Mommy, my brain is hungry!

goldfish_crackers

Young kids tell you what they want. The iPad. Angry Birds. Skylanders and Lego Ninjago. American girl dolls and My Little Ponies.  A pop tart. A fruit rollup. Goldfish. Noodles with butter. Sound familiar?

If only they knew what their brains wanted to help regulate their physical and emotional states. Their pleas might then sound like this: “Mommy, my brain is hungry!  I gotta have some protein to focus. I need some avocado to think of something else before I hit my brother!”

 

The brain/nutrition link is elementary. The brain runs on neurotransmitters. Neurotransmitters are made from food, specifically protein. Neurotransmitters are carried on the superhighways between cells that are coated with fat. [Fat, you say? Good fats.] And sugars provide glucose for brain energy.  Complex carbohydrates supply sustained, long-lasting energy; simple, quick burning carbs only give rapid, short-lasting energy, leading to “zoom and crash.”

A parent might as well say,

“Blood sugar, go to your room!”

 

An after-school tantrum can reflect low blood sugar.  Classroom distraction can reflect inadequate intake of quality protein. Poor impulse control can reflect deficiencies and DHA and EPA.  I am no longer content to blame behavioral problems on “psychological” issues when the body may be the problem, or at least part of it. How silly that distinction even sounds… the distinction between mind and body is history.

Parents bring kids to psychologists to help change how their minds work … when it’s children’s bodies that often get them into trouble. The unspoken assumption is that the child mind can control his body, given the proper “tools.” But it’s more and more clear to me ~ we often have to help the body and brain first before I can do much with the mind.

Nothing is more proximal to your child ~ closer to his interior being ~ than what’s in his cells at any given moment.  

… closer than your hug, your touch, your loving words or threatened punishment … closer than therapy interventions. 

 

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Knowing children’s brains are hungry, I now routinely recommend a nutritional consultation at the commencement of care.  Sometimes, I advise parents at the intake to return in 30 days after  implementing nutritional changes.  No longer can I accept parents’ money and take their time if I believe a child’s body needs help before her mind can respond. How would I know this?


Over the past 4 years of my practice, my referrals for child psychiatry consults have plummeted.
 Why? Because parents are trying nutrition first with profound results. Many kids accept new food routines and even request specific foods at key times. They quickly recognize how different ~ and better ~ they feel.  These children actually start to say, “Mom, I need some protein…” My colleague Jan Katzen, former Montessori teacher and Certified Nutritionist, often says, “I have yet to meet a brain that does not respond to better nutrition.”  Jan is one of my most valued referral sources. Learn more about her at http://www.NutritionforLearning.com.


Do I lose business with all my nutrition referrals?
 
 Sort of! Some kids improve by eating differently and no longer need my services.  But more often, kids come back after a nutritional boost. Then therapy is more efficient and effective. That’s because a child’s brain chemistry and blood sugar is working with me.


Findable, affordable foods could potentially transform your child’s brain and body from dysregulation to balance.
 
Changing the timing and composition of snacks and meals can make all the difference. Canned black beans, apples with almond butter, stone-ground tortillas, walnuts and cage free eggs can turn around brains and behavior. Not being a nutritionist, I’ll stop there and leave it to the experts.  Picky eater?  Nutritionists of often have sneaky ideas for helping gradually change your child’s palate.


Does changing your child’s diet take some time and money? Yes. So does therapy. Try one, and you may not need the other.

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Child nutrition a module in Dr. Onufrak’s ChildSightTools® parent seminar series, delivered live in small-groups through out the year in her Phoenix, AZ office.
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The Summer Before Kindergarten

Your child is “so excited” to start Kindergarten ~ so what’s with this clinginess, baby talk and tantrums of the past?

“He visited his new school and totally LOVES it.”

“She’s really trying to read! 

“He CANNOT WAIT to go to big-kid school.” 

With evidence like that, no wonder you are shaking your head. What are these sudden, summer tantrums over “nothing?” Clinginess like two-year old days? Baby talk that’s driving you bananas?

