What to do if you think your child is suicidal

Many parents ask me about what to do if their child is suicidal. The idea is very scary especially because we do not discuss mental health issues in our society. However, suicide rates are at an epidemic level for children ages 10 to 18 years old. In fact it is the third leading cause of death for children ages 10 to 18 years old.

A successful suicide attempt is definitely a tragedy for the entire family. However, an unsuccessful attempt can be a tragedy for the child and the family. Depending on the method used, a child who has an unsuccessful attempt may have to live the entire life with major medical complications. They can cause brain damage which may cause them to lose the ability to speak or the ability to breath on their own. Therefore, they may spend the rest of their life on a ventilator. Guns are one of the main three ways teenagers attempt suicide. However, teenagers forget that guns have a kick when they are fired. Many teens who use a gun do not kill themselves, but they do shoot off their face. The result is they have to have numerous surgeries to reconstruct their face, but their face and life are never the same.

I read this very good article describing what to do if you think your child is suicidal. It provides the steps you need to take in a non-threatening manner. It also addresses issues parents often may not think about, if they are concerned about their child being suicidal. The most important step is don’t be afraid to ask your child if they are feeling suicidal. It is a myth that if you ask someone if they are suicidal that you will cause them to become suicidal. In fact, you may save their life by asking them if they are suicidal. By asking you let them know it’s ok to talk about their feelings. Also by asking you reassure them there is nothing wrong with them and that you are emotionally strong enough to cope with the situation. Therefore, you may save their life by asking.

I have included the link to this article and I encourage parents to read it and to save it. What to Do if You’re Worried About Suicide |. https://childmind.org/article/youre-worried-suicide/#.W9PRyfwKel8.twitter.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating suicidal children and teenagers. For more information on his work or private practice visit his website http://www.RubinoCounseling.com or Facebook page http://www.facebook.com/drrubino3.

Facts about Bullying at School

Many kids, despite what they say, really enjoy school. They like seeing their friends, their teachers and learning. However, some kids are not as excited and even worried about going to school. Many of these kids have been bullied and they are afraid of being bullied again. October is National Bully Awareness month and these article will provide you with information you need to protect your child from being bullied. Hopefully, we may even be able to stop bullying.

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. Our society teaches children these messages, especially boys. Children receive these 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. It is on Netflix and it might be helpful if you watch it.

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 would 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 any longer. The boy committed suicide to escape the bullying. He is not the first child to commit suicide due to bullying. One 15 year old girl committed suicide due to bullying and she left a note to be placed in her obituary. In the note she asked kids to be kind to each other. Some kids are turning to drugs and alcohol to numb the pain and we are seeing a significant number of accidental overdosages resulting in teenagers’ deaths. We assume they were accidents, they could also 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 on the college’s email for others to see, 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 know it is now a very serious problem in 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. I also explain that their parents would want to know so they can help them. I need to emphasize that Mom and Dad won’t blame you or be ashamed of you. It is amazing to see how relaxed these children become when I tell them this about their parents.

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 home

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 to contact or you can 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. They hope that 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.

One last comment, I saw a school install a “buddy bench.” If anyone had been bullied, having a bad day, feeling lonely, all they had to do was sit on the buddy bench. Another student or teacher would then go over and ask how they could help. There was no shame associated if you sat on the buddy bench. It was presented as a brave choice. The school was using it as part of their program to stop bullying at school. This fantastic idea came from a 10 year old student. Children often have fantastic answers and we need to listen.

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.

