In early December PEN (Parents Education Network) hosted two speakers from the Abbey Neuropsychology Clinic, Richard D. Abbey, Ph.D., Clinical Neuropsychologist and Diana Barrett, Ph.D., Clinical Psychologist. Their focus was three complex issues: Depression, Anxiety and Learning. I was impressed with the ease that these two specialists shared the podium as they imparted their expertise. A more detailed background on both speakers can be found at the conclusion of this blog.
They began their morning talk with a focus on depression, advising us that it appears differently with children and adults. For a child, irritability is a key element. They become very edgy and display a lack of interest in something that they previously very much enjoyed, walking away from any involvement with it or others. Whereas a tip the speakers provided to indicate whether an adolescent might be in a depressed state is sleeping till noon or complaining about a tummy ache. These are safer ways for an adolescent to express depression. If there evolves a pre-occupation with poetry whose topic is life threatening, it could mean the adolescent is exploring the possibility. The challenge for a parent is discovering whether the comments are simply anxiety which interferes with a child’s functioning or whether the issue comes from a depressed state.
Often depression comes when there is a problem with learning. This causes emotional issues. Ask yourself the question: are the emotional issues out of control? Or is depression causing a learning problem? It is clear that when a child, adolescent or adult is depressed, this state interferes with other and important daily functions.
The frontal lobe of the brain is where Executive Functioning (ie: skill building) occurs. It can be one of the first segments of the brain affected by depression or anxiety. Kids who can’t keep information being taught in their mind are offering a good clue that this skill is not working well. Perhaps the school teachers are unable to track the child’s reading skills which can result in their teaching approach not matching the way the child learns. When a student hears from a teacher: “try a little harder” or, “we just told you” when they are not doing what is being asked, more than likely the child/adolescent internalizes, “I am stupid.” This can lead to depression.
There is another clue: Is the student taking a long time to accomplish a task, especially if there is sequence of tasks to accomplish with the project. This inability can lead to the student getting caught up in right and wrong. And, then they begin to say to themselves if I can’t do it perfectly I am not going to do it at all. Their anxiety becomes dominant.
These are some questions the speakers provided to begin assessing whether your child/adolescent is experiencing anxiety or depression:
1. Is anything significantly different in any domain of your child’s life?
2. Is their day to day functioning different from the norm?
3. Does the child have a problem reading aloud. Do they lose their place, skipping
words or replacing words?
4. With Executive Functioning: is there a switching of letters and numbers? Can they sort out a lot of information being taught? does their attention keep varying?
5. Are you concerned that your child may not be safe?
There are solutions/interventions to these tell tale signs: A few are listed below.
1. Professional emotional and learning assessments to diagnose what is happening with your child.
2. Cognitive Behavior Therapy. The process focuses on solving problems concerning dysfunctional emotions, behaviors and cognitions: I looked up the word “cognitive” on Wikipedia for a definition. It refers to the following skills: attention, remembering, producing and understanding language, solving problems, and making decisions. The speakers had some good news about the effectiveness of Cognitive Behavior Therapy confirming that 75% of the time there is some kind of improvement with anxiety and depression.
3. Medications: The speakers did not spend much time on this topic. They did comment that kids on medication do seem to have a working memory problem. This is a controversial issue which has been discussed at PEN many times. See former PEN and Emotion blogs within my various blogs for more information.
3. Reading interventions. The speakers cautioned parents to undertake due diligence before taking action. Some therapies only look at a part of the problem – which may or may not be appropriate for your child. For an overview the speakers recommend using the National Reading Panel. http://www.nationalreadingpanel.org.
4. Executive Functioning Coaching. The need for this skill may not present itself until college level. When it does, coaching is very important. Each person needs to learn
how to plan, how to live with goal oriented behavior.
5. Software: These speakers were promoting the use of a Pulse Pen. It records what is being said and relieves the need for the listener to take notes. They also mentioned the Intel Reader which was discussed in more detail in the previous PEN blog.
6. Cogmed: This process helps improve working memory, expand attention and executive functioning. http://www.cogmed.com/about-working-memory
7. What to do at home: Adjust expectations of your child: Set realistic goals. schedule free time along with time with you, the parent. Have a listening ear, find a way to bring up the topic you want to discuss or to hear more about from them.
