Head Injuries in Teenagers

Head Injuries in Teenagers

Parents are learning that 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. This can result is teenagers turning towards drugs as away to self-medicate or suicide due to the depression they are experiencing.

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

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

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

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

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

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

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

The Deadly Teenage Heroin Epidemic

The Deadly Teenage Heroin Epidemic

ABC 20/20 did a very good show the other night about the epidemic of heroin use in the United States. If you did not see it, you can probably find it on their website. Parents this is a show you need to see because many teenagers I work with are not afraid or concerned about how dangerous heroin can be.

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

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

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

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

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

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

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

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

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

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

Ideas on how to help you child start school

Ideas on how to help you child start school

Advice for School Starters – Smoothing the Transition

A teacher reads to schoolchildren in a primary classWith the beginning of term fast approaching, parents and children will be facing the start of the new school year with a whole range of emotions. The thought of a new class, new teacher, new subjects or even a new school might be exciting, nerve wracking, confusing or a mixture of all 3 emotions with many more besides. Whether your child is starting nursery, a new school or a new class within a known school, here are some top tips to consider when trying to ensure that the start is as smooth as possible.
Acknowledge your child’s feelings
With thousands of children starting school or nursery /changing class across the country, it is easy to down play what a big deal this is for your child. It might be their first step away from you and into a more formal educational setting, or it might be a move to a new teacher. Whatever the transition is, it is likely to be huge for your child. It will be a new environment, with new staff and possibly different peers. All of the constants that help your child feel secure might have been taken away to be replaced by unknowns. Imagine how anxious you might be when starting a new job – where do you sit? What are the rules around breaks? Where do you get your lunch? What happens if you don’t know what to do? As adults, we have the ability to reflect on these questions and form plans to deal with them (what is known as executive functioning), children don’t have this ability until well into middle childhood and sometimes later. Instead they are just left with a general sense of unease and emotional upheaval. It is a big deal. Being able to listen to your child’s worries, naming them and talking about them will help. Also recognise that their behaviour might become unsettled during this time. Remember that all behaviour is a communication – what is your child trying to tell you about how she /he is feeling?
Protect their sense of security
As a parent, you will have spent a long time building up a sense of trust and security between you and your child. By the time they go to nursery or school, they will know that they can trust you, that you are there for them and that you can meet their needs. Imagine how confusing it would be if this feeling was suddenly replaced by anxiety and insecurity by suddenly being left in a new place with no where that you know to be safe and familiar. No matter what advice you are given, it is important that you recognise what your child needs. If they need you to stay a bit longer, then stay, if they need a comforter, allow this. Recognise that the first few weeks of a new environment will be unsettling for a child – what can you do to protect their sense of security (even when others may be telling you to leave them)?
Trust your instinct (and your child)
No-one knows your child like you do. You are the expert in what your child needs to feel safe. If you feel that your child needs you to stay to help them settle in, then do this. If you know that your child will settle better with you remaining at distance, then this is fine too! Children are not all the same and just as each of us need different things in our adult lives, then this applies to children too. Yes, nursery or school staff may have years of experience in settling children into their new class, but they have no experience of what your child needs. This is where working in partnership with the school or nursery really needs to take place. If your instinct is telling you that your child needs something other than what school or nursery are suggesting, talk to them! Recognise your absolute expertise in knowing what your child needs.
Preparation
Giving your child a sense of predictability is important when it comes to change. Most of the things that we find anxiety provoking are to do with not knowing what to expect. Younger children will often work through these anxieties through play if they are given the opportunity to do this. Play is a non threatening way to explore different scenarios and difficult emotions. If your child is starting school, is there a way that you can help them role play this either with toys or with you / older siblings? Can you set up a pretend classroom? Other effective ways of helping prepare children for school might be to think about visual timetables/cues – the simple act of looking at photographs together of their new environment will be helpful in lessening any anxiety. Talking to your child about the day to day detail of what will happen will also be helpful.
Give your child control
The feeling of not being in control when starting something new is the one that can create the most anxiety, and for some children, the most challenging behaviours. Think about any way that you can give your child an appropriate sense of control over what is happening. Simple things like picking their bag, clothes etc can be helpful, but don’t limit this to just thinking about school related things. Are there other points in the day where you can give your child a sense of control?
Transitions can be very exciting but are a time of great change for both parents and children. Be kind to yourself as you go through this time, you both deserve it!
by Dr. Sarah Hulme

