anxiety Archives

Special Needs Children and the Holidays—Tips and Strategies

Posted on December 5, 2022December 5, 2022 by mks_allc

It’s the holiday season and that means lots of get-togethers, shopping trips, crowds, music and lights. It’s loud, colorful and…immensely stressful, full of potential triggers for children with autism, anxiety, sensory issues and other special needs. This time of year presents many challenges at home, in school and throughout the community. By planning ahead and having alternate or back-up plans, you can help make the holiday season less stressful for your child. It is important to speak with any visiting friends and family member as well as those whose homes you will be visiting. Share with them any special behaviors, quirks or sensitivities of your child so that they may better understand your child and his (and your!) needs and expectations.

For children with anxiety, anticipation is a big trigger in the time leading up to the holidays. This feeling often leads to anxiety overload, causing them to have a melt down just before, during or after the holiday. For these children, keeping the holidays low-key helps greatly. It’s okay to treat the holiday as an important day, but not in an over-the-top crazy way. To some children, piles of wrapped presents that cannot be opened can be stressful. Keeping these gifts out of sight can help children get stressed about waiting, and possible even opening gifts too early.

At this time of year, there is always an overload of sensory stimuli such as lights, music, bells, odors, tastes, crowds, and hugging. There are strategies for each of these situations; if you can speak with your child and discuss what elements are the most stressful, you can formulate a plan. For example, if certain smells upset your child, consider getting an artificial tree and battery-operated candles. If lights are a trigger, try ones that don’t blink. Decorate tastefully, leaving plenty of space throughout the home so that it doesn’t feel overdone or overcrowded with seasonal items. Try listening to instrumental, relaxing holiday music instead of loud, “busy” music. While planning visits to the mall, try to go during less-crowded times, when your child is well-rested and not hungry.

Family visits can be especially stressful for children with autism, sensory processing disorder, or other special needs. Prepare your child for any dinners or social events in advance. Discuss who will be visiting or where you will be going. Explain that it’s okay if he doesn’t want to hug or shake hands. Let him know there will be a quiet place where he can go to relax; this can be in your home or in someone else’s home (ask your host in advance). Be sure to prepare items such as noise cancelling headphones, a weighted blanket, a stuffed animal, tablet or books. Whatever soothes your child should be available to him, either in your home or in a backpack packed for the day.

It is important to let your child know that it is okay to feel a bit ‘off’ during the hectic, crowded time of the holidays. Let him know that his normal routine will return after the dinner/visit/outing. Work with your child to be sure to get positioned in a place (a corner of someone’s living room, a separate quiet room, a seat in a house of worship such as an aisle near the exit) that offers some comfort and an exit strategy.

An important element to consider is YOUR level of stress. If you are feeling out of sorts and overwhelmed, your special needs child will likely react to your stress. It is at this time that you need to take care of you. Breathe. Take a bath. Go for a walk. Take a break and ground yourself, so that your child will relax too.

Here are some tips from A Day in Our Shoes (adayinourshoes.com) that can function as a checklist for the holidays with children with special needs:

School Holidays and the Special Needs Child

Communication is key! Communicate with your child’s teacher, read the school website. Find out what changes are going to happen as best as you can. Prepare your child for these changes–different meals, assemblies, early dismissals, whatever it may be.
Ask your teacher to have a “one sheet” included in her sub-folder about your child. This should include the necessary information that a sub would need to know about your child and what may cause him anxiety.
Have daily briefings at breakfast and dinner. It sounds formal, but it doesn’t have to be. Just talk about what is going to happen that day or what did happen that day. What will be different?
Contact his therapists or whoever works with your child and ask if they can do more role-playing, scripting and/or social stories related to holiday festivities.

Holidays with a Special Needs Child at Home

If you haven’t sent out holiday cards in a while (not many people do it anymore!), consider sending them to the people you will come into contact with, might be visiting or might be staying with this holiday season. This is an easy and private way to share your child’s “quirks” and expectations.
Talk with your child. Find out what their expectations are and make sure everyone is on the same page. Prepare them as best you can. Again, consider the morning and evening daily briefings.
Pick your battles. Food doesn’t have to be an issue. Consider bringing some healthy snacks with you to family dinners. If your child refuses to wear a shirt and tie, it’s okay!
When visiting, bring things that are a comfort to your child, especially if staying overnight. A favorite blanket, pillow, and his own shampoo will go a long way in soothing a child that is not sleeping in his own bed.
Don’t force affection. This is another item you can explain to friends and family before your visit. If your child does not want to embrace and kiss relatives they barely know, or do not enjoy being hugged, respect that. Explain to the relatives that your child really does care about them, but that this is not how he shows it.
Have an escape signal or word. Give your child an “out” if it is more than he can handle.
Go visual. Have a color-coded calendar or some other method of visually outlining what your family is doing. Consider doing it with velcro so that items can be moved and removed if you need to alter your schedules.
Sensory-friendly events and Quiet Santas are very common around the holidays. These are a great opportunity to participate and be able to relax a little bit.
Set your child up for success. Pre-arrange conversations with relatives so that your child is included. A simple “I heard that you really enjoyed your school field trip to the museum” might be much more engaging for your child instead of “what’s your favorite subject at school?” but a relative may not know that.

Stress, Holidays and Special Needs Moms

Remember that holidays and holiday breaks are intended to be a relaxing time and a “reset” so that you can go back to work/school rested and refreshed. Keep that in mind as you do your holiday schedule.
Say no. Often. You don’t have to do everything.
These are good opportunities to educate family and friends about your child’s issues. But, keep your child in mind–do not talk about them in front of them.

The bottom line is that families celebrate holidays in many ways. For families with special needs children, some additional planning may be necessary to comfortably experience this time of year. But with a lot of communication and much planning, it can truly be a magical time of year.

Wishing you and yours a healthy, happy holiday season!

Note: The information in this article is for informational purposes only. It is not an attempt to diagnose or treat any medical condition. Always consult your child’s pediatrician with any specific medical questions. MKSA is also available to answer questions about child development. Contact us at 516-731-5588 or www.mksallc.com.

Sources:
Adayinourshoes.com
Comfortinganxiouschildren.com

Pandemic Anxiety in Children

Posted on May 3, 2021 by

The coronavirus pandemic has been a long, stressful time for most, but especially for young children. While we are hopefully moving in the right direction about transitioning toward more pre-pandemic routines and activities, there is still much cause for anxiety in children.

Uncertainty, fear and staying at home has made changed routines difficult. Children don’t always understand why they can’t go to school, see their families, or play with their friends. Remote learning, while a way to attempt to keep children current with their studies, can be another cause of anxiety. For children with special needs, the disruptions are amplified. Services that have moved to teletherapy are additionally challenging, and maintaining a calm, albeit new routine is difficult as well.

We are sharing the following information from Boston Children’s Hospital:

Some kids hide in their rooms. Others turn their cameras off during remote learning and don’t want to talk to anyone. Still others feel panicky when they do go out in public. As the COVID-19 pandemic wears on, its effects on our mental health may have become increasingly noticeable — especially in children and teens. “My daughter used to be really energetic and motivated,” says one mother. “She was happy and light. Now, she’s just folded into herself.”

She’s not alone. Families are reporting troubling changes in their children’s emotional well-being, particularly when it comes to anxiety. To better understand the problem — and learn what parents can do to help — we spoke with Allison Scobie-Carroll, senior director of social work and family services at Boston Children’s Hospital.

A lot of kids seem to be experiencing increased anxiety. Why?

Like adults, children and teens are missing being around their peers. They need those relationships not just to feel good, but also to practice social skills. Now that we’ve been in this for a year, we’re seeing the effects of what happens when children are separated from regular social interaction for long periods of time.

What are some aspects of the pandemic that can cause or worsen anxiety in kids?

Our “new normal” means that the way we interact with each other has changed. Things that once came naturally — like just being out in the world — are now fraught with concern. If a child is already prone to anxiety, the rejection they might feel when someone steers away from them may be amplified, even if that person is simply trying to physically distance.

Then add in masks, which can contribute to anxiety in a couple of different ways. First, they block our ability to read social cues, like smiles or frowns. They can also impede the ability to practice deep breathing, which is a natural way to counteract anxiety and for some people contributes to feelings of claustrophobia. That said, masks are critical to protecting against COVID-19, and most kids have adapted well to wearing them.

Can kids “catch” anxiety from their parents and other adults?

Collectively, we’re transmitting a lot of worry and kids absolutely pick up on that, particularly if they’re already sensitive or prone to anxiety.

What can parents do to help their children cope with anxiety?

The most important thing you can do is to let your child know you’ll be there for them — it’s so simple but so fundamental. You can also try the following tips:

Listen to them. Children experience and navigate the world through a different lens than adults. Their worries need not be rational or fact based, but they are still valid.

Teach them coping skills. Regular exercise, turning off screens at least an hour before bed, and using apps like Calm to practice deep breathing and other relaxation techniques can all help kids (and parents) ease anxiety.

Schedule safe playdates. There’s no substitute for being around friends — kids relate to each other in ways that adults just can’t. Ask your child if they’d be interested in seeing the friends in their circle, as long as they follow safe precautions like wearing masks and practicing physical distancing.

Connect with other parents. The pressures of life right now might make you feel something is very wrong with your child — but many families are experiencing the same thing. Situational anxiety can be a natural response to chronic stress. It can help to know that it’s not a failure on your part and that you aren’t alone.

Know your child. A lot of kids and adults are experiencing panic attacks, having night terrors, or developing phobias for the first time during the pandemic. If you’re concerned about new or worsened symptoms in your child, contact your primary care provider for help.

The Mayo Clinic offers additional suggestions for helping children with special needs during this time:

Kids with special needs and their parents may feel anxious, just like any family. At the same time, families with complex needs have a hidden strength: They’re resilient, and they know what it takes to adapt to the unexpected. If you’re in this situation during the COVID-19 pandemic, know that you can navigate uncertain times successfully. Here are some suggestions:

Rely on your experience

Think back to strategies that have worked for you in the past. Go back to the basics. This might include:

Keeping a consistent schedule for meals, medications, exercise and bedtime
Planning gradual transitions that suit your child’s pace
Using visual cues to illustrate schedules and activities
Scheduling quiet time to reduce sensory input and de-stress
Offering warm praise for a job well done
Promptly correcting or redirecting negative behavior and offering a chance for a redo

Help your child feel in control

Explain that everyone is working together to keep the virus that causes COVID-19 from spreading and making people sick. This is why some schools and playgrounds may be closed. Likewise, having a playdate or going to a friend’s house may not be an option. Explain that kids can be a big help, too, by following such practices as:

Washing hands with soap and water often, or clean hands with sanitizer
Sneezing or coughing into a tissue or a bent elbow, not hands, and throwing used tissues in the trash
Keeping 6 feet of space between themselves and others outside of the house
Waving or giving smiles instead of hugs, fist bumps and high-fives
Wearing a face mask at grocery stores and in other public places

Revisit your child’s treatment plan and care needs

If your child has a treatment plan — which might include things such as a list of prescription medicines, therapy instructions, and emergency and medical contacts — make sure that it’s up to date and accessible. It may help to have it in the form of an electronic document that you can easily share. In addition:

Identify potential alternative caregivers, in case you or your child’s regular caregiver is sick.
Gather specific instructions for caregivers, including information on your child’s medical conditions, doctors and therapists, daily schedules, and preferences.
Visit websites of support groups and organizations you’ve typically relied on in the past.

Manage stress

During the pandemic, everyone feels added stress. But it’s possible to manage stress so it doesn’t get overwhelming. Consider these tips:

Take breaks.Remember to make some time for yourself. Wake up a few minutes early to gather your thoughts. Pause a minute or two before bedtime to do some stretches or deep breathing. Take time to gather your mental reserves.
Limit access to the news.Being informed is good. But information overload can heighten anxiety about the disease.
Stay healthy.Even though schedules feel off, prioritize getting enough sleep, eating balanced meals and staying active. These fundamentals will reduce stress and improve everyone’s state of mind.
Connect with loved ones.Stay connected with grandparents and friends via phone or video chat. Or write a letter. Maintaining your family’s support network is a key coping strategy.
Have some fun.Share relaxed moments with your family, when you’re not focusing on work or school. Play games with your kids, go for sunset walks, do cooking projects together and enjoy home movie nights.

It’s a challenging time for sure. Children experience their own anxiety, but also feed off the environment within their home. To handle both yours and your child’s anxiety it is important to find ways to enjoy the time together with your family. The weather is changing; get outside and play, take a walk, create a scavenger hunt…just be together and soak up some fresh air. We’ll all get through this together.

Stay safe and be well.

Sources:
https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/special-needs-parenting-covid-19/art-20487665
https://answers.childrenshospital.org/covid-anxiety-kids/

All About Separation Anxiety in Children with Special Needs

Posted on September 2, 2019 by

Separation anxiety is a normal stage in a baby’s development that helps them to understand relationships and master their environment. Crying, clinginess or tantrums are healthy reactions to separation and are a normal stage of child development. Typically, it ends around 2 years of age, as toddlers start to understand that a parent/caregiver may be out of sight but will return later. Separation anxiety disorder exists when the anxiety symptoms are excessive for the developmental age and cause significant distress in daily functioning.

At around 8 months old, a child may fear less familiar people and places. This usually peaks between 10-18 months of age and disappears by 2 years of age, however both attachment and the ability to easily separate may develop at an older age in a child with developmental delays or special needs. Some children experience severe anxiety—even as newborns—that does not improve over time and may even worsen. These children are often diagnosed later with a mood disorder or a neurological disorder such as autism or ADHD.

While some separation anxiety shows that a child has formed attachments with loved ones, leaving a child with child care providers or others can be stressful for everyone. To ease typical separation anxiety, parents can make partings easier for a child in several ways:

-follow a goodbye ritual; children with special needs find structure reassuring

-stay with him until he becomes familiar with a new person or place

-do not sneak away or scold a child for being upset

-reassure the child that you will be back after naptime or at dinnertime; keep that promise

-do not leave a child when he is tired, hungry or ill

-leave your child with his favorite blanket or other “lovey”

Separation anxiety disorder is not the same as separation anxiety and is not a normal stage of development. It is a serious emotional problem characterized by extreme distress when a child is away from the primary caregiver. Since both situations share many symptoms, it is sometimes difficult to differentiate which your child is experiencing. The main differences are the intensity of your child’s fears and whether these fears keep him from normal activities. Separation anxiety disorder is the most common anxiety disorder in children under 12 years of age. Symptoms must be present for at least four weeks for separation anxiety disorder to be considered.

Some causes and risk factors for separation anxiety disorder in children include: change in environment (new house, school, or day care), major stressor or loss (death of a loved one or pet, change of schools, divorce) and overprotective or intrusive parents.

Symptoms of separation anxiety disorder may include:

-excessive distress when separated from attachment figures or the home

-worry about harm coming to attachment figures

-refusal to go to school because of fear of separation

-refusal to sleep away from home or to go to sleep without attachment figures nearby

-nightmares involving themes of separation from home or attachment figures

-repeated physical complaints such as headache or nausea when separate has occurred or is anticipated

-clinging to the caregiver; the child may shadow you around the house or cling to your leg if you try to leave

-for a child with special needs, he may show distress by regressing or becoming hyperactive

It can be very upsetting to see your child stressed, and sometimes parents inadvertently reinforce the anxiety by helping a child avoid things they are afraid of. Instead of avoiding separation, it is helpful to learn more about the disorder and take steps to make a child feel safer. Strategies for dealing with separation anxiety include:

–start with very brief separations: begin with increments of 5 minutes and gradually increase time spent apart

–teachers should use positive language: try “your dad will pick you up after story time” instead of “he left”

–try a photo story: make a picture story that includes photos of your child with alternate caregivers and school classrooms; if possible, you can arrange for a school/teacher visit before school starts so you child can see the photo of his teacher and classroom before school begins; he’ll know exactly what to expect on the first day of school

-“magic bracelet”: this bracelet can chase away anxiety; it can be made of materials that remind the child of his parents, or it may be something that belongs to the parents; it is used as an attachment object to transfer emotional security from the parent to the child

–say goodbye with a smile: try to say goodbye while the child is engaged in something positive; tell him briefly what you will be doing while you are apart, and give a return time

–let your child walk away from you: for many children, it’s easier to leave than to watch a parent/caregiver retreat

–try field trips: take trips together to reduce sensitivities and increase awareness of other people and life experiences

–play therapy: a play therapist directs play to work through specific issues a child is having

For children with separation anxiety disorder, a common symptom is refusal to go to school. There are tips for both parents and teachers that may help reduce a child’s symptoms. Parents can try the following suggestions:

-help a child who has been absent from school return as quickly as possible: if a shorter day is necessary initially, symptoms may decrease once they discover they can handle the short separation upon return

-ask for late arrival accommodations: additional flexibility to talk and separate at a slower pace can help a child separate

-have a safe place: find a place at school where your child can go to reduce anxiety, perhaps the nurse’s office or the library

-allow contact with home: sometimes during times of stress, a brief phone call with family can reduce separation anxiety

-send notes for your child to read: a note in his lunch box can work wonders

-reward your child: every good effort deserves to be praised

Parents might also want to discuss the following classroom tips for dealing with separation anxiety with their child’s teacher.

-make sure the child is prepared ahead of time: be sure the child has a morning routine and knows what to expect, and knows an exact time a parent will pick her up

-be sure to share background information about your child with the teacher: share info about your child’s daily routine and how he copes with change, including methods for soothing

-consider providing a comfort item such as a stuffed animal or a laminated family photo

-provide distraction: picture books are good distractions; consider stories that explain how a parent comes back

-try a little extra TLC: sometimes a child just needs a bit more attention, whether it’s holding her close or just an extra hug or time to sit alone with the teacher

-engage the child: if a child is busy making a special art project for mommy or daddy, he will be distracted and excited to surprise them when he gets picked up

As your child moves through ages and stages, if you feel his/her separation anxiety is causing significant stress regarding daily activities, you should seek professional help. Your child’s pediatrician can refer you to professional specialists who can help your child and your family. Anxiety disorders can be effectively treated, and treatment should be based on a comprehensive evaluation of the child and family. Treatment often involves cognitive behavioral therapy for the child, focusing on helping the child learn skills to manage his anxiety and help him master situations that contribute to anxiety. Some children benefit from treatment with medication that helps them feel calmer. Family therapy and consultation with the child’s school may also be recommended.

Early detection and intervention can reduce the severity of the disorder, enhance the child’s normal growth and development and improve the quality of life experienced by children with separation anxiety disorder.

Sources:
https://www.thesteppingstonesgroup.com/6-classroom-tips-deal-separation-anxiety-children-special-needs/
https://www.friendshipcircle.org/blog/2012/06/27/10-ways-to-remove-separation-anxiety-from-your-special-needs-child/
https://eiclearinghouse.org/einotes/sepanxiety/
https://www.helpguide.org/articles/anxiety/separation-anxiety-and-separation-anxiety-disorder.htm
https://www.chop.edu/conditions-diseases/separation-anxiety-disorder