EDU Healthcare Blog
10 Ways to Help Your Grade-Schooler Manage Stress...October 6, 2017 8:18 AM
Grade school is full of challenges, especially for kids with learning and attention issues. Here are some tips to prevent your child from feeling stressed.
1. Help them figure out how their feeling.
Kids with learning and attention issues might not be aware that they’re feeling stress. Try to keep your questions low-key. Drawing together is a good way to get conversation flowing. Mention you’ve noticed something has been bothering her. Help her put a name on what it might be. “Are you feeling scared about reading out loud in Ms. Smith’s class?” Simply talking about feelings can be a relief.
2. Take homework apart.
A whole page of word problems can seem overwhelming, especially for kids with attention issues. Break the problems down into chunks—groups of three, for example. That can make the task more manageable. Promise fun breaks in between—she can FaceTime with a friend or take the guinea pig out to play. Praise her for each set she completes.
3. Help them prepare for new things.
If your child is going to start a new activity, such as karate, visit ahead of time. Let her meet the lady at the front desk, check out the bathroom, and see the dojo. Ask the teacher to describe what she’ll do the first day of class. If the new activity seems familiar, your child won’t feel nearly as much anxiety about participating.
4. Celebrate even the smallest victories.
Most kids feel some stress when facing a new challenge. But they eventually dive in because past success gives them confidence. Kids with learning and attention issues need that same motivation—but success is often harder to come by. Watch for opportunities to praise accomplishments. It could be as simple as finishing three word problems without getting up. Knowing what success feels like may help her feel less overwhelmed and panicked when facing bigger challenges.
5. Help them create a “can do” mantra.
Suggest phrases she can repeat when facing stressful situations. “I am not afraid to try” or “I can do this” are two good examples. These thoughts will crowd out negative talk (“I’m too stupid to do this!”) and repeating the words over and over can be soothing.
6. Make sure you have rituals and order at home.
Coming home to an organized place and rituals that stay the same can give your child security after a busy day at school. When possible, stick to a routine. Maybe it’s an afternoon snack, a walk with the dog, and then homework. On days with afterschool activities, try to have a regular routine too. Create some structure for weekends as well. Too much time without a schedule can make kids antsy.
7. Blow off steam!
Stress can build up like steam in a locomotive. Give your child plenty of opportunities to release some of the pressure. Make exercise a part of everyday life for her and the whole family. Sign up for a membership at your local Y and go together. Show her how to jump rope, sing out loud or dance to her favorite song between homework assignments.
8. Find balance with afterschool activities.
For the child who struggles in school, being good at something like karate can be a big boost. Afterschool activities also give structure to the afternoons and stress-busting release. But don’t go overboard or you’ll make your child's stress worse. Ease into activities carefully, and do your best to leave some days open.
9. Be clear and reasonable about what you expect.
You may simply want her to do the best she can on spelling tests. But she may think she has to get “100%.” Tell her what you actually expect—that will lessen her stress. Or, for example, you might want her to clean her room on her own. But is that big task realistic? She might need you to break it into steps or keep her company.
10. Consider outside help.
Find a class where your child can learn yoga, meditation or deep breathing. Mental health experts who specialize in treating children with learning and attention issues can also help with stress management skills.
Research Shows Full-time School Nurses Improve Student Healt...October 2, 2017 2:58 PM
Study shows full-time school nurses improve student health and learning
What happens when you put a full-time school nurse in a school that hasn’t had one before? What impact does the school nurse have on student health? On attendance? On academic achievement?
In late 2006, the Lucile Packard Foundation for Children’s Health and Lucile Packard Children’s Hospital at Stanford approached San Jose Unified School District in California with these same questions. They proposed partnering in a demonstration project to evaluate what really happens to children’s health and academic outcomes when there is a full-time school nurse at the school.
San Jose Unified already had a team of nurses who were each responsible for two to three sites within the district’s 40 schools, but the project grant—$2.65 million over five years—provided funds for two elementary schools and two middle schools in low-income communities to each have a full-time school nurse. The project also formally linked the full-time school nurses to a nurse practitioner. The nurse practitioner was hired specifically for this project and stationed at a school health clinic close to the four schools and operated by School Health Clinics of Santa Clara County, which serves as a medical home to children.
The project, which concluded last year, demonstrated what many teachers, principals, parents and school nurses know intuitively: a full-time school nurse can improve students’ health and academic performance.
Today, we’re excited to share some of this project’s most significant findings:
A full-time school nurse improves student health.
Students with access to a full-time school nurse are less likely to visit the emergency room. Parents whose children attend schools without a full-time school nurse reported twice as many emergency department visits for asthma as did those in schools with a full-time school nurse. (The numbers: 26.68 emergency department visits versus 15.15 emergency department visits per 1,000 students).
