Information Parents Need about Teenagers and Concussions

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

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

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

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

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

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

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

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

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

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

Does My Child haveADHD?

Does my child have ADHD? I hear this very often and do many assessments on children to determine if a child has ADHD. Yes ADHD is a really disorder, but too many teachers and schools rush to the conclusion that a child has ADHD.

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

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

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

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

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

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

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

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

How Closely Should Parents Monitor Their Teenagers 

How Closely Should Parents Monitor Their Teenagers 

In today’s world there are many things for parents to worry about regarding their children. Parents worry about drugs, alcohol, sexting, teenagers send naked photos of themselves and online predators just to name a few. Teenagers have also developed ways to engage in activities without their parents knowledge. They have developed a texting language and apps that look like a way to get help for homework when it is really a way to chat online just to name a couple. So what is a parent to do?
Many parents have resorted to installing software on their teenagers cellphones and laptops so they can monitor everything their teenager is doing online. Other parents insist they must be present if their teenager is going online. However, are these approaches effective? From my experience as a therapist working with teens, the answer is no. I have many teens who tell me they now their parents are spying on their cellphones and they simply use different apps or have learned how to deactivate the program without their parent knowing. As for their parent being present again teenagers tell me they have developed a text language that their parents don’t understand so they don’t care if parents are present.
Another tactic that parents are using is monitoring where there teenagers are all the time via their cellphones. In addition parents are questioning their teenager about everything and wanting to meet all their friends and their friends parents. This often causes a number of arguments. Teenagers tell me they feel smothered by their parents and they resent the lack of trust. The most common result is this pushes the teenager a way from their parents and damaging the parent-teen relationship.
One final example is that more parents are using their teenager’s school website. Parents are often checking weekly, some daily, what grades their teenager are getting in their classes and have they been doing and turning in their homework. Again, this creates a number of arguments. Teenagers feel like their parents don’t trust them and they feel like they are being treated like a ten year old. The result I usually see are angry teenagers who don’t want to talk to their parents due to the lack of trust.
When I speak with these parents, most parents are using these approaches out of fear. They hear about all the risks teenagers are exposed to these days and they don’t want their teenagers to get hurt. In the parents defense, I have many teenagers in therapy because they are in trouble at school and/or probation for doing something they didn’t think they could get in trouble for. The best example are pictures. If a teenager sends a naked picture of themselves to their boyfriend or girlfriend, they are guilty of transmitting child pornography. They are under 18 years old so they broke the law that they never were thinking about.
Since most parents are concerned about safety and not invading their teenagers privacy, I recommend a different approach to parents. We need to start discussing all of these issues with children in the third grade. Yes the third grade and it needs to be an on going conversation. Third graders are using computers and the research indicates this is usually the age when most children see porn for the first time.
Parents need to start discussing drugs, alcohol and sex too at a younger age. The research shows many kids try marijuana for the first time in the fifth grade. Also on middle school campuses many kids are selling Vicodin, Concerta etc. Furthermore, many middle schools provide condoms to sixth graders because research shows many children in middle school are sexually active.
The point is for parents to start having conversations early so your child is educated about risks and so they feel comfortable coming to you if there is a problem. Monitoring your child at this young age is appropriate. They still don’t understand everything yet and as a parent it is your job to educate your child and keep them safe while doing so.
If you do so, this should reduce arguments and help build an open, honest relationship with your child.
As for teenagers who are 16 and 17 years old. Parents need to start to take a step back. The spyware is inappropriate and checking their homework all the time is inappropriate in my opinion. Knowing where there are going and coming home is appropriate especially if they are using your car. You need to remember in a year, year and a half your teenager will be 18 years old. They are then a legal adult and are responsible for their behavior.
Yes if you step back they may make some mistakes, but that is one way we learn. Also if they are going to make a mistake, it is better if they make it at 16 versus 18 years old. I understand that it may be frightening to let go, but if we want them to act like an adult, we need to allow them the opportunity to act like an adult. If you have been discussing issues with them since they were nine years old they should be prepared. Additionally, this way strengthens your relationship and helps your teenager make appropriate decisions because they know they can ask for help by talking to you.
Dr. Michael Rubino is a psychotherapist who specializes in treating children and teenagers especially high risk teenagers. For more information about his work with teenagers or his private practice visit his website at http://www.rcs-ca.com or his Facebook page at http://www.Facebook.com/Drrubiano3

Bullying and Suicide

Bullying and Suicide

I have had many teenagers and children talk about being bullied at school. I have seen them cry and talk about how bad their lives are because of the bullying. Sometimes they even talk about killing themselves. This is really hard to hear a child at 10 years old saying their life is so bad due to the bullying that they want to kill themselves.

I offer to help and often the kids say there is no point – no one will help. The sad thing is many times the children are right. I tell the parents who contact the school, but the school does nothing. Often the school doesn’t take it seriously or they claim both children are at fault. Other times they talk to the bully which makes the bully mad and the bullying increases. The problem is the school never follows up on what happens after they spoke to the bully. They assume the problem is solved.

If the parents go back to the school the school often claims they have done all they can do. We encourage the child to tell the teacher, the yard duty or the principal about the bullying. An adult is supposed to help. However, many times the child claims he is ignored and no one listens to him.

What can happen at this point? The child becomes so depressed they think of suicide. They feel death is better than the teasing they have to endure daily. We need to remember that suicide is the third leading cause of death for children. So when a child talks about suicide, they often are serious. This is why we must act to stop bullying.

Read a suicide note from a 13 year old boy who could no longer tolerate the bullying he was experiencing. Read it and learn what bullying can do to a person & why it must be stopped. The life you save might be the life of your own child, you never know. http://nypost.com/2016/08/13/staten-island-boy-takes-his-own-life-after-ripping-school-bullies-in-suicide-note/

Dr. Michael Rubino specializes in treating children and teenagers. He has over 19 years experience and is considered an expert in treating suicidal children and teens. For more information about Dr. Rubino’s work and private practice visit his website at http://www.rcs-ca.com or his Facebook page http://www.Facebook.com/drrubino3

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