- Behavioral Health, PediatricsGeneral Page Tier 3BlogChildren with attention deficit hyperactivity disorder (ADHD) often have a difficult time in school. If your child with ADHD is having trouble at school, Jennifer Williams (Walton), MA, LPC, LCPC, a mental health professional at Anne Arundel Medical Group (AAMG) Mental Health Specialists, offers some important tips. “Children with ADHD respond well to having a structured daily schedule. Make sure that your child’s day has a large amount of clearly defined structured time to prevent them from making impulsive decisions that will lead to negative actions. Children will feel more comfortable if they know exactly what is happening during the day, and when it will happen,” Williams says. School Rules Make sure your child is seated in the front row, close to the teacher, and not next to a window or in the back of the room where distractions abound. Children with ADHD need their teachers’ and parents’ help de-cluttering their school backpack, which lessens the confusion and frustration when looking for homework that needs to be completed or turned in. Along with your child’s teacher, take a proactive stance to break large assignments into smaller parts. Big projects can frustrate kids with ADHD. Home Sweet Home With school presenting its own challenges, it’s time to reinforce steps that make for a calmer home life. For example, Williams stresses the positive effects of a goal or reward chart. Immediate rewards for smaller goals might include extra video game time or a favorite snack. Larger rewards for bigger accomplishments can include an outing to your child’s favorite park. A Helping Hand If it feels like your child is struggling more than usual with distraction, impulse and hyperactivity, it may be time to seek additional medical help. For children 6 years of age and older, the American Academy of Pediatrics recommends behavior therapy with medication. While your pediatrician can prescribe medication, behavioral therapy for children can be hard to find. Your pediatrician may be able to help. If your pediatrician tried one or two ADHD medications but results are not as hoped, that points to a more complex case that calls for a psychiatric provider. This is particularly important if your child is dealing with ADHD plus other issues, and these cases are typically beyond the pediatrician’s expertise. Ask questions, find resources and learn more at askAAMC.org/HealthyMinds. Author Jennifer Williams (Walton), MA, LPC, LCPC, is a mental health professional at Anne Arundel Medical Group (AAMG) Mental Health Specialists, located in Annapolis. To reach her, call 410-573-9000. Originally published Sept. 15, 2016. Last updated May 14, 2018. Save
- Men's Health, Senior Care, Women's Health, UncategorizedGeneral Page Tier 3BlogCan we talk for a minute? When you hear this question, you wonder, what is this going to be about? You might fear the worst. But one conversation about a very important, albeit uncomfortable, subject can make all the difference. I’m talking about sharing your wishes for end-of-life care. I’ve been a registered nurse for 31 years. I’ve coached other families on the importance of having end-of-life discussions as a trained facilitator for The Conversation Project, a national campaign dedicated to helping people talk about their wishes for end-of-life care. An experience in my own family served as my wakeup call for why talking matters. My aunt went to the hospital for what we thought was a quick visit for a chronic condition. We didn’t know she wouldn’t return home. She suffered a massive stroke. She was unable to move her right arm or leg or even speak. Without a medical power of attorney or living will, her husband automatically became the decision maker. Facing the greatest grief of his life, he now had some difficult choices. He turned to me for help and, together, we blindly did the best we could. We made decisions based on what we thought my aunt would have wanted. Too often people die in a way they wouldn’t choose, leaving loved ones feeling guilty and uncertain. According to The Conversation Project National Survey, 90 percent of people say talking with their loved ones about end-of-life care is important. Yet only 27 percent of people have actually done so. We may find ourselves having the conversation about end-of-life wishes over our loved ones’ hospital beds. Let’s not save this important conversation until there is a medical crisis. How do I start? This topic often triggers fear in loved ones that something is wrong. Break the ice by immediately deflecting from the worst. You might start with, “Even though I’m okay right now, I want to be prepared.” Or, “I need to think about the future. Will you help me?” When’s a good time? Timing can be an essential element to having the conversation. Initiate the conversation when your family is together, perhaps during a holiday or family event. Also use life’s milestones, such as a birthday or graduation, to spark the conversation. What to talk about? Here are just a few things you should consider discussing: Who would you like to make decisions on your behalf? What affairs (finances, property, relationships, etc.) do you need to get in order, or talk to your family about? Where do you want, or not want, to receive care? What kinds of treatment (resuscitation, breathing support, feeding tube, etc.) do you want or not want? Your first conversation should be the first of many. Remember, you don’t have to cover everyone or everything at once. Learn more about The Conversation Project and use these free tools to help you start talking to your loved ones. Author Ann Marie Holland, MSN, RN, CNOR, FNE-A, NPD-BC, is a clinical education specialist at Luminis Health Anne Arundel Medical Center. Originally published Nov. 14, 2017. Last updated April 15, 2021.
- Behavioral Health, PediatricsGeneral Page Tier 3BlogChildren are extremely savvy when it comes to using electronic devices. Starting at a young age, they learn how to maneuver electronics better than some adults. In fact, some children know how to turn on their favorite YouTube channel before they learn how to properly speak. In today’s society, children are exposed to technology through tablets and computerized learning toys from infancy. Smartphones and tablets have become the go-to devices to keep infants and toddlers occupied to avoid public tantrums due to idle time. Therefore, it’s only a matter of time before your child will want his or her own smartphone. As a parent, how do you respond to the constant nagging for a smartphone? And more importantly, how do you really know when your child is ready for one? Allowing your child to have a smartphone can be a great thing for both of you. You can instantly contact your child when you are running late for pickup; you can be contacted immediately if there is a problem at school; and you can use it as your own personal tracking device to keep tabs on your child’s location. However, before allowing children to dive headfirst into the smartphone world, be sure to have a conversation with them about appropriate use and responsibility. Here are some simple steps to help make sure you and your child are ready for the responsibility that comes with having a smartphone. Set up rules and expectations. Have a conversation about the rules and expectations of cellphone use. Create a cellphone contract with clear expectations for usage, and consequences if the contract is broken. It is extremely important that the contract is meaningful and enforceable at all times. If you treat it as another piece of paper, children will take it for granted. Set up time limits for phone use and rules around data usage. Make all rules clear! Do not assume that children “should have known” something. Have your child turn in the phone to you at night to ensure they are getting proper sleep and not messaging with friends throughout the night. Warn about inappropriate texts and pictures. You may not be prepared to have a conversation about sexual messages and pictures with your child. However, if they are old enough to have a smartphone, then you are trusting them enough to have a smart conversation about inappropriate behaviors. Sexting is real and it happens every day in the school environment. Make sure your child knows what to do if they get an inappropriate text or picture. Inform your child to not forward messages to friends and to immediately tell you or a teacher. Inform your child of the legal implications of sending nude pictures of themselves to someone or forwarding a sexually suggestive picture that he or she may have received from a classmate. Teach your child about cyberbullying and how NOT to be a cyberbully. A cellphone means 24/7 access to everyone. In a pre-cellphone and pre-social media era, bullies stayed at school and what happened at school most likely stayed at school. With round-the-clock electronic access, a bully is now hard to escape. Inform your child of the steps to take if he or she is bullied. Know the passwords of your child’s phone, Instagram, Facebook, Twitter, Snapchat, Kik and any other social media app he or she is using. READ MORE: Safeguard your child against cyberbullying Know who is sending direct messages to your child and the type of messages your child is sending to others. Social media platforms, games and group chats make it easy for kids to be bullied. Talk to them about the signs of and have open conversations with them on what you and the school will do about bullying when it is reported. Use it as an opportunity to teach responsibility. When children have a smartphone, they have a major responsibility. Smartphones are an expensive item. No matter if your child has the first version of an iPhone or the latest-and-greatest device, there are costs associated with having a smartphone. If your child earns an allowance, have your child contribute financially. As a household, brainstorm ways that you can use a cellphone as a teaching tool to increase personal responsibility. Always remember it is YOUR phone. If you buy a phone for your child, then you are allowing your child to use your phone. No matter what your child tells you, the phone is your property — you own it. It is your right to take it back, turn off the data and turn off the service if you feel your child cannot be responsible for your phone. Since it is your phone, it is important that you make sure you know how to use it. Children are smart and have amazing skills with using electronic devices, which can be dangerous for them. Don’t let your child outsmart you. When you give your child a cellphone, know what apps are downloaded and how to use them. Be aware of where they save pictures, texts, emails and messages so when you conduct daily searches of the phone, you know exactly what you are looking for. Always know passwords to unlock the phone. Be aware of the phone’s parental controls and safety measures. Smartphones are your child’s lifeline to the world. As a parent, you need to know what is going on in your child’s world to protect him or her from themselves and others. Teach and model putting the phone down. Have a set time each day for the family to unplug from electronic devices. Unplugging is an important habit that we all need to practice daily. For many of us, electronic devices are ringing, buzzing and pinging from the time we wake up in the morning to the time we go to bed at night. Set family time that is phone-free time. Create a phone box to put everyone’s phone in. Then, for at least 30 minutes to an hour each night, try to make your home a cellphone free zone. The use of electronic devices can quickly turn into an addictive behavior for some individuals. Allow children the ability to unplug from the electronic world so they can feel re-energized and refreshed the next day. Remember that you know your child best. You are aware of your child’s maturity level, friends and daily habits. When handing your child a device that requires a great level of responsibility, be sure to trust your instinct. A smartphone allows quick, instant access to everything in the real world. As a parent, do your best to monitor, protect and prepare your child so they can use their smartphone in a manner that is safe and responsible. Author Jennifer Williams (Walton), MA, LPC, LCPC, is a mental health professional at Anne Arundel Medical Group (AAMG) Mental Health Specialists, located in Annapolis. To reach her, call 410-573-9000. Ask questions, find resources and learn more at askAAMC.org/HealthyMinds.
- Behavioral Health, PediatricsGeneral Page Tier 3BlogThe term “helicopter parent” may have been recently coined, but it’s certainly not a new phenomenon. The term is applied to parents who “hover over” their children, like a helicopter, paying extremely close attention to their experiences and problems, both in everyday life and academic settings. Parents may feel as if they’re looking out for their children’s welfare and helping their children excel, but there’s a downside to being overly involved and concerned. Studies are finding significantly higher levels of anxiety and depression in college students and young adults with helicopter parents. Ask questions, find resources and learn more at askAAMC.org/HealthyMinds. Why might that be? For one, helicopter parents may not allow their children to experience adversity and establish a sense of their own competence at managing things in the world around them. They can also convey a sense that perfection is what is required and demanded. “Hovering parents can lead to anxious kids because it doesn’t allow children to learn resilience. Parents need to give kids the opportunity to fail a bit, to learn from their mistakes and to grow from them. This helps build resiliency and the ability to deal with things in a healthy way,” says Ruth Milsten, MSW, LCSW-C, a mental health clinician and licensed social worker with AAMG Mental Health Specialists. Studies on the mental health of our youth confirm the harm done by expecting little when it comes to independence, yet much when it comes to achievements in school, sports or other extracurricular activities. Kids who are used to having their parents make every decision for them may face quite a shock when they enter a stage of life where more independence is expected, such as college or work. Inevitable small setbacks can feel like big failures, and a lack of feelings of self-sufficiency can lead to anxiety and depression. READ MORE: How to help your child cope with school safety anxiety One of the primary developmental tasks of adolescence is to create a growing sense of autonomy. Healthy functioning depends on learning to navigate between demands that are too extreme—creating too much anxiety—and a realistic sense of what is actually required in the world for success. Part of normal development has to involve processes of trial and error. What can parents do to help? Get comfortable with failure. The feeling of disappointment can be actually beneficial and children need to know you accept them as imperfect. Talk openly about dealing with setbacks or failures to help your child develop coping skills and emotional resilience. Be mindful of praise. We all know lack of approval can be devastating to children. At the same time, confidence grows from overcoming challenges, not being told how great you are all the time. Strike a balance, and keep in mind that sometimes “good” truly ought to be good enough. Remember, you’re the role model. It’s important to handle your own disappointments with grace—your kids are watching you. Help them see that adults make mistakes and experience setbacks. Own your decisions, and let them take ownership of theirs. It can be difficult for parents to experience the world as complicated and demanding and not be highly anxious about their children going out into it. Parents should support their children when they fail, but they shouldn’t prevent their child from ever experiencing failure. It’s the ability to go out into the world, experience some degree of failure, and pick oneself up to try again that gives an individual a healthy sense of the resources they have inside themselves to successfully navigate a path through life—a path that is truly theirs, not someone else’s. AAMG Mental Health Specialists offer care for diverse mental health needs. To schedule an appointment call 410-573-9000. Author Ruth Milsten, MSW, LCSW-C is a mental health clinician and licensed social worker with AAMG Mental Health Specialists. Originally published Aug. 25, 2015. Last updated May 7, 2018.
- Behavioral Health, PediatricsGeneral Page Tier 3BlogIn the wake of tragic events involving school shootings in our country, school safety has become a top concern for parents, children and school officials. The conversation around school safety has become an important topic that can at times seem scary, yet necessary to have. The sense of fear and worry about being safe at school is real —children want to feel safe at school. However, what happens when your child expresses daily worry and fear about going to school? What do you tell your child to give them a sense of comfort and security to help him or her have a normal school day? When children hear about events involving a school shooting on the news or on social media, each child will react differently. Some children will not show concern or fear and will continue with normal daily activities. Some children may develop a sense of anxiety about going back to school. An anxious child may start to wonder, “Will this happen at my school?” or, “If there is a school shooting, what will happen to me?” Children may show their anxiety in a variety of ways such as refusing to go to school; complaining of stomachaches or headaches so they can stay home; frequently visiting the school nurse; and being less focused in class because they are watchful of the door, window, or a particular student in the classroom. If you notice that your child is expressing this type of anxiety, here are some ways to ease his or her fears and help your child feel safe again. Listen to your child It is important to listen to your child if he or she is worried about going to school. Ask your child about school, including their daily routine, classes, and other students or teachers that make him or her anxious. Younger children like to use drawings or paintings to express their feelings. Sit down and have art time with them to help them communicate what they are feeling. Acknowledge that the anxiety exists and feel free to ask questions about what you can do to help. This can include talking to teachers, counselors and administrators so both you and your child are aware of safety procedures at school. Have open and honest conversations When children hear about school shootings or threats of a shooting, they will have questions. If children come to you with questions about school safety, have an age appropriate conversation with them about their feelings. Younger children may express more worry about themselves and will have broader questions due to lack of full understanding. With younger elementary school children, you should leave out details but answer any questions they may have. According to the American Psychological Association (APA), psychologists who work in the area of trauma and recovery suggest to be honest and let children know that bad things do happen. But even though you cannot always stop bad things from happening, children should know that school is still safe. Older children may have more specific questions and worry about the possibility of an active shooter at school. Even if the conversation makes you nervous, talk to your child about a safety plan. This plan should include how you will communicate with each other if an active shooter event occurs. Even though the risk may be low, having a safety plan in place increases a sense of safety. Let children know that administrators, teachers, counselors, and school resource officers work hard each day to make sure that school is a safe place and the risk of harm to students is low. READ MORE: Safeguard your child against cyberbullying Cut down on news and social media Always hearing about or seeing negative events increases anxiety for both children and adults. Research shows that some younger children believe the events are happening again each time they see a replay of the news footage. Children who frequently hear about negative events can experience more anxiety that leads to a snowball effect of worries. If possible, limit the amount of news and social media your child accesses. Sit down as a family and talk to your child about his or her day and things that happened during the day. Have family time away from the television and internet so children can come to you as a source of information instead of relying on coverage from the media. Support the desire for change For middle school and high school students, the sense of anxiety may leave them feeling helpless. They may even feel a sense of anger because they think the school administration is not doing enough to keep them safe. Encourage your child to write letters to the school principal or state government officials to express his or her concerns about school safety. Support your child with joining student government organizations so he or she can be a voice for change. When children are able to take a proactive stance on change, they will feel they have a voice that needs to be heard and are more likely to attend school daily to express their point of view. For more information, visit the American Psychological Association’s website. Author Jennifer Williams (Walton), MA, LPC, LCPC, is a mental health professional at Anne Arundel Medical Group (AAMG) Mental Health Specialists, located in Annapolis. To reach her, call 410-573-9000. Ask questions, find resources and learn more at askAAMC.org/HealthyMinds.
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