Students are more likely to visit an appropriate health care provider if they have a medical referral from the school nurse. By year four of the study, in schools with a full-time school nurse, 98 percent of students who were referred by a school nurse for a suspected vision deficit were evaluated by a vision specialist, compared to only 58 percent of students who received referrals in schools without a full-time school nurse.
A full-time school nurse improves student achievement.
Students are less likely to miss school due to illness when they have a full-time school nurse in their school. On average, students in schools with a full-time school nurse missed 3.03 days of school per year due to illness, while students in schools without a full-time school nurse missed 3.51 days per year due to illness. The reduction in absenteeism due to illness in the four demonstration schools was equal to a total savings of $48,518.62 in Average Daily Attendance (ADA) funding during the first two years of the project.
A full-time school nurse can help reduce the achievement gap that students with chronic health conditions face. By year three of the study, the academic achievement gap was eliminated between students with asthma and students reporting no chronic health conditions. Fifty percent of asthmatic students in the schools with full-time school nurses had significant gains in either their math or English-language arts scores.
Melinda Landau, manager of health and family support programs for San Jose Unified School District, has played a key role in this project from the start and we commend Melinda and her team for their successful work.
Just last month, Melinda presented at the launch of the National Collaborative on Education and Health to share the results of this project and highlighted the key role school nurses can play in meeting our country’s health and education goals.
We look forward to working with the collaborative to identify strategies for ensuring that more students across the country can realize the full benefits of having a full-time school nurse in their school.
Understanding Your Child’s Trouble With Social Skills...September 25, 2017 2:27 PM
At a Glance
- Issues with social skills can be a symptom of brain-based conditions like NVLD.
- Trouble with social skills includes difficulty with understanding communication that isn’t spoken.
- You can help your child build social skills.
Making friends and fitting in—it’s an important part of a child’s life. It can be challenging at times, too. But if connecting with others is a constant struggle for your child, it could be a sign of learning and attention issues.
There are a few issues that make it hard to have conversations and socialize. There’s one, however, that’s mainly known for impacting key social skills. That condition is called nonverbal learning disabilities (NVLD). Learn more about what might be behind your child’s trouble with social skills, and how you can help.
What You Might Be Seeing
Trouble with social skills may not be that obvious in early childhood, depending on the cause. Some kids with NVLD, for instance, don’t show signs until grade school or middle school. That’s when socializing becomes more complex. You might start noticing that your child doesn’t seem to get it when others look or sound annoyed. Or maybe he responds inappropriately in conversations.
What Can Cause Trouble With Social Skills
NVLD is a learning issue that primarily involves social skills. Other conditions can also make it hard for kids to interact, but for different reasons. Here are some of the causes of trouble with social skills.
Nonverbal learning disabilities: This brain-based condition makes it hard for kids to understand communication that isn’t spoken. Kids with NVLD tend to miss social cues. Those are the messages people send through body language, facial expressions and tone of voice. For instance, kids with NVLD might not understand that a classmate who is crossing her arms and looking away doesn’t want to talk.
Many kids with NVLD don’t get abstract concepts. They may have trouble reading between the lines. If someone says, “I’m so mad I could spit,” they may take it literally. NVLD often affects self-control skills like taking turns, letting others speak and keeping emotions in check. It can also cause problems with coordination and balance, along with math skills. Here are some of the main symptoms of NVLD that involve social skills:
- Talks too much
- Shares information in inappropriate ways
- Relies on adults to get information
- Doesn’t understand facial expressions
- Is overly literal and doesn’t get riddles and sarcasm
- Withdraws from conversations with peers
- Prefers talking to adults rather than other kids
The signs of NVLD can vary at different ages. What you see in a grade-schooler might not be the same in a middle-schooler or high-schooler.
Attention-deficit hyperactivity disorder (ADHD): The symptoms of ADHD can make it hard for kids to socialize. Kids with ADHD tend to have trouble with focus and impulse control. They may also be overactive. Here are some of the behaviors of ADHD that affect social skills:
- Has trouble taking turns
- Interrupts or blurts out answers
- Wants things immediately
- Doesn’t give others the chance to speak
- Is a poor listener and loses the point of what’s being said
- Gives up easily on tasks, even in group activities
- Constantly moves around and fidgets
The signs of ADHD can vary at different ages. Like with NVLD, what you see in a grade-schooler might not be the same in a middle-schooler or high-schooler.
Social communication disorder (SCD): Kids with SCD have issues with spoken language. Unlike those with NVLD or ADHD, they often don’t want to talk to people. Here are some symptoms of SCD that make it hard to connect with others:
- Has little interest in social interactions
- Goes off-topic or monopolizes conversations
- Doesn’t adapt language to different situations or people
- Doesn’t give background information when speaking to an unfamiliar person
- Doesn’t know how to properly greet people, request information or gain attention
- Is overly literal and doesn’t understand riddles and sarcasm
- Has trouble understanding nonverbal communication
- Has difficulty understanding things that aren't spelled out
The signs of SCD can vary at different ages.
