Preparing for Middle School — Navigating preadolescent challenges and considering when to seek help

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The transition from elementary school to middle school can be a very challenging time for tweens, both socially and academically. The signs of young adolescent moodiness can make you, as a parent, want to “nag” or “pry.”  Alternatively, some parents step back thinking, “it’s just a phase” or “it’ll pass.” While a temporary increase in moodiness and a greater tendency to push back against parents and adults is typical, some tweens experience more significant challenges.  Now is not the time to leave your pre-teen to deal with his or her challenges alone. Rather, it’s important to monitor your child’s mental health and provide guidance and support. Sometimes, this requires professional help, particularly at an age when your young adolescent may not be as open with you, the parent.     

Moodiness and Irritability

For many tweens and teens, puberty begins during the middle school years.  Hormone levels increase, which can lead to mood swings and a general sense of irritability.  Six months ago, your child was an upbeat kid, and now he or she is changing before your eyes, both physically and emotionally.  As a parent, it can be hard to predict which presentation you will get on a particular evening. This increased moodiness can disrupt the entire household and may even have an impact on younger siblings.  

Meanwhile, your young adolescent is dealing with his or her own body changes and development, something he or she has no control over.  Some adolescents develop earlier or later than others, which can be socially difficult for young adolescents on either end of the continuum.  At this age, tweens and teens often become more physically self-conscious and vulnerable to feeling embarrassed. For many adolescents, these feelings naturally pass over.  For others, this is a time when self-harming behavior (e.g., cutting), experimentation with drugs (e.g., juuling) or alcohol, and disordered eating may occur. It is important to monitor your child during this time of change, offering support and seeking professional help, as needed.  When these challenges are caught early and addressed appropriately, you can mitigate risk and improve long-term outcome.

Social Pressure to Fit In

One of the main issues that arises in early adolescence is the drive to fit in with one’s peer group, which causes many youngsters to feel socially insecure.  This is a time when instances of teasing, exclusion, rumors, and social bullying increase. While these behaviors have been part of adolescence for many decades, today’s teens have a new platform for teasing and social bullying—social media and electronic communication more broadly.  This platform makes it easier for teens to hide these issues from adults, while also giving bullies a wider reach. While some of these behaviors have become accepted as “normal” for a preteen to navigate, it is important to watch for signs of anxiety and depression resulting from social pressure and peer bullying.  If you see these signs, it may be time to call a professional for help.

Executive Functioning and Learning Issues

While many learning challenges are identified in elementary school, a number of bright children are able to manage during the early years of their education.  Then, middle school begins and the child no longer has one consistent teacher who can provide support and advocate for his or her needs. He or she must manage a day with six different teachers and sets of expectations.  The academic demands increase, homework becomes more demanding, and the amount of personalized attention decreases. All of this is occurring amidst the social and emotional changes described above. No wonder middle school is a difficult time for many young teens!     

Many adolescents struggle with planning, organization, time-management, self-monitoring, and initiating tasks—all aspects of executive functioning.  For some individuals, these challenges catch up with them in middle school when they are no longer able to compensate for these weaknesses and manage on their own.  For others, they may have been receiving support via an IEP or 504 Plan in elementary school (e.g., for ADHD, a learning disability, or high functioning autism formerly known as Asperger’s); however, he or she now has new or different needs.  This is an important time to watch for changes in your teen’s academic performance. Often, when grades begin to falter at this age, there is a complex set of challenges going on, underneath the academic difficulty, that needs to be addressed.  Psychoeducational and neuropsychological testing can help identify these of challenges and guide recommendations and support.

If you are concerned about your young adolescent’s behavior, I encourage you to contact me for assistance.  I look forward to working with you and your tween or teen during this time of transition. Please don’t hesitate to call me at 703-825-0502.  

