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Saturday, January 31, 2015

Bridging the ADHD Gap

From Edutopia

By Merle Huerta
January 22, 2015

According to the National Education Association, educational equity means that education should be accessible and fair to any child who wants it. In principle, it’s based on the 14th Amendment and the 1954 school desegregation case, Brown v. Board of Education. The aim of that court decision was to fix the ills of an educational system based on segregation and inequity in the funding of schools as it pertained to minority students.

The decision did improve educational equity for children with disabilities. As a result of the decision, the Education for All Handicapped Children Act (that includes IDEA, Section 504, and ADA), signed into law in 1975, paved the way for students with disabilities and made it easier to secure services.

DSM-5 defines attention deficit hyperactivity disorder (ADHD) as a developmental disorder, and the Americans with Disabilities Act considers it a disability. But getting a 504 accommodation or special services based solely on an ADHD diagnosis is difficult. Rulings laid out by the U.S. Board of Education are stringent, and unless students manifest "one or more specified physical or mental impairments," they won't be eligible.

Without these accommodations, many students with ADHD don't thrive in the classroom. Betrayed by their bodies, these kids struggle with peer relationships, feel like failures, and are stigmatized. In 2012, the CDC reported that 33 percent of all students with ADHD who didn't have a comprehensive therapeutic/educational plan failed out of high school.

These kids are caught in the middle. Not necessarily minority, they're not part of the educational equity debate. Not necessarily disabled, they're ineligible for services.

As teachers, despite being a part of an embattled profession, we do hold tremendous power. We can help flailing learners believe in themselves. Even without a 504 accommodation, we can with some ingenuity create a more effective learning environment for children with ADHD. Here are five possible approaches.

1.) Make learning child-centered. Child- or student-centered learning presumes that students who are drivers in their own learning will be more invested and motivated. It's a tenet of the Constructivist Learning Theory first proposed by Piaget, and it considers the learning styles, preferences, and interests of the student. It's also a way to accommodate a child with ADHD.

The teacher must map out goals and resources, and assumes the facilitator role. Gaming, MOOCs, hands-on activities, webquests, and mini-lessons can all be integrated as resources.

2.) Differentiate learning and encourage mastery. This is the basis of the Montessori Method. Assess each child's learning style and design an individualized learning plan to accommodate that child. It's student-centered learning at its best, facilitated by the teacher and encouraging mastery, confidence, and enthusiasm -- and students with disabilities do well with this method. In What Works for Differentiating Instruction in Elementary Schools, Grace Rubenstein shows how this can be put into place.

3.) Integrate movement breaks and mini-mindfulness meditation sessions. Children with ADHD are statistically quite bright. Unfortunately, their symptoms of ADHD -- distractibility, hyperactivity, clumsiness, impulsivity, nervousness, and poor focus and concentration -- can undermine learning. To help them "blow off steam" and refocus, schedule some short movement sessions such as yoga, tai chi, Zumba, or a quick power walk. The exercise causes the brain to release endorphins, the "happy”" hormones.

Mindfulness meditation is another activity gaining in popularity. Scientific American, in a recent article, reports that after an eight-week course of mindfulness meditation, MRI scans showed the amygdala, the brain’s "fight-or-flight" center, shrank. It also showed that the prefrontal cortex, the area associated with executive function (concentration and decision-making) became thicker.

A recent report in Clinical Neurophysiology concurs with the benefits of mindfulness meditation in the treatment of ADHD. In one study, adults with ADHD showed marked improvements in mental performance, a decrease in impulsivity, and greater self-awareness after participating in a series of mindfulness meditation sessions.

4.) Create a positive, supportive learning environment. There are common practices that teachers use to reduce classroom distractions. Seating the child in the front row, away from doors and windows, is just one approach. Jane Milrod, Director of Princeton C.H.A.D.D. and an ADHD/Executive Function coach, strongly recommends mentoring programs. Her approach is the "study buddy," a fellow classmate who shows another classmate with ADHD "the ropes." Knowing that one person is there to help him or her can empower a student with ADHD. School becomes a less hostile environment.

Another program through Eye-to-Eye, a national mentoring organization, places high school and college students with similar labels into the schools to help students with ADHD develop their homework, study, communication, and peer interaction skills.

5.) Document as much as possible. District policies do change. With change, students with ADHD may be eligible for accommodation and special services. Document whenever possible, and involve the parents in your strategies. Note any modifications made in the classroom and their effectiveness, and make recommendations toward creating educational equity when strategies that don't include special education are insufficient.

Most importantly, consider these strategies as fresh ideas. Teaching a child with ADHD is challenging, frustrating, and exhausting. New ideas can generate new energy. And that new energy can revitalize and bring hope to a child with ADHD. It can also help to bridge the gap between educational equity and the children without it.

Friday, January 30, 2015

The Pajama Game: Autism-Friendly Performance Saturday, March 7th

From The Boston Conservatory

January 30, 2015
This is a special performance for families and friends of those who have been diagnosed with an autism spectrum disorder (ASD) or other sensitivity issues. At this performance, the theater environment and production will be altered to provide a sensory-friendly, comfortable and judgement-free space that is welcoming for this audience.

This performance is recommended for those families bringing a loved one on the autism spectrum, and their teachers and advocates who are familiar with and accepting of behaviors exhibited by some individuals on the autism spectrum.

For more information, resources and FAQs on autism-friendly performances, click HERE.
When:   2:00pm Saturday, March 7, 2015

Where: The Boston Conservatory Theater
                 31 Hemenway Street, Boston, MA 02215

Buy tickets HERE!

Use code PJAFP14 or contact the Audience Services Manager at (617) 912-9142.

About The Pajama Game

The Pajama Game explores the dangers of a workplace romance to hysterical effect. Conditions at the Sleep-Tite Pajama Factory are anything but peaceful, as sparks fly between new superintendent Sid Sorokin and Babe Williams, leader of the union grievance committee. Their stormy relationship comes to a head when the workers strike for a 7.5-cent pay increase, setting off not only a conflict between management and labor, but a battle of the sexes as well.
  • Music and Lyrics by Richard Adler and Jerry Ross
  • Book by George Abbot and Richard Bissell
  • Directed by Laura Marie Duncan (B.F.A. '94, musical theater)
  • Musical Direction by Steven Ladd Jones
  • Conducted by Peter Mansfield 
To learn more about Autism-Friendly programming at The Boston Conservatory, visit bostonconservatory.edu/autism

The Power of Mindfulness

From the Child Mind Institute

By Juliann Garey
January 20, 2015

How a meditation practice can help kids become less anxious, more focused.

By now, there's a very good chance you've heard the term "mindfulness." Suddenly, it seems to be everywhere—touted as the new yoga, the answer to stress, the alternative to Xanax.

But beyond the buzz, what is it?

Jon Kabat-Zinn, the scientist and widely recognized father of contemporary, medically-based mindfulness--over 30 years ago he developed a therapeutic meditation practice known as Mindfulness-Based Stress Reduction (MBSR)--defines mindfulness simply as "paying attention in a particular way: on purpose, in the present moment and non-judgmentally."