Helping Children Cope Emotionally with The Current Bomb Threats

This week children have been hearing about how bombs were delivered in the mail to former Presidents Obama and Clinton and others as well. In addition to hearing about this incident of domestic terrorism, they have also been hearing about school shootings such as the school shooting in Parkland, Florida where 17 students were killed. Additionally, in June of this year, students heard how someone had threatened to go Valley View Middle School and kill at least 30 students. So students who were use to these school shootings occurring typically thousands of miles away from us, now could happen in our area based on the threat made on 6/5/18. This made many students very anxious that the horrific events they have been hearing about could actually happen here and to them. Now this week they are hearing someone is mailing bombs and for people to be aware of their surroundings because we don’t know if it is over or will more bombs be mailed. Also they are hearing that a bomb was mailed to a Congresswoman in California. When you combine these recent events with the number of school shootings which have occurred and it’s no surprise that children are anxious about their safety and their parents safety. and today there was another school shooting. I have been seeing more and more children and teenagers who are complaining of anxiety and depression. Many of these children and teenagers are also afraid to go to school too. I have also been seeing more children and teenagers being placed on home/hospital for school. This means a teacher comes to the house once a week instead of the child or teenager going to school because they are too afraid of being shot at 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, the teenagers are saying they do not feel safe at school and now the incident with the bombs in the mail is exacerbating their anxiety significantly.

However, if you take a step back and look at what these children have seen over their lives it makes sense. Most of these children and teenagers were very young on 9/11, or were not even born yet, when the United States was attacked. Since 9/11 they have also seen two wars and heard on the nightly news about numerous terrorist alerts or attacks around the world and here in the United States. They also hear how the TSA are putting tighter security on travelers and places such as Disneyland are increasing security due to concerns about terrorism.

And now, children and teenagers are hearing how numerous bombs were mailed to people yesterday. These also are hearing that we do not know who did it and there is a strong possibility that there are more bombs out there and one of the bombs may explode and kill people.

Teenagers and parents have been asking Congress for sane gun laws so they can go to school safety. However, their requests have been ignored and school shootings continue. Therefore, many children and teenagers do not feel safe at school. Furthermore, the President is blaming the bombing situation on the press and not doing anything to stop it. In fact, the Time Warner building in New York City is being evacuated again tonight due to a suspicious backpack. Families were at restaurants having dinner and had to immediately evacuate. This current bomb threat only serves to add to the anxiety that children and teenagers are feeling. They do not feel safe at school, restaurants and are anxious about what may be in the mail. Is their mother or father going to go to work and be killed by a bomb that was delivered to the building they work in.

In addition to terrorism and bombs, we need to remember 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 combined. 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. Also because of school shootings, students have seen increased security on their school campuses. Many campuses have metal detectors that students have to pass through as the enter the campus and there are police officers assigned to school sites due to the fear of violence.

Now, in addition to these facts stated above, think about what these children see on the news nightly and the video games they play daily. Anytime there is a shootings incident in the United States, or any where in the world, there is pretty much 24 hour news coverage of the event for days. Now with the bombs that are being mailed, children are hearing that we have no answers and that there are more bombs out there and one may explode and kill people. The evacuation of the Time Warner building in New York City again tonight supports this fact that there are more bombs and we do not have the situation under control. Furthermore, 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 very realistic. Therefore, the video games children and teens are playing are adding to their anxiety or worse desensitizing children and teens to violence and death.

As a psychotherapist, I am hearing children in the fourth and fifth grades telling me they are worried about our election results. They have heard what the President has said and they are afraid about other countries attacking us or that the President 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 by daily events occurring in our country. 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 with in the world. 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 information about the current bombing situation and 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. We can explain that at Dad’s office or Mom’s office, they are taking extra precautions to make sure their mail is safe. 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. Also try to become active by looking at sites by the Red Cross. Making a donation helps children to feel there is something they can do instead of just being a victim.

Finally, if you start to notice a change of attitude in your child that you are concerned about have your child assessed by a psychotherapist who specializes in treating children dealing with trauma. I have included a link to an article by the American Association of Child and Adolescent Psychiatry which describes what parents can do http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Talking-To-Children-About-Terrorism-And-War-087.aspx. 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 is an expert treating victims of trauma and also performs Critical Incident Debriefing. For more information about his work or private practice visit his website at http://www.RubinoCounseling.com or his Facebook page at http://www.Facebook.com/drrubino3.

The Problem of Bullying Looking at Both Sides

We all have heard about kids being bullied at school and about the anti-bullying programs being developed to stop bullying. In fact, the month of October is dedicated to Bully Awareness and to stop bullying. However, do we really know how severe the problem is? Research shows that 1 in 4 children are bullied at school. It also shows that children who are bullied are more likely to do poorly in school, are more likely to become depressed or suicidal, more likely to develop eating disorders and tend not to tell anyone (CDC). The statistics also indicate that children who are teased in school are more likely to develop emotional problems as an adult (CDC). One surprising statistic is that if another student intervenes while someone is being teased the bullying is likely to end by 51% (CDC).