Shira Gottlieb, Psy.D., Licensed Clinical Psychologist

Dr. Gottlieb is a licensed clinical psychologist. She received her B.A. in psychology, with a minor in neurobiology, from Harvard University, and her Psy.D. from the George Washington University. Dr. Gottlieb utilizes an integrative approach to therapy, incorporating both CBT and Family Systems techniques. Treatment goals are discussed with the child/adolescent and family and are developed with the individual child's needs in mind. For more information on Dr. Gottlieb please visit her website at http://www.gottliebchildpsych.com/

What to Expect at Your First Individual Education Program or 504 Plan Meeting

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Last month, we looked at what it means when your child’s testing results indicate that he or she would likely benefit from an Individual Education Program (IEP) or 504 Plan.  While eligibility is a team decision made during a meeting with school staff, I am committed to helping families navigate this process to get the best support for their child or adolescent.  Therefore, my neuropsychological and psychoeducational testing services do not end with the feedback meeting.  Rather, I consult throughout the IEP/504 Plan process, including attending meeting(s) at your child’s school.  To that end, let’s consider what to expect at the first IEP meeting with your child’s team.  

The process begins with an eligibility meeting during which your child’s educational team (including you) will review the IEP eligibility criteria.  This includes selecting a code, or the category that best describes your child’s challenges.  These terms can be confusing as there is educational and bureaucratic jargon involved.  For example, your child may have diagnoses of both ADHD (which falls under the code “Other Health Impairment”) and Dyslexia (which is included under the code “Learning Disability”).  I meet with parents in advance to discuss which label best fits their child and how it may affect services and priorities.  It is important to gather information and ask questions at the eligibility meeting, and I am available to help parents navigate this process. 

Next, if your child is determined eligible for an IEP, the special education lead (or another designated member of the school support team) will prepare a rough draft of your child’s first IEP for you to review in advance of the second meeting.  We can discuss this via phone, and I do my best to clarify and explain what the document means for your child.    

A team is necessary to put the IEP in place, and the school is required to have certain people participate.  The team may include: a special education teacher; a general education teacher (most likely your child’s current teacher); the principal or vice principal (or a district administrator like the special education department chair); a school psychologist; and you, the parent(s).  Additionally, the meeting may include an occupational therapist, school counselor, and other support staff.  Adolescents, typically beginning in high school, may be invited to attend a portion of these meetings.  You are also permitted to invite an advocate, such as myself or an educational consultant, to provide support and guidance during these meetings.  You will be asked to sign multiple agreements throughout this process, and the school is required to provide you with your child’s rights and safeguards in relation to special education.  If you are looking at a 504 Plan for your child, the meeting will likely be smaller and less formal; however, there will still be multiple contributors involved.  

During the second meeting, you will learn more about the school’s plan to help your child access the curriculum.  It is important to take your time and ask questions at this meeting as decisions will be made about the amount of support (i.e., the number of hours per week) and types of assistance (e.g., “pull out” or push in” special education) your child will receive.  The IEP document will discuss your child’s present levels of performance (commonly referred to as “PLOP”), areas of need, specific goals, proposed number of support hours, and types of accommodations.       

While the process can sometimes be frustrating, it is designed to protect the needs of children with a disability or condition that prevents them from accessing the curriculum and succeeding at school.  My attendance at these meetings can be extremely beneficial for families as I am able to explain the testing results to the team in-person, provide support and guidance to parents, and work alongside the school to develop the best IEP or 504 Plan for your child.  I look forward to helping you navigate this system through providing advocacy, support, and guidance in order to get your child the services he or she needs to succeed.    

Shira Gottlieb, Psy.D., Licensed Clinical Psychologist

Dr. Gottlieb is a licensed clinical psychologist. She received her B.A. in psychology, with a minor in neurobiology, from Harvard University, and her Psy.D. from the George Washington University.  Dr. Gottlieb works with children and adolescents, and their families, to provide comprehensive neuropsychological and psychoeducational assessments to better understand the individual child or adolescent’s attention capacities, learning profile, emotional functioning, and behavioral presentation. For more information on Dr. Gottlieb, please visit her website at http://www.gottliebchildpsych.com/

IEPs and 504 Plans: What they mean for your child’s success

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As a child psychologist, I’m committed to empowering children with learning disabilities to succeed in school. Dealing with a learning disability is a journey, and I am dedicated to supporting my clients and their parents during this time period and beyond. I want your child to get the help he or she needs to succeed in school, and I know that’s what you want as well. My neuropsychological and psychoeducational testing services don’t end with our feedback meeting.  I don’t consider my job to be done once the evaluation results are provided to you.

