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NAMI NC Young Families Advocate List Improving the Mental Health & Well-being of America’s Children Children's Disorders FACT SHEETS EMPOWERING WORKSHOPS FOR CHILD-SERVING AGENCY PROFESSIONALS AND PARENTS NAMI North Carolina offers lively and informative teacher in-service trainings on “Emotional, Behavioral, and Mental Disorders in Children and Adolescents.” These workshops cover current brain research, warning signs in the classroom, treatment approaches, working with families, and behavior management strategies. The presentations are suitable for all child-serving agency personnel and parent groups as well.
Perhaps the most important content involves reframing behaviors to the point of view of a child or adolescent with a brain disorder. For example, a student who is trying to hide compulsive behavior may act-up in order to avoid a class that triggers the compulsion. For that student, in-school suspension may be preferable to embarrassment in front of peers. The behavior cannot be dealt with positively until its true function to the child is understood. The
North Carolina Department of Health and Human Services, DMH/DD/SA,
sponsors this program.
We have presented for:
Participant comments include: "Good
job!” “Educational and thought provoking and cutting edge."
If your
school or agency wants a workshop, please contact: Help and Hope – Caring for Your Child’s Mental Health The Center for the Advancement of Children’s Mental Health Putting Science to Work As families we know - Just as diabetes is a disorder of the pancreas, and asthma is a disorder of the lung’s airways, mental disorders are a group of individual illnesses of the brain that affect behavior, mood, and even thinking processes. Commonly, teachers, the general public, and many professionals characterize mental disorders as "emotional and behavioral problems." When behavioral and emotional symptoms occur in childhood, the youth may be delayed in developing social skills and often cannot maintain regular progress at school. Often these problems also can result in a youngster’s inability to relate well to family and peers, poor coordination and lack of success in typical recreational and athletic pursuits. Left untreated, the child can get into greater difficulties by attempting "self-medication" (through drug and/or alcohol abuse) or by experiencing other co-occurring difficulties, such as decreased self-esteem, school failure, or rejection by peers. Worse still, the continuing toll of untreated behavioral and emotional disorder can often lead to a worsening of the child’s original problem, as well as to an increased risk for developing longer term problems in his or hers late teens and early adulthood. We understand your concern. But you should know — Mental disorders are not the result of individual weakness or poor upbringing. More likely than not, a combination of biological and environmental forces combine to result in the development of a mental disorder. Biological influences may include genetic factors and disturbances in brain development during early pregnancy. Likewise, environmental factors such as severe stress and/or trauma can also disrupt the brain’s functions. Thus, all mental disorders have a pronounced biological basis. The genes that we inherit, and which continue to be influenced by experience throughout life, may predispose a person to the illness, although this predisposition, or vulnerability, often is "triggered" by other factors. Researchers have begun to identify these triggers, called risk factors, for mental disorders affecting children and youth, including depression, attention deficit hyperactivity disorder (ADHD), bipolar disorder, schizophrenia, anxiety disorder, obsessive-compulsive disorder, and autism. These triggers differ, depending upon the disorder. For example, identified "triggers" that may predispose a child to depression may include the death of a loved one, as well as severe medical illness. Triggers that predispose a child to certain types of anxiety disorders include a history of certain bacterial infections when coupled with specific genes. Triggers that can predispose a child to attention deficit disorder include severe head injury and problems during labor and delivery. Mental disorders may — and frequently do — occur when no other member of a family has knowingly experienced a serious mental disorder. The underlying biological mechanisms and triggering events for illness in these instances have yet to be clearly understood. What can be said with surety is that in children (no less than in adults), mental disorders should not be confused with character weakness, "family dysfunction," normal sadness, or a passing phase. These conditions are real medical illnesses that can be accurately diagnosed and effectively treated. Thus, science has shown that mental disorders are best understood as a result of a combination of factors: disturbances in the brain’s "wiring" process during early development, genetic influences, chemical imbalances, brain trauma, and severe life stress. Parents cannot be blamed (and should not blame themselves!) for these disorders any more than they can be blamed for asthma or juvenile diabetes. The good news is that research is finding new treatments for these disorders every day. Just as a child with diabetes takes insulin, children and adolescents with these conditions will need specific treatments to help control their symptoms, to ensure that the disorders do not interfere with development and to maximize their ability for full and productive lives. When the child is carefully and expertly diagnosed, medications may sometimes be very appropriate, even life saving in some instances. But in addition, special education services, mental health services, individual and group therapy, respite care, and other such community services can provide support and