New Information About Head Injuries and Teenagers

New Information About Head Injuries and Teenagers

Many parents of high school athletes are aware of the dangers of concussions. Research now shows that even one concussion can cause permanent damage according to recent research studies. However, there is another condition that parents need to be aware of when their child plays sports. This disorder is CTE. CTE is Chronic Traumatic Encephalopathy (CTE) it is a progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic subconcussive hits to the head.

Our brain sits in our skull surrounded by fluid. Therefore, any time anyone hits their head or their head is jarred around, the brain moves in this fluid hitting the front and back of your skull or the sides of the skull depending on what direction the force came from. When the brain hits the skull it can cause bruising and microscopic tears of very fine nerve fibers. Nerve fibers that are too small to be seen on an MRI or a CT scan.

Physicians have known that CTE effects boxers for many years, however, it was just a few years ago that evidence showed that football players are at risk too. This was the main focus of the movie, Concussion, starring Will Smith. The NFL did everything they could to stop the filming of this movie. The movie shows how CTE results in the patient becoming severely depressed and psychotic. Many of the patients with CTE commit suicide. Also many CTE patients were professional football players who started playing in High School.

Why is this important for parents to know? It is important because CTE is caused by chronic head injuries. Head injuries that date back to when a teenager was playing high school sports. Therefore, it is important for parents to ensure that their teenager’s school is using the latest safety gear, especially for the head, and to take any head injuries seriously. There is no way to tell what will happen when these teenagers become adults.

For many years, football and schools have reported that they are developing helmets that protect the head better. However, these safer helmets are not being used in high schools or professional football. Schools and professional football are monitoring players closer after a head injury, but still little to nothing is being done to protect the brain prior to an injury. Furthermore, this week evidence was uncovered showing that professional football players may not receive an adequate evaluation for a concussion if they are hit during a game. In fact, it is believed that even with all the information we have regarding concussions that many professional football players continue in games even though they have a concussion.

This issue game up during the week when a player for the Miami Dolphins suffered a hit and was assessed not to have a concussion. He resumed play and four days later sustained another hit and was diagnosed with a concussion. He was believed to be suffering from second impact syndrome. “What we currently believe second impact syndrome to be is a second blow to the head or second concussion prior to the resolution of a first one. And that can result in uncontrolled swelling of the brain,” explained Steven Broglio, director of the University of Michigan’s Concussion Center. Broglio is a certified athletic trainer and is a lead author on the National Athletic Trainers’ Association position statement on management of sport concussion (CNN). It is estimated that it takes approximately 14 days for the brain and the brain chemistry to return to normal after the brain sustains a hit causing a jarring motion of the brain. Often these injuries have no symptoms (CDC).

If professional football players are being allowed to play with concussions and are developing second impact syndrome, what are happening to high school athletes? Researchers such as, Neuroscientist Julie Stamm, a clinical assistant professor in the Department of Kinesiology at the University of Wisconsin-Madison, are questioning the protocol being used to assess athletes for concussions (CDC). If professional athletes are not being adequately assessed and now developing a new condition, second impact syndrome, what is occurring with high school athletes?

As an adolescent psychotherapist who has been practicing for 25 years, I am seeing more evidence of student athletes sustaining head injuries every year. Every year I am seeing more teens with Post Concussion Syndrome. This may occur after a concussion and can be associated with headaches, mood swings and memory difficulties. The teenagers who experiences this Syndrome become very frustrated because they are aware of the changes and because no one can say how long the symptoms will continue. In fact, no one can guarantee that the symptoms will disappear.

This becomes very frustrating to the teenager and their parents. Some teenagers are so overwhelmed that they start self-medicating with drugs and alcohol. Anything that they think might help. Others become so depressed because they fear that the symptoms are permanent that they become suicidal and may attempt suicide.

For many years these head injuries in teenagers were down played because there was not enough evidence to indicate that teenagers could be impacted by head injuries. Well the research clearly indicates that teenagers can suffer long term results from a single concussion. Additionally, this can create symptoms that are overwhelming for the teenager and their family. Imagine being a parent and you see your child suffering with Post Concussion Syndrome and there is nothing you can do to stop it. Parents also become depressed and nervous that their child may never recover.