That's the short version. To expand on that just a little, mindfulness is a meditation practice that begins with paying attention to breathing in order to focus on the here and now—not what might have been or what you're worried could be. The ultimate goal is to give you enough distance from disturbing thoughts and emotions to be able to observe them without immediately reacting to them.

In the last few years mindfulness has emerged as a way of treating children and adolescents with conditions ranging from ADHD to anxiety, autism spectrum disorders, depression and stress. And the benefits are proving to be tremendous.

But how do you explain mindfulness to a five year-old? When she's teaching mindfulness to children, Dr. Amy Saltzman, a holistic physician and mindfulness coach in Menlo Park, CA, prefers not to define the word but rather to invite the child to feel the experience first—to find their "still, quiet place."

Choosing Behaviors

"We begin by paying attention to breath," she says. "The feeling of the expansion of the in-breath, the stillness between the in-breath and the out-breath. I invite them to rest in the space between the breaths. Then I explain that this still quiet place is always with us—when we're sad, when we're angry, excited, happy, frustrated. They can feel it in their bodies. And it becomes a felt experience of awareness. They can learn to observe their thoughts and feelings, and the biggest thing for me is they can begin to choose their behaviors."

In her private practice, Saltzman, and her Still Quiet Place CDs for Young Children and Teens, teaches mindfulness to children and adolescents with a variety of challenges. "I work with kids individually with ADHD, with anxiety, depression, autism, anger management issues. The lovely thing about working one-on-one is you get to tailor what you offer to them."

Saltzman also conducted a study in conjunction with researchers at Stanford University showing that after 8 weeks of mindfulness training, the fourth through sixth graders in the study had documented decreases in anxiety, and improvements in attention. They were less emotionally reactive and more able to handle daily challenges and choose their behavior.

As a teacher at The Nantucket New School, where every student gets instruction in mindfulness, Allison Johnson has learned first hand what a difference it can make for kids. So she tried it at home:

"I have a six-year-old son with ADHD," she says. "I brought a chime home. We use it most nights before bed. 'Cause he doesn't love going to sleep. We sit on the floor facing each other, we close our eyes and we ring the chime. Sometimes we incorporate a visualization—like he's floating on a cloud. We go on this little journey. And we ring the chime again and we say 'when you can no longer hear the chime it's time to open your eyes and come back to focus.'

And now, if he gets in trouble and gets sent to his room, I can hear him upstairs doing it himself. Or, when he's getting rowdy, he'll say, 'okay, lets do our mindful breathing now.'"

Johnson says since Curren started practicing mindfulness she's seen subtle but noticeable differences in his behavior. "He's more able to bring his focus and attention back to where they were—remembering to raise his hand and not move around so much."

Mindfulness and Teenagers

While the research on children and adolescents is really just beginning to gain real traction, there are several small studies showing that for kids who suffer from anxiety and ADHD, mindfulness can be especially helpful. Diana Winston, author of Wide Awake and the Director of Mindfulness Education at UCLA's Mindful Awareness Research Center, started taking teens with ADHD on retreats for what she calls "mindfulness intensive camp" back in 1993. Twenty years later the program is still going strong.

"Teens benefit tremendously," she says. "Kids talk about their lives being transformed. I remember one girl with ADD who'd been very depressed and I didn't think we were reaching her. On the last day of class she came in and said, 'everything is different. I was really depressed. My boyfriend broke up with me and it's been so hard but I'm finally understanding that I'm not my thoughts.' That concept is huge—the non-identifying with the negative thoughts and having a little more space and freedom in the midst of it."

Stress reduction and self-acceptance are two of the major perks of mindfulness, benefits Winston says are particularly important during the drama and turmoil-filled teen years. "Emotional regulation, learning how to quiet one's mind—those are invaluable skills."

Managing Anxiety

Randye Semple, Ph.D., an assistant professor at USC's Keck School of Medicine, has spent her career developing programs to teach anxious kids how to quiet their minds. "When I look at childhood anxiety I see an enormous problem and a precursor to other problems in adolescents and adults," she says. "So I figured if we could manage the anxiety we could head off a lot of the other problems."

Mindfulness-Based Cognitive Therapy for Anxious Children, the book she co-authored, is based on the program she developed. A study she and her co-author, Clinical Psychologist Jennifer Lee, conducted from 2000-2003 showed significant reductions in both anxiety and behavior problems in 8- to 12-year-olds in Harlem and Spanish Harlem who participated in the program.

Teaching mindfulness to children and adolescents is a growing trend—in private practices as part of therapy and increasingly as part of the curriculum in both Special Ed and General Ed classes throughout the country.

"We're at the beginning of a movement," says Megan Cowan, co-founder and executive director of programs at Mindful Schools in Oakland, California.

"Jon Kabat-Zinn's work really set the stage for mindfulness to be visible on a mainstream landscape. I think we all have the sense that society's a little out of control. Education is a little out of control. We're all looking for a way to change that. This is meaningful to almost everybody."

This is the first of a three-part series:

Thursday, January 29, 2015

Behavioral Treatment for Kids with Anxiety

From the Child Mind Institute

By Jerry Bubrick, Ph.D.
Senior Director, Anxiety & Mood Disorders Center;
Director, Intensive Pediatric Obsessive-Compulsive Spectrum Disorders Program

January 5, 2015

Kids learn to handle the bully in the brain.

When a child shows signs of anxiety, we tend to think it will go away—she's just nervous or shy, and she'll grow out of it. But when the anxiety becomes so intense that it's seriously interfering with her life, and the life of her family, it's important to get help.

Serious untreated anxiety tends to get worse over time, not better, because the child learns that avoidance works in reducing the anxiety, at least in the short run. But as the child—and, indeed, the whole family—work to avoid triggering those fears, they only grow more powerful.

Medication is often prescribed for children with anxiety, as it is for adults. And medication—antidepressants are usually our first choice—often helps reduce anxiety. But what many people don't know is that cognitive behavioral therapy (CBT) can be very effective for kids who are anxious.

In fact, research over more than 20 years has shown that CBT is the most effective treatment for reducing symptoms of severe anxiety. And unlike taking medication, the therapy gives children the tools to manage the anxiety themselves, now and in the future.

What is cognitive behavioral therapy?

Cognitive behavioral therapy is based on the idea that how we think and act both affect how we feel. By changing thinking that is distorted, and behavior that is dysfunctional, we can change our emotions. With younger children, focusing first on the behavioral part of CBT can be most effective. The goal is, essentially, to unlearn avoidant behavior.

One of the most important techniques in CBT for children with anxiety is called exposure and response prevention. The basic idea is that kids are exposed to the things that trigger their anxiety in structured, incremental steps, and in a safe setting. As they become accustomed to each of the triggers in turn, the anxiety fades, and they are ready to take on increasingly powerful ones.