stability for the child and his or her caregivers. Appropriate services provide an opportunity for all to focus on recovery, not just on crisis management. When to Seek Help for Your Child Parents are usually the first to recognize their child has a problem. The earlier problems are addressed, the sooner they are resolved. Step 1: Validate your concerns. By talking with your child’s teachers, daycare or after-school providers, or a close relative who interacts on a regular basis with your child, you can begin to get a picture of how well your child is functioning. It is important to know how he or she is doing when with others, and how teachers or childcare professionals may compare his or her development with children of the same age. Step 2: Warning signs of trouble Based on your child’s developmental phase, be aware of warning signs that something may be amiss. CHILDREN OF ELEMENTARY SCHOOL AGE
PRETEENS AND ADOLESCENTS
3: Talk to your child’s doctor If you realize your child demonstrates any of the significant behaviors from the above list, you should bring your concerns to your child’s doctor. You may want to make a special appointment to talk about the difficulties your child is experiencing. Ask your child’s primary care physician to make a referral to a mental health professional if he or she shares your concerns. A psychological assessment may be useful in order to determine how best to help your child. Step 4: Get another opinion Beware of "it’s just a phase" if your instinct tells you your child indeed has a problem. Some family physicians and pediatricians may not recognize symptoms of mental disorders. If you are not comfortable that your concerns are adequately addressed by your child’s doctor, you can request a second opinion. This might take the form of a consultation with a child and adolescent psychiatrist or developmental pediatrician. The developmental specialist can allay your fears about the appropriateness of behaviors at any given age. He/she also can confirm your concerns and assist you and your primary care physician in obtaining a complete assessment, and arrange for any interventions that may be appropriate. Trust your instincts! If you suspect that your child may have a mental health problem, you should seek a comprehensive evaluation by a mental health professional. It is especially helpful when this person is trained to work with children and adolescents. Throughout this assessment process, you should be directly involved and ask questions. It is important that you understand the process your child will undergo during an assessment and that you understand the results of the mental health evaluation. If your child is given a diagnosis be sure to ask for the full range of treatment options—therapy, medications, or a combination of both. If you are not completely comfortable with a particular clinician, treatment option, or are confused about specific recommendations, then consider a second opinion. Assessments are performed by specially trained psychiatrists and psychologists. Before your child begins any treatment regimen, ask the following of your treating clinician:
What you need to know about medications Treatment with psychiatric medications is a serious decision for most of us. Conflicting research and "expert" claims have left us all wondering "what’s best for my child?" Medications may be an important part of your child’s treatment for a mental health problem. Psychiatric medication should only be used as one part of a comprehensive treatment plan. Ask your child’s physician why other forms of therapy are not prescribed if only medication is offered. Although many types of medications have been tested and proven effective in children, there are just as many medications that have not been thoroughly investigated specifically for use in children under 18. When your doctor prescribes medication, ask him if the medication is indicated by the pharmaceutical company, or the Food and Drug Administration (FDA), specifically for use in children. If the clinician cannot answer yes, then this medication is being prescribed "off label," or in other words, the pharmaceutical company that developed the medication has not yet shown its efficacy in treating youngsters under the age of 18. If this is the case, insist that your doctor share with you the reasons for using the medication in question, and whether another form of treatment would be better prescribed. Even when well-tested medications are used (and there are many safe medicines approved for use in children with a history of effectiveness), ongoing evaluation and monitoring by a physician is essential. By asking the following questions, children, adolescents, and their parents will gain a better understanding of why the psychiatric medication is being used and what to expect in the short and long term. -Are there any laboratory tests (e.g. heart or blood test, etc.) which need to be done before my child begins taking the medication? -How long will my child need to take this medication and how often will progress be checked? -How will the decision be made to stop this medication? -How will the medication help my child and how long before I see any improvement? -Is this medication addictive? Can it be abused? What precautions need to be taken with this medication? -Should the medicine be taken with food, or at a particular time of day? -Has this medication proved helpful to other children with a similar condition? -What are the side effects that commonly occur with this medication? What rarer side effects have been reported? -What is the expected cost of the medication? -Is there a generic version and has it been proven to be generally as helpful as the brand name medication? -What is the recommended dosage? How often will the medication be taken? -How long does it take before I’ll see some results? -Are there other medications or foods that my child should avoid while