While we know bullying effects the student being teased, there are interesting statistics about bullies. Students who bully are more likely to have emotional problems and school problems too (CDC). The research also shows that students who bully are also more likely to become depressed, suicidal or be involved with violent acts as an adult (CDC). As we can see the person being bullied and the person bullying are both at higher risk for significant problems as a child and as an adult. Therefore, it makes sense that we do stop bullying in childhood as soon as it starts.

One statistic I would like to go back to is 51% of bullying tends to stop if another student intervenes. However, this does not happen often. I hear many of the children I work with who are bullied tell me that no one ever helps them. They say that none of their friends or other students get involved. They tell me the other kids look the other way and ignore it. These children also tell me that they often receive little assistance from their teachers. They say that if they say something to the teacher often the teacher often ignores what the student reported or blames both students for the problem which provides no help.

This is what I hear from the children who decide to tell someone. Most children I work with decide not to tell anyone. They are afraid of people thinking they are weak, “a cry baby”, things getting worse and letting their parents down. They feel their parents will think they should know how to handle the situation and if they don’t they will disappoint their parents. This helps no one and it only helps to perpetuate stereotypes such as all boys and men need to be big and strong physically and fight to prove their manhood. This type of thinking hurts boys and it hurts girls too who have to grow up with boys who act on this stereotype. Often girls become the victims of the stereotype such as date rape.

There is another issue involved in the bullying situation. It is called the Bystander Effect. It was first widely described when we were focusing on “road rage,” where people felt the permission to be rude or felt no responsibility to get involved in a situation they witnessed. With “road rage,” since the person’s identity was protected by their car they felt safe swearing at people or running the person off the road. In the other situation, people felt like no one could positively identify them it was alright not to speak up when they witnessed someone hurting someone or committing a crime in public.

We have part of this happening in schools. Students feel that since no one else is saying anything it is okay for them not to say anything. After all no one else is getting in trouble for not saying anything so how could they get in trouble, therefore it’s better to say nothing.

Also we have our politicians bullying people with no consequences. The President routinely tweets insults or threatens some one via his tweets and no one does anything. He also encourages physical violence at his rallies. Last week, he was proud of people body slamming others and said so and demonstrated it. How do you tell children not to tease or hit, when the President encourages bullying? I have children confront me with the question all the time? If I’m explaining teasing is not appropriate, they say to me but the President does it. They see it on the news and online. This is a difficult question to confront. I typically point out two wrongs don’t make it right.

The other factor fueling this lack of students speaking up against bullies is the “typical male stereotype.” According to this stereotype if you speak up and tell a teacher you are a “tattle tale” and you might get beat up. Another part of the stereotype is if you speak up then you just made yourself the same as the kid being teased so you will be teased. Students who are being teased are usually viewed as the “weird kid” and no one wants to be labeled the “weird kid” so most kids will say nothing about another student who is being teased.

Think back to when you were in school. There was that one kid who was labeled “weird” and teased, but did you say anything? Most likely not. You did not want to be associated with the “weird kid” and risk getting teased, getting beat up or losing friends. So instead of saying anything, you did what most other kids did, you said and did nothing. All this did was help keep the male stereotype alive and allowing bullying to continue.

Therefore, in my opinion if we want to eliminate bullying, we need to start working with are children. We need to teach boys and girls that this old “male stereotype” is wrong and to ignore it. We need to teach our children if you notice or are aware of someone doing something to hurt someone else or someone else’s property, they have an obligation to speak up and if you don’t you are as guilty as the person who did it. You need to explain that they are just as guilty because by not saying anything you are allowing the bullying to happen and continue. Some parents may say I am going to far, but if you are aware of a crime such as an assault and saying nothing, you can be charged as an a compliance. By not saying anything, you allowed a crime to occur and you can be punished. Therefore it’s good to teach our children this lesson early.