At the testing feedback meeting, I’ll answer any questions you may have, and I may recommend seeing a pediatrician or a psychiatrist if a medication consultation is indicated. I’ll provide strategies for you to employ at home with your child, and resources for you to get more information. We will review the type of services, ways of teaching, assistive technology, and other support that may benefit your child. We will also go over what happens at the first Individualized Education Plan (IEP) or 504 Plan meeting with your child’s school support team.

Let’s take a look at these two terms: IEP and 504 Plan.  Section 504 of the U.S. Rehabilitation Act of 1973 is designed to help students with physical, mental, or emotional impairments in public schools (or publicly funded private schools) using accommodations that can be carried out in the classroom. These 504 Plans ensure that students will be treated fairly at school.

Examples of accommodations in 504 plans include:

  • Preferential seating
  • Extended time on tests and assignments
  • Reduced homework or classwork
  • Verbal, visual, or technology aids
  • Modified textbooks or audio-video materials
  • Behavior management support
  • A modified testing setting  

The goal of 504 Plans is for students to be educated in regular classrooms, along with the accommodations or educational aids they may need.

A 504 Plan is different from an IEP. The main difference is that a 504 Plan modifies a student's educational program in a regular classroom setting. A 504 plan is monitored by classroom teachers. A student with an IEP, as part of the Individuals with Disabilities Education Act (IDEA 2004), may receive individualized educational services in a special or regular education setting, depending on the student's need. IEP programs are delivered and monitored by additional school support staff, and parent approval is required.

As you can already tell, the IEP/504 meeting is often quite complicated and can be overwhelming for parents. One of the things that makes my practice unique is the extra steps I take to support you and your child beyond the testing phase. One of these steps is accompanying you and your child to his or her IEP/504 meeting. This way, I can speak to my testing findings and recommendations; consult with teachers, special education staff, and administrators; and provide support for you and your family. I also make myself available to consult with therapists, teachers and others on an as needed basis.

My role is to help you, as parents, navigate the educational system and embark on a path to success for your child.  I've participated in a variety of meetings at the elementary school, middle school, and high school level in multiple school districts. I have also visited many schools in the area for child observations, which is a component of my testing process for young children.  Through these visits, I not only learn about the particular child I am observing, I also become familiar with the different school settings and administrations.

I’m committed to making sure you understand your child’s results and am here to help you navigate the next steps. I look forward to working with you and your child. Next month, we will look at what to expect from the first IEP/504 meeting and how to prepare for it.

Shira Gottlieb, Psy.D., Licensed Clinical Psychologist

Dr. Gottlieb is a licensed clinical psychologist. She received her B.A. in psychology, with a minor in neurobiology, from Harvard University, and her Psy.D. from the George Washington University.  Dr. Gottlieb works with children and adolescents, and their families, to provide comprehensive neuropsychological and psychoeducational assessments to better understand the individual child’s attention capacities, learning profile, emotional functioning, and behavioral presentation. For more information on Dr. Gottlieb please visit her website at http://www.gottliebchildpsych.com/

Childhood Anxiety: Recognizing the difference between stressful circumstances and clinical anxiety

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Springtime is a wonderful time of year; however, it can also be a stressful time for children and teens of all ages.  For younger kids and preteens, it’s the time of year for state mandated testing in schools, which can certainly raise stress levels.  For teens, it is the time of year when seniors hear back from colleges and many juniors begin the college application process. These adolescents are confronted with major decisions about their future, a source of worry and anxiety for many.  For those seniors waiting to hear from colleges, it can be a time of anticipation and apprehension.