Steps towards using gentle parenting

Steps towards using gentle parenting

Six Steps To Work Towards Gentle Parenting

Woman reading book to young girl in bed smilingThe following six steps can help you to transition to more gentle parenting:
1) Resolve to respect your children
As adults we command respect from our children, and other adults, on a daily basis. We expect to be treated in a certain way, we expect others to take our thoughts, rights and beliefs into account in all dealings with us. If a child in particular shows us a lack of respect we are quick to pull them up on it (especially if they are tweens or teens!), yet do we afford our children the same priviledge?
If we respected our children we would listen when they woke crying in the middle of the night instead of returning them to bed with minimal eye contact or conversation. If we respected our children we would not force them to eat the untouched brocolli on their plate that they beg us to leave. If we respected our children we wouldn’t say “because I said so” or escalate into yelling at tweens and teens. If we respected our children we would not ignore their overwhelming emotions when they tantrum in public. If we respected our children we would never consciously hurt them emotionally or physically.
If we respected our children they would respect us and not feel the need to display half of the behaviours listed above.

2) Resolve to empathise with your children
Children have bad days just like us, some days the world is overwhelming, some days they are scared, lonely, confused, anxious or angry. Some days they need duvet days, hugs and for us to listen to them. How would you feel if you were treated in the same way that you treat your child?
If we empathised with our children we would not leave them crying alone in their crib at night – even if it is for only 5 minute intervals. If we empathised with our children we would never make them sit on a naughty step or put them in ‘time out’. If we empathised with our children we wouldn’t yell at them and we would never intentionally hurt them. If we empathised with our children we would listen to them more and speak at them less.
If we empathised with our children they would grow to be empathic towards others, including their parents, and would not feel the need to display half of the behaviours listed above.

3) Allow your children to have their own opinions and make their own choices.
For some reason many adults seem to believe that children are incapable of making their own good choices and need steering as much as possible, similarly we often punish a child who holds different opinions to us. We do however aspire to raise children who are thinkers, confident and assertive and questioning of the world – how do we expect them to be so if we take such control over their lives?
Children need to make mistakes, the best way for them to learn what is a good and what is a bad choice is to let them experience the natural consequences of their actions. The best way to raise a child who respects the opinions of others is to respect the child’s individual opinions ourselves. That also means allowing them to make age appropriate decisions as much as possible. If they are not of an age where they are capable of making a big decision about their lives – then we owe it to our children to not make that decision for them unless it threatens their physical health or psychological wellbeing.
If we allowed our children to make mistakes and valued their opinions they would grow to respect the opinions of others and know the value of good and bad choices at an age when they need to the most.

4) Reset your expectations to what is age appropriate and normal
Much parenting angst stems from our skewed perceptions of what is and isn’t normal when it comes to babies and children. From night waking to naps, eating to behaviour, our perception of what is normal and what is “a problem” is usually far from the truth.
It is normal for babies to wake regularly throughout the night well into their second year, it is normal for toddlers to bite, throw and hit, it is normal for preschoolers to not want to share, it is normal for a 5 year old to not understand – or care – how their actions can upset another and it is normal for a tween or teen to have uncontrollable bouts of anger that result in door slamming or wall punching. All of these behaviours are related to brain maturation (or rather the lack of), they are not behaviours that mean you are raising a monster they are just a relection of biology.
Make a resolution to understand the normal physiology and psychology of children, particularly the same age as yours and throw out any books or magazines that are ignorant to this knowledge and stop visiting parenting websites that are full of forums and advice article that promote otherwise.
When we reset our expectations of our children based on biological fact it is easier to be kind to ourselves as well as our children and will also result in more respect, empathy and allowance of control too.

5) Take time to nurture yourself
Parenting is really hard, particularly in the times that we live in. We are not meant to parent alone, we are meant to do it as part of a group – who provide emotional and physical support. We are not meant to parent and take a full time job, parenting is a full time job. We are not meant to worry about our physical appearance 3 weeks post partum.
As parents today we have so much added stress that we forget to see parenting for what it is – the most important job in the world. If you spend all day doing nothing but cradling a fractious newborn, bouncing a teething 6 month old or laying with a poorly toddler you haven’t “failed” or “done nothing” – you have done everything, and then some.
We get so frazzled as parents – with money worries, relationship issues and work concerns, we are exhausted dealing with all of the sleepless nights alone and our stress rises. We become so full of our own overwhelming emotions that we are unable to ‘hold’ any from our children. So we snap. We shout at them, we send them to their room when we know what we really should have done is talk. We leave babies to cry themselves to sleep because we just can’t face another night with no sleep. These problems though are ours, not those of our children. They don’t need fixing – we do.
Taking care of yourself as a parent is not a luxury or a bonus if you have a spare 5 minutes, it’s is a vital part of who you are and what you do. When you nurture yourself in body and soul you will have more patience, more respect, more empathy and more understanding of your children and your increased ability to deal with their issues as well as your own, will mean you will have far less of their issues to deal with.

