Category Archives: behavior

Georgetown Pediatrics has a new counselor!

In keeping with our commitment to serving the whole child (physical, mental, and behavioral) we recently hired Staci Case (CRC, LPCC) to join our staff.

Staci is both professional and personable, the perfect combination for her work. Her education is all from Kentucky: an undergraduate degree (BA in Social Work) from the University of the Cumberlands, and a Master of Science in Rehabilitation Counseling from UK. In addition, she holds two specialty certificates in Developmental Disability and Applied Behavior Analysis.

Staci works with each patient to make the counseling process individualized, because each child or teen is different, with unique needs.

As a Certified Rehabilitation Counselor (CRC) and Licensed Professional Clinical Counselor (LPCC), Staci has worked with and advocated for disabilities and issues of all kinds. Included in those issues are

Autism,
Learning Disorders,
Behavior,
Brain Injury,
and others.

When asked about her work, Staci says, “I love working with kids using their strengths and interests to develop needed skills for daily life, school, and relationships. I like to help kids take ownership of their treatment goals by finding the right tools to succeed and build confidence.”

She will use Assessment, Behavior Modification, & Cognitive Behavioral Therapy in sessions; however, she makes sure therapy time is unique to each patient and their family, giving them appropriate space to explore and process. She offers academic testing, when needed, as a tool to identify possible learning limitations and to problem-solve solutions.

As a mom of 3 girls—Aubrey, Taylor, and Berkley—Staci can relate to the joys and issues of parenting. Together the family enjoys camping, fishing, softball, ballet, and helping others at every opportunity.

Are you interested in making an appointment with Staci Case? Call our office at (502) 863-6426. We are happy she’s a member of our staff, and look forward to serving your particular counseling needs.

Help your child want to wear a mask

Leave a reply

A year ago, no one could have guessed that a back-to-school list would include face masks, but that’s definitely where we are in 2020.

The school year is starting soon, with some huge changes. Many people are more than a little anxious about what the classroom will be like, and how students and their families, faculty, and staff will be able to navigate this new landscape of social distancing, extra hygiene, and mask-wearing.

A recent article from the American Academy of Pediatrics discusses the whys and hows of wearing masks.

Here are some guidelines.

Follow school rules. You always teach your child to respect the teachers and staff, and to obey school rules. Rules about mask wearing are no different. You may not agree with every rule, but it’s important that you support mask wearing if the school requires it.
Make sure the mask fits well. One that is too tight, too loose, or doesn’t cover both nose and mouth is not very effective.
Practice wearing at home. The whole family can wear masks for an hour, making everyone more comfortable with the sensation. Wear when you go into a store, and keep masks by the door so you don’t forget to take them when you go out.
Use age-appropriate talking points like, “Masks help us keep our germs to ourselves.” For teens, remind them that they are part of the solution for keeping themselves, their friends, and their families safe—they are being good citizens.
Avoid creating fear and anxiety. For young kids, here’s a great song video with Sesame Street characters about how we care for each other by wearing masks, washing hands, and keeping social distance.
Make mask-wearing fun. For younger children, put masks on their favorite stuffed animals. Give the child a gift of a mask you know they’ll enjoy.
Consider your budget and provide your child or teen with masks they’ll love showing off at school. Even though spending $10 or $15 for a mask sounds like a lot of money, think of it as an article of clothing. A purchase of two masks allows you to rotate them through the laundry each day. Buy masks that are washable, reusable, and that demonstrate individualism. From Amazon to Old Navy, there are masks that show support for your favorite team, are in a special color or design, or make you into a super hero. Your child or teen doesn’t like masks? Consider a neck gaiter instead; they also come in a variety of designs.
Find more ideas here from Norton Hospital in Louisville.

It takes all of us working together to keep our children, teens, and adults as safe as possible until a vaccine is widely available. We know you care about your family and your community, and we’re here to help you navigate this uncharted territory together. Call us if you have questions.

Talking to children after a tragedy

Leave a reply

The recent shooting in Orlando leaves every parent—and anyone who cares about children and teens—in the position of wondering what to say and how to say it. You are reeling from the news, and you want to protect the children you love from being hurt by it.

There is no perfect way to handle tragedy with youngsters, but here are a few basic guidelines. All of the quoted information below comes from an article you may want to read in its entirety, from the American Academy of Pediatrics (AAP).