As a parent, how can you tell whether your child or teen is experiencing heightened levels of stress due to temporary circumstances versus if he or she has clinical levels of anxiety and should see a therapist?  When parents ask me, I tell them to consider the length of time and the impact of the stress on your child’s life. How frequently does he or she experience this anxious behavior? How long have the worries been a concern?  To what extent do their worries negatively affect your child’s life?

Many children and teens suffer from debilitating worry.  Recent national polls have found that 1 in 8* children suffer from anxiety.  Many kids miss school, social activities, and a good night’s rest due to ongoing worrying.  With this in mind, what signs should parents be looking for? Anxiety can present through physical, emotional, and behavioral signs, and the following list provides common indicators for each of these categories.   

Physical Signs of Anxiety

  • Your child complains frequently of headaches or stomachaches, for which his or her pediatrician has found no medical reason;

  • If your child’s eating habits have changed significantly, including an increased or a decreased appetite.  Again, you should first seek out your pediatrician to rule out any physical reasons for this behavior; however, if those are ruled out and your child is still not eating properly, it could be a sign of anxiety;

  • He or she starts to shake or sweat during mildly stressful situations, such as school testing or performances; and

  • Your child has trouble falling or staying asleep through the night.

Emotional Signs of Anxiety

  • Your child cries often, especially in response to seemingly minor issues;  

  • Your child is extremely sensitive to feedback, even when the content is not critical in nature;

  • He or she is irritable regularly, without any clear reason;

  • Your child is afraid of making even minor mistakes;

  • He or she has regular panic attacks or is afraid of having panic attacks (Panic attack symptoms may include sweating, trembling, shortness of breath, a choking sensation, chest pain, nausea, dizziness, fear of losing your mind, fear of dying, skin flushing, a racing heartbeat or heart palpitations, feeling that danger is nearby, and feeling an intense need to escape the situation.);

  • Your child has phobias (e.g., bees, dogs, shots) or exaggerated fears (about things like natural disasters) that prevent him or her from participating in activities or interfere with his or her daily life; and

  • Your child has frequent nightmares about losing a parent or loved one or is obsessing about death in general.

Behavioral Signs of Anxiety

  • Your child asks “what if?” constantly, and it’s related to terrible things happening. For example, “What if an earthquake happens?” or “What if a robber breaks into our house?”;

  • Your child avoids participating during circle time or other class activities at school every day;

  • If your child refuses to go to school on a regular basis;

  • When your child avoids social situations with peers after school or on weekends that he or she used to enjoy (e.g., extracurricular activities or birthday parties);

  • If your child constantly seeks approval from parents, teachers and friends, and reacts negatively to any form of constructive criticism; and

  • Your child frequently says “I can’t do it!” without a real reason.

If your child is showing the aforementioned signs on a regular basis, I urge you to seek mental health support for him or her.  There will always be stressors in life, and you can’t protect your child from everything. However, therapy can help your child learn to manage his or her anxiety and continue to function in life, even when stressed or worried.  It is important to keep in mind that untreated anxiety tends to get worse over time. When a child—and sometimes the whole family—works to avoid triggering situations, the worries only grow more powerful. The best way for children and teens to conquer anxiety is to learn to face and master their fears.   

If you are concerned about your child’s anxious behavior, I encourage you to contact me for assistance.  I look forward to working with you and your child to provide strategies and support. Please don’t hesitate to call me at 703-825-0502.
 