As I started this article out with various statistics about bullying, it is obvious bullying is very serious. It is something that we need to address and to address it and help everyone, we need to work together.

Dr. Michael Rubino specializes as a psychotherapist for children and teenagers with over 20 years experience. For more information about Dr. Michael Rubino’s work or his private practice visit his website at http://www.rcs-ca.com or on Twitter at @RubinoTherapy

Is my child being bullied ?

Many kids, despite what they say, really enjoy school. They like seeing their friends, their teachers and learning. However, some kids are not as excited and even worried about going to school. Many of these kids have been bullied and they are afraid of being bullied again this year. October is National Bully Awareness month and these article will provide you information you need to protect your child from being bullied. Hopefully, we may even be able to stop it.

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 home

Hungry

Angry

Lonely

Tired

Helping Special Needs Children Cope with Holiday Stress

As a psychotherapist who treats children, I work a great deal with children with special needs. Children who have Autism, ADHD, difficulties with being over stimulated by noise, processing difficulties etc. These children can respond differently to Holiday activities. Since the Holidays are just around the corner, we need to consider this fact. In just about two weeks we have Halloween, then Thanksgiving and then Christmas or Hanukkah. Therefore, parents need to be prepared to cope with the Holidays and how their child might respond. I read a blog by Lori Lite which gives good tips for how parents can prepare. I have provided some of her tips below.

Set Up a Safe Brain Break Space: Your child can enjoy downtime when they feel over-stimulated at your house or at your relatives. Set up a brain break space and be sure that the other children and guests know that this space is off-limits. Empower your special needs child to recognize when they need to go to their brain break space. Practice, practice, practice…. ahead of time to recognize when mood is escalating… Did I say practice? Empower children by packing a relaxation bag they can go to if they are feeling anxious. Bring earphones and their special relaxation music or stories. Play dough, stress ball, music, video game, even a camera can help children relax and give them a focus if they have social anxiety.

The Indigo Dreams Series gives you stories that incorporate actual relaxation techniques. The stories and music can be downloaded to an iPod or iPad. The other kids may actually be jealous…give them their own space to de-stress. You may start a new trend!

Get Ready: Social stories, books, and movies can be a big help in preparing your child emotionally for holidays. Comfortable clothing and small dose exposures to holiday sounds can help physically. Think ahead with an eye for anxiety causing issues. If wrapping paper too loud? Use easy open bags or just decorate with a bow. Are the electronic bears with bells at Grandma’s house going to cause sensory overload? Ask her to unplug them before you get there. Let friends and family know about triggers ahead of time. If your child doesn’t like to be hugged suggest a handshake or just a wave. Your friends, family, and special needs children will be glad you did.

Prepare Your Children For Gatherings: Eliminate unnecessary anxiety associated with getting together with family members you rarely see by looking through photos of relatives prior to your event. Play memory games matching names to faces. This will help your children feel more comfortable with people they may not have seen in a while. Aunt Mary won’t seem quite so scary when she bends down to greet your child.

Use Relaxation Techniques: Incorporate deep breathing or other coping strategies into your day. Let your children see you use techniques when you are feeling stressed. Encourage them to use relaxation techniques on a daily basis. Breathing, visualizing, and positive thinking are powerful tools.

Incorporate Positive Statements Into Your Dinner: This is empowering and reflective. Each person at the table can state an attribute of their own that they are thankful for. For example, “I am thankful that I am creative.” Feeling stressed? Try, “I am thankful that I am calm.” Your special needs child can prepare ahead with a drawing or sign language if they want to participate without speaking.

Don’t Rush: It’s simple; none of us are very good at rushing in a relaxed way. The two just do not go together. It is impossible for children or teens to rush without getting angry. Make sure you leave enough time to enjoy the journey and avoid meltdowns. Children with special needs should be given notice of transitions.

Write Things Down: Getting the constant chatter and lists out of your head decreases stress and anxiety. Kids love making lists. Give them a clipboard or dry erase board. Help your child make a list of what they want to do for the holiday. It might be helping decorate or what to pack for self-care relaxation bag. This will help you relax and help your children feel involved. Encourage them to add happy words like laugh or draw a smile face on their list.