“No matter what age or developmental stage the child is, parents can start by asking a child what they’ve already heard. Most children will have heard something, no matter how old they are. After you ask them what they’ve heard, ask what questions they have.”
“In general, it is best to share basic information with children, not graphic details, or unnecessary details about tragic circumstances. Children and adults alike want to be able to understand enough so they know what’s going on. Graphic information and images should be avoided.”
“Keep young children away from repetitive graphic images and sounds that may appear on television, radio, social media, computers, etc.”
“With older children, if you do want them to watch the news, record it ahead of time. That allows you to preview it and evaluate its contents before you sit down with them to watch it. Then, as you watch it with them, you can stop, pause, and have a discussion when you need to.”
“Today, most older children will have access to the news and graphic images through social media and other applications right from their cell phone. You need to be aware of what’s out there and take steps in advance to talk to children about what they might hear or see.”
“The reality is that even children as young as 4 years old will hear about major crisis events. It’s best that they hear about it from a parent or caregiver, as opposed to another child or in the media…

The underlying message for a parent to convey is, ‘It’s okay if these things bother you. We are here to support each other.’”

What if you have an older child or teen? “After asking your child what they have heard and if they have questions about what occurred during a school shooting, community bombing, natural disaster, or even a disaster in an international country, a parent can say something such as: ‘Yes. In [Orlando, Florida]’ (and here you might need to give some context, depending on whether it’s nearby or far away, for example, ‘That’s a city/state that’s pretty far from/close to here’), there was disaster and many people were hurt. The police and the government are doing their jobs so they can try to make sure that it doesn’t happen again.’”

If your child seems to be overwhelmed with anxiety after a tragedy, and that feeling doesn’t get better with time, talk to your pediatrician. You may also request our office to refer you to a counselor who specializes in working with children or teens. Signs that they are having trouble coping include problems with sleeping or eating (too much or too little); physical symptoms such as tiredness, headaches, digestive issues; or behavioral changes.

It is only natural to be upset when a tragedy occurs. Every adult feels that way, and so do children and youth. If you haven’t had a conversation with them about it, today is a good time for that discussion.

Bullying is a serious matter

Leave a reply

October is National Bullying Prevention Awareness Month. That means now is a good time for us to talk about this important subject.

Bullying can occur at school or on the bus, in the neighborhood, on the playground— anywhere. Cyber bullying is also on the rise, where people use the internet or phone apps to harm others.

At the very least, bullying lowers self-esteem. But as we know, continual bullying can cause children and teens to withdraw socially, may create depression or other mental health issues, and can even result in physical harm.

Parental awareness is essential. It’s almost certain that your child will, at some point, either be on the receiving end of bullying behavior, or will bully someone else, or both. An article on the American Academy of Pediatrics (AAP) website references a study from 1999, in which four out of five teens admitted to participating in bullying behavior at least once a month. Those who have been bullied often go on to mistreat others.

Conversations about appropriate behavior and language need to begin early between parent and child. Don’t hesitate to correct your child or teen when you hear name-calling or witness unkind behavior, even between siblings. They can learn early the boundaries between acceptable and unacceptable behavior. Teach them how to express themselves, especially when hurt or angry, by using language that doesn’t cross the line into disrespect. Don’t tolerate violent acts against people or animals.

Of course, your kids are not always near you, and you won’t be aware of everything that happens to them or everything they do. Continue the conversation about bullying; remind them to walk away from confrontations and to inform a responsible adult if they experience or witness bullying. Talk about kindness; role-play sticky situations. Monitor their internet and cell phone activity and discuss what you find there.

Teach your kids some nonviolent and non-confrontational ways to handle conflict. There are excellent resources for this in the article mentioned above, also here and here.

Remember that school counselors and other therapists can be really helpful if your child or teen is a victim or perpetrator of bullying, and our office can always make a referral.

As children get older, remind them that they help create a safe environment for others. They can be a positive force by refusing to contribute to an atmosphere of hatred.

As the school year continues, things can get very hectic. Don’t forget to pay attention to what’s going on with your youngsters. Ask questions, be supportive, get help when needed. Let’s keep our schools and community safe for everyone’s children.

Artwork by Shawna

Halloween Safety Tips

Leave a reply

Today’s entire blog below is quoted from the AAP, here. Have a great Halloween!