8 School: School placement is very important. See previous PEN blogs on this topic.
These speakers gave me a giggle when they said: We have never spoken to a parent who didn’t think that they were right. A part of me, Ann, who is writing this blog and is not a parent, sees that part of needing to be right in myself. It takes time to undo that belief. If you, as parent are so challenged, give yourself time to learn more about the topic. Yes, I know sometimes that’s a difficult step for a parent to take. Our ego can make it difficult for us to accept there is a learning challenge. Your goal is to keep the best interests of the child to the fore. Here’s a sobering comment made by the speakers. There is evidence now that if one parent experiences depression, the risk for the child developing depression goes up. So, if you as parent experience the same issues as the child, the speakers said it helps the child if the parents also do the interventions.
The speakers urged the parents to go to gatherings, like EdRev in San Francisco, a yearly event produced by PEN which occurs at the Giant’s Baseball Park. Here parents can intermingle with hundreds of other parents and learning specialists and Depression, ansietydiscover ways to increase their knowledge base on the issues facing their child.
Remember, the brain is neuroplastic, it can and does change!
The speakers were:
Dr.Richard Abbey is a clinical neuropsychologist who specializes in assessment, diagnosis, and treatment of ADHD, learning disorders, and other neurocognitive and emotional conditions. Prior to opening the Abbey Neuropsychology Clinic in Palo Alto, Dr. Abbey was a clinical faculty member at Stanford University School of Medicine/Lucille Packard Hospital. His areas of specialty include ADHD (and non-medication based interventions for ADHD), learning disorders, pediatric brain tumors, autism, and treatment of neurocognitive deficits.
Diana Marchetti Barret, Ph.D. is a clinical psychologist who assesses and diagnoses learning disorders, developmental disorders (e.g. autism, aspergers), mood disorders, and ADHD. Dr. Barrett completed post-graduate work at the University of Utah Neuropsychiatric Institute and post doctorate training at Stanford University School of Medicine, Child and Adolescent Psychiatry. Dr. Barrett also has specialty training in Motivational Interviewing, Dialectical Behavior Therapy, non-medication treatment for ADHD, and Pivotal Response Training (PRT) for Autism Spectrum Disorders.
The speakers can be reached through: Abbey NeuroPsychological Clinic located in Palo Alto, CA. They offer ccomprehensive neuropsychological evaluations for infants, children, and adults. http://www.abbeyneuropsychologyclinic.com
On Friday, December 10th 2010, Jeffrey Lazarus, M.D, a Menlo Park pediatrician who specializes in the treatment of situational anxiety and test-taking anxiety utilizing clinical hypnosis, was the speaker at PEN’s morning session held at the Exploratorium in San Francisco. www.parentseducationnetwork.org.
Dr. Lazarus works primarily with children and feels that clinical hypnosis can assist students with their academic performance if they are affected by anxiety or distractibility. Clinical hypnosis is defined as helping another reach a highly focused state of mind. In that condition a student is able to visualize doing things he or she didn’t expect they could.
Anxiety happens when a student overestimates the risks/challenges or when he or she underestimates his/her resources. For example, a child who starts coughing because he feels anxious can in a highly focused state of mid learn to stop this condition before it gets to the cough state. One of Dr. Lazarus’ students visualized a stop sign and now uses this image as a tool when the condition begins to make its presence known.
If negative self-talk is the issues, he helps the student learn how to deep breath, relaxing their muscles as he teaches them meditation, positive self-talk and clinical hypnosis/guided imagery. Dr. Lazarus was clear that a highly focused state doesn’t necessarily mean an individual is relaxed. Rather, the guided imagery process enables an individual to find a place in their imagination where they feel relaxed, like a beach or driving down a mountain, or listening to music, whatever. It’s that state that the student recalls during times of stress.
The issue of distraction or lack of focus where the student might be thinking about recess, playing after school or remembering a fight with a friend/student can also benefit from clinical hypnosis. The process of visualization can provide confidence and focus.
Dr. Lazarus commented that he screens his patients before introducing clinical hypnosis into their life. If he discovers the child has a hearing or vision issue or learning disability that requires special attention he recommends other specialists in the field required. He was clear this approach is not for everyone. However, his experience and the results have proven to him and his clients that clinical hypnosis provides an opportunity for an individual to perform differently. It helps students think about how to solve their problems.
More can be learned about his approach on his website: http://www.jefflazarusmd.com.