Schedule Downtime: Don’t overbook your children. It’s important to use holiday time for relaxation. Try staying in pajamas till noon. Pop your favorite popcorn and watch a movie when you wake up. You’ll be surprised how an hour or two of relaxation can rejuvenate your children’s bodies, minds, and spirits.

Shopping: Avoid taking your children shopping on the busiest shopping days of the year. The chaos, noise of large crowds, and long lines will definitely add stress to your life. If your child is absolutely known to meltdown during shopping you can select a few gifts and bring them home. Set up a shopping experience in your home for your child. The whole family can participate. Have a checkout counter and a gift-wrapping table.

Be Flexible: Relax your expectations and definitions of what a fun experience is for your children. Most of us do not need the full blown exhausting experience of holidays to reflect that we had a good time. A few positive minutes is worth a lifetime of memories!

Let The Children Participate: Let your children do one thing for the holiday that makes them feel proud. Kids can collect acorns or place a few jingle bells into a bowl for a beautiful stress free centerpiece. Children can fold the napkins or put the forks out. Let them draw a special picture to place on your guest’s chair. Be prepared to accept their participation as perfect and wonderful. Restrain for correcting or straightening out the napkins and enjoy the holidays with your special needs child!

Dr. Michael Rubino has over 20 years experience working with teenagers and children with special needs. For more information regarding Dr. Rubino’s work or private practice visit his website http://www.RubinoCounseling.com.

What Is The Least Restrictive Environment ?

Parents this video explains that least restrictive environment at school refers to the best environment for your child based on their needs. Therefore, some times being placed in a general education classroom may not be the least restrictive. The Court has decided that the lease restrictive environment is the environment where your child will benefit the most from their education. This is an important concept for parents. It is also very important that parents understand this definition when they attend their child’s IEP meeting. I have included a link which defines this term further. IDEA Basics: (LRE) Least Restrictive Environment https://youtu.be/sc5pgXhyLoQ via @YouTube

Does My Child have ADHD?

School has been in session for several weeks and many teachers may be telling parents that their children are having problems concentrating. Also some parents have been struggling with getting their child to do homework. The school or family members may be suggesting to parents that the child has ADHD and needs medication. Many parents are not sure about the diagnosis and they are concerned about their child taking ADHD medication. I hear this very often from parents 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 child does have ADHD, they are entitled to accommodations such as extra time taking a test. This would be covered by a 504 plan. However, if your child has severe ADHD and needs resource assistance too, they are entitled to an Individual Educational Plan (IEP). Many schools may tell parents ADHD does not qualify for an IEP. This is not true. The severity of the ADHD determines if a child needs an IEP. They would qualify under the categories of Emotional Disturbance or Other Health Impairments.

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 http://www.rcs-ca.com or his Facebook page http://www.Facebook.com/Drrubino3

The Reality about Guns and Teenagers

I hear many children and teens talking about their safety at school and around town while they are playing. Many teenagers seem to believe if they have a gun that will keep them safe. While research this issue I read an article by Cody Fenwick regarding children and gun violence. His article was very alarming. September was dedicated to suicide prevention and October is dedicated to the issue of bullying so this month and last month were dedicated to safety issues involving teenagers and children. Therefore, it seems appropriate to address the issue of guns because they are a popular method of suicide and they can be used to bully kids too.

Many of us feel because we live in Pleasant Hill, Walnut Creek or Lafayette that our children and teenagers do not have to worry about gangs or gun violence. Unfortunately, this is not the truth. According to a new research study in the Journal of Pediatrics, guns continue to be the third-leading cause of death for Americans younger than 18 years old, killing around 1,300 children and teenagers a year in the United States. In addition, almost 6,000 children and teenagers are injured per year. Many teenagers are permanently disabled from these injuries.

The study examined data from the Centers for Disease Control and Prevention and the Consumer Product Safety Commission between 2002 and 2014. The study found that boys, especially older boys such as teenagers and minorities, were much more likely to be the victims of gun violence. The study did not say anything about where the boys lived. The facts are children who are male and teenagers, are at a higher risk for becoming a victim of gun violence. Therefore, teenagers in our area are at risk of becoming a victim of gun violence.

