The Ethics of It:
As Applied Behavior Analysis (ABA) professionals, and as a commitment to the clients we serve, we are required to follow the ethical code for behavior analysts. In the section of the Ethics Code for Behavior Analysts referred to as “Responsibility in Practice” behavior analyst are required to collaborate with colleagues as outlined in Section 2.10:
“Behavior analysts collaborate with colleagues from their own and other professions in the best interest of clients and stakeholders. Behavior analysts address conflicts by compromising when possible and always prioritizing the best interest of the client. Behavior analysts document all actions taken in these circumstances and their eventual outcomes.”
Behavior analysts are required to obtain informed consent to arrange appropriate consultation with referrals, and operate in accordance with all requirements including, but not limited to regulations, laws, and funder policies (Section 3.06: Consulting with Other Providers).
Collaboration with colleagues is an integral and necessary part of clinical practice, and time should be allotted for effective collaboration. One method to establish effective collaboration is by creating opportunities to collaborate from the outset–this can be achieved by including colleagues in the initial assessment process.
Initial Assessment:
When conducting an initial assessment with a new client, the initial assessment is typically comprehensive, and includes direct observations of the client in their natural environment; preference assessments; the utilization of formal assessment protocols; parent interviews; and data collection pertaining to possible behaviors targeted to be decreased. In designing their initial assessment process, behavior analysts should seek to collaborate with school personnel to understand some of the strengths and interests of the learner. For example, a paraprofessional may have insight into items that can be incorporated into a preference assessment for a learner. In including other professionals in the initial assessment process, one can not only gain valuable information about the client, one can also build a professional relationship from the outset, and potentially create a foundation to be able to address (possible) future disagreements in a cordial manner.
Open Lines:
Effective, thoughtful and empathetic communication is essential to building meaningful collaborative relationships. Indeed, communication should be initiated when challenging behaviors arise and when clients are performing well. Collaboration shouldn’t only occur in times of difficulty–it should occur when progress is directly observed, and planned long or short-term objectives are met. In this sense, maintaining open lines of communication means collaboration can be enduring, authentic and positive. In my own experience of managing more complex cases, proactively securing consent to connect with school-based behavior analysts has helped to facilitate the functional behavioral assessment process, increase the effectiveness of data collection procedures, and ensure continuity of skill acquisition goals.
Managing Disagreements:
How one communicates in disagreements is equally as important as what one communicates during disagreements. Disagreements should be approached from the perspective of mutual respect and intention to understand. We can demonstrate mutual respect by actively listening through nonverbal and verbal communication—leaning towards the speaker, nodding our head, and even taking notes are outward behavioral signs that one is engaged with the speaker. We can practice active listening even in moments when we may disagree. In addition, mutual respect involves recognizing that one is working within their discipline, and attempting to tackle problems from the perspective of their discipline, and this commitment to helping the learner should be respected even if there is disagreement. I have practiced active listening in virtual meetings with related service providers whose nonverbal communication has indicated their disagreement with my approach. In allowing other providers space and time to articulate their point, even when there is visible disagreement, I’ve created effective opportunities for collaboration.
On-Site Visits:
With the onset of the pandemic, many collaborative opportunities have moved to a virtual mode; however, one should consider scheduling onsite visits and in-person meetings. Such meetings not only provide an authentic context for communication, they simultaneously offer opportunities to observe the learner in a different environment to program for the generalization of skills. For example, the behavior analyst who works with a learner who also attends a Saturday program at a sensory gym under the supervision of an occupational therapist, may not only gain insight into the learner’s behavior in a different context, they may also have the chance to display mutual respect, and active listening during a pre-scheduled meeting with the occupational therapist.
Mode & Flexibility:
Importantly, in-person meetings may not always be the preferred or available mode of collaboration. Time constraints and commute times may make regular in-person meetings difficult to schedule. One must decide on a mode or multiple modes of collaboration that are effective. Some providers may prefer to meet via a video call or in person. It’s important to establish modes of collaboration and times of day that work in order to schedule meetings for all parties involved. With the intention of resolving and/or preventing disagreements, behavior analysts can see advantages in flexible scheduling with collaborators. I’ve seen the benefits of exhibiting flexible scheduling particularly in collaborating with school-based staff whose schedules might be busy with larger caseloads, and faculty meetings–in scheduling meetings that are convenient for collaborators, I’ve been able to build connections, and open lines of communication, which would otherwise have not occurred.
