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Mental health professionals

My 13 year old son has always been rather anxious and lately has developed some behaviors that seem troubling – like having specific rituals for checking that doors are locked and being very regimented in his grooming habits. Also, he gets upset when his personal things are not precisely organized. Is this a sign of compulsive behavior that I should be concerned about or just teen idiosyncrasies?

Although there is some discrepancy among professionals about the specific age of onset for Obsessive Compulsive Disorder, it is possible that a 13 year old boy could present with symptoms. Frequently, life transitions can trigger or intensify those symptoms as well. In fact, Allen H. Weg, EdD, states that it is believed that a combination of the hormonal changes that take place during adolescence, together with the growing demands and responsibilities of life might also play a role.

Depending on the severity and intensity of the activities, it may not necessarily need treatment at this time but it is good to know that treatment is available. OCD is a neurobiological illness that can be effectively treated by training the brain how to respond differently to obsessions. The first step, as a parent, might be to help your child identify behavior and thought patterns and their frequency. For example, do the obsessions seem to intensify before bed, or right before school or a test? Are they coping skills to manage stress? If so, introducing other grounding and mindfulness-based activities and thoughts could assist in minimizing the obsessive behaviors (i.e. meditation, yoga, deep breathing, visualization, etc…).

Recognizing and changing thought patterns can also be helpful to address obsessive behavior. For example, changing the thought “Everything has to be perfect before I leave my room” to “I will be okay today, even if my room doesn’t look perfect.” Eckart Tolle teaches us that “once we begin to see the pattern, it already begins to lose its power.” Perhaps these can be the most comforting words for parents and children suffering with OCD. Finding a good therapist to talk through other options and assist in making more proper diagnosis can also be helpful.

Submitted by Stephanie Lowe-Sagebiel, MSW, LCSW, of Centerpoint Counseling

My four year old son has a great deal of difficulty expressing his anger in appropriate ways. When he’s upset, he will hit, kick, pinch and even bite us sometimes. We are trying to get him to talk through what is upsetting him, but we aren’t making much progress. What can we do to get him to vent his frustrations in more socially acceptable ways?

There are two issues you should be commended for recognizing: 1) that your son is using physical aggression as a means to communicate that he is “angry” and (2) you are acknowledging that the issue is not his “anger”, but the way he is expressing his anger. Sometimes, caregivers fail to realize that children are just as entitled to their feelings as adults.

If you have already ruled out any emotional or mental health issues that would complicate his ability to self-regulate, consider the following: 1) Make sure he can recognize and label emotions. 2) Use social stories as a creative and visual way to show him social situations that could lead to an anger outburst and appropriate responses. This can expose him to the process of chaining events and the cause/effect connection between an event and the following response. 3) Practice role playing. This will give him experience using the techniques you are teaching him. 4) Closely monitor your son for real life situations. When he is faced with an opportunity to use his techniques, quickly jump in and guide him through the process. 5) Praise him when he does express his anger appropriately! He needs to know what he is doing right, not just what he did wrong! If he still has an anger outburst, but at least tried, be sure to talk with him about it later and praise him for the attempt.

Submitted by Dr. Gwen Martin-Perryman, Board Certified Behavior Analyst, of Conduct Curb, LLC

I think my 2 year old niece may be autistic. I would like to bring up my concerns to my sister-in-law but I’m afraid she will not be receptive. I know early intervention can make a big difference in kids with autism, so I want to broach the topic with her, but I’m just not sure how to. What is the best way to start a conversation with her?

Often, broaching a parent about their child’s special needs is difficult. Since you are a relative you can demonstrate love toward that child while mentioning some observations that you have noted about your niece. Using an opportunity that naturally occurs would be ideal. Perhaps the mother says she is tired of her little one’s inability to accept change, or how she doesn’t look at her much when she is talking. Then, if  you believe the parent may be open to direct feedback, you can say that these are often similar to some children who are on the autism spectrum. A less direct approach or simultaneous approach could be to ask if the mom has considered taking her to a professional to discover if there is something she could be doing to help her child. Even if it is not autism, there can be help to ease other issues and aide development.  Family physicians should be informed of parent concerns during check-ups and a parent can visit In.gov to learn about First Steps through the Bureau of Child Development Services. At times the best support for a parent can be encouragement to look for professional attention as you validate their concerns.

The Center for Disease Control and Prevention has reported new figures that 1 in 68 people are acknowledged as being on the autism spectrum.  Some therapists believe that girls are much more likely to be missed by a diagnosis due to the criteria being slanted toward male symptoms. This trend needs to be addressed. Early intervention does aid not only the child, but the whole family. While difficult to do, open conversations help provide needed care.

Submitted by Sandi French, M.S., EdS, LMHC, NCC and Gloria Hood, M.S., LMFT/LSW of North Meridian Psychiatric Associates and the Indiana Center for Children and Families, Inc.

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