Exposure therapy is very different from traditional talk therapy, in which the patient and a therapist might explore the roots of the anxiety, in hopes of changing her behavior. In exposure therapy we try to change the behavior to get rid of the fear.

Exposure therapy is effective on many different kinds of anxiety, including separation anxiety, phobias, obsessive-compulsive disorder (OCD), and social anxiety.

The Bully in the Brain

For children with anxiety disorders, the process begins by helping them, and their parents, get some distance from the anxiety and start thinking of it as a thing that is separate from who they are. One way I do this is by having them conceptualize it as a "bully in the brain," and I encourage kids to give the bully a name and talk back to him.

Kids I've worked with have called him the Witch, Mr. Bossy, Chucky, the Joker, and, in the case of some teenagers, names I cannot repeat here.

We explain that we are going to teach skills to handle the bully, giving children the idea that they can control their anxiety rather than it controlling them.

It's also important to help kids really understand how their anxiety is affecting their lives. I may actually map out things a child can't do because of his fears—like sleeping in his own bed, or going to a friend's house, or sharing meals with his own family—and how that makes him feel. Getting kids to understand how their anxiety works and gaining their trust is important because the next step—facing down their fears—depends on them trusting me.

Adopting Robert Frost's observation that "the only way around is through," exposure therapy slowly and systematically helps a child face his fears, so he can learn to tolerate his anxiety until it subsides rather than reacting by seeking reassurance, escaping, avoidance or engaging in ritualistic behaviors such as hand washing.

How does exposure therapy work?

The first step is identifying triggers. We design a "hierarchy of fears"—a series of incremental challenges, each of which is tolerable, and which together build to significant progress.

Instead of thinking in black and white terms—I can't touch a dog or I can't cross a bridge—kids are asked to consider degrees of difficulty.

We might ask a child with contamination fears, for example, "On a scale of 1 to 10, how difficult would it be to touch the door handle with one finger? To touch and open the door?"

For a child with a fear of vomiting, we might ask: "How difficult would it be to write the word vomit?" If that is a 3, saying "I will vomit today" might be a 5. To see a cartoon of someone vomiting might rate a 7. To watch a real video of someone vomiting might be a 9. At the top of the hierarchy would likely be eating something the child thinks will make him vomit.

By rating these different fears, kids come to see that some are less extreme, and more manageable, than they had thought.

Next, we expose the child to the trigger in its mildest possible form, and support him until the anxiety subsides. Fear, like any sensation, diminishes over time, and children gain a sense of mastery as they feel the anxiety wane.

With a child who is severely anxious—who can, for instance, barely leave his room for fear that his parents will die, or must wash his hands dozens of times a day to avoid contamination—I may work with him several times a week, for several hours at a time. We do exposures in the office and then, when a child is comfortable enough, do them outside.

For someone with social anxiety, for instance, we might go out wearing silly hats, or walk a banana on a leash. For someone afraid of contamination, we might ride the bus together, or shake hands with strangers, then eat chips without washing.

Once we have worked through some exposures and he is feeling more confident, I assign homework to practice what we did in the sessions. We want kids to really master their exposures before moving up the ladder. And parents are taught to help kids progress by encouraging them to tolerate anxious feelings, rather than jumping in to protect them from their anxiety.

Treatment for mild to moderate levels of severity usually takes eight to 12 sessions, and some kids make more progress if they are also taking medication to reduce their anxiety, which can make them more able to engage in therapy.

It's important to understand that exposure therapy is hard work, both for kids and their parents. But as fear diminishes, kids get back to doing things they like to do, and the family gets back a child they feared they had lost—and that's a great reward.

Wednesday, January 28, 2015

Grief In The Classroom: 'Saying Nothing Says A Lot'

From National Public Radio's Blog
nprEd - How Learning Happens

By Elissa Nadworny
January 13, 2015

"Grief can have a tremendous impact on a student's ability to stay on track, stay focused and stay enthusiastic towards school."

Deborah Oster Pannell's husband died when her son, Josiah, was 6 years old. That week, Pannell visited Josiah's school and, with his teacher and guidance counselor, explained to his first-grade class what had happened.

"I'll never forget the three of us sitting up there — and all these little shining faces looking up at us — talking about how Josiah lost his dad and he might be sad for a while," Pannell says.

Josiah, who is now 11 years old, has a few painful memories of the visit. "That day they were all just blatantly explaining what had just happened to me," he says. "It was really uncomfortable."

But Josiah also believes the visit helped make his classroom a healthy, safe space for his grieving.

So how should educators handle the death of a student's loved one?

A new website — GrievingStudents.org — is trying to help teachers and school leaders answer that question. It's a database of fact sheets, advice and videos. The materials were produced by the Coalition to Support Grieving Students, a group including 10 national organizations that represent teachers, school administrators and support staff.

Using census data, the group estimates that 1 in 20 children will lose a parent by the time he or she graduates from high school. And that doesn't include the many more kids who will lose a sibling, grandparent or close friend.

Grief is a fact of life in our nation's schools; 7 out of 10 teachers have a student currently in their classroom who is grieving, according to research by the New York Life Foundation and the American Federation of Teachers.

"Virtually all children will go through it — but that doesn't mean it's a normalizing experience," says Dr. David Schonfeld, an expert on student grief and a driving force behind the new website. "Even though it's common, it warrants our attention."

Schonfeld, who founded the National Center for School Crisis and Bereavement, has seen his share of student grief. He's spent the last decade advising schools on what to do after major tragedies, including Sept. 11 and the mass shootings in Newtown, Conn., and Aurora, Colo.

But Schonfeld is quick to point out: Grief does not require a national tragedy.

"If the person you care about most in your life is dead, that's huge," he says. "For the individual who's experienced a loss, it's infinite, and we have to have that perspective."

Attending to student grief isn't just about creating a more compassionate classroom either.

"Grief can have a tremendous impact on a student's ability to stay on track, stay focused and stay enthusiastic towards school," says Erin Kimble, a social worker at Indianapolis Metropolitan High School in Indiana.

For a grieving student, just showing up at school can be a challenge. And when they do make it to class, Kimble says, some kids' grief can turn to anger, leading to disruptive outbursts.

At Indianapolis Metropolitan, when a student loses a loved one, teachers often come to Kimble first for advice and guidance. "The most common question teachers ask me is, 'How do I have this conversation?' " Kimble says. "The teachers want to know exactly what and what not to say to a student."

And that's the challenge: Most teachers aren't trained social workers. Which is why Luz Minaya welcomes the extra resources. She teaches Spanish and technology at a public middle school in New York City. The 17-year teaching veteran says she received "no training" for how to deal with student grief.

"You go to college and you study to become a teacher. But no one tells you how to deal with the emotional aspect of students," Minaya says.

Her school has a large population of Latino students. Many are very close to their grandparents, Minaya says, and when an elder dies, she's seen that grief affect behavior, attendance and performance.

"Teachers really have a major role in the safeguarding of the student," Minaya says. "I don't want to have to depend on the guidance counselor or wait for the social worker who comes once a week."