Word Choice:
When communicating, behavior analysts should refrain from the utilization of behavior analytic terminology, which could serve as a barrier to effective collaboration. Such terminology may be confusing to a professional who is unfamiliar with the science of ABA. Not everyone is familiar with how to label different components of verbal behavior. Further, it is within our scope of practice to communicate in a way that helps the listener understand, and therefore able to implement our recommendations.
In summary, it is necessary to collaborate with providers, teachers, and healthcare professionals who may not be familiar with ABA–we must obtain informed consent prior to doing so. While we have a commitment to practicing ABA rooted in evidenced-based techniques, we should also adopt methods to facilitate ongoing collaboration and resolution of disagreements while centering the individual needs of the client.
References:
Behavior Analyst Certification Board (2020) Ethics Code for Behavior Analysts https://www.bacb.com/wp-content/uploads/2022/01/Ethics-Code-for-Behavior-Analysts-230119-a.pdf
When we consider supporting autistic individuals in finding jobs, first “why” questions emerge from a psychological perspective. Why do autistic people experience the highest rates of unemployment for all disabled groups? And why do autistic individuals struggle to find employment?
I want to review <strong>How</strong> can we support autistic individuals to find jobs and <strong>What</strong> action steps can we take to provide that support. I feel inspired to support autistic individuals who are in pursuit of employment, and I hope you will be, as well.
A simple way to conceptualize how to support autistic individuals to find jobs involves (a) to provide job coaching (see Tips for a Mind-Centered Pathway) and (b) to take a person-centered approach (see Tips for a Heart-Centered Pathway). We invite you to and recommend engaging in both of these pathways simultaneously!
What is the objective of Applied Behavior Analysis (ABA) when treating neurodiverse individuals? At Manhattan Psychology Group (MPG), providers in the field of psychology, behavior analysis, and education share a vision that the purpose of therapy is to equip our learners with the tools they need to navigate life’s challenges and to achieve personal growth. Treatment should be individualized and designed to incorporate the specific desires of the individual receiving therapy, making space for each individual to gain access to joys of life that may be unique to them. We should celebrate everyone’s differences, and create a therapeutic environment where individuals and their families feel safe and supported.
Typically when therapists suggest parent training, this feedback is sometimes not received well by parents or caregivers – especially if the initial request was individual treatment for their child. So, why is parent training recommended for families who are dealing with their child’s disruptive behaviors at home? And what does parent training really mean?
The Connection Between the Anxiety and Autism Spectrum Disorder
Anxiety is one of the most prevalent mental health disorders in the United States. The National Institute of Mental Health estimates that roughly 32% of adolescents have or have had an anxiety disorder, and approximately 19% of adults have had an anxiety disorder in the past year, with rates higher in females than males. What is more, an estimated 31.1% of adults will experience an anxiety disorder at some time in their lives. Rates of Autism Spectrum Disorder (ASD) have also spiked in the last 20 years as reported by the Center for Disease Control. In 2002, rates of Autism were thought to be 1 in 150 children. By 2018, 1 in 44 children were suspected to fit the criteria for an ASD diagnosis. So how and when do these disorders intersect, and in cases of comorbidity, what can parents look for or expect? In order to better understand, we need to look at what each condition is.
What is Anxiety?
The Diagnostic and Statistical Manual (DSM-5) defines anxiety as “excessive worry and apprehensive expectations, occurring more days than not for at least 6 months, about a number of events or activities, such as work or school performance”. We all experience anxiety occasionally, but to meet the criteria of having an anxiety disorder, these anxious thoughts interfere with daily activities like schoolwork and relationships. There are different types of anxiety disorders ranging from Generalized Anxiety Disorder, to Post Traumatic Stress Disorder, Social Anxiety Disorder, Panic Disorder and more. It is common for anxiety disorders to co-occur with other disorders such as ADHD, depression, and eating disorders. The Autism Research Agency reports that Anxiety is also reported at much higher rates for people with ASD, with half of autistic adults also meeting criteria for an anxiety disorder. Steensel et. Al. (2011) found that 40% of autistic children experience a comorbid anxiety disorder.
What is Autism Spectrum Disorder?