Shira Gottlieb, Psy.D., Licensed Clinical Psychologist

Dr. Gottlieb is a licensed clinical psychologist. She received her B.A. in psychology, with a minor in neurobiology, from Harvard University, and her Psy.D. from the George Washington University. Dr. Gottlieb utilizes an integrative approach to therapy, incorporating both CBT and Family Systems techniques. Treatment goals are discussed with the child/adolescent and family, and are developed with the individual child's needs in mind. For more information on Dr. Gottlieb please visit her website at http://www.gottliebchildpsych.com/

Strategies for Teachers: How to talk to parents about their child’s classroom struggles

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As a psychologist who specializes in neuropsychological and psychoeducational evaluations, I see many parents who have recently received recommendations from their child’s teacher or school support staff that they should consider having their child assessed.  Parents, and sometimes the child himself or herself, may be worried when they arrive for an intake meeting.  They might have questions about the testing process, concerns about the child’s school performance, or could be struggling to process the situation.  However, I am rarely the initial point of contact for these families.  Rather, teachers (and pediatricians) are often the first to notice when a child is struggling.

Teachers see students on a daily basis and have unique insight into a given child’s academic, behavioral, and social functioning.  In addition, they have age-based comparative data.  Therefore, teachers are often one of the first people to notice when a student is struggling due to attention and learning challenges, processing concerns, or behavioral issues.  This role is both influential and challenging.  Even when parents are aware that there is an issue, it is difficult to hear their child is struggling.  Therefore, it is particularly important for teachers to consider how they convey this information in a way that is compassionate, honest, and clear.  Ultimately, the goal is to work together with the parents, child, and other professionals for a supportive, team approach.      

Throughout my clinical work, I have developed a list of techniques and strategies that tend to be effective in this challenging situation.      

1. Contact parents early.  When a child is struggling in the classroom, early intervention is very important and typically leads to the best outcomes.  Over time, if the problem is not addressed, the child will fall further behind.  In addition, what may begin as an academic or attention-based challenge, can lead to feelings of low self-esteem and growing social-emotional difficulties. Furthermore, parents typically appreciate ongoing feedback, rather than waiting until the issue has reached “crisis mode.”  The evidence is overwhelming; the sooner developmental delays or learning disabilities are addressed, the better the outcome for the child.

2. Create a “positive-feedback sandwich.” People are typically more receptive to constructive feedback if you position it between two positive comments.  Begin with a positive experience you had with the student.  Then, express your concerns while also explaining ways that you and the child are already working together to address the challenge.   Keep in mind, it often helps to provide specific scenarios, as they can be easier to process than broad generalizations.  Finally, as the sandwich metaphor implies, end on a positive note by giving the parents a genuine compliment about their child.

3. Listen to the parents.  While it is important for you to keep the parents informed about what is going on in the classroom with their child, it is typically very helpful to listen first.  Ask the parents about their observations at home regarding homework, any history of learning challenges, or if they have any concerns.  Ask the parents about their child’s strengths and weaknesses, interests outside of school, and how he or she talks about his or her school day.  Do you see similar challenges in the classroom?  Remember, everyone behaves differently in unique environments.  This does not mean observations in one setting are “correct” and the other is not.  

4. Recommend solutions that incorporate the school, parents, and child.   Often teachers make the mistake of thinking they must develop the solutions to a child’s classroom struggles on their own.  Instead, think of the student’s parents, and other relevant professionals, as part of a team.  It is important to offer solutions from your own unique perspective, while also asking for suggestions and input.  This approach can help parents and students regain a sense of control and agency amidst a challenging situation.    

5. Avoid using labels too soon in conversation.  While you may have a sense that a child is likely to have a specific learning disability, attention challenge, or processing issue, it is important not to label his or her behavior prematurely.  Although labels can be very helpful after the complete picture has been assessed, they can be limiting if used before various causes are considered.  In addition, certain terms can be difficult for parents to hear and may not encourage openness and collaboration.  

I consider teachers and other educational professionals to be my partners in working with children and their families.  Please feel free to contact me (703-825-0502) with any questions you may have regarding how to speak to parents about their child’s classroom struggles. I look forward to working with you, your students, and their families.  