Halloween is an exciting time of year for kids. Here are some tips from the American Academy of Pediatrics (AAP) to help ensure they have a safe holiday.

All Dressed Up:

Plan costumes that are bright and reflective. Make sure that shoes fit well and that costumes are short enough to prevent tripping, entanglement or contact with flame.
Consider adding reflective tape or striping to costumes and Trick-or-Treat bags for greater visibility.
Because masks can limit or block eyesight, consider non-toxic makeup and decorative hats as safer alternatives. Hats should fit properly to prevent them from sliding over eyes.
When shopping for costumes, wigs and accessories look for and purchase those with a label clearly indicating they are flame resistant.
If a sword, cane, or stick is a part of your child’s costume, make sure it is not sharp or too long. A child may be easily hurt by these accessories if he stumbles or trips.
Obtain flashlights with fresh batteries for all children and their escorts.
Do not use decorative contact lenses without an eye examination and a prescription from an eye care professional. While the packaging on decorative lenses will often make claims such as “one size fits all,” or “no need to see an eye specialist,” obtaining decorative contact lenses without a prescription is both dangerous and illegal. This can cause pain, inflammation, and serious eye disorders and infections, which may lead to permanent vision loss.
Teach children how to call 9-1-1 (or their local emergency number) if they have an emergency or become lost.

Carving a Niche:

Small children should never carve pumpkins. Children can draw a face with markers. Then parents can do the cutting.
Consider using a flashlight or glow stick instead of a candle to light your pumpkin. If you do use a candle, a votive candle is safest.
Candlelit pumpkins should be placed on a sturdy table, away from curtains and other flammable objects, and should never be left unattended.

Home Safe Home:

To keep homes safe for visiting trick-or-treaters, parents should remove from the porch and front yard anything a child could trip over such as garden hoses, toys, bikes and lawn decorations.
Parents should check outdoor lights and replace burned-out bulbs.
Wet leaves should be swept from sidewalks and steps.
Restrain pets so they do not inadvertently jump on or bite a trick-or-treater.

On the Trick-or-Treat Trail:

A parent or responsible adult should always accompany young children on their neighborhood rounds.
If your older children are going alone, plan and review the route that is acceptable to you. Agree on a specific time when they should return home.
Only go to homes with a porch light on and never enter a home or car for a treat.
Because pedestrian injuries are the most common injuries to children on Halloween, remind trick-or-treaters:
- Stay in a group and communicate where they will be going.
- Remember reflective tape for costumes and trick-or-treat bags.
- Carry a cell phone for quick communication.
- Remain on well-lit streets and always use the sidewalk.
- If no sidewalk is available, walk at the far edge of the roadway facing traffic.
- Never cut across yards or use alleys.
- Only cross the street as a group in established crosswalks (as recognized by local custom). Never cross between parked cars or out driveways.
- Don’t assume the right of way. Motorists may have trouble seeing trick-or-treaters. Just because one car stops, doesn’t mean others will!
Law enforcement authorities should be notified immediately of any suspicious or unlawful activity.

Healthy Halloween:

A good meal prior to parties and trick-or-treating will discourage youngsters from filling up on Halloween treats.
Consider purchasing non-food treats for those who visit your home, such as coloring books or pens and pencils.
Wait until children are home to sort and check treats. Though tampering is rare, a responsible adult should closely examine all treats and throw away any spoiled, unwrapped or suspicious items.
Try to ration treats for the days following Halloween.

Whether dressing up in costumes, trick-or-treating, or having parties with their friends, most kids love Halloween. But did you know that Halloween is also a time when more children than usual end up in the emergency room due to falls, traffic collisions and other injuries? All the sweets in the house (and at school) can also wreak havoc on a child’s teeth and healthy diet.

To help ensure your child’s Halloween is both safe and healthy, pediatrician Corinn Cross, MD, FAAP joins the Healthy Children show on RadioMD with some tips from the American Academy of Pediatrics. Listen here.

Marijuana, the safe drug? Think again.

Leave a reply

Now that laws in some states (though not in Kentucky) are easing in regard to marijuana possession and usage, some teens and adults believe it must be a harmless drug.

Not so, especially for teens.

Marijuana, according to an article by the American Academy of Pediatrics (AAP), affects many aspects of a young person’s mental, physical and emotional health, and it’s certainly addictive.

For someone who smokes or ingests marