October 5, 2016
Autism spectrum disorders have increased dramatically over the past few decades, the U.S. Center for Disease Control and Prevention (CDC 2012) recently established the prevalence to be 1 in 88 American children and estimated 1 out of 54 boys being diagnosed with Autism. ASD affects over 2 million individuals in the U.S. and is one of the fastest growing mental health concerns. As of today, nobody can explain the exponential increase; there is stipulation that there is strong genetic involvement, due to the fact that it affects boys much more frequently than girls and tends to run in families. There is also speculation about risk factors that include advanced parental age (fathers and mothers) and maternal illness during pregnancy, however not one single factor has been determined to “cause autism”. Autism is a neuro-developmental condition and establishes its pathway early during fetal development and may alter parts of the developing infant brain. Recent research has concluded that the brain of the child with autism is larger and that parts of it develop faster (e.g.,amygdala which helps control emotions).
Symptoms of autism can range from the inability to articulate wants and needs (limited or no language skills) to subtle difficulty with social situations; people with autism often have many strengths, including the ability to excel in visual skills, music, math and art.
Early diagnosis and intervention are the key and may improve quality of life and social adjustment, including success in school, college and place of employment.
Check ups with the pediatrician should include assessment of gross- and fine motor skills, language development, social interaction with care takers and children, and play skills. If your pediatrician recommends further assessment, or the parent seems concerned about the child’s development, an evaluation by a pediatric psychologist who specializes in autism may be indicative and helpful to rule out a diagnosis.
Some signs of autism are not noticed until a child enters school, as early development appeared normal and often precocious (early language development and reading skills); once a child enters preschool or kindergarten, specific signs of autism may be: intense focus on a specific subject (unusual knowledge of planets, dinosaurs etc), very formal language skills (I do not want to sleep during the day, for napping ); deficit in perspective taking (I don’t understand why other kids are not interested in planets); preferring mature and solitary activities to play; seeking out familiar adults to spend free time activity with; excelling academically but showing difficulty with timed math or writing activities; sleep rhythm difficulties.
A diagnosis of autism is often a relief to the child and the parents who have wondered for a while “what’s wrong”.
I also suggest that we need to stop focusing on “deficits” of the individual and all the things that a child can not do and shift our paradigm to “Neuro-diversity”: this means that we start viewing the individual with autism through the eye of human diversity. Each child with autism is unique as the rest of us and requires acceptance for a blend of cognitive strengths and weaknesses (language, sensory procession and motor skills). Early identification and subsequent treatment should focus on autism presenting contextual difficulties that could be avoided by giving each individual with autism unique and individual goals that will help him or her succeed. Sensory demands, social ambiguities and information complexities are some of the barriers that individuals on the autism spectrum have to conquer, however they need help from society.
As parents, professionals, fellow-human beings, educators and politicians the success of individuals with autism lies in accepting neuro-diversity and providing each of them with acceptance and tolerance, setting unique goals and teaching tools that help them succeed from early childhood into later adulthood. ( Come to think of it, that would include attention-deficit disorders as well).
What’s your EQ?
“No act of Kindness, no matter how small, is ever wasted” (Aesop)
We take great pride in sharing our intellectual intelligence with others, however it is also important to talk about Emotional intelligence (EI); or Emotional Quotient (EQ) meaning “the capacity of individuals to recognize their own, and other people's emotions, to discriminate between different feelings and label them appropriately, to use emotional information to guide thinking and behavior, and to manage and/or adjust emotions to adapt to interpersonal changes and goals.” (Goleman, 1995); Empathy is the key element of EQ and the feeling that you understand and share another person's experiences and emotions; the ability to share someone else's feelings. (Merriam-Webster 2014).
There is ample research about high EQ and success in business: “Emotional Intelligence (EQ) will turbocharge your Career and Just might save your Life” (Forbes Contributor Travis Bradberry, March 2016)
Just eyeballing and not needing a Gallup survey, we live in a “selfie” society that focuses on self-serving achievement, competition and entitlement. We expect our children to share and show compassion, however as adults and leaders we are often not walking our talk and are pushing our kids into “survival of the fittest mode”.
Empathy is not only healthy for our emotional well-being, making us feel good but it also boosts our immune system and contributes to a healthier and happier human; it also calls for action and doing something to change something for the better; empathy can give us moral courage and do something positive, for example, not only giving a homeless person on the street a few dollars but volunteer at a food shelter or participate in making decisions about social change.
“It is one of the beautiful compensations of life that no man can sincerely try to help another without helping himself” (Ralph Waldo Emerson).
It is not too late for all of us to focus on caring and compassion, and most certainly pass that along to our children. If we focused more on genuine empathy when we parent, we may end up having a generation of happier and more motivated individuals that are not only better at understanding themselves but others as well.
Much of our human interaction is disrupted by electronic devices, to the point where eye contact lasts for a split second, if even at all, really not enough time to even try to decipher another person’s facial expression, or show that you even care what someone may be feeling.
As a family, start making it a habit to share a simple meal, without electronic devices, play a new game: “name that facial expression and reteach detailed descriptions as to what that particular emotion entails”; or better yet, watch a baby’s behavior and describe in detail what he or she may be feeling.
The sooner we start paying attention to one another by showing true empathy, the sooner we will have less bullying in schools and more caring individuals who show moral courage and remind us all of what we have in common, being human!
Dr. Astrid Heathcote Licensed Psychologist
An ounce of prevention is a ton of cure…
The month of May marks National Children’s Mental Health Awareness (Substance Abuse and Mental Health Services Administration, SAMSHA, 2016) and it seeks to publicize the importance of children’s mental health is essential to a child’s healthy development from birth to adolescence. Needless to say that this would begin with childcare for infants that supports healthy emotional and cognitive development by keeping infant/caretaker ratio at a low level to ensure prompt and sensitive attention to a baby’s overall needs. However, careful attention may include the collaborative effort of parent(s) and school, starting with preschool and kindergarten, where formal education often begins with academic goals to prepare the child for the next grade. From a developmental perspective, keeping in mind the young child develops in some predictable and structured pattern, kindergarten can be very stressful for some children as their emotional needs cannot be met in a highly academic environment, resulting in a child who may appear to be “uncooperative and noncompliant” but is actually expressing anxiety and frustration. For the most part, public schools have to respond to producing high test scores, leaving teachers often unable to tend to social-emotional needs children have, adding “behavioral problems”, as another important agenda they have to deal with on a daily basis. By the time the child enters middle school, it may be poorly prepared to function in an even more stressful environment, not only academically but socially as well; young teens’ brains are a “work in progress” and social skills are poorly developed, coupled with exaggerated self-awareness, can result in an insecure child that feels isolated and lonely and if there is a lack of adult support, even trigger depression and/or anxiety. ALL Children across developmental milestones thrive on adult attachment and positive acknowledgement, reinforcing self-confidence and –worth and ultimately resulting in a well-adjusted and competent adult. As the high school years approach, some teens are excited about entering this new environment with hopefully a “clean slate” and finding friends and people who understand them. Nevertheless, high school presents yet another academically and socially stressful environment for some teens, who are ill equipped not only managing this intense setting but have acquired poor coping skills and ways to manage it (e.g. drugs and alcohol, sexually acting out). Teenager’s experience very profound changes: physically, mentally, psychologically, and emotionally and struggle to maintain a “balanced and healthy life style”; as parents, educators and administrators we must ask ourselves: “Are we raising mentally healthy and well-adjusted children to become responsible and independent adults?” Statistics speak for themselves, showing that 25% of American children meet criteria for a mental health concern (e.g . depression, anxiety) and many kids go without mental health care, because many adults assume “its just a phase” or “she will grow out of it”. As adults we must also assume the role of leadership and guide our children in learning to live a balanced life with a strong support system that provides an environment of genuine care and understanding, accepting and enjoying unique differences in EVERY child! Public schools and parents must become aware that WE teach a moral compass that kids accept and use to navigate life on a daily basis: does the punishment fit the crime? Schools and parents need to learn about child development from birth to adolescence to know what behaviors are “normal” and to guide the young person into feeling competent and successful. It is time for a change in the educational system that provides success for ALL children by providing individual education plans for each child and not by “cookie cutter academic goals” that have demonstrated poor outcomes for many children. ALL of us need to participate in sensitivity training to accept and enjoy unique differences in EVERYONE and not provide a confusing and contradictory moral compass to our young generation!
Topic of the week:
PTSD can affect all of us
Imagine you just experienced a serious car accident without injuries and you are fully conscious, how would you respond to what just happened?
You may experience the after math of the accident, responding with high anxiety, even terror, cognitively (e.g. poor concentration), emotionally (e.g. feeling numb), physically (e.g. feeling lightheaded), and behaviorally (e.g. irritability).
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM V), “Acute Stress Disorder” is defined as “Exposure to actual or threatened death, serious injury, or sexual violation…learning that an event happened to a close relative or friend…experiencing repeated or extreme exposure to aversive details of a traumatic event(s) (e.g. first responders, such as police officers repeated exposure to details of child abuse)”.
Symptoms of acute stress disorder (a car accident for example) may be intense anxiety, confusion, rapid heart beat, intrusive memories of the event (nightmares or flashbacks of images of crashing into the other car), startling when hearing an ambulance drive by, anger or depression, altered sense of reality, and avoiding situations (such as driving a car). Often these symptoms will resolve within the first few weeks of the “trauma”, however if they persist past 30 days, the individual may meet criteria to be diagnosed with Posttraumatic Stress Disorder (PTSD) and should be evaluated by a psychologist, who specializes on trauma.
PTSD is a complex health condition that can develop in response to a traumatic experience – a life-threatening or extremely distressing situation that causes a person to feel intense fear, horror or a sense of helplessness. PTSD can cause severe problems at home or at work. Anyone can develop PTSD – men, women, children, young and old alike. Prevalence of PTSD ranges from 6.8% in the general population (NIMH, 2014) to 25% (PTSD.gov) among military veterans., and 35% among first responders (fire fighters) to the September 11th tragedy.
Trauma is about perceived threat and not all individuals experiencing a life-threatening event end up with Acute Stress- or PTSD.
However, along with military veterans, first responders, such as fire fighters, EMTs and police officers have a higher risk in developing not only acute stress disorder, but also complex and delayed (symptoms surface 6 months after the trauma) PTSD, due to the frequency of involvement in detailed stressful events (deaths, injuries, domestic violence, child abuse etc.).
Untreated PTSD can have devastating consequences on the individual’s quality of life; not only does sleep become severely compromised, due to frequent nightmares about traumatic events, but often severe depression and anxiety set in; the individual with untreated PTSD may avoid social interactions and appear irritable and sometimes even explosive in their daily interactions with friends and family; his or her professional life may also be affected, because the individual may call in sick often, suffering from headaches, frequent colds and other illness, and exhaustion due to severe insomnia; he or she may avoid responding to specific job duties because they trigger more anxiety, even panic attacks.
Daily life becomes hopeless because added stressors, such as fighting with a spouse often related to substance abuse, can turn thoughts into a very dark place.
Fortunately, PTSD is not a life-long condition and very treatable via psychotherapy and sometimes medication can be helpful.
First responders are not very good about asking for help themselves; often they are noticed because of drastic performance changes at work (not responding to an emergency call, and/or displaying exaggerated aggressive behavior toward coworkers or while on duty).
On the home front, first responders with PTSD may become more and more socially withdrawn and appear “mentally checked out” or aggressive toward spouse and children; a spouse is frequently the first one to notice drastic changes in behavior, sleep patterns, and overall negative demeanor in their wife or husband.
I am urging not only spouses, friends or family members to encourage first responders to seek help for psychological assessment and treatment of PTSD, but also administrators, human resources and public policy to provide regular “checkups from the neck up” to all professionals who are first responders to emergency situations (Firefighters, EMTs, Police Officers etc.); it is time to stop stigmatizing utilization of mental health services to those who may need it the most but may never ask for it, resulting in a poor quality of life and also potential liability issues on the job.
If you think someone needs immediate mental health assistance call 911 or the nearest hospital emergency room.
Resources: ptsd.va.gov ptsdalliance.org nimh.nih.gov samsha.gov