taking the medication? -Are there any activities or sports that my child should not participate in while taking the medication? -Will any tests (x-rays, MRIs, lab work) need to be done while my child is taking the medication? How often should I expect these tests to be needed? -Should my child’s teacher or the school nurse be informed to watch for any changes as the child begins treatment? -When possible, your youngster should be included in the discussion about medications, using words they understand. Sometimes preteens and adolescents can be embarrassed about taking medications, especially at school. This happens when they are singled out to report to a school nurse, or given their medication in front of others. Discuss these circumstances with your child and tell your doctor if your child mentions concerns of this nature. The NAMI North Carolina Young Families network is a group of individuals across the state of North Carolina who are willing to take phone calls from young families. The group of volunteers consists of parents of children or adolescents with mental illness, severe behavioral problems, or neurobiological disorders; parents of those who developed the above disorders during childhood or adolescence and are now adults; and professionals who are willing to function on the network on a non-professional basis. The Young Families network offers young families support, information and referral services with backing from the state office of NAMI North Carolina. In coordination with the Helpline in the Raleigh office, volunteers help families who are struggling with the system to get appropriate services for their children. Young Families network is a service in its infancy. Although the Helpline has always fielded calls from young families and referred parents to other parents for support, NAMI NC is trying to expand this service on a broader scale. We are looking for volunteers, and we are looking for ways to plug in those who need the service. If you are in need of another parent to talk to, contact the Helpline at NAMI NC: 1-800-451-9682 (NC only). In Raleigh you can also call 788-0801. For a list of current family advocates offering support to young families, see the NAMI NC Young Families Advocate list. Childhood Mental Illness
NAMI NC CHILDREN'S RESOURCE LIST The Bipolar Child. Papolos, Demitri and Janice. New York, NY: Broadway Books: 2006 Explains childhood bipolar disorder using advances in neuroscience and genetics. Discusses how to obtain good treatment and medications as well as introducing school advocacy. Breaking the Silence: Teaching the Next Generation About Mental Illness. NAMI-New York State. Albany, NY. Lesson plans and colorful posters for upper elementary, middle, and high school that teach basic information on mental disorders including warning signs, treatment, and how to fight stigma. To order contact NAMI Queens/Nassau (NY) at 516-316-0797. Day for Night: Recognizing Teenage Depression, a video offering an in-depth look at the signs, symptoms, and treatment of teenage depression. Features teens with bipolar and major depression as well as families, friends, and healthcare professionals. Video is sponsored by DRADA (Depression and Related Affective Disorders Association) who can be reached at 410-955-4647. The Explosive Child. Greene, Ross W. New York, NY: HarperCollins: 1998. A leading therapist offers a new approach to understanding and helping children who suffer intense temper outbursts, extreme noncompliance, and verbal and physical aggression. Hearts and Minds, an award winning 27 minute film that focuses on four rural youth who speak candidly about what it is like to live with mental illness. Each has a different but serious mental disorder: schizophrenia, bipolar disorder, OCD, and major depression. To order, contact Monique Lewis at 703-516-7961 or e-mail Monique@nami.org. It’s Nobody’s Fault: New Hope and Help for Difficult Children. Koplewicz, Harold S. New York, NY: Random House: 1996. This guide for parents of troubled children provides compassionate advice on the diagnosis, treatment, and prognosis for thirteen psychological disorders, including ADD, depression, and anxiety, dispelling myths about medication and other available treatments. Kid Power Tactics for Dealing with Depression. Dubuque, Susan and Nicolas. King of Prussia, PA: Center for Applied Psychology, Inc: 1996. A book written for children that focuses on ways depression can affect how they feel - sad, insecure, alone, tired - and ways children can help themselves. To order, call 1-800-962-1141. Susan Dubuque also wrote a book for parents, A Parent's Survival Guide to Childhood Depression, that explains depression, its causes and treatment. Parents and Teachers as Allies: Recognizing Early-onset Mental Illness in Children and Adolescents. A monograph by Joyce Burland, Ph D, Director of NAMI's Department of Education and Training, 2001. Describes specific age-related symptoms of ADHD, ODD, conduct disorder, major depression, early-onset bipolar disorder, anxiety disorders, and OCD. Discusses issues these disorders raise for parents and teachers and encourages communication. To order, contact Monique@nami.org or visit NAMI's web site for an order form, http://www.nami.org/youth/allies/form. Shadow Syndromes: The Mild forms of Major Mental Disorders that Sabotage Us. Ratey MD, John and Johnson PhD, Catherine. New York, NY: Bantam Books: 1998. Book features treatments and strategies that can help change lives. Shadow syndromes can include "chronic sadness, outbursts of anger, inability to finish tasks, acute anxiety, and disabling discomfort in social situations," syndromes that affect one's ability to live a full, happy life. Straight Talk about Psychiatric Medications for Kids. Wilens, Timothy E. New York, NY: Guilford Press: 1999. Practical and useful, this book will strengthen parents' ability to understand the role that psychiatric