Another issue to consider, athletes can develop second impact syndrome which can lead to CTE, causing patients to have mood swings and feel like they are going crazy. They do not understand what is happening inside their head. Many teenagers who act out often report the same feelings and the fear that they are going crazy. Many of these teenagers have had head injuries. It is possible that teenagers may also suffer from second impact syndrome, post concussion syndrome or developing CTE?

Everyone’s brain is different and so is the recovery process. This means we have no way of knowing how many Concussions or head traumas it takes before CTE is started in someone. It also means we have no way to determine how long it will take for someone to recover from a concussion or if they will have permanent impairments. If we are unable to adequately assess concussions, how many players are developing second impact syndrome? We only can tell after it occurs not before.

We do know that patients recovering from Post Concussion Syndrome or dealing with CTE can benefit from psychotherapy. Often this option is not given to teenagers because again many people believe teenagers are very unlikely to suffer with these issues. However, if you look at the research it indicates that teenagers can and do suffer from Post Concussion Syndrome and teenage head injuries can cause CTE.

As a psychotherapist who treats teenagers with head injuries, I strongly encourage every parent to watch the movie, Concussion. Also before your child starts playing any competitive sports, such as football or soccer, go online and research head injuries and signs and symptoms of concussions. Also if you teenager does sustain a head injury while playing sports or just playing have them evaluated. You never know how severe a head injury is by just looking at someone. A few years ago an actress fell in the snow and her friends said to go to the doctor she said she was fine. Two hours later she was dead. When she fell she caused her brain to bleed and she died.

Above all, use your best judgement as a parent. Do not be afraid to ask for a CT scan or an MRI if your child suffers any type of head injury. If your teenager does sustain a concussion and you notice a personality change or memory issues do not hesitate to seek psychotherapy for your child and for yourselves. Also don’t hesitate to talk to your teenagers high school. If the teenager is having problems concentrating after a head injury, the school may need to provide them with accommodations until the child recovers.

This can be an overwhelming and frightening topic to consider but the more you educate yourself, the easier it will be to manage. If you have additional questions regarding the personality changes or neuropsychological changes with head injuries, please feel free to contact me.

Dr. Michael Rubino has been treating children and teenagers for over 25 years. Dr. Rubino specializes in treating children, teenagers, trauma victims including first responders. He also has training in neuropsychology. For more information about Dr. Rubino’s work or private practice visit his website at www.RubinoCounseling.com or his website that deals with accommodations at school www.LucasCenter.org.

High School Sports and Head Injuries

High School Sports and Head Injuries

Schools are back in session and many high school students are back playing sports. The main sport at this time of year is football and cheerleading goes along with it. Both football and cheerleading are high risk activities for concussions. Parents are also learning that “basic” Concussion in teenagers are more common than people think and can create more problems than 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.

After a concussion many teenagers develop Post Concussion Syndrome. Teenagers can have violent mood swings, difficulties concentrating and difficulties with memory. This can cause problems at school and with family and friends. I have seen teenagers who get so depressed by these changes that they become suicidal. Post Concussion Syndrome can last a year or more and typically physicians do not warn parents or teenagers about this syndrome. This makes matters worse because they feel like they are crazy because they don’t understand why they have the symptoms. Also these symptoms can create problems at school that the student may need accommodations for in order for the student to understand the classes.

We have been hearing more and more about 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.

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

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

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

Also boys are not the only ones at risk for concussions. Girls are at risk for concussions too. In fact, some studies show that cheerleaders are at a higher risk of getting a concussion than foot players. Cheerleaders do not use helmets and have no head protection. Also many people assume a child needs to be knocked out in order to sustain a concussion. This is not true. You can sustain a concussion without losing consciousness. So football players are not the only one at risk. Any high school athlete is at risk – boy or girl. Anything that causes a jarring of the head can cause a concussion. Our brain sits in fluid in our skull. Therefore any jarring force can cause the brain to hit the side of the skull and cause a concussion. Also as the brain moves in the skull it can twist causing shirring. When the brain twists microscopic nerves can be severed adding to the concussion. Furthermore, no two brains are the same. This is why it is almost impossible to determine how long it will take someone to recover from a concussion. Two people’s scans may look the same and one may recover quickly and the other may need a long recovery period. There is no way to predict how long the recovery period will be. This is why all high school athletes are at risk for concussions and some may recovery quickly and others do not.

Therefore a concussion or post concussion syndrome can be very serious and impact a teenager for life. For the reason, parents need to be aware of the risks involved and if their child’s school is using the appropriate safety equipment and has a protocol for how they respond to a student with a concussion.

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

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

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

Dr. Michael Rubino has over 25 years experience working with children, teenagers, trauma victims and their families and first responders. For more information on Dr. Rubino or his work please visit his websites at www.rcs-ca.com, www.RubinoCounseling.com, his Facebook page www.Facebook.com/drrubino3 or follow him on Twitter @RubinoTherapy.

Good sleep is vital to teenagers mental health

Good sleep is vital to teenagers mental health

Parents are usually arguing with teenagers about how much sleep teenagers are getting and the quality of their sleep. Turns out that parents are right. Getting enough good quality sleep is vital to teenagers mental health.

Research has shown Sleep is necessary for good physical and mental health. This article outlines the benefits of getting enough good quality sleep. Teenagers may want to disagree bet the research is consistent on this fact.

Here is another study outlining the benefits of sleep. The Science of Sleep: 10 Surprising Health Benefits | Psychology Today https://www.psychologytoday.com/us/blog/the-healthy-journey/202108/the-science-sleep-10-surprising-health-benefits.

Dr. Rubino is a psychotherapist with over 20 years experience treating children and teenagers. For more information about his work visit his website at http://www.RubinoCounseling.com or his Facebook page at http://www.Facebook.com/Drrubino3.

The quarantine and domestic violence

The quarantine and domestic violence

The isolation of the quarantine can exacerbate mental health issues such as anxiety & depression. People are cut off from their normal support system such as psychotherapy and this can trigger their mental health issues. Another issue is Domestic violence victims, stuck at home, are at risk during coronavirus pandemic. The victim is isolated with the abuser who may use the isolation to increase their control over the person. Also being isolated can cause the perpetrator to become anxious and out of control of life so they turn to domestic violence again to help them feel empowered again. If you know someone at risk call and checkin on them. If you do not receive an answer or the conversation seems odd to you, call your local police and ask them to do a safety check. Explain why you are asking for the safety check so the officers know what to look for. You may be saving a life.

I have included a link to an article which will explain in more detail why the quarantine places victims of domestic violence at risk. https://www.cnn.com/2020/03/27/health/domestic-violence-coronavirus-wellness-trnd/index.html.

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

Do Not Leave Your IEP at Home when You Leave for College

Do Not Leave Your IEP at Home when You Leave for College

Working with children and adolescents I have had many parents ask about 504 plans and Individual Educational Plans (IEP). Parents tend to focus on the assistance their child may need in elementary or high school due to a learning disability or mental health issues. Over 20 years as a psychotherapist, what I have observed is that children who need assistance in elementary and high school typically need assistance in college. However, many students are not aware that they are entitled to assistance in College too. Right now many students are preparing to leave home and start their new lives in college. Parents are trying to anticipate what their child will need at college, such as laptop etc. However, do not forget their Individual Educational Plan (IEP) so they can arrange for accommodations at their college.

From my experience, most families assume there is no assistance in college. However, typically if a child has an IEP, they are also entitled to assistance in college. Most colleges in their Counseling departments have people and programs designated to help disabled students. A student with a physical or learning disability or mental health issue such as ADHD or depression would qualify for assistance by the Disabled Students Program at a college. I have recently been receiving many questions from Parents about what happens to their child’s IEP when the go to college and questions from parents who have college freshmen asking about their child’s IEP. Therefore, I thought it would be beneficial to provide information about how IEPs are handled by colleges. In addition to an IEP, any student with a learning disability or mental health issue is entitled to accommodations by their college because they are covered by the Americans with Disabilities Act of 1991.

Additionally, if you live in California and you have a physical or learning disability or a mental health issue and if you had or did not have an IEP while in school, you may qualify to be a client of the California Department of Rehabilitation. This Department is responsible for assisting people in California, with a disability, find a job and get the education they may need to find a job. The Department may assist their clients by providing tuition assistance for community or state colleges and provide financial assistance to buy text books and school supplies. What they are able to do depends on the State budget.

This is another reason for parents to insist when their child does need an IEP that the school district places the child on an IEP. The lies schools tell parents that an IEP will prevent their child from getting into a college, the military or getting a job are not true. Another reason to insist on the IEP, if your child qualifies for an IEP, as a result of having an IEP, your child can be granted accommodations on the SAT or ACT. These are tests seniors typically need to take when they are applying to four year universities. The common accommodation most students require is additional time to complete the tests. I have had many teens with ADHD come to me seeking accommodations on the SAT or ACT. A common requirement that the testing boards require is that a student needs to have had an IEP if they are seeking accommodations on these tests.

Therefore, many students who have disabilities or mental health issues can receive assistance in college. While many people may be surprised, it is true. However, for many college students finding the assistance can be confusing and overwhelming. For a Freshman in college, dealing with heath or mental health issues, the confusion and embarrassment the feel at times because of society’s stereotypes can cause students to give up. The best place for a college freshman to start is the student counseling center. They can then direct them to the correct department and they can avoid some of the embarrassment and confusion.

Also I was contacted by bettercollege.com with a resource guide they developed for college students with mental health issues. While their guide was created for students with mental health issues, it can also be used as a guide for students with physical or learning disabilities. This guide can help a student not feel so overwhelmed or embarrassed too.

Since I feel this is a valuable guide to Freshman students and their families, I am including a link to this resource guide below:

Guide to College Planning for Psychiatrically Impaired Students – https://www.bestcolleges.com/resources/college-planning-with-psychiatric-disabilities/

Dr. Michael Rubino is a psychotherapist with over 20 years experience working with children, teenagers and college students. For more information about Dr. Rubino’s work and private practice visit one of his web sites www.RubinoCounseling.com or www.rcs-ca.com or his Facebook page www.Facebook.com/drrubino3.

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Could My Child have ADHD?

Could My Child have ADHD?

School is now in its second semester and many parents are tired about fighting over homework or telephone calls from school that their child is being disruptive in class again. 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. According to the CDC 15.9% of boys and 5.6% of girls have ADHD. 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. It’s important to get them the accommodations they need. Children who have ADHD, but do not receive accommodations tend to show signs of low self-esteem around the fifth grade. These 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 websites at http://www.rcs-ca.com, http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/Drrubino3

The Truth about IEPs and 504 plans

The Truth about IEPs and 504 plans

It’s getting close to the end of the school year and children with 504 plans and Individualized Educational Plans (IEP) must be re-evaluated. Many parents do not know what an IEP is or what a 504 Plan is in regards to a child’s education. Also many parents are not aware of their rights or their child’s educational rights. I receive numerous emails from parents anytime I write about IEPs. Therefore, here is an article describing IEPs and 504 plans for parents. Hopefully this will explain the differences between an IEP and 504 plan and help parents understand what their child is legally entitled to regardless of what the teacher is trying to make you believe.

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 20 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 or his new website that deals specifically with IEPs, lucascenter.org.

Why Teenage Boys Refuse Psychotherapy

Why Teenage Boys Refuse Psychotherapy

Teenage males and men hate to go to therapy. Therefore, let’s address this issue. Here is a link for a movie, “The Mask You Live In” https://youtu.be/hc45-ptHMxo. The above trailer contains explicit language, but it is language your third grader hears every day at school, from friends and television. Men and teenage boys are very resistant to taking care of their physical and mental health. The question then becomes, why? If you watched the trailer, you will have a very good idea why.

In our society there is a stereotype of what it takes to be a “man.” A man is strong, healthy, and can take care of himself, knows everything about sex and is sexually active, has a lot of money and never afraid to fight and never cries. These are a just a few parts of the stereotype. Many parents may be saying, “but I don’t bring up my son like that.” You don’t have to, but it is part of our society. If a little 5 year old boy falls down at school, the school staff picks him up and tell him shake it off, don’t cry, take it like a man. A boy playing soccer or baseball gets hurt during the game, the coach says shake it off, take it like a man. You have even saw examples of it on Dancing with The Stars. A couple of times some of the men have started to get teary eyed and the asked for the camera to be moved because they did not want anyone seeing them cry.

Boys continue to be exposed to the stereotype in high school. There is a major focus on losing their virginity as fast as possible and sleeping with as many girls as possible. They can’t be a man if they are a virgin. Also boys are getting into fights and having a friend record it and post it on YouTube. They want everyone to see how tough they are and it makes them feel like a man. Also in High School boys stop accepting and asking for help, they are a man and they can handle life on their own. Also look at the movies and video games boys play. They have to do with fighting, killing and sex. Emotions are never mentioned and if a boy does cry he is called a “sissy, or a fag” just to list a few.

If men and boys are living with this stereotype going to a physician or a therapist is a very dangerous thing to do. They might have to confront the fact that they are not able to do everything by themselves and they might need help. This would mean they are not the tough guy. Also they know physicians and therapists have treated other men and they are afraid how they might be compared to other males. If they are not as tall or as strong or don’t measure up to the other men they are not a man. They feel like a failure.

Going to a therapist is extremely dangerous for boys and men. Therapists ask you to deal with your feelings. What if they cry or admit they feel overwhelmed by life or inadequate to other men? If they do, they worry about their identity as a man. I have men and teenagers who cry in my office. They all get really embarrassed and beg me not to tell their family and want to know if other guys cry have ever cried in my office. They need reassurance that they are still a man. The truth is it takes more strength to cry than not to cry, but most guys don’t believe this due to the male stereotype.

We need teenage boys to focus on their emotions. The best way for us to help boys and men is to eliminate this stereotype. Parents contact your son’s school and ask them to invite groups to the campus that are trying to eliminate this stereotype. Challenge Day is an excellent organization which tries to help teenage males face their feelings. Also monitor what they watch and how they talk with friends. Fathers don’t be afraid to cry and go to the doctor regularly and ask for help. Look for movies that show males as men even though they don’t follow the stereotype. This is a problem in our society which leads to crime, killings and needless deaths from heart attacks and strokes. It is going to take all of us to solve the problem.

While teenage boys resist therapy for these reasons, you need to remember you are the parent. If you notice your teenage boy is depressed and talking about suicide, therapy is not a choice. Yes you want to give choices about their lives, but remember they still are kids and cognitively not able to reason as an adult. Therefore, at times you must say there is no choice. Would you give them a choice of having surgery, if they had appendicitis?

Dr. Michael Rubino is a local psychotherapist who specializes in treating children and teens. He had over 20 years experience working with teenagers. To find out more about Dr. Rubino and his practice or to contact him visit his website at http://www.RubinoCounseling.com or Facebook page at http://www.Facebook.com/drrubino3

Teenagers and Dating Relationships

Teenagers and Dating Relationships

Having a girlfriend or boyfriend is very important to many teenagers. Often teenagers feel defective if they do not have a girlfriend or boyfriend. Many people are familiar with this line, “you complete me,” from the movie, Jerry McGuire, starring Tom Cruise. A deaf couple signs this message to each other in an elevator and Tom Cruise’s character assumes they must really be in love. However, this may not be the reality. In reality it may be an unhealthy relationship.

As a psychotherapist with 20 years experience treating couples and teenagers, I have observed a common mistake that many people make regarding relationships and love. Many people tell me they feel an emptiness inside themselves and describe it as a “big empty hole.” They assume that a relationship will fill this emptiness. In other words, they are relying on their partner to eliminate the empty feeling they are experiencing.

This is a mistake. The only person that can fill that emptiness you feel is you. When I work with couples or an individual who is experiencing this emptiness, they usually are upset with their partner. They are upset because their partner is not filling the emptiness. Also the other partner is frustrated because they are tired of having to constantly reassure their partner. They report they are tired of always having to worry about meeting their partner needs and that their needs are constantly being pushed aside.

This type of pattern is very common in relationships where there is domestic violence or a substance abuse problem. Also jealousy is a major issue in these relationships. The person who is experiencing the emptiness is very sensitive to feeling rejected or abandoned. This is usually a result from childhood issues that have never been addressed. However, as an adult, if they sense these feelings in their relationship they tend to over react to them. The person may drink excessively to reduce their fears and men often result to verbal or physical abuse. Anything that will keep their partner in the relationship and continue to fill the empty space.