According to the DSM-5, ASD is an extremely broad diagnosis that encompasses a wide array of children who have persistent deficits in social communication, social interaction, and restricted, repetitive patterns of behavior, interests, or activities. ASD may or may not be accompanied with intellectual impairment, medical, genetic, or environmental factors. Severity ranges from “Requiring support” (Level 1) to “Requiring very substantial support” (level 3).
Explaining Co-Morbidity
Why would individuals who meet criteria for an ASD diagnosis be more likely to fit criteria for an anxiety disorder? Our world is not designed with the function and comfort of neurodivergent individuals in mind. It is not surprising that trying to function in an environment that is not designed with one in mind would lead to stress or anxiety. This question is still being researched but from my own professional experience I have observed several phenomena:
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- Individuals with ASD are more likely to be inflexible or have rigidities. When they may not be able to have their need for rigidity met, and know this to be the case, anxiety is a natural response.
- Individuals with ASD are likely to have a different sensory experience than a “neurotypical” person. Things like sounds can be physically painful to them. Anticipation of possible pain is a reasonable cause for anxiety.
- Social situations are not intuitive for many individuals with ASD. It is common for people with ASD to know that they are not meeting social expectations without knowing what they should be doing differently. This is another cause for anxiety.
- It is not unusual for individuals on the Autism Spectrum to struggle with communicating their needs effectively. Being unsure that one’s needs will be met or understood is a reasonable cause for anxiety.
- Some individuals with ASD have been taught to “mask”. Another way of describing this phenomenon is these individuals have been persistently and consistently taught that behaving in a way that is counter to what they naturally enjoy or experience is the only way to access preferred stimuli or social acceptance. Constantly suppressing the behaviors that feel right to these individuals creates stress and anxiety.
How do you recognize if a neurodivergent child is experiencing anxiety?
Just like anxiety that is not accompanied by a comorbid diagnosis, presentation can look a little different for everyone. Sometimes the anxiety is obvious—your child’s breathing and heart rate may elevate, they may hide, say “I’m scared”, verbalize what their anxiety feels like and is happening around, or do something else to make it easy for parents to identify. Other times, it’s not so obvious. Anxiety can often look like avoidance or a lack of interest in the activity that is generating anxiety for someone who falls on the Autism Spectrum. In my practice, I have frequently seen anxiety in children on the spectrum look like anger, or a temper tantrum. When children are asked to participate in an activity that makes them anxious, they may not have the language or self-awareness to describe that emotion as anxiety. This can lead to children genuinely feeling angry that someone is trying to make them participate in an activity that makes them anxious, and mask the anxiety, which can be confusing and frustrating for parents. Seeking to control things is another common way anxiety can be expressed. Children may act out and behave in ways they know to be inappropriate to escape a situation that is creating anxiety.
Anxiety for children with Autism Spectrum Disorder is normal. If you think your child could benefit from some help recognizing and addressing their feelings of anxiety, please feel free to contact us. We would love to help you!
References:
https://adaa.org/understanding-anxiety/facts-statistics
There are many signs that your child may benefit from psychological counseling or therapy. Some of these warning signs include: persistent and pervasive sadness or feelings of hopelessness, disproportionate reactive behavior including extreme anger, behavioral challenges at home and in school, persistent irrational worry or fear, sudden changes in mood, sleep irregularities, and difficulty accomplishing previously mastered day to day tasks. The signs of mental health concerns vary from child to child and it is always beneficial to consult with a psychologist, who will suggest the best course of treatment. It is critical for the psychologist to maintain open communication with families to determine progress and alignment on therapeutic goals. During this time, the psychologist and family may agree that a higher intensity of intervention and support is required, which leads to the question of alternative treatment. When consulting with your support team it is important be aware of all the treatments available that may assist in managing symptoms and challenging behavior. The following is a list of examples and explanations of intensive treatments that are available beyond individual therapy.
1. In home parenting support
Parent Management Training (PMT) encompasses psychoeducation regarding behavior and behavioral functions, as well as targeted work on the development and maintenance of parenting skills. At times, there is a disconnect between parenting work done in office and skill implementation at home. When this happens, a more intensive approach to parenting support may be indicated. This includes the psychologist or behavior analyst coming to your home during challenging moments and providing coaching based on skills learned in session. In home parenting support can vary in degree and intensity. Typically, a psychologist will start with multiple sessions per week at different times of day to establish rules, routines and expectations before beginning to fade out. For example, if evening routine (including homework, bath and bed) is consistently difficult the therapist will come to your home to provide support during these hours. This intervention is designed for parents to feel supported and empowered in the home environment.
2. Specialized school or school shadow
At times, a child requires intensive daily intervention that a mainstream school cannot support. Depending on the specific need, a psychologist may recommend a more supportive school environment or the introduction of a school shadow. A specialized school placement may include the following: increased therapeutic support (psychologists on staff), increased behavioral support (behavior analysts on staff), smaller student to teacher ratio, differentiated learning for children with learning differences, as well as social skills groups.
In other situations, a child may need some additional support in their school in order to meet expectations. During these times, the support team may recommend either a part time or full-time shadow. A behavioral shadow works under the supervision of a psychologist or behavior analyst and implements the behavior plan that has been developed. This individual has training in behavioral support and communicates daily with the supervising clinician as well as the family. The psychologist will meet regularly with the school as well as parents in order to track progress and make changes as needed.
Some families also consider the possibility of residential support programs. These schools encompass all areas of psychological and behavioral treatment, while also fostering independent living skills. At times, there is also a focus on vocational skill development. The duration of these supports varies child to child. If you are considering a specialized school placement for your child, a complete neuropsychological evaluation as well as meeting with an educational consultant is recommended.
3. Medication management –
Research tells us that evidence based therapies, including Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are indicated in the treatment of many psychological disorders. Sometimes; however, these therapies work best in conjunction with the support of medication. Specifically, medication may help support your child in better accessing therapeutic support and increase motivation to engage in sessions. If the intensity of symptoms does not progress with therapy alone, your child’s psychologist may suggest consultation with a psychiatrist. Furthermore, if your child presents with severe symptoms during an intake appointment, the psychologist may immediately recommend consultation with a psychiatrist in order to jump start progress. Psychiatrists and psychologists often work in conjunction to best support the psychological well-being of their patients.
4. ABA or intensified behavioral support at home or in the community
Challenging behavior can be a large impediment to day to day functioning for children and their families. While Applied Behavior Analysis (ABA) is commonly considered a support for children with Autism Spectrum Disorder (ASD), it has benefits that extend far beyond the ASD community. ABA is an intensive treatment delivered multiple times per week in various settings. The ABA therapist will work with you as well as any caregivers in developing a treatment plan as well as maintaining integrity and consistency in the intervention. Depending on individual need, ABA therapists can also provide support during playdates, after school activities, as well as during summer camp programs. ABA is data driven, meaning all therapists working with your family will be specifically tracking the frequency, intensity and duration of all targeted behaviors. As specific treatment goals are met the intensity of the therapy may start to decrease. ABA therapists often work in conjunction with other disciplines as well in order to ensure consistency across environments. ABA is indicated if behavioral concerns span settings (home, school, etc.) as well as caregivers.
When considering all available options, it is always best to maintain open and consistent communication with your child’s therapist, as well as any other members of the treatment team (school based professionals, speech therapist, occupational therapist, psychiatrist, etc.) to determine if an alternative treatment is the appropriate next step for your child. All of the supports listed in this article are designed to be complementary, meaning they are indicated alongside individual therapy as well as other therapeutic supports. They are also founded on evidence based principles, meaning there is significant research to support each treatment. If you are unsure where to start, an initial consultation with a psychologist is a great first step.
Trigger warning: self harm
Raising awareness and understanding regarding self harm is important. A study in 2020 found that Self Injurious Behavior (often referred to as SIB) is common with individuals diagnosed with Autism, with an estimated prevalence rate of 42% cited in this article.
According to experts, these behaviors can often promote feelings of control and help relieve tension, allowing individuals to express their emotions and escape from an uncomfortable feeling. While this may be the case for individuals with clinical depression, drawing explanations for self injury among autistic populations can be more difficult, as many who engage in this behavior are unable to explain the feelings associated with it.
Autism refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and non-verbal communication. Some common presentations of self injury that autistic individuals may engage in include: hitting themselves with their hands, pulling their own hair, or scratching their own skin. In severe cases, these can occur daily or multiple times throughout every day, which negatively impacts both the child and their family’s quality of life.
Often, a BCBA will work with students and their families on developing a behavior intervention plan to help reduce the presentation of the self injurious behavior. The BCBA’s main objective, at the start, is to identify why the self injury may be occurring. The ‘why’ behind any behavioral issue is referred to as the function, and identifying the function is critical to understanding how to help autistic children get their needs met without engaging in dangerous behavior.
What’s The Function? Self injurious behavior is known to occur for one or more of four possible functions:
Sensory:
Some children with autism may engage in self-injurious behavior to access sensory stimulation. A study conducted in 2018 estimated that approximately 80% to 100% of individuals with autism have sensory processing difficulties. SIB may serve as a self-regulating system of balancing excessive or insufficient extrinsic stimulation (Berkson, 1983).
Example: Scratching self in an effort to self-soothe. Potential replacement behavior may include teaching the student to ask for deep pressure or other physically stimulating items.
Escape
It is possible for self-injurious behavior to occur in order to escape from something aversive. It is a completely normal characteristic for humans to want to run away when they are in danger, or when extremely distressed or uncomfortable. Some autistic children may engage in self-injury to escape from certain events that they have a certain learning history with.
Example: Pinches self whenever the teacher says, “It’s time for math class!” Potential replacement behavior may include teaching the student to request a break, or teaching the student to ask for help.
Attention
Self-injurious behavior can also occur in order to obtain attention from others. These behaviors may evoke a reaction from other people whenever the child desires a social interaction from another person. It can be described as an attempt for a child to gain attention, whether positive or negative.
Example: Banging head on wall to get Dad to run over and say, “What’s wrong?!!” Potential replacement behavior may include teaching the student to request attention or teaching the student to request a hug.
Tangible
These instances of self-injurious behavior provide access to highly preferred items or activities. Behavior that holds a tangible-access function occurs during times when the child may desire a specific item or activity. This behavior may be reinforced by gaining or earning back something of high value to the child like a game, food item, or a toy.
Example: Pulling own hair, which frightens grandma, to gain access to iPad. Potential replacement behavior may include teaching the student to request the item they would like to access.
Treatment Planning
After identifying the function, the BCBA is then able to develop a method of treatment that directly addresses the self-injurious behavior. Depending on the function and severity of the self-injurious behavior, the BCBA will design a treatment plan that addresses the behavior directly, but also to teach an appropriate replacement behavior. Stay tuned for a future blog post where we will discuss more specifics on the treatment of self-injurious behavior using evidence based practices while adhering to the dimensions of applied behavior analysis (ABA).
It is not uncommon for me to hear about parents concerned that their child is addicted to “screens” (e.g., TV, computers, video games, and portable gaming systems like the “DS”). While a little screen time can serve as a great reward for hard work, a lot of screen time can have negative consequences. (more…)
Strategies that can be reviewed and individualized during my picky eating consultations can help parents of children along the continuum of food selectivity; from passively-avoidant picky eaters to children who display challenging behaviors at mealtime.
The following is a brief overview of how food selectivity may present in children, as well as some resources that may be helpful in your search to support your child…
Children develop a pattern of selective eating over the course of weeks, months, and years
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- Selective eating can be the result of genetic, psychological, and triggering events (e.g., choking)
- Even if a child seems to be more sensitive to taste, visual presentation, smell, texture or other sensory aspects, most children can learn to eat a wide variety of foods
What is selective eating? Thing to know: It occurs on a broad continuum!
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- From a parent(s) perspective, probably something like…
- “My child won’t try anything new!”, “My child hardly eats anything!”
- Limited diet
- Specific Food preferences – placement, closeness of foods to one another, temperature, eats foods in specific form
- ARFID – Avoidant/restrictive food intake disorder. Fairly new – children who are extremely picky eaters may get diagnosed with ARFID by a medical practitioner. ARFID may lead to poor growth and nutrition. Behavioral intervention strategies may be helpful in increasing eating behaviors in those diagnosed with ARFID, however, parents/caregivers should consult with a medical practitioner first
- From a parent(s) perspective, probably something like…
How did my child become a selective eater?
- Medical issues – this should always be ruled out before seeking behavioral consultation for selective eating
- Patterns of eating that become increasingly restricted over time – when coming from a behavior analytic perspective, keep in mind what is known about behavior and the history of reinforcement (positive and negative). If access to specific foods, attention, and routines were provided/removed over time (and functioned as a reinforcer for behaviors), then selective/restrictive eating behaviors were learned and reinforced over time
- Problems with sleep – evokes irritability and lower threshold for variation and novelty when it comes to eating for some
- Conditioned taste aversions – association of certain foods with symptoms of being sick or other aversive effects in environment (e.g., smells, sounds, visuals)
How and When to Work on Selective Eating Behaviors
- Impacts day-to-day functioning and the ability to participate in family/social routines without additional preparation and/or modifications
- Nutrient intake
- Evoking novel challenging and interfering behaviors
What are the most effective interventions for selective eating behaviors?
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- Most food selectivity interventions include multiple treatment components, such as:
- Positive reinforcement (e.g., reward system, behavior contracts, praise)
- Incremental changes
- Support from multidisciplinary providers (e.g., dietician, therapist, etc.)(Freeman & Piazza, 1998; Anderson & McMillan, 2001; Najdowski et al., 2003; McCartney et al., 2005; Ahearn et al., 2001; Ahearn, 2002)
- A heavy focus on proactive strategies (setting up for success!), such as:
- Timing – Select a time of day when trying something new is most likely to be successful
- Location – maybe away from the usual meal-time location as to not contaminate the target location
- Visual Supports
- Review a story with a preferred character who is eating different foods, different ways, in different places
- Reward chart outlining expectations
- Pairing of Preferred Activities with Meals – music, TV, iPad (if socially valid for the family/child)
- Food – type and amount
- Type – similar shape, texture, and color to other preferred foods in the child’s repertoire (e.g., if square cheese crackers such as Cheeze-Its are preferred, maybe the next new food is a Goldfish cracker)
- Size – it matters! Think about only placing the amount the child is expected to eat on the plate/table
- Most food selectivity interventions include multiple treatment components, such as:
- Script and Instructions – plan out what will be said and shown to the child ahead of time
- Build in choice – if the function of the child’s eating behavior is access to tangibles and/or attention in the form of control around choices related to food, proactively build in choice while setting clear boundaries paired with a reward for making a choice – pick choices the family and providers are comfortable with!
- Examples: If rice and pasta are new targeted foods, can say: “Do you want rice or pasta as your side for dinner? When you make a choice and eat it, you can get ice cream for dessert” OR If the target for eating behavior is to increase the amount of food consumed, can present something like: “We are having meatballs with dinner – do you want 1 ½ or 2 with your dinner? When you eat most of the amount you picked out, you can have some dessert when dinner is done”
Resources for Parents
These books present behavioral interventions to successfully expand children’s diet variety and preferences
- Broccoli Boot Camp: Basic Training for Parents of Selective Eaters
- Helping Your Child with Extreme Picky Eating: A Step-by-Step Guide for Overcoming Selective Eating, Food Aversion, and Feeding Disorders
A child’s well being is a critical component of their confidence, success in school, and social and emotional growth. But it can be difficult to get your child to open up about their feelings or challenges so you feel fully aware of their mental health status.
There are approaches to communication and signals to pay attention to regarding your child’s mental health that can help them thrive as they return to school.
1. Talk it out together to ease anxiety
Discuss classes and pieces of school or extra-curriculars outside of the classroom to balance talking about things your child might feel nervous or excited about.
2. Frame your questions thoughtfully
Ask questions about what’s going well, but also about what’s not going well to get the full picture. Ask “What’s challenging?” instead of “Why is it challenging?” to remove any signal of accusation and help your child open up more, because they are less likely to feel defensive.
3. Look for changes in your child’s behavior
Make note of increased irritability, changes in appetite or sleep habits, or a loss of interest in their activities. These could be signs that you’re child is struggling with depression, anxiety, or another mental health challenge.
While temporary behavioral changes can be considered a normal part of adjustment to the back to school routine, if they continue beyond the back to school period or create disruptions in your child’s day to day life, we recommend you seek professional help.
4. Listen and offer support so they know you’re there for them
Communicate clearly that you are available if your child wants to talk, and seek additional resources – from books to journals to a licensed therapist – if you think they need additional help.
Mental healthcare is healthcare. From parents to professionals, additional support for students can make a meaningful difference.
For more information on our Special Group Programs or treatment options for children and teens, contact us.