medicines can play in their children's health and well being. Survival Strategies for Parenting Children with Bipolar Disorder. Lynn, George. Philadelphia, PA: Jessica Kingsley Publishers, Ltd: 2000. This book provides practical and realistic strategies for raising children and teens diagnosed with Bipolar Disorder and related conditions such as ADHD, Tourette Syndrome, and Asperger's Syndrome. Mr. Lynn is a pioneer in developing counseling strategies for children diagnosed with attention differences. He is also the parent of a child diagnosed with Tourette's and Asperger's Syndromes. Survival Strategies for Parenting Your ADD Child: Dealing with Obsessions, Compulsions, Explosive Behavior, and Rage. Lynn, George. Grass Valley, CA: Underwood Books: 1996. A handbook of essential stress management skills for families of children with ADD and other related disorders. Lynn gives parents very practical methods they can use and helps them to appreciate their troubled child as gifted in unusual ways. Taking Charge of ADHD: The Complete Authoritative Guide for Parents. Barkley, Russell A. New York, NY: Guildford Press: 1995. This book is unique in its up-to-date and clear presentation of the scientific basis of the disorder and offers a down to earth approach to intervention. Teaching the Tiger. Dornbush, Marilyn and Pruitt, Sheryl. Duarte, CA: Hope Press: 1995. This book is an essential guide and resource for parents and school personnel working with children with these disabilities. Parents, teachers, social workers, psychologists, occupational therapists, all will gain valuable insight and techniques for helping these children. RESOURCES ON THE WEB www.aacap.org - The American Academy of Child and Adolescent Psychiatry site with information on child and adolescent psychiatry, current research, practice guidelines, managed care. www.bipolarchild.com - Site features Demitri Papolos, M.D and Janice Papolos, authors of The Bipolar Child and Overcoming Depression. Includes general information on early-onset bipolar disorder, a model IEP (Individualized Education Program) for a bipolar child, free on-line newsletter. www.bpkids.org - A "virtual community center" with an extensive library, message boards, chat rooms, "Ask the Expert" feature, gallery of children's art, and more by the Child and Adolescent Bipolar Foundation. www.brainplace.com - An interactive website with concise information on the brain from The Amen Clinic for Behavioral Medicine. Dr. Amen uses SPECT, Single Photon Emission Computerized Tomography to observe brain activity (metabolism) by studying cerebral blood flow. www.childspirit.com - From George Lynn, psychotherapist and author of "Survival Strategies for Parenting Children with Bipolar Disorder" and "Survival Strategies for Parenting Your ADD Child..." He has a son with Tourette Syndrome and Asperger's. http://www.childtrends.org - Child Trends is a nonprofit, nonpartisan research organization dedicated to studying children, youth, and families through research, data collection, and data analyses.http://www.dhhs.state.nc.us/mhddsas/childandfamily/index.htm - The homepage Child and Family Services Section of the Division of Mental Health in North Carolina. Offers a wide variety of information including reports, programs, services, contacts. www.ecac-parentcenter.org - A parent training and information center, ECAC (Exceptional Children's Assistance Center) offers a wide variety of information and workshops plus a lending library on a variety of topics including advocating for children and special education issues. www.ldonline.org - Offers well-organized, practical information for parents and teachers of children with learning disabilities. http://fsnnc.med.unc.edu/ - From the Family Support Network (FSN) of North Carolina. The Central Directory of Resources (CDR) is a database of service providers and support organizations. www.mindsonline.org - All Kinds of Minds undertakes applied research, product development, program design, and professional training to foster the understanding and optimal care of children with differences in learning. www.nami.org - Spectacular site featuring fact sheets on mental disorders, brochures, reading list, and the latest on research and medication management. www.naminc.org - Local affiliate contact information, conference information/registration, legislative agenda, newsletters, and on-line store. www.nccovenant.org - Become a "cyberlobbyist" for kids' issues and keep current on legislative issues affecting families. The Covenant with North Carolina's Children is a multidisciplinary, statewide coalition advancing public policy to benefit children. www.nichcy.org - Site features searchable database, information in Spanish, fact sheets, briefing papers. NICHCY is the national information and referral center that provides information on disabilities and disability-related issues for families, educators, and other professionals. www.ocfoundation.org - Distribution of a wide range of articles, pamphlets, books, audio and video tapes about OCD and related disorders, bi-monthly newsletter. www.pbis.org - Positive Behavioral Interventions & Supports' site where attention is focused on creating and sustaining school environments that improve lifestyle results for all children/youth by making problem behavior less effective and desired behavior more functional. www.rtc.pdx.edu - From Portland State University's Research and Training Center on Family Support and Children's Mental Health. The center's focus is on improving services to children and youth who have mental, emotional, or behavioral disorders and their families. Focal Point is their online bulletin. www.wrightslaw.com - Hundreds of articles, cases, newsletters, and other information about effective advocacy for children with disabilities and special education law. Free online newsletter.
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