The study does indicate there has been a decrease in accidental deaths such as boys cleaning a gun. However, the rate as a method for suicide has increased. I have mentioned before that suicide is the third leading cause of death for 10 year old boys. This study confirms that statistic and indicates the preferred method of suicide for boys and teenagers are guns. According to Katherine Fowler, one of the lead researchers at the CDC, “Firearm injuries are an important public health problem, contributing substantially to premature death and disability of children.” Understanding their nature [guns] and impact is a first step toward prevention.”

When we look at these numbers, can anyone argue against taking steps to protect our children? Can you imagine a 10 year old boy using a gun to kill himself? Can you imagine a 10 year old boy feeling that his life is so bad at the age of ten that death seems like a better option than living?

The study indicates that in recent years guns were responsible for a large number of adolescent, males who were murdered. The study documented that deaths in the category of murder for boys under the age of 18 years old decreased to 53 percent. This is a decrease yet the rate is still 53%. The other causes of gun-related deaths include:

• 38 percent — suicides

• 6 percent — unintentional deaths

• 3 percent — law enforcement/undetermined cause

The study found 82% of deaths by guns were boys. This means 82% of gun deaths were boys who were children or teenagers. Putting it another way, this means these boys were not even 18 years old yet at the time of their deaths. The study also found that white and American Indian children have the highest rate of suicide using a gun.

We also like to think that the United States in one of the most advanced nations in the world. However, the statistics show that the United States has the highest rate in the world for children under 14 years old committing suicide. Again, the United States has the highest rate of children under 14 years old using a gun to commit suicide. That number scares me and is appalling to me. However, as an adolescent and child psychotherapist, I do not doubt it. I have heard 6 year old boys seriously discussing suicide.

Furthermore, I hear teenagers routinely talking about needing to carry a knife or gun with them for protection. They tell me you never know when you will be jumped and you need to be able to protect yourself. In fact, a few years ago a teenager was shot on his front door step in Danville over a marijuana deal. When I mention to teens the risks they are taking, they tell me there is no guarantee they will live until 30 years old. They would rather die protecting themselves than doing nothing.

As a society, we need to look at these numbers and ask ourselves some questions. What are we going to do in order to improve gun safety? Most importantly, why are children as young as 6 years old thinking about suicide? Also what are we going to do so that children who are suicidal have access to mental health care? This is our problem because it does happen in Pleasant Hill, Walnut Creek and Lafayette.

Dr. Rubino has 20 years experience as a psychotherapist working with children and teenagers. For more information about his work or private practice visit his website at http://www.RubinoCounseling.com.

Research Indicates Parents Often Deny Teenage Depression

A recent research study by Yahoo finds that despite the fact that parents may be concerned about their teen being depressed, they don’t seek treatment due to the negative stereotype associated with mental health.

This stigma associated with mental health is resulting in many teenage deaths. Suicide is the third leading cause of death for children 10 to 18 years old (CDC). In fact, suicide is considered a teenage epidemic (CDC). Research studies have confirmed that teenagers who report symptoms of depression are more likely to attempt and succeed at suicide (CDC).

Parents are reluctant to seek treatment because they are afraid if the diagnosis of depression is on their medical records their teenager may denied medical insurance and possibly job opportunities in the future. We need to change this stereotype. Parents need to feel safe to seek treatment for their children are depressed. They should not have to worry about insurance coverage or how people will judge them or their child. Parents are also reluctant to seek treatment because people may judge their child as weird or label them as bad parents.

If we want to decrease the number of Teenage Suicides and the number of teens dealing with depression or anxiety, we must change how we view mental health. I have included a link to the article so you can read more about this issue. Parents ‘In Denial’ About Teens’ Depression and Anxiety https://www.yahoo.com/parenting/parents-in-denial-about-teens-depression-and-117195820377.html?soc_src=community&soc_trk=tw via @YahooNews.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers. For more information about Dr. Rubino’s work or private practice visit his website http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/drrubino3

Dr Michael Rubinio

Understanding Your Teenager

Month: October 2018