Shira Gottlieb, Psy.D., Licensed Clinical Psychologist

Dr. Gottlieb is a licensed clinical psychologist. She received her B.A. in psychology, with a minor in neurobiology, from Harvard University, and her Psy.D. from the George Washington University.  Dr. Gottlieb works with children and adolescents, and their families, to provide comprehensive neuropsychological and psychoeducational assessments to better understand the individual child’s attention capacities, learning profile, emotional functioning, and behavioral presentation. For more information on Dr. Gottlieb please visit her website at http://www.gottliebchildpsych.com/

Is your Teen Experiencing “Adolescent Angst”, End of the Quarter Stress, or Something More?

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It’s that time of year when many people, including teenagers and pre-teens, feel tired, irritable, upset, or blue.  For many adolescents, it is also a time of academic stress, as the second quarter comes to a close.  For older teens, college application season is in full force, which can exacerbate this pressure.  You might think it is “normal” for your teen to be moody, especially during the winter when there is less opportunity to go outside for exercise, sports, and other activities.  However, for some individuals, this winter “slump” can be severe and may have lasting effects.  

Seasonal Affective Disorder (SAD) is a form of depression that can develop from inadequate exposure to sunlight.  As you might expect, there are more people who experience SAD in the most northern and southern parts of the world, (e.g., Alaska); however, even people in our area can experience symptoms.   

For some individuals, SAD can be a serious issue and shares many signs and symptoms with Major Depression. Understanding your teen’s risk factors for SAD can help you identify symptoms, should they arise.  While SAD, and depression in general, is more common in adolescent girls than boys, the symptoms are not exclusive to one demographic.  As with many types of mental health issues, the risk of SAD is higher for teens who have a family history and a genetic predisposition (e.g., have a close relative suffering from depression).

According to the National Institute of Mental Health (NIMH), here are some symptoms of SAD to watch for in your teen:

  • Increased need for sleep, and a lack of energy. Many teens enjoy sleeping in on the weekends, but if your teen is having problems crawling out of bed every day, it may be a sign of SAD.

  • Change in appetite or weight. Certainly, the fall and winter are times when we typically crave more comfort foods (e.g., sweets and carbs), and the fact that it coincides with so many food-focused holidays such as Thanksgiving, Hanukah, and Christmas adds to this experience.  However, it’s important to take note if your teen’s eating habits change drastically during this time.   

  • Irritability. Teenagers often experience moodiness with all of the new hormones surging through their bodies.  However, once again, you want to note if it is more extreme, consistent, and/or pervasive.

  • Inability to concentrate and difficulty completing tasks. Focus and concentration are two of the key ingredients to academic success. If your teen’s grades begin to slip at this time of year, or if his or her teacher asks for a conference to discuss his or her lack of focus and motivation, it may be a sign of SAD.

  • Problems with relationships, withdrawal from friends, family and social activities. During adolescence, many teens struggle with their relationships.  However, for some, these challenges can be more extreme.  If you notice a sudden or progressive change in your teen’s social behavior (e.g., an outgoing adolescent who now wants to spend all of his or her time in his or her room), it is important to take note.

  • A sense of hopelessness, worthlessness, or guilt.  When teens experience symptoms of depression, it is often accompanied by feelings of low self-esteem and a sense that they can’t or don’t deserve to feel better.  These feelings are important and may be red flags for a mood disorder.   

  • The aforementioned symptoms appear to increase seasonally during the fall and winter. January and February are often difficult times for individuals with SAD or related symptoms.  It has been dark for several months and the holiday rush is over, with seemingly little to look forward to in the upcoming weeks or months.

Over a few months, the lack of light and the increased symptoms of depression can lead to feelings of hopelessness, and a general sadness about life.  There are many cases where SAD leads to depressive symptoms that can extend into the rest of the year. Furthermore, untreated depression can get worse over time. In extreme cases, a teen can begin experiencing suicidal thoughts, a serious threat to their welfare.

As with any mental health issue, it is important to seek appropriate treatment and support. If you are concerned about your teen’s mood or behavior, do not hesitate to contact me for assistance.  I look forward to working with you and your child to provide solutions and support.  Please don’t hesitate to call me at 703-825-0502.