Your child could be feeling ambivalence about kindergarten. Let’s get our magic 8 ball.  Your child’s predominant statements may indicate “signs point to yes.”  But your child’s regressive behavior may invite you to “concentrate and ask again.”

Ever had two feelings at the same time?  Of course you have ~ it’s part of the human emotional condition. Love to go on vacation, dread the long drive.  Want that new phone, but ugh, the learning curve. How easy it is for us, however, to forget this basic tenet when it comes to kids. Children can have more than one feeling at a time. But they don’t know this fact and are confused by multiple feelings themselves. Their mouths may say one thing, but their bodies act out another. Everyone is confused.

For every independence striving, there is anxiety.

“I want to … but will I be able UofR Rush Rhees libraryto?”  The little 5-year-old, having left the familiar safe rooms of a preschool she’s attended for up to three years, is indeed excited. And scared to death. The thought of the new grade can feel as intimidating as towering university columns.

Just because he saw the campus and classroom, adores his new teacher and has a couple of good buddies there … change is hard. And young ones do not have a long remember-able history of managing changes that turned out okay.

“Kindergarten-me” was terrified about grown-up words. Adults read me engaging storybooks featuring a recurring word: “particularly.” Spoken with eloquence and inflection. Made me shiver. How in the world would I ever be able to pronounce that word? Growing up clearly required it. Maybe staying little was the answer. “Beth, pay attention,” said the teacher, unaware of my paralyzing angst. Your little one could be harboring silent worries like this. Memories such as these flowered my path to becoming a child psychologist.

So, how to manage regressive behavior in the summer before Kindergarten?  

  • Park your logical brain.  It will only stall your efforts to look through your child’s eyes.  One feeling stated is one feeling stated.  There can be additional feelings too, that are contradictory.

  • Take a little walk back in time.  How did YOU feel the summer high school ended? No matter what your plans ~ college, work, or “no idea” ~ you likely had nostalgia for the place and life-stage you were leaving, and anxiety about what lay ahead.

  • Think to yourself:  Ending preschool is like being a senior ... looking ahead to the future.  Seeing the younger students, feeling older, knowing you are leaving. Heck, we give preschoolers caps and tassels now in in mock graduation ceremonies. Not so make-believe.

  • Notice and ask:  Talk to your child ~ “I know you’re feeling excited about Kindergarten.  Do you know people can have more than one feeling at the same time? I wonder what other feelings you might have.”  Validate and accept the feelings – don’t dismiss or whisk them away. Normalize and give reassurance that adults will be there to help, every step of the way.

  • Draw a feelings heart.  Get a bunch of markers, outline a heart, and color it in with  patches of color ~ each representing a feeling and its relative momentary “size.” Draw your own heart first, choosing colors to stand for feelings you have right now: tired, sad, excited, worried.  Invite your child to draw his or her own.  Don’t worry about percentages or doubles (same feeling represented twice) ~ rather than a pie chart, it’s a feelings-identification exercise.

“Child-Sight” can help you through this developmental transition.  Child-Sight is a process I teach parents ~ to look through their child’s eyes, informed by child development secrets and brain function facts.  Simply recognizing your child may have multiple feelings about Kindergarten is the beginning of Child-Sight. It’s an eye-opening pair of glasses that helps you change your view and what you think, say & do.

Try using Child-Sight on your ambivalent Kindergartener!  Watch the regressive behaviors fade away as they begin to step into the Big Kid Shoes at their feet.

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The Child-Sight Treatment Model is Dr. Onufrak’s integrated program of child therapy, blending cognitive-behavioral play therapy with her Parent Toolbox of strategic support solutions.  

What’s Wrong with “Wh” Questions? 5 Things and The 5-Word Fix

 

Your child is falling apart. Another volcanic meltdown, drowning in a tsunami of tears, siren-like screams. If you knew what specifically was wrong, you’d know what specifically could help. So you resort to the strategy that helps you the most in adult life:  specific questions.

what-why-how2What are you upset about?
What happened?
When did this happen?
Where were you?
Why are you so upset?
How did this happen?

Who? What? When? Where? Why? How?
Wh-wh-wh …

It truly is unfair that the style of inquiry that helps us function in the adult world incapacitates us when trying to help a young child.  Specific questions can even prolong and impede the process, while emotions spiral further out of control like a tornado on the plains.   Why? (oops!)

In 20 years of being a child psychologist, and the years of training before, I learned the cardinal lesson: “Wh” questions shut a child up faster then you can say ice cream sandwich.

 “Wh” questions can be unhelpful, even anti-helpful, because they:
    1. Shut down a child’s own narration and conception of the problem
    2. Block a child’s sharing of the salient details to him
    3. Pigeonhole a child’s thinking into your categories of thought
    4. Build a child’s frustration with us adults
    5. Make a child more upset from the communication gap

May I suggest an alternative ~ my 5-word Fix: “Tell me all about it.” It may sound similar to asking …  but this approach to inquiry is completely different. How so?

Consider the last time your computer displayed a cryptic, terrifying error message before going blank, toying with your life. In consultation with the  IT person, it may be very hard for you to explain the problem.  The IT person might ask you specific “wh” questions, such as: What did the error message say?  What were you doing right before this happened? What gobbledygook thingy is your thingamajig?

But you’re upset and you don’t have computer language. It may be doggone difficult to answer those “wh” questions. You might even grow more frustrated in this process. You might wish the IT person would simply say, “Tell me all about it.”  At that point, you could begin with the language you have to describe the problem at the level you are capable of.

When a child hears “Tell me all about it,”  it feels like “Just give it to me, however it’s going through your head right now, with whatever words you got … and I will just listen.”

“Tell me all about it” also opens up your child to tell you a detail you’d NEVER have asked for.  Because you couldn’t have thought of that.  Because you’re weren’t there … and you’re an adult.

haystack
Relying on “wh” questions in a meltdown is like trying to find a specific needle in your child’s haystack.  It’s like asking, repeatedly:   Is this the needle? Is this the needle?  Is THIS the needle? You would get infinitely farther, infinitely faster by just saying “Tell me about this haystack you got here.”

Naturally, you have to ask “wh” questions at some point. Probably several, to get the clarity you need. But starting out with nine “wh” questions will create more problems than progress.  “Tell me all about it” may be the most productive start.

You can add “I’m so sorry you’re so upset.”  When you’re lost, interject, “Help me understand; tell me some more about this, honey.” (Hint:  forget about solving this problem right now; her brain needs empathy too cool the limbic system down.) 

“Wh” questions are like putting your hand on a specific door knob and asking, “Is it this door?” Saying, “Tell me all about it” opens doors you didn’t even know were there.  Try it and you will see.

Parents: Why a Workshop?


question marksSo, you’ve been concerned about your young child
for quite some time. You’re not sure if you need a child psychologist … maybe, maybe not. Starting therapy is not like signing him up for soccer! It’s a larger decision. Some friends say get help now; others say, “it’s just a phase.” You and your spouse may not even be on the same page about your child.

A few new good ideas would be soooo nice. So you read articles, blogs, posts, tweets … but none seem to address the specific issues in your life with your child. You’d love specific parenting advice, some face-time with an expert, and the support of other struggling parents like you. A safe place where you wouldn’t have to worry about judgment. And it would be great to “test drive” a therapist before signing up for care.

That’s when a workshop may be “just what the doctor ordered.”

people link

Workshops are one of my favorite clinical activities. For one, I can talk with grownups and don’t have to sit criss-cross applesauce on the carpet! More importantly, they serves my deep need to help more than one child per hour. Workshops serve my growing drive to get basic, customized, high-quality information to parents of young kids in a cost-effective format.

And these days, cost-effective things are more needed than ever! Workshops extend child psychology services in an affordable, comfortable, helpful way so people don’t have to forestall something this important. That being, helping your child connect, cope, and thrive.

For many years – 13 to be exact – I resisted the notion of holding parent workshops. How could I ever help children I’ve never met … especially when each child is so unique? Then it hit me. Week after week, along with the customized advice I dispense, a set of core principles and “prescriptions” kept coming in handy.

For any given child & family, about 50% of my interventions are singular and customized; the other 50% come from foundational elements of pediatric mental health & balanced parenting. These common elements are pervasively, predictably helpful across a wide range of diagnostic conditions, family circumstances and child problems. From these elements, the content of my Parent Workshops was born.

In the hot Phoenix summer of 2013, I launched my first workshops. Feedback from the initial sessions revealed what parents really need. In addition to facts, approaches & strategies, they craved something else as well. They needed the opportunity to …

    • step away from their busy lives
    • reflect deeply about their children
    • absorb new ideas while out of the house, and
    • receive laughs, tissues & high-fives from other parents.

Workshop attendees found encouragement through another week of tantrums. And cheers after sharing a breakthrough. Some of the best moments occurred as I listened in the circle. And whadya know … I actually helped children I had never even met. Several, in fact, in a few hours time. As Mr. Rogers used to sing, “It’s such a good feeling …”

Workshops resume next month.
Dr-copy.Beth-Kite-Story-3-PRINTSavvy Solutions for Your Challenging Young Child will run Wed. nites, March 5th thru April 2nd and Thurs. mornings, March 6th thru April 3rd.

Workshops in development include: My Child & Me and ADHD and You & Your Anxious Child.

For details and registration, visit the Workshops tab on my website at DrBethKids.com. If you’re a Phoenix local in the Valley of the Sun, take a look or tell a friend. If you live elsewhere, look into parent workshops near you – for facts and friendship, solutions and support.


“You’re Taking Your Child to a Shrink?”

You’ve wondered and waited ~ with your worries and wishes.  You’ve hoped this was “just a phase” in your young child’s life. Time after time, you’ve reassured yourself, “He’ll outgrow this; he’s young” or “she has so much time.”  In talks with your partner, you’ve raised your concerns … and talked yourself out of them as the weeks and months (or years) passed. There have been periods when he blossomed and was doing just fine. Times when those problems seemed far behind her.

Then the difficult days return … An event occurs, a moment arrives when it’s all too clear – you cannot manage this yourself. You are out of ideas. You begin to ask around, look online, make some calls. Make an appointment with dread and hope, shaky nerves and eager heart. Nearly every parent who seeks child treatment describes these phases. Now that you’ve made that call, you wonder what (or whether) to tell family & friends. The reactions of others can be a gnawing concern:

what

“I’m not even mentioning this to my mother, she’d have a cow.”

“I can just hear my dad now … ‘MY grandson is not crazy!’ ”  

“We’re not telling our friends, they wouldn’t get it – she’s an angel at other people’s houses.”  

You are not alone if this story sounds like yours. In fact, you are entirely typical. You may feel wary of following your plan while anticipating disapproval from others. It is hard to seek outside help. So hard that many families put it off a little longer. A good number of parents arrive moist-eyed and shake my hand confessing, “We should have been here two years ago. We knew things were getting bad, but we just weren’t ready.”  

How do you know when it’s time?  The following benchmarks may tell you: When you have tried countless strategies, but the problem keeps worsening; when you’re starting to worry about the safety of your child and those she plays with;  when the problem is hampering friendships, school, and family life; when your child doesn’t seem to enjoy “being a child;” when there are more “bad” days than good and his or her self-esteem appears to be suffering.

How do you select a child mental health provider? At local community mental health centers, staff assign a therapist to match your needs.  If you select a health insurance provider or elect to private pay, your choice will be more personalized.

checklist

    • Ask trusted people.  You’d be surprised how many parents have struggled behind the scenes just like you. Many have a favorite provider they count upon.
    • Look online.  More and more providers have websites and social media presence.  How do they describe their practices? Check out their Facebook business page posts. What do they Tweet?  How do you like  their material?
    • Call for an initial inquiry.  Do you feel comfortable interacting with the office staff?
    • Understand medication vs. therapy.  Medication is prescribed by psychiatrists, physicians & nurse practitioners. Therapy is provided by psychologists, counselors, & social workers
    • Ask if a parent-only intake is possible.  Not all providers can offer this. However, such an intake allows coverage of sensitive topics you don’t wish to discuss in front of your child.

O.K., so you’ve made an appointment. Or you’ve begun the process and feel ready to tell people.What do you say?  I offer these suggestions:

We’ve found a provider who specializes in young children.

We need “new ideas” to address a big problem that just isn’t going away.  

We want to help our child now before the problem grows so we can have “better days” together. 

After meeting your therapist, assess how you feel. Provider-family “fit” is very important! But a degree of unease is natural until you all settle in. Be open to sharing information. Providers cannot truly help your child or family without the “full picture.” Know that any personal information you share is entirely in service of your child. Also, be ready to change yourself! Providers help young children by giving their grown-ups “new ideas.”

Seeking help for your young child is a step of courage.  And it can make a world of difference! Intervention with young children sweeps stones off the path of development before they become boulders. Begin early so the only thing weighing upon his young shoulders is sunshine. happy20sun


Big Upsets? The Three C’s of Calming Down

I have a child in mind … crying and wailing, stomping and screaming. How can we help young ones calm down? The secret lies with us.  Grown-ups’ reactions can determine the course of a meltdown. The ball is largely in our court.

It doesn’t really seem fair … child meltdowns inconvenience the adult agenda, right?  Then why must the adult orchestrate the calm-down? Many parents bring children to therapy to acquire emotional “tools.”  But equipping the child is only half the work.

Within the child, a meltdown is a cataclysmic force.  Like a “volcano tsunami,” an articulate 2nd-grader explained. (Now that he has such words!)  Reasoning goes off-line like the internet in a downpour.  Parents say: “There’s no talking to her when she gets like that.”   “He gets this glazed look and I can’t reach him.”  If parental agitation escalates, the child perceives a Grand Canyon-sized gulf between one’s anguished self and the adult whose help he needs.

In the young years, calming down is a two-player game.  Adult frustration can generate auto-responses, such as “Quit acting like a baby,” or “Stop it, you are just fine!  But telling a distressed child she’s “fine” is like ordering rain back up into the clouds. Calming down is a complex, full-body skill to be learned.  And no one can be embarrassed or disciplined into a learning a new skill.

To assist parents, I created a quick, portable tool: THE THREE C’s for Helping a Child Calm Down.  The work of two psychology heroes of mine, Drs. Dan Siegel and Becky Bailey (see below), inspires this approach.

  1. CONNECT with your child through empathy. Stand in her shoes. Describe your compassionate grasp of her feelings  (“Oh, this is so hard for you / You really wanted that …”).  Don’t know what’s wrong? Say, “Ohh, tell me all about it.” Empathy calms the brain’s limbic system enabling the cortex to problem solve.  This is Step One, because nothing positive can happen until your child feels “felt” by you.   The Message: “I notice and care about your feelings.”
  2. COOL DOWN yourself first (count to 10, say a mantra “we can do this”), then cool down your child.  Guide and join him in body-calming strategies – watch his reactions and adjust your moves (hug him, stroke his back, say “Let’s breathe together,” “Let’s shake out our hands …”)  The Message: “We can cool you down together – I’m with you.”
  3. COACH your child in a guiding spirit.  Start the ball rolling, point her in the right direction, let her carry the ball across the finish line.  Think of yourself as a sports coach instructing others’ children – teaching a skill.  The Message: “Together we can get through this moment.”  Coaching may look like:
    • “You be the picker – this arm first, or that one” [through a sleeve]
    • Let’s give your brain a break for a minute, and think about something happy – like HoneyBear”
    • “I  wonder if you try that [puzzle] piece over in this area …”

While not a panacea, the Three C’s form a component of my interventions across a wide diversity of child conditions, including ones that bring severe impairment.  Try the Three C’s – your child’s meltdowns may have a lot less lava!

Literature of interestParenting From the Inside Out – Daniel Siegel & Mary Hartzell / Easy to Love, Difficult to Discipline – Becky Bailey.

#parenting #child #meltdowns