These three conditions are separate, but a child can have more than one. Knowing what’s behind your child’s trouble with social skills can help you find the best help for his specific issues.
How to Get Answers
If your child is having trouble with social skills, finding out why is key to getting the best support. Observing and taking notes on your child’s behavior is a good place to start. That information will be helpful to the professionals who evaluate him. Getting to the bottom of your child’s issues may be a multi-step process. Here’s how to start.
- Talk to your child’s teacher. You know the social challenges you’re seeing at home. But the teacher can shed new light by sharing what’s happening in the classroom. Talking about your concerns and observations can lead to informal supports at school. For instance, the teacher might pair your child with kids who share similar interests or make sure to give him very clear instructions.
- Look into an educational evaluation. If you think your child’s social skills issues are caused by a learning or attention issue, you or your child’s teacher can request that the school evaluate him. If the school agrees, you won’t have to pay for it. Depending on the results, your child may be able to get services and supports to meet his needs. The school would commit to providing these services in writing, through a 504 plan or an IEP. But the choice to pursue an evaluation is totally yours.
- Talk to your child’s doctor. You can also start by talking to your child’s doctor. Together you can come up with a plan for finding out what’s causing your child’s trouble with social skills. The doctor may be able to rule out any medical problems. You may also get a referral to a speech therapist or learning specialist for testing.
- Talk to a specialist. Some pediatricians can check for ADHD. But a psychologist trained in learning and attention issues can check for both NVLD and ADHD. A speech therapist can identify SCD in your child. There are different types of tests and assessments for NVLD, ADHD and SCD. You will need to pay for any evaluations made by a private specialist.
- Talk to a learning specialist. This professional can evaluate your child for learning and attention issues using the same tests the school would use. But you will need to pay because it’s a private evaluation.
What You Can Do Now
No matter what’s behind your child’s trouble with social skills there are ways to help her get support, build social skills and gain confidence. Just knowing you’re there for her can make a big difference. Here are some things than can make things easier for your child and for you:
- Learn as much as you can. The more you know about your child’s specific social challenges the better able you’ll be to help.
- Observe and take notes. Noticing when and where your child has social difficulty can be a big help. Look for behavior patterns, so you can try different strategies to change them. Your notes will also be helpful when you’re talking to your child’s doctor, teacher or specialist.
- Do some role-playing. Act out social situations you know your child will be in. That might include playdates, parties and family gatherings. Practice things like taking turns, starting conversations and greeting people.
- Help your child meet other kids. Finding kids who share your child’s interests can make it easier for her to connect. Look for classes or clubs that focus on things she enjoys.
- Look into social skill building classes. Your school may offer them for free. Some private counselors with training in learning issues may also run programs for kids who struggle socially.
- Try different strategies. You may find useful tips and suggestions in Parenting Coach. Get advice on how to help your child with making friends and improving social skills.
- Connect with other parents. Although it may feel like you’re the only family dealing with social skills issues, you’re not. Talk to parents in similar situations and share insights and strategies.
Kids with issues that impact social skills don’t usually outgrow them. But with your help your child can learn strategies to have better social interactions. Every success she has can build her self-esteem and motivate her to keep working at it.
Creating Good Practices...September 19, 2017 11:28 AM
The following general strategies are intended to help all children improve their organizational skills, work habits, and overall production.
- Use assignment books.
Teach children to use assignment books and “To Do” lists to keep track of their short- and long-term assignments, tests, and quizzes. Use resources provided by the school —a “homework hotline” on voicemail or homework posted on the school Web site, for example— could help you support a student who does not yet consistently record assignments.
- Provide models of assignments and criteria for success.
Give children a clear sense of how a final product might look by showing examples —perhaps samples of work from previous years (obtained from the teacher) to illustrate specific qualities of the work— and by sharing exemplary products. Do not, however, compare children’s work with that of peers or siblings.
- Build in planning time.
Parents can talk with teachers about providing children with five minutes of planning time before beginning an assignment. Both can also provide guidance in effective planning when necessary.
- Prioritize assignments.
Help students prioritize their assignments according to level of importance, difficulty, or due date.
- Use step-by-step approaches.
Require children to break down tasks into parts, write down the steps or stages, and compile steps of frequent tasks into a notebook for easy reference. For long-term assignments, provide a due date for each step of the assignment.
- Stress the importance and positive impact of organization and preplanning on completed projects or assignments.
Have children preview an assignment, collect the materials they will need before starting one, and keep their materials and notebooks organized and easily accessible. In middle and high school, conduct intermittent “notebook checks” and, if necessary, suggest ways to improve organization.