Shira Gottlieb, Psy.D., Licensed Clinical Psychologist

Dr. Gottlieb is a licensed clinical psychologist. She received her B.A. in psychology, with a minor in neurobiology, from Harvard University, and her Psy.D. from the George Washington University. Dr. Gottlieb utilizes an integrative approach to therapy, incorporating both CBT and Family Systems techniques. Treatment goals are discussed with the child/adolescent and family, and are developed with the individual child's needs in mind. For more information on Dr. Gottlieb please visit her website at http://www.gottliebchildpsych.com/

Signs of Childhood Depression

How to know when your child’s behavior is more than just the “holiday blues”

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At this time of the year, everywhere you turn you are surrounded with images of gregarious, happy families. Television shows, holiday specials, and social media showcase idealized family gatherings, bountiful piles of gifts, and unbelievably happy people. However, for some children, the holidays can be one of the most difficult times of the year. The expectation that they should be happy and carefree is simply unrealistic. School can be a significant stressor for children during the winter months, and the additional pressure of the holidays can be hard on everyone. This is why so many people suffer from the “holiday blues.”

There are plenty of reasons for unhappiness around the holidays. They create economic stress and time pressure as we rush about to create the “perfect” holiday experience. Families may be dealing with loss, divorce, or other situations that are not depicted in our idealized holiday vision. In addition, the winter holidays come at a time when it’s cold and dark outside, which often leads to fewer opportunities for exercise.

The holidays can also bring up difficult emotions.  It is a time when children really miss those family members who have passed away or are too ill to participate in the festivities.  Splitting time between divorced parents can be particularly difficult, as children may feel guilty for not spending time with one of their parents, or may not want to spend time with a normally absent parent just because it’s the holidays.  For some older kids, midterm exams create additional stress.  This can be exacerbated because they typically take place at the same time as major extracurricular activities, like holiday plays and concerts.

General feelings of unhappiness are not the issue though. It is important to distinguish the “holiday blues” from more consistent mood patterns. Depression is a persistent condition that lasts for weeks or months at a time, and interferes with a person’s ability to function in daily life. It has a number of causes, including genetics and neurochemical imbalances, as well as environmental, psychological, and social factors. Here are some of the signs you should monitor for during this season and year-round.

  • Increased sadness or irritability. While everyone feels this way sometimes, if your child is feeling this way for more than two weeks, it may be a sign of something more serious.  
  • Changes in sleeping patterns and appetite. Excitement about the holidays can cause kids to sleep less and eat more. However, you should be looking for the more notable symptoms, such as not wanting to get out of bed, showing extreme fatigue, or not eating regular meals.
  • Your child suddenly complains of vague physical ailments, such as headaches or stomachaches, when they are normally quite physically fit and healthy.
  • He or she withdraws from activities that used to be his or her favorites, whether it’s sports or after school activities. They could even be losing interest in their favorite hobbies around the house.
  • Deteriorating academic performance, losing interest in school, and “playing sick.”
  • Reckless and impulsive behaviors such as angry outbursts and hostility. Or perhaps your child starts to express feelings of worthlessness or undue guilt.
  • Your child retreats into himself or herself and refuses to tell you what’s wrong. In this case, see if there is someone in his or her life with whom he or she is willing to talk, and if not, seek a professional for him or her to speak with.

It is important to understand that all children express some of these symptoms at times. However, for children experiencing depression, these symptoms interfere with daily function often impacting family life, academic performance, and peer relationships.  

If you observe these behaviors in your child, seek professional help for him or her. Unaddressed social and emotional challenges during childhood can increase in severity as children get older and could lead to secondary challenges (e.g., social isolation, learned helplessness, and family turmoil). If your child is showing symptoms of depression during the holidays, address it, and it is quite possible your whole family will have a happier holiday as a result. I look forward to working with you and your child to provide support and guidance. Please don’t hesitate to call me at 703-825-0502 or email me at shira@gottliebchildpsych.com.