This tends to occur because as we grow up there is a great deal of pressure for people to be in relationships. You see this in children in first grade or kindergarten when adults jokingly ask children if they have a boyfriend or girlfriend. If a child doesn’t they often feel there is something wrong with them.

I see this issue a lot with teenagers. I have teenagers who feel they are defective because they never had a girlfriend or boyfriend. This defective feeling increases significantly, if the teenager never has been on a date. They believe if they are going to be a “normal” teenager, they must at least be dating. Boys tend to believe they must be sexually active too. I have had teenagers tell me they felt suicidal or were using drugs because they did not have a girlfriend or boyfriend. They are willing to risk their lives using drugs or believe they are better off dead, if they don’t have a girlfriend or boyfriend. They are so tied up trying to live the stereotype, they can’t believe that many teenagers do not have a girlfriend or boyfriend and do not date in High School.

This pattern continues into adulthood. Many women feel defective if they are 30 years old and not married. Men feel as if they are not men if they do not have a girlfriend. Both men and women often settle for anyone as long as they can say they are in a relationship.

As children, we never learn how to love and care for ourselves. Ask someone if they would go out to dinner by themselves and most people look terrified by the idea. They have no idea what they would do and they are afraid about what other people with think. This is a sad state that we cannot love ourselves. If we always need someone to reinforce we are lovable, we turn our power over to strangers. If someone says something nice about us we feel good, if they say something hurtful, we feel unworthy as a person. But, why should someone else determine our value? We should be the one who judges if we are lovable or not. A relationship should add to our life like a bottle of wine adds to a meal. A relationship should not define us as a person.

As a result of this problem, many couples end up divorcing because a partner is tired of having to reassure their spouse daily. I have seen these divorces become very nasty and costly. So both parties are hurt even more and so are the children. They only people benefiting are the attorneys.

We also have this same issue with teenagers. However, when they break up it tends to be more dramatic. A teenager may start to use drugs, develop an eating disorder, start cutting, become depressed and may attempt suicide. The behaviors are not uncommon after teenagers break up.

We see this acting out behavior more in teenagers and children. Teenagers and children are desperate to feel that they are loved by their parents especially. If they don’t feel they are loved, there is a tendency to act out. Disney’s movie, Frozen, has a segment where the trolls explain that if someone doesn’t feel loved they may act out in pain or make poor decisions in an attempt to find love. Oprah, during her last show, had a very good way of expressing this need. She stated, “everyone wants to know: ‘Do you see me? Do you hear me? Does what I say mean anything to you.” The program Challenge Day, which Oprah recommends, states what teens are looking for this way: every teenager wants to feel safe, loved and celebrated. I see it every day, when teens don’t feel loved, they act out. Negative attention is better than no attention.

How do we handle this issue? We need to start to acknowledge as a society that a relationship doesn’t make you a complete person. Only you can make yourself feel complete as a person. Also we need to remove the stigma of seeking mental health care. We need to encourage adults who feel incomplete without a relationship to seek psychotherapy and deal with their issues. Parents, if you notice that your teenager is desperate to be in a relationship, help them get psychotherapy so they can deal with the pain they are feeling. Remember this emptiness feeling typically begins in childhood. Therefore, if we show children and teens that they are loved or get them help when they are acting out, we can prevent them from dealing with this emptiness for years.

Again, please remember a relationship should add to your life, it should not make you a person or define you as a person.

Dr. Michael Rubino has 20 years experience working with families and teenagers. If you would like more information about his work or private practice visit his website at http://www.rubinocounseling.com or his Facebook page http://www.Facebook.com/drrubino3.

Having A Safe, Fun Super Bowl Party

Having A Safe, Fun Super Bowl Party

Super Bowl Sunday is coming up in a couple weeks. Since the San Francisco 49ers are playing, there will be a large number of Super Bowl parties and events in the San Francisco Bay Area. As I stated in my previous article for many people it is a day to party and have fun, but it is also the day when the most domestic violence occurs in the United States. This statistic is for adults and teenagers. So, how do you have a safe, fun Super Bowl Sunday? You need to develop a plan that reduces stress and too much drinking.

First, remember that it is just a day and just a football game. Therefore, if everything is not perfect such as you don’t have all the food you wanted or things are not arranged how you wanted, do not stress over it. You can still enjoy the game without a lot food or alcohol. Also if everything is not arranged perfectly, you can still enjoy the game. In other words, do not stress and argue over minor details.

If you are going to have small children around, set up a separate room with food and activities for them. Many children under 10 years old will lose interest in the game and if there is nothing else for them to do, they will want attention and distract people from the game. Therefore, set up another room where they can watch other television shows and have games to play. This way they are not bored and they can enjoy themselves.

People drinking too much is a common problem during Super Bowl parties. Therefore, when your friends arrive, tell them you care about them and their safety. Therefore, you want everyone to put their car keys in the basket as they enter. This way if someone accidentally has too much to drink, you can give them a ride home. This way if someone has too much to drink, you don’t have to argue about them driving if they are not safe to drive. This can help avoid an argument and a possible physical fight.

Also watch how much alcohol you are serving. If you are serving alcohol, serve food too. The food helps to absorb the alcohol and decreases the likelihood that someone will drink too much. Also towards the end of the game stop serving alcohol and switch to sodas. If someone has had too much to drink, this gives them a chance for their body to process the alcohol they consumed so they can lower their blood alcohol level.

Another good idea is to set rules for your party. Announce to your guests that you want everyone to have a good time and no arguing or fighting. Therefore, cheering for their team or favorite player is fine, but you do not want any name calling nor is there to be any insulting other people at the party. Also good nature teasing is fine but no swearing and if someone asks you to stop the joking, respect their request. Bottom line, state that regardless of who wins or loses, you expect everyone to act like adults and to treat each other respectfully so it is a fun day for everyone.

It would also be helpful to remember the acronym HALT:

H – hungry

A – angry

L – lonely

T – tired, too much alcohol

If you notice someone expressing these emotions or drinking too much, this is a situation which could result in an argument or violence. Therefore, if you notice a potential violent situation, try talking to the person to see what is bothering them. If you notice a couple arguing try having one person step outside with you for a time out so they can calm down. You may want to let them know that they seem slightly upset and you are just checking-in to see if there is a problem and if you can help. Instead of ignoring the situation try to offer some help so people can calm down. This can help a great deal.

At the end of your party, if someone is not sober enough to drive, offer to drive them home. Remember all the car keys are in a basket so you do not have to argue to get the car keys. Remind them that you are only offering to drive because you care about them. You do not want to see them arrested for driving under the influence, you do not want to see them get into a car accident and you definitely do not want to see them kill someone else or themselves in a car accident.

If you notice a couple who appear to be arguing, offer to allow one person to stay for a while and you will drive them home later. Giving them a chance to calm down could help avoid a domestic violent incident. If after a little while the person at your house or the person who went home tells you they do not feel safe around the other person right now – listen to them! Offer to let the person stay at your house for the night. You do not want to assign blame to anyone. Simply state that they seem to be having a stressful day and instead of them both staying in the same house that night and arguing all night and arguing in front of the children is not a good idea. It is okay if they need to take a break for the night and talk about it tomorrow. You are providing them and the children with a safe environment and hopefully avoiding a domestic violent incident. Many people are afraid to step in and offer help when they see a potential domestic violent situation. However, if more people offered to help and did not shame the family, the incidence of domestic violence could decrease and more people may be willing to seek help.

If you are a couple who are having incidents with domestic violence, discuss the issue before the day. Hopefully, the two of you are in psychotherapy and can discuss the issue in a therapy session. Discussing a potential problem with a therapist or even a friend prior to the event can be very helpful. If you are not in therapy and afraid to talk to a friend and do not feel safe call the following number for help: The National Domestic Hotline 1-800-799-SAFE (7233). Someone will answer 24 hours a day, 356 days a year. Do not be embarrassed to call. If you need help, please reach out and ask for it before someone gets seriously injured or killed.

Hopefully these suggestions help and you can enjoy the game in a fun peaceful environment.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers and he is certified to assess and treat domestic violence. If you want additional information regarding Dr. Rubino’s work or his private practice visit his websites http://www.rcs-ca.com, http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/drrubino3.