'At Least'

The Coalition's new site includes lots of guidance for teachers that's refreshingly specific, like this: Avoid comparisons. Saying "my father died, too" shifts attention to a competing loss and away from the grieving student.

Also, avoid trying to comfort a student with any sentence that begins with "at least." Educators shouldn't try to make light of the situation or find good in the sad, says Schonfeld.

The teacher's goal should be to support grieving students by making clear to them that they are safe and have someone to talk to.

And it's a long-term process, not just a one-day or one-month challenge. Five years after his father died, Josiah had trouble transitioning to middle school this year.

"The grief hasn't gone away, so I'm just waiting for it to calm down — like a volcano," Josiah says.

And, as he waits, year after year, his teachers will learn of Josiah's loss and they will struggle to find the right words, the right approach. For educators, these new resources represent a challenge and an opportunity.

"Saying nothing says a lot," Schonfeld says, "and that's a message we should never leave a child."

Tuesday, January 27, 2015

When Should Kids Start Kindergarten?

From Great Schools

By Jessica Kelmon
January 16, 2015

Redshirting kindergarten - holding kids back to start school later - is increasingly popular. But does redshirting help, or hurt, a child? The research may surprise you.

This fall, four-year-old Luke will be starting kindergarten in Centerville, OH. He’ll be one of the youngest in his class — turning five just before the school year begins — and his mother is concerned.

Nationwide, the starting age for kindergarten varies widely. In states like Connecticut and California, you can easily find a four-and-a-half-year-old and a six-and-a-half-year-old in the same kindergarten class. That’s exactly what worries Luke’s mom, Deb Nelson, who has seen the difference just a few months can make, whether at home with her three sons ages 6, 4, and 3 or at school with the kids in her older son’s kindergarten class.

Some kids are ready to read and write; others have trouble sitting still and paying attention. Being younger is particularly problematic as kindergarten becomes increasingly academic.

While there’s no statistical evidence that delaying kindergarten is on the rise, anecdotally it appears that more and more parents are doing it. But will this benefit or hurt children in the long run? Educators and parents are wondering just that, as they weigh the potential risks of starting kids in kindergarten when they're either much younger or much older than other kids in their class.

Why redshirt?

Nelson’s not only worried about kindergarten. "It’s junior high," she says. "I don’t want him to be 11 when everyone else is turning 12, and have him be practically a year behind everybody in sixth or seventh grade." Both concerns — for a child’s success in kindergarten and through adolescence — are driving forces behind the popular practice of "redshirting," or delaying a child’s kindergarten entry by a year or more.

(The term is borrowed from collegiate sports, where athletes will practice with the team for the first year, but sit out competition while they get bigger, stronger, and more competitive.)

Parents typically hold a child back because they feel he isn’t ready — cognitively, socially, or emotionally. Others may want to give their child a leg up, on the assumption that being older will make him more advanced.

"In a lot of circles, it’s the fad," says Gary Painter, an associate professor at USC’s School of Policy, Planning, and Development, who authored a paper on redshirting. "Particularly in upper-middle-class circles where parents want to give their children every advantage, and want their kids to be ahead of their peers."

Does redshirting make a difference?

Painter’s work is based on a longitudinal study that looked at academic and social outcomes of delayed kindergarten entry. He followed children starting at age four or five through age 25 or 26. Incredibly, he found no academic or social benefit to redshirting (The one exception? Varsity football.)

In fact, he found a small benefit to being younger in terms of slightly higher college attendance rates. But is Painter’s data, which is necessarily old (his subjects are now all in their thirties), on target? "There’s other research out there from here and abroad that finds older kids do slightly better than younger kids while they’re in school," Painter says. "We need to keep a close eye on it."

Overall, research on has found mostly unfavorable results for being older than your grade-level peers, including academic achievement that disappears in later grades and an increase in social and behavioral problems in adolescence, when being older (or different in any way) can create problems.

But much of this data is old, and, in many cases, linked to studies on grade retention, which is likely more of a social stigma for a child than starting kindergarten later.

Mixed Results

A recent Canadian study suggests that redshirting can have positive academic outcomes, including a reduced chance the child will repeat the third grade and improved math and reading scores in tenth grade. According to this study by the NBER, the effects are highest for boys (who are more often redshirted) and low-income students. Additionally, the researchers’ estimates suggest that not only is delayed kindergarten better, but starting too early may have negative consequences for kids.

Given these mixed findings, redshirting clearly needs more study, especially since the average age of kindergartners is on the rise. In the past 35 years, scores of states have raised their kindergarten cut-off dates. In 1975, only nine states required that kids be five when they start kindergarten. By 2010, 37 states had that requirement, with more states following suit (California will be there by fall, 2014).

Ready or Not

In the meantime, it’s up to parents to determine their child’s kindergarten readiness on a case-by-case basis, taking into consideration social and emotional readiness, as well as cognitive ability. For many parents, evaluating a child’s kindergarten readiness isn’t easy. Former preschool teacher Tracy Gibb delayed her son’s kindergarten entrance because he was immature socially.

"I’ve worked with kindergarten teachers for many years, and what they want are kids who can sit still and behave themselves well enough to learn, rather than a child who understands what’s going on but is a discipline problem because he’s too young to handle the responsibility of kindergarten," she wrote in an email. Now, she thinks her 11-year-old son is on a par with his fifth grade peers emotionally. "This is a decision I have never regretted."

When 4-year-old Delilah’s preschool teachers suggested she might not be ready for kindergarten, her mother, Los Angeles-based songwriter and music teacher Deborah Poppink Hirshland, was impressed with how the teachers explained their conclusion. In kindergarten, they told her, there are a lot of three-step processes, such as get a piece of paper, draw a shape on it, then cut out the shape. "Delilah went to the teacher after every step to ask what to do next," Poppink Hirshland says.

After an assessment, Poppink Hirshland learned valuable information about her bright daughter, who grew leaps and bounds thanks to occupational therapy. Now, six-year-old Delilah is thriving in kindergarten.

The school Nelson’s sons attend offers a young fives program for kids who may not be kindergarten-ready. At a pre-enrollment panel discussion with four local kindergarten teachers, Nelson raised her hand and asked the all-consuming question: "When should my son start kindergarten?"

"One teacher said, 'In my 35 years of teaching, I’ve never encountered anyone who wishes they hadn’t done the young fives program, but I’ve encountered some who wish they had done it,'" Nelson recalls. She was sold, and asked to have Luke evaluated for the program.

The assessment included tests of Luke’s fine- and gross-motor skills, attention span, attention to detail, ability to follow directions, number knowledge, ability to spell his name, alphabet knowledge, color vision, and a hearing test. Luke scored high and showed no discernable deficiencies. So despite actually being a young five-year-old, he was deemed ineligible for the program.

Still worried her son wasn’t ready, Nelson went to the principal. "[The principal] said in his case, because he doesn’t have any deficiencies and scored so high, maybe a regular classroom would be better for Luke," recalls Nelson. Still worried for her son down the road, Nelson made plans with the principal to have Luke take kindergarten twice. "We just tell him that he gets two years of kindergarten. He doesn’t have any feelings of being held back or retained."