Shira Gottlieb, Psy.D., Licensed Clinical Psychologist

Dr. Gottlieb is a licensed clinical psychologist. She received her B.A. in psychology, with a minor in neurobiology, from Harvard University, and her Psy.D. from the George Washington University. Dr. Gottlieb utilizes an integrative approach to therapy, incorporating both CBT and Family Systems techniques. Treatment goals are discussed with the child/adolescent and family, and are developed with the individual child's needs in mind. For more information on Dr. Gottlieb please visit her website at http://www.gottliebchildpsych.com/
 

Beyond the Feedback Meeting: Implementation, Consultation and Support

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When your child’s teacher expressed concern at parent-teacher conferences that your child may be struggling due to a learning disability and/or attention challenges, you may have been encouraged to seek neuropsychological or psychoeducational testing. Or, maybe you have become concerned after seeing your child’s first quarter report card and have begun to look into the process yourself.  

In my last blog post, I spoke about how to talk to your child about these evaluations.  Now, I would like to talk about what happens after the assessment, including how I work with families, teachers, and other professionals in your child’s life to put the findings and recommendations into action.  

While there are commonalities among psychologists in how the testing process is structured, my practice is unique in important ways.  Throughout my clinical experience, I have found that parents often finish the testing processes feeling overwhelmed.  They may be struggling to make sense of a testing report that is difficult to understand.  Or, they may feel inundated with information that is given at a single feedback meeting without guidance regarding next steps.  When I developed my practice and testing style, I prioritized writing reports that are accessible and providing hands-on follow-up consultation.

Overcoming attention and learning challenges is a journey, and I am committed to helping my clients and their parents as they begin implementing strategies and recommendations.  This begins with a 90-minute feedback session about two weeks after testing is complete.  At this time, there will be a comprehensive and accessible written report outlining the findings and recommendations.  For a young child, this is a parent meeting.  For an adolescent, the student may be included in the feedback session.  The level of preteen or teen involvement is discussed on a case-by-case basis and is carefully fitted to the adolescent’s developmental stage. 

While the traditional testing process ends with the feedback meeting, I view the feedback meeting as the beginning of a new phase.  My comprehensive package includes a follow-up meeting and additional consultation.  For many children and adolescents, this includes attending an IEP or 504 Plan meeting at their school, or a private school equivalent.  This allows me to work with the teacher and relevant school staff, creating a team to support your child’s learning.  For many children, particularly children ten and under who are struggling in the school setting, this will not be the first time I have visited their school.   For these children, I organize a school observation with your child’s teacher and school prior to meeting your child.  Then, when it comes time to implement strategies following the evaluation, I have a better understanding of your child’s school environment as well as a collaborative relationship with your child’s teacher and school.     

In addition, I often consult with therapists, psychiatrists, pediatricians, tutors, reading centers, and executive functioning coaches.  These individuals are part of your child’s team.  My goal is to work collaboratively, while providing a deeper understanding of the assessment findings and recommendations.   I’ll also provide strategies for you to work on with your child at home, referrals to other professionals, and resources for you to access additional information.

I’m committed to providing accessible written and in-person feedback following your child’s evaluation.  Furthermore, I am dedicated to facilitating follow-up consultation and support.  I am here to help you navigate the next steps.  I look forward to working with you and your child.  Please call my office for more information (703-825-0502).

Shira Gottlieb, Psy.D., Licensed Clinical Psychologist

Dr. Gottlieb is a licensed clinical psychologist. She received her B.A. in psychology, with a minor in neurobiology, from Harvard University, and her Psy.D. from the George Washington University.  Dr. Gottlieb works with children and adolescents, and their families, to provide comprehensive neuropsychological and psychoeducational assessments to better understand the individual child’s attention capacities, learning profile, emotional functioning, and behavioral presentation. For more information on Dr. Gottlieb please visit her website at http://www.gottliebchildpsych.com/