- Provide opportunities for children to review their assignments before turning them in.
Parents can ask teachers to build in a due date that is one day before an assignment is actually due and should use this time to review the child’s work and check it with an adult. This will give the children enough perspective to catch errors or add more details and to produce better work.
- Encourage self-evaluation.
Set a standard of work quality or criterion for success that children can follow and encourage them to self-assess the quality of their work before turning it in.
- Set goals and record progress.
Have children set a short-term goal —such as completing all homework for the week— and post a record of their daily progress in a visible place. Graphic recording, such as plotting their own line graphs, may be particularly reinforcing for some children.
- Practice estimating.
Because children benefit from estimating answers to math problems and science experiments, stress the real-life benefits of estimating and understanding what the correct answer might look like.
- Eliminate incentives for frenetic pacing.
To slow down children who work too quickly and speed up children who work too slowly, remove any positive reward for finishing first and state the amount of time a task should realistically take.
- Provide consistent feedback.
So children understand which behaviors, actions, or work products are acceptable and which are not, create a feedback system by using specifics to praise good work and recognize when children use strategies effectively. Say, for example, “I like the way you drew a table to help explain the problem” or “Asking to take a break really seemed to help you come back and focus.”
- Try a mentor/tutor.
Some children may benefit from a mentor who will work with them to analyze their academic progress, improve basic skills, brainstorm alternative strategies, and provide recognition of progress. The mentor/tutor must be seen as credible and may be an individual from either inside or outside the school.
- Celebrate progress.
Have children look back at past work and celebrate the progress they have made. Graph their weekly progress with them.
Parent Training and Education for ADHD...September 19, 2017 9:35 AM
Behavioral parent training programs have been used for many years and have been found to be very effective. Although many of the ideas and techniques taught in behavioral parent training are common sense parenting techniques, many parents need careful teaching and support to learn parenting skills and use them consistently. It can be very difficult for parents to learn behavior modification and implement an effective program just from books and websites on their own. Help from a professional is often necessary. The topics covered in a typical series of parent training sessions include the following:
- Establishing house rules, structure and consistent routines
- Learning to praise appropriate behaviors (praising good behavior at least five times as often as criticizing bad behavior) and ignoring mild inappropriate behaviors (choosing your battles)
- Using appropriate commands
- Using “when…then” contingencies (withdrawing rewards or privileges in response to inappropriate behavior)
- Planning ahead and working with children in public places
- Time out from positive reinforcement (using time outs as a consequence for inappropriate behavior)
- Daily charts and point/token systems with rewards and consequences
- School-home note system for rewarding behavior at school and tracking homework
Some families can learn these skills quickly in the course of 8–10 meetings, while other families—often those with the most severely affected children—require more time and energy.
Parenting sessions usually involve an instructional book or videotape on how to use behavioral management procedures with children. The first session is often devoted to an overview of the diagnosis, causes, nature and prognosis of ADHD. Next, parents learn a variety of techniques, which they may already be using at home but not as consistently or correctly as needed. Parents then go home and implement what they have learned in sessions during the week and return to the parenting session the following week to discuss progress, solve problems and learn a new technique.
Parent training can be conducted in groups or with individual families. Individual sessions often are implemented when a group is not available or when the family would benefit from a tailored approach that includes the child in sessions. This kind of treatment is called behavioral family therapy. The number of family therapy sessions varies depending on the severity of the problems.
When the child involved is a teenager, parent training is slightly different. Parents are taught behavioral techniques that are modified to be age-appropriate for adolescents. For example, time out is a consequence that is not effective with teenagers; instead, loss of privileges (such as having the car keys or cell phone taken away) or assignment of work chores would be more appropriate. After parents have learned these techniques, the parents and teenager typically meet with the therapist together to learn how to come up with solutions to problems on which they all agree. Parents negotiate for improvements in the teenager's target behaviors (such as better grades in school) in exchange for rewards that they can control (such as allowing the teenager to go out with friends). The give and take between parents and teenager in these sessions is necessary to motivate the teenager to work with the parents in making changes in his or her behavior.
Applying these skills with children and teens with ADHD takes a lot of hard work on the part of parents. However, the hard work pays off. Parents who master and consistently apply these skills will be rewarded with a child who behaves better and has a better relationship with parents and siblings.
As a parent, you will want to educate yourself about ADHD diagnosis, treatment and ways to manage it. CHADD offers a unique educational program to help parents and individuals navigate the challenges of ADHD across the lifespan. Information about CHADD’s “Parent to Parent” program can be found at Parent to Parent.
It is also important for parents of children with ADHD to learn to advocate for their children so that they can secure services for their children and ensure their success in all facets of life.