Yet another part of the equation with today’s high-stakes testing is that we expect more of kindergartners. Unfortunately, they’re less prepared for success.

"Kindergarten is much more academic than ever," says Emily Glickman, a Manhattan-based educational consultant. "Many people feel that kindergarten is the new first grade."

Reading expert J. Richard Gentry, Ph.D., author of Raising Confident Readers: How to Teach Your Child to Read and Write--From Baby to Age Seven,  says the problem is exacerbated by parents failing to prepare their children for reading. Nearly half our nation’s kindergartners aren’t set up for reading success, he says. "The big question is whether a child is ready for formal reading instruction," says Gentry, who explains that in terms of brain development, kids aren’t ready to read until age six.

But, starting from birth, parents need to start preparing their kids to read with "joyful literacy activities" such as reading aloud, drawing, and playing writing games. According to Gentry, too many children aren't getting this kind of preparation.

"About 1.5 million kids come to kindergarten and they can’t write their name or retell the story of a favorite book," he says. "They’re already behind. They’re the achievement gap."

Who Gets Helped — and Who Gets Hurt

Simply staying home and being a year older in kindergarten isn't the answer. "We need to consider what the child is doing, when otherwise he would’ve been in an educational and enriching environment," says Shane Jimerson, professor of school psychology at University of California at Santa Barbara. Educational researcher Melodye Bush agrees.

"It’s not good to start everyone later," she says. "It’s not good to have everyone start at age six. What we see is that the earlier you start [kids] learning to read and write, the better. As far as ability to retain knowledge, it's better to start them at age three." Bush speculates that with time-strapped, stressed parents, "kids aren’t getting the necessary pre-learning they need."

Both Gentry and Painter say that ultimately redshirted children from engaged, middle-class families "won’t be helped, but it likely won’t hurt." But the practice puts a strain on families that don’t have the resources to pay for an extra year of preschool.

If these younger kids have to compete with older, better prepared children, it will, "exacerbate the achievement gap that already exists," Painter says. "I don’t advocate that school districts ban redshirting, but it’s a caution to keep in mind."


Related Articles

Monday, January 26, 2015

Full Life Ahead - What Your Child Needs: All about Assessments and Evaluations

From Mass. Families Organizing for Change,
with Mass. Down Syndrome Congress and Riverside Community Care

January 24, 2015

“A Full Life Ahead”

A series of monthly workshops for parents and guardians of young adults with a disability. The series focuses on transition, employment, housing, friendships and other topics
leading to interdependent, full lives in the community
for young adults with disabilities.

When do I assess? Who offers assessments?
What documentation will I receive?

Quality assessments provide professional, objective documentation of your child’s strengths and the supports they require. This information is critical in determining the direction to take when planning for your child and how much it will cost.

When:   7:00 - 9:00pm Wednesday, February 11, 2015

Where:  MDSC Office
                    20 Burlington Mall Road, Suite 261
                    Burlington, MA 01803

Panel Presenters
  • Kevin Berne, Clinical Supervisor, Assistive Tech Program- Easter Seals
  • Chloe Browning, Assistant Division Director of Residential Services – Northeast Arc
  • Teresa Devlin, Supports Intensity Scale (SIS) Assessor - Department of Developmental Services (DDS)
  • Lisa Sirois, Director of Transition Services -Easter Seals
  • Myra Terry, Qualified Vocational Rehab Counselor, Massachusetts Rehabilitation Commission (MRC)

RSVP to Adrienne adrnnszf@aol.com

Someone on My Side of the IEP Table

From Understood
by the National Center for Learning Disabilities

By Gail Belsky
December 17, 2014

"...until we felt confident and comfortable with the process, we always made sure we had someone else on our side of the IEP table to compare notes with and draw strength from."

Our first IEP meeting was a lopsided affair.

Inside a cramped office at my child’s school, my husband and I occupied two of the seats around a little table. Staff from the school took every other seat in the room, plus an extra chair they pulled in from the classroom next door.

There were six of them: The case manager, school social worker, classroom teacher, resource room teacher, occupational therapist and speech therapist. And just two of us. We felt outnumbered and overwhelmed.

Our 7-year-old son had only just been diagnosed with ADHD, dyslexia and a slew of other learning issues. We were still trying to process the news and accept that a long and unpredictable road lay ahead. We were nervous—and clueless. We asked few questions during the meeting, and left in a fog when it was done.

Fast-forward a year and, thankfully, we were in a better place. Our son was seeing a tutor and was making slow but steady progress. We knew much more about his issues and about special education. And we’d come to the conclusion that we needed more support—and extra ears—at the next IEP meeting.

So we assembled our own team of advisors, including family members as well as three professionals who knew our son and us. The professionals included the tutor, a local child psychologist we’d consulted and the neuropsychologist who’d done an independent evaluation of our son. We brought all three to the IEP meeting.

This time, it was standing room only in the office at the school. From the start, it was a better experience. There was a real dialogue about our son and his needs. The professionals we brought asked fantastic questions that we would never have known to ask. They provided information that we couldn’t provide. And we were better able to communicate our thoughts and requests.

We still left in a daze. There was just too much information to absorb. But as we walked out of the building, each of our professionals shared their thoughts about the meeting. They explained the things we didn’t understand, and gave us new things to think about.

Their insight was invaluable. But their support was equally important. They weren’t just there as hired experts; they cared about our family. And it made all the difference in the world. Unlike the year before, we didn’t feel alone at the meeting—or afterward. We had people we could call when we couldn’t remember something that was said, or when we needed a sounding board.

We never brought that many people to an IEP meeting again. But in the years to come, we continued to call on our team of advisors when we needed to.

Until we felt confident and comfortable with the process, we always made sure we had someone else on our side of the IEP table to compare notes with and draw strength from.

Sunday, January 25, 2015

Parental Guilt and Children with Developmental Disabilities

From The Doctor's Tablet
The Blog of the Albert Einstein College of Medicine

By Lisa Shulman, M.D.
January 20, 2015

Recently, at a holiday meal with my extended family, it came to light that neither of my typically developing teenage children really knows how to tie his or her shoes. It seems that for the past decade or so, both have been using the “bunny ears” technique introduced to preschoolers for tying their shoes. My children appear never to have moved on from there to the mature “around the tree” technique.

Now, if just one had this pattern, we could chalk it up to individual differences, but the fact that neither has mastered a skill expected by 7 years of age—well, before I knew it, the eyes of all my relatives seemed focused accusingly on me…or so I thought. I, in turn, found myself feeling an emotion I am not unfamiliar with: guilt.

Ah, parental guilt. I believe all parents experience this emotion at times. But based on my experiences over the past 20 years as a developmental pediatrician at Albert Einstein College of Medicine’s Children’s Evaluation and Rehabilitation Center, parents of children with disabilities take on far more parental guilt than other parents. It rolls in at the time of the initial diagnosis of developmental disability, and surfaces regularly through the years of raising children into adults with developmental problems.

Guilt at Initial Diagnosis

For example, guilt finds its way into the history parents share with me at the time of the initial diagnosis. It seems no matter when the diagnosis is made, the parents are always wondering if it should have or could have been made earlier. They will replay in their minds early observations about their babies. Did they ignore important signs? Delay seeking input? “We shouldn’t have listened to the pediatrician when he said to watch and wait” and “If only I had listened to my neighbor’s or friend’s suggestion to get my son checked out” are common laments.

What Did We Do Wrong?

The cause of the developmental disability is another topic that inevitably gives rise to parental guilt. Mothers frequently ask, “Did I do something during my pregnancy (or not do something) that caused this?” Parental guilt often leads parents to comb through the family tree with a guilty eye: “Did this disability come from my side of the family or yours?” “Is God punishing me for something I did wrong by giving me this child?”

Then, there are the “If only”s: “If only we hadn’t moved away from our family”; “If only we hadn’t had another baby so soon”; “If only we hadn’t worked full time and put him in daycare. …” The literature doesn’t help. Every few months there is another headline announcing that some parental quality or situation is associated with an increased risk of having a child with autism: for example, babies are more likely to be autistic if they are born to older mothers or fathers, overweight mothers, mothers who took various medications during pregnancy, and on and on.

For one mother with a child with a significant disability whom I have known for many years, the mom’s history of alcoholism causes guilt. When her baby was born with developmental problems, the problems were attributed to the mother’s consumption of alcohol during the pregnancy. The mother, now long sober, spent years feeling that her actions had caused her daughter’s significant developmental disability.

Recently, more-sensitive genetic testing that is available showed that the child has a genetic mutation, a “genetic accident” that most likely occurred at the time of conception, and this mutation—not the alcohol—was likely the cause of the child’s developmental problems.

When that information was shared with the mother, the reaction was immediate and dramatic. I saw years of parental guilt slip from her shoulders. She actually sat up straighter right before my very eyes, relieved of the heavy burden of parental guilt she had been carrying for the previous 18 years.

Is My Child Getting the Right Treatment?

In families of children with autism, I hear guilt come up frequently surrounding treatment decisions. A particular celebrity appeared on late-night TV talk shows claiming to have cured her child’s autism with the gluten/casein-free diet. Parents often describe feeling “guilted” into using this difficult diet, despite its lack of empirical support, by other parents at support groups, or by therapists, neighbors and so on.

Reports in the media on therapeutic techniques that, when implemented early, reduce autism severity have also contributed to parental guilt in the many families I work with whose children continue to have severe autism despite receiving excellent intervention. Inevitably they question: “Did we give enough therapy?” “Did we start the therapy early enough?” “Did we advocate enough for therapies—maybe he would have done better with more therapy, or with different therapy…?”

Guilty consciences for parents of children with developmental disabilities come up with endless numbers of “what if”s.

Words that Wound

Parents often tell me how comments of others frequently spark their feelings of guilt. Parents of children with severe autism describe strangers making thoughtless comments that elicit guilt: “Oh, you didn’t get him early intervention” (the assumption being that any child who received early intervention would not have such severe symptomatology at this point…alas, untrue).

When a child has emotional or behavioral outbursts in public due to the core features of autism—at family gatherings, religious services, restaurants, on the subway—these are situations ripe for eliciting parental guilt. Parents regularly describe being berated by other people for spoiling their child. Strangers will shout out unsolicited advice when they are dealing with the child’s behavior. Strangers have called Child Protective Services, reporting parents for their out-of-control children whom they have difficulty soothing in public.

These situations are among the most stressful for parents of children with severe autism, undermining their confidence in their parenting, leading to reluctance to take their children out in public and making parents of these children feel very GUILTY.

Guilt over Neglecting Typically Developing Children

Then there is the double whammy of the guilt parents of children with special needs feel toward their typically developing children. I frequently hear from parents who worry that, with all the time and resources required by the child with special needs, the other children in the family are “neglected,” deprived of the parental attention they require. Parents express feeling guilty over the daily stress and disappointments that can go along with having a severely impaired sibling.

Over the years, there is often guilt expressed about the eventual need of the typical siblings to be responsible for the one with developmental disability when the parents are no longer around, the anticipation of guilt following the parent to the grave.

When our conversation about the deficient shoe-tying wrapped up at our holiday table, my daughter must have recognized that faraway look I tend to get when the wheels of my mind are in motion. She said, “Should I expect that your blog audience is now going to be aware that I can’t really tie my shoes?”

“Yup,” I said.

I feel a little guilty about that now too.

About Lisa Shulman, M.D.

Lisa Shulman, M.D. is a neurodevelopmental pediatrician. She is an associate professor of pediatrics at the Albert Einstein College of Medicine, director of Einstein's Infant and Toddler Services and heads the RELATE program at the Children's Evaluation and Rehabilitation Center.

Saturday, January 24, 2015

Transition Planning: What to Do When They “Age Out”?

From Special-Ism

By Joanna Keating-Velasco
January 16, 2015

The Individuals with Disabilities Education Act (IDEA) mandates a public education for all eligible children ages 3 through 21 (in most states), and holds the schools responsible for providing the services and supports to ensure this occurs. Through the Individualized Education Program (IEP), the IDEA requirements are facilitated.

Part of this ongoing process is to include a transition plan which must also support students in their teens as they approach graduation or “aging out” of their school system. Ideally, a family should initially start this process when their child is 14 or so, but definitely should begin exploration and information gathering by age 16.

Do not wait until the last year of schooling!

This is part one of a two-part article which covers the suggested steps toward transition into two categories: Exploratory and Self-Development. Of course each transition planning process will be unique based on the individual’s abilities, interests, aptitudes, social skills, life skills and what is available in your area, but the suggested steps are all vital once specifically refined for your child. This article focuses on Parental Exploration.

Individual Transition Assessment

Basically, this is the ongoing process of collecting information to help your child (and you) learn more about his/her abilities, interests, challenges and needs as they relate to the demands of current and future working, educational, living, and personal and social environments.

During this assessment period, be sure to pay close attention to any challenges in functional life skills or extreme challenging behaviors. Some programs are restrictive in these areas; therefore, these challenges may limit your program options.

Your child’s continued improvement can open up more opportunities. Ongoing exploration can help improve opportunities for self-advocacy and self-determination as well. Assessment tool kits and resources can be found online or in bookstores. Families should begin this process in the early teens.

Program or College Opportunities and Visits

Research through school staff recommendations, parent referrals and online investigation what local programs, continuation schools or colleges are available and good potential fit for your child. Make appointments with program directors or college staff for visitations on your own as well as with your young adult.

Several years before your child “ages out” of the school system, begin a file of options and then begin visiting programs about a year prior to school exit.

Do not rely solely on recommendations from other parents (whether positive or negative). What’s great for one friend’s child may not be great for yours – and vice versa.

Conservatorship or Guardianship Legalities

Depending on your young adult’s cognitive level and abilities, you may need to seriously explore this avenue of legal process to help direct financial and medical affairs. This journey should be investigated no later than when your child turns 17 in order to obtain the necessary medical, psychological or psychiatric opinions and then prepare the court petition.

Once a child turns 18, theoretically, their medical professionals are no longer allowed to discuss their health decisions with you without proper authorization. Another less invasive alternative to consider is power of attorney. A special education or living trust is also something for parents to consider.

Seek resources from your Regional Center, district’s special education counsel or get a referral to a legal office with a specialty in this area. If you are utilizing legal advice, get solid trustworthy referrals to ensure you are working with people who are knowledgeable and will not take advantage of you financially.

Transition IEP Meeting

The Transition IEP Meeting should involve your young adult’s current teacher, administrator, your regional center contact, service providers, potential program agents, (possibly) an advocate and your young adult child. Many of the facets of your exploration process will “come together” at this meeting. Utilize this meeting and the resources in attendance to help you further navigate your child’s transition. Be ready with questions.

Contact Local “Transition” Agencies

Touch base with Regional Centers, adult program organizations (like Easter Seals), Social Security Administration, etc., to investigate transition possibilities such as day programs, vocational services, continuing education and residential living options. The timing of this contact may depend on your child’s age so keep key timing in a tickler file for future contact.

Navigating Through “Rough Waters”

If you have a child who exhibits aggressive behavior, major toileting issues or potentially dangerous elopement, make sure that the school and your family continue to address these challenges as a team early on. Much progress can be made if there is a team mentality to help your family maneuver through “rough waters.” Lack of forward progress in these three areas can severely limit your child’s future options when they “age out” of your public school system.

Issues that your school may have tolerated and cooperated with your family don’t necessarily have to be “accepted” or managed by privately-operated programs. This could severely limit your family’s possibilities, which can be discouraging. So please focus on these areas as soon as possible.

And finally, keeping a file or binder of all of the information discovered in your exploration can help you keep track of your progress. You will find that all of your “baby steps” in this area will soon add up to be “big leaps” of positive progression.

Also, you are not alone on this journey. Join a network (whether online or through your school district) of other parents who are also navigating these “strange new lands.” And finally, bon voyage in your adventures through Adult Transition!

About Joanna Keating-Velasco

Joanna Keating-Velasco has worked with students with various special needs ages 3 through 22 as a Paraprofessional for over fifteen years and is currently specializing in adult transition. She has authored two books, A Is for Autism, F Is for Friend, and In His Shoes – A Short Journey through Autism.

Friday, January 23, 2015

Top Tips for De-Stressing IEP Meetings

From Brenda Dater's Blog

By Brenda Dater, MPH, MSW
September 15, 2014

IEP meetings can be very stressful--especially if you feel that your child is misunderstood and other parents have told you to expect a fight. As a mom who has attended IEP meetings since 1998 for my own kids and sat in on countless others through my work at AANE and helping friends, I've noticed that these key tips can help you leave the meeting in a more hopeful state. Try them out at your next meeting and let me know if they help!

What to Do Before the Meeting

1.) Ask for an agenda or provide one to the team chair. Think about what's most important to discuss with your team and if that isn't on their agenda, let them know ahead of time that you'd like to include it.

2.) Clarify how much time you will have for the meeting. If there isn't enough time to cover important concerns it is okay to request another meeting to continue the conversation and make decisions about your child's plan.

3.) Think about your triggers. What sets you on edge in your child's meetings? Is it a particular person, subject or phrase? In my case, it was when a teacher told me that labeling my child with a disability was holding him back and hurting him. I don't remember exactly how I responded, but I'm pretty sure it was loud and filled with fury. It's okay to ask for a break or be silent for a moment while you take a few deep breaths.

4.) Organize your own thinking and priorities. It's easy to feel overwhelmed when you don't have a sense of what to focus on or what's most important to put in place for your child. Review current evaluations, your child's strengths and needs, and make a list of needs you want to talk about.

How to Respond During the Meeting

If the team members make the following types of statements and you start to feel angry or anxious, try some of these responses:
  • If a team member says, "We don't do that", try responding with, "You haven't done it yet. It doesn't mean it's not possible. How can we individualize his program to meet his needs?"
  • If a team member says, "We don't think your child needs that level of support or services", try responding with, "It sounds like we're in disagreement about what my child needs. I think we need more information to better understand his academic and functional needs."
  • If a team member says, "We don't have anybody on staff who can provide that service for your child", try responding with, "It sounds like it might be time to find an outside consultant who has the skills to do the work."
  • If a team member says, "We don't see the needs in school", try responding with, "She isn't generalizing skills into other environments. Demonstrating a skill in a small group setting is necessary but not sufficient."
  • If a team member says, "You need to sign the IEP today so we can start providing services", try responding with, "I need to take this home and review it. I will get it back to you before the deadline."
  • If a team member says anything else that upsets you, try responding with, "I'll need to think about that and get back to you." You can also say you need a break.

What to Do After the Meeting

1.) Do something relaxing.Team meetings can take a toll on parents (and teachers). Please take care of yourself afterwards.

2.) Send a follow up email to your team. I usually wrote an email that stated, "This is my understanding of what we agreed to and what is still to be decided. Please let me know if there are any corrections needed."

3.) Do something fun with your child. Choose something you and your child will enjoy together. It's important to take a break from thinking about the meeting and put your energy into positive time with your child.

About Brenda Dater

Brenda Dater, MPH, MSW is author of Parenting without Panic: A Pocket Support Group for Parents of Children and Teens on the Autism Spectrum (Asperger’s Syndrome).

She is also the Director of Child and Teen Services at AANE (the Asperger/Autism Network), where she teaches workshops, facilitates support groups and provides consultations for parents, grandparents and professionals. She attended the University of Michigan where she received a Bachelor’s degree in Psychology and Masters’ degrees in Social Work and Public Health.

Thursday, January 22, 2015

Unsolicited Praise for NESCA Yoga Therapist Hannah Gould, M.Ed., RYT


January 22, 2015

The other day, quite unexpectedly, we received the following testimonial from a mom who had enrolled, with her son, in Hannah Gould's "Yoga Connects" program. Hannah has been coordinating yoga-based therapies at NESCA for seven years and, most recently, developed "Yoga Connects," a curriculum for visual learners that is remarkably effective with children on the autism spectrum. We've always thought that in Hannah, we had a gem; this letter confirms it. Nice work!  

"I had a wonderful time and learned a lot! I am confident that we will be using Yoga Connects in many ways throughout the day. The short sessions before homework continue to be a great way to transition from a preferred activity like video games to a less preferred activity. I am starting my mornings with waterfall flow. Just taking a moment to stretch and take deep breaths before I even leave my bedroom helps me immensely!..."

Hannah is a gifted teacher for both children and adults. She is patient, kind, and funny. Her accepting nature makes you feel immediately at ease. Both my son and I have learned through Hannah how to make yoga a part of our lives.

I used to be intimidated by yoga, but Hannah showed me how even short yoga sessions are beneficial and can fit into and enrich our lives. Our home practice may be a tad unorthodox, but through it we find a little more clarity each day. It reminds us to breathe deeply and find our inner strength."

How to Help Your Depressed Teenager

From the Child Mind Institute

By Stephanie Dowd, Psy.D.
January 13, 2015

When kids are young, parents are used to swooping in and rescuing them whenever they need help. As your kids get older and their problems become more complex, you have to transition into more of a supporting role, and that can be difficult. This is especially true with teens who are struggling with depression. They need help to get better, but first they have to want that help.

How do you know if your child is depressed?
  • Has she been sad or irritable most of the day, most days in a week for at least two weeks?
  • Has she lost interest in things that she used to really enjoy?
  • Have her eating or sleeping habits changed?
  • Does she have very little energy, very little motivation to do much of anything?
  • Is she feeling worthless, hopeless about her future, or guilty about things that aren't her fault?
  • Have her grades dropped, or is she finding it difficult to concentrate?
  • Has she had thoughts of suicide?
If your teen shows more than a few of these signs she may have depression that warrants professional attention. While you can't make her want to get better, there are some things that you as her parent can do. And it starts with simply being there for her.


What Are the Symptoms of Depression in Teenagers?
  • Signs you child might be more than moody start with losing interest in things she usually enjoys. Here's what to look for. READ MORE.

Be Supportive

One of the most important things you can do for your teen is to work on strengthening your relationship. Try to build empathy and understanding by putting yourself in his shoes. You might be frustrated that he seems down and irritable a lot of the time and doesn't seem to be doing much of anything to help himself.

But if there isn't much in his life that is making him happy, or something intensely disappointing has happened to him, it's understandable that he might avoid things he used to enjoy and retreat to his room. Depression makes even doing the smallest things more difficult.

Try to validate his emotions, not his unhealthy behavior. For example, you could say, "It seems as though you've been really down lately. Is that true?" Make it clear that you want to try to understand what's troubling him without trying to problem solve.

Be compassionately curious with him. Ask him questions about his mood gently, without being emotional. Even parents with the best intentions often don't realize that their concern can come across as critical rather than loving. Do not be judgmental or try to solve his problems, even if you disagree with his point of view.

Listening to him talk about his problems might seem as though you're highlighting the negative, but in fact you're letting him know that you hear him, you see him, and you're trying to understand—not fix him.

People don't like to be fixed. Listening without judgment will actually make him more likely to view you as an ally and someone he can turn to when he's ready to talk.

Try also to give him opportunities to do things without being critical of him. Instead of saying, "Honey, you should really get up and do something. How about calling an old friend?" you might say, "I'm going to the mall to do an errand. Let me know if you want to come with me, and maybe we can get lunch together."

For some parents this can feel passive, as though you're not doing enough. But being there for him and communicating your acceptance of him is exactly what he needs from you right now. It's actually a very active way to strengthen your relationship.


Mood Disorders and Teenage Girls
  • Why are they more vulnerable than boys to depression and anxiety, and what signs and symptoms should you look for? READ MORE.

Accentuate the Positive

Make sure you're noticing the positive things your teen does, too. Going to school, holding down a part-time job, doing the dishes or picking up her brother from soccer practice: These are all good things she's doing, and it's important to recognize them rather than thinking, "This is what she should be doing."

We all like to be appreciated and recognized for doing a good job, even when it's expected of us.

Ask yourself how many positive things have you said to her today? How many negative things have you said? How many times have you highlighted her problems or tried to fix them? The positive should outweigh the negative.

Let her know that you're proud of her, that she's doing a good job if you see her taking care of herself, doing homework, interacting with the family, or doing other things that take effort. She'll likely appreciate that you noticed.

Likewise, you don't need to mention that you're disappointed she isn't hanging out with friends as much, or taking the interest she used to in guitar, for example. She probably feels disappointed, too, and doesn't need to be reminded of what's not going well in her life. She doesn't want to feel this way. If she could snap her fingers and feel better, she would.

Helping Kids Get Treatment

Some teens will want to go to therapy when you ask them and some won't. For those who are resistant, know that they aren't going to suddenly open up to the idea of therapy (or to you) quickly, but you can help guide them towards treatment by opening the door and then waiting patiently for them to walk through it.

Try saying, "I know you're having a hard time, and I have some ideas of things that could help. If you'd like to talk with me about them, let me know. I'm here for you." It's also a good idea to ask her if she has any suggestions on how you might be able to help her. You might be surprised with what she has to say.

Be aware that your teen might tell you to back off. That's fine; it's her way—albeit a slightly irritable one—of telling you that she needs space. It's normal for teenagers to want independence, and it's important for you to respect that. You can respond by saying, "I'll give you more space, but know that I'm here for you if you ever want to talk or hear my suggestions."

If she does come to you wanting help, be prepared. Do your research. Find two or three therapists she can interview and tell her that she can choose the one that she feels most comfortable with, and thinks will help the most.

Finding a therapist who is a good fit is extremely important, and making the choice hers will help her feel ownership over her own treatment, which is extremely important to teens and sets the stage for effective therapy.

It's also important to know that there are several different kinds of therapy that might be helpful for your teen, including some well-studied behavioral therapies. Interpersonal therapy (IPT), cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and behavioral activation have all been shown to be helpful for teenagers with depression.

Make sure that your child has had a thorough evaluation that includes treatment recommendations to help guide you.

Many teens with depression benefit from medication, such as an anti-depressant. While therapy alone may be effective with mild to moderate depression, the best results are usually gained with a combination of medication and therapy.

If medication is a consideration, it is important to make sure that the doctor you see—whether she's a pediatrician or a child and adolescent psychiatrist—has experience treating teenagers with depression, and has time to monitor your child's progress.

Why Treatment Might Not Be Working

If your child already is in treatment but it isn't helping, ask him why he thinks that is. What isn't helpful or what doesn't he like about therapy? Are there things about therapy he does like? Maybe you can work together to find a therapist who does more of the things that he likes. If you do consider changing therapists, it's important to discuss this with his current therapist before the decision to change is made. Many times, the therapy and/or the therapeutic relationship can be improved.

Keep in mind that therapy usually isn't effective if the person in treatment isn't committed to it, or is doing it to please someone else. Your child should want to get better for himself. Unfortunately, sometimes people have to get worse before they want help. But the good news is that if you lay the groundwork by strengthening your connection with him now, he'll be more likely to turn to you for support when he's finally ready.

Taking Care of Yourself

Lastly, it's important to make sure that you're taking care of yourself. It can be emotionally and physically exhausting to be a parent of someone who is struggling with depression. Know that you are not alone, and get support for yourself. Make sure that you make time to do things you enjoy and go out with friends. The phrase: happy mommy(or daddy) = happy baby (read: teenager) still applies!