6) Give them your attention.
Many ‘parenting experts’ comment that babies and toddlers only behave in a certain way in order to elicit the attention of their parents, like this is a bad thing. Parents are advised to ignore the attention seeking behaviour, when what they really need to do is to see it as a need that should be met.
Our lives are so busy, so full of screens and half hearted “in a minute honey” and “that’s nice dear” comments, so full of rushed bedtimes, meals on the run, clubs, classes and playdates. Our lives are so full of ‘stuff’ – toys, apps and equipment – that our children are growing up ‘stuff rich’ but ‘attention poor’.
If children persistently act in ways we do not like in order to get our attention – be that hitting, biting, throwing, crying, tantruming, door slamming or sulking – by far the easiest way to distinguish the unwanted behaviour is to give them our undivided attention. Not only does this have untold benefits for our children – but for us too, for it means we slow down and begin to see the wonder in the world once again.

Understanding How Your Teen Thinks

Understanding How Your Teen Thinks

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

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

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

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

What does this mean to you as a parent? It means that you cannot expect your child to reason as an adult would reason. Children and teens typically have concrete reasoning skills until their brain is fully developed. When the brain is fully developed then they have abstract reasoning and can think a head about consequences. Until such time their ability to do so is limited. This makes teenagers more vulnerable to peer pressure or making impulsive decisions which can result in trouble for the teenagers that they never expected.

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

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

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

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

When do I Have My Child Assessed for 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.

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

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

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

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

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

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

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

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

The Difference between an IEP and 504 plan

The Difference between an IEP and 504 plan

 

School is starting soon and many parents may need to decide between an IEP or a 504 plan for their child. Parents here is important information about Individualized Education Plans (IEP) and 504 agreements. Besides ensuring that your child receives a good education, you do not need to pay for items such as special computer programs that the school district should be paying for not you. If your child has an IEP the school district is responsible for most educational expenses even a private school if necessary. Please read this article so you understand your rights and your child’s rights.

The beginning of the school year is fast approaching. Besides the mad dash to get ready for school and schools are going to start assessing students to determine if they qualify for an Individualized Educational Program (IEP). I am already hearing from parents how school districts are misleading them and pressuring them to sign an agreement for a 504 before the parents clearly understand the difference between an IEP and 504 plan. The definition for both is further down in this article. An IEP and 504 are not the same. An IEP is legally enforceable and has legal guidelines and time frames. An IEP follows a student from school to school or state to state. A 504 is not legally enforceable and doesn’t follow a child nor are there legal guidelines.

An IEP will not stop your child from getting a job or from getting into college. In fact and college because they still would be entitled to assistance and the State of California may pay for their books. Also educational records are confidential therefore, no one would know your child had an IEP in school.

Many schools say your child must be two grades below in order to qualify for an IEP. If you said your child had a math or reading disability this is true. However, if they have ADHD, Bipolar, school anxiety etc. they can qualify under OTHER HEALTH IMPAIRMENTS. All your child needs is a diagnosis such as ADHD which would interfere with their ability to fully benefit from their learning experience in the classroom. The 2 grade below level qualification doesn’t apply to this category.

Also if you have a child in private school and they would benefit from additional assistance, contact your child’s public school district. Even though they attend private school the public school district is legally obligated to provide your child with services.

One more issue, never pay for outside testing before the school district tests your child. They have the right not to accept any outside testing until they test the child. If you disagree with the district’s testing then you can request an objective testing from an outside professional and you can request that the school district pays for the testing and you can select the evaluator.

An IEP or an Individualized Education Plan is a document that outlines the specialized education services that a student will receive due to their disability. It ensures the student will receive the assistance necessary so they will receive an education.
When most parents hear disability, they usually think of a person in a wheelchair or a student wIth a learning disability. There are various condItions that can qualify as a disability. Depression, Bipolar Disorder or even diabetes. The disability is any condition that will interfere in the student receiving the same education as other students. The students who qualify for an IEP need accommodations which meet the criteria of needing specialized education. As I stated above their are numerous conditions which may qualify a student for an IEP.
if a student does qualify for an IEP, they also qualify for Special Education. Many parents hear this and are afraid or embassies. There is nothing to be afraid of or embossed about. If a student qualifies for Special Education, if the student needs speech therapy or special computer programs, the school district is obligated to provide the services to the student at no expense to the student’s family.
There is also an option called a 504 Plan. This was established in the Rehabilitation Act of 1973. The 504 plan ensures that a student with a disability will receive accommodations so they will receive the same education as other students. However, the 504 plan does not qualify a student for Special Education services and It is not overseen as closely as an IEP plan.
Currently, many districts are telling parents that their child does not need or qualify for an IEP and a 504 plan is just a good. This is not true. Many school districts are telling parents that their child does not qualify for an IEP because the IEP is more expensive for the district and most districts are trying to save money.The districts take advantage of the fact that as parents, you do not know all the differences between an IEP and a 504 so they can talk a family into a 504 plan easily.
If you find that your child is having difficulties at school due to a learning disability, health issue or emotional issue, consult an outside professional before you automatically assume that the school is giving you the appropriate recommendation.
I see many parents who have been told that their child is better with a 504 plan and that is not the truth. You can consult an educational consultant or a therapist who works with children. You can contact me at via my website http://www.rcs-ca.com. I help many families at their child’s IEP meeting. The main thing is, do not be afraid to ask if your child should have a 504 or an IEP. Also don’t let the district make you feel guilty because you want time to think and investigate the options. This is your child and you should never sign anything until you are sure it is in your child’s best interest.
I have added a link to a chart that will help you compare the two and understand the differences.

504 Plan vs. IEP – Education Centerwww.ed-center.com/504This pages lists the differences between an IEP and a 504 plan.

I have also added a link to a video which helps to explain the differences between an IEP and 504 plan.

Dr. Michael Rubino has over 18 years experience working with children and teens. He also has over 19 years experience working with children in Special Education and was an Intern for the AB3632 program which works with children in Special Ed and IEPs. For more information about Dr. Rubino’s practice visit his website at http://www.rcs-ca.com

The Vicarious Trauma of Teenagers

I have been seeking more and more teenagers who are complaining of anxiety and depression. Many of these teenagers are also afraid to go to school too. I have also been seeing more teenagers being placed on home/hospital for school. This means a teacher comes to the house once a week instead of the teenager going to school. This is an alarming trend.

I have also been hearing more teenagers talking about needing to carry a knife with them for their own safety. They tell me you never know when someone might try to attack you. These are not juvenile delinquents or gang members, these are average teenagers. They come from healthy families and are doing well in school and not involved in drugs. This need they feel to protect themselves is an alarming trend.

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

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

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

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

The question now becomes, what do we do? Well we can not change the world unfortunately. However, we can monitor how much exposure our children are receiving to mass shootings when they occur. We can monitor the video games they are playing and limit access to games that focus on violence and killing. We can demand that the Congress pass gun control laws that make sense. No one needs an assault weapon to hunt a deer. We can also listen to what our children are saying and talk to them about their concerns. When a mass shooting occurs we can ask them how they are feeling, ask if they have any concerns and reassure them that you are there as their parents to protect them.
Finally, if you start to notice a change of attitude in your child that you are concerned about have them assessed by a psychotherapist. There is nothing to be ashamed of if a child needs therapy. We are exposing children to situations that most adults have problems dealing with themselves. You may find it very upsetting to talk to your child about these incidents. For these reasons and many more, if you feel your teenager has been traumatized vicariously make an appointment with a psychotherapist who specializes in treating teenagers and victims of trauma. Our kids have had to deal with a lot. We can help make it easier for them growing up in this time by providing the help they need.

Dr. Michael Rubino has over 19 years experience treating children and teenagers and dealing with victims of trauma. For more information about his work or private practice visit his website at http://www.rcs-ca.com or his Facebook page at http://www.Facebook.com/drrubino3

Does My Child have ADHD?

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.

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

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

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

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

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

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

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

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

What to Expect as Your Teenager Starts High School

What to Expect as Your Teenager Starts 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 19 years visit his web site at http://www.rcs-ca.com