weed. I have seen teens actively using vaporizing pens on school campuses. They feel they are safe and they will not get into trouble using them.

Many people will say E cigarettes are safer. However the newest research does not indicate that is true. They have not been on the market long enough to know the long term effects. The newest research indicates that E cigarettes can cause health problems. Therefore, you should not assume they are safe.

Teens are also using vaporizers to use weed. Again they claim it is healthier. While vaporizing prevents some chemicals from getting into a teens body, vaporizing allows more THC into the teens body. People state it creates more of an intense body high that lasts for a day or two. People warn that if someone is not use to this it can create a traumatic experience for the teen. With vaporizing someone can do what is referred to as a volcano. The weed is vaporized into a plastic bag so it can be inhaled over time.

People who I have spoken to state vaporizing is not as safe as teens think. The body high it creates and the length of the high could be traumatic for a teenager. However, they are seeing more teens getting into it even though they don’t know exactly what they are getting into.

Parents do your own research and talk to your teens. There are more and more drugs out there and more ways to use them than ever before. Teenagers don’t know exactly what they are getting into and can end up in a bad situation. They need your guidance more than ever regarding these new drugs and methods of use.

The Hookah Pens and Vaporizers are more popular today. In addition so are the designer drugs Mollies and Thunder Bolts. No one knows exactly what is in them so many Emergency Room doctors are unable to treat these teens and they die.

Another thing teens are using is GNC stores. Everything in there is a vitamin so it does not have to be tested by the FDA. However many of these vitamins used at the right amount give teens a long lasting high. Many parents don’t suspect anything because their teen says they are taking vitamins for their sport team their on. Look at and research anything they are taking.

Well your teenager has found a new toy to use. Many teens have been smoking Hookah because they believe that it is safer than cigarettes or marijuana. Unfortunately they are wrong. It is just as dangerous and might be more dangerous.

Smoking Hookah is a group activity that is common in the Middle East and India. Since it is a group activity, it is appealing to teens. Also since many adults here in the United States know little about it, this makes it more appealing to teens because it is easier to lie about. If you look up Hookah, you will find there are numerous places that teens can go in Pleasant Hill, Walnut Creek and Concord to buy a Hookah pipe and Hookah to smoke. There are also Hookah cafes similar to Starbucks where teens can go and smoke it. And now finally there is the Hookah pen. It looks like a regular pen so they can take it any where such as school and smoke.

However, the Hookah pipe can be used for smoking more than Hookah. The teens are combining Hookah with marijuana to get high. Now that there is a Hookah pen, or vaporizer pen, teens can easily take this to school and smoke during class. As a parent you may want to discuss Hookah with your teen and see what they know or don’t know. You may want to discuss the pros and cons too. Also remind them if they get caught with the pen on campus, they are in trouble.

One thing this should point out to parents is that you should never let your your guard down. Teens are always developing new ways and new devices to get high. Check out this video on YouTube to learn more about these pens.

Read more about the effect of these “waterpipe” smoking devices from the World Health Organization.

Dr. Michael Rubino specializes in treating teens. He has over 20 years experience treating children and teenagers. For more information on Dr Michael Rubino’s work or his private practice visit his web site at www.rcs-ca.com

Family Connections are Important to Children

Family Connections are Important to Children

In our fast pace world and chaotic lives we sometimes forget the importance of passing on traditions from generation to generation. Another problem that impacts this is our society has become very mobile. We no longer live close to our relatives. It’s not uncommon for grandchildren to live in California and grandparents to live back east. And with jobs becoming more difficult to find and the cost of living increasing families are moving where ever they can find a job or to a place where the cost of living is affordable.

The problem is the close family provided support and help for the family. Children could establish close relationships with grandparents and aunts and uncles. These adults could serve as additional role models and inform parents if something seemed off with the child. They are also able to spend additional time with the children and reinforce what parents are teaching their children and reinforce the family traditions.

The other thing that the close connection to generations provided was a sense of security. If there was a problem a child knew they could turn to their parents, aunts or uncles or cousins. It also helped a child’s self-esteem. You had the adults who could reinforce that you were worthy and you had cousins who would defend you at school or in the neighborhood because you were worth it. Also your older cousins could help you learn what to expect as you went from grade to grade. There was a sense of support and security that most children don’t have today.

The advancement in computers and communication may provide a way to try to recreate this sense of family. With such things as Skype where you can talk and see the other person, it’s almost like being with the person, but it is not the same. Children can Skype with grandparents, aunts and uncles and cousins too. We just have to make time for it. For those families that live close to each other, you need to remember the value of family and make time for family. At times it may be difficult, but you will find that the time and effort are worth it. I have found that children with close family ties and connections to their cultures do better. They have a sense of pride and a sense of where the came from that other children don’t.

I have attached a link to an article with a link to an article about sharing traditions with family. Check out this article from First 5 LA: http://www.first5la.org/index.php?r=site/article&id=3615&utm_content=buffere936a&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer.

I think you will find it interesting.

Dr Michael Rubino has been working with children/teens and their families for over 20 years and is well respected. For more information at Dr Rubino’s work or his private practice visit his website at http://www.rcs-ca.com.

Does My Child Have Attention Deficit Hyperactivity Disorder ?

Does My Child Have Attention Deficit Hyperactivity Disorder ?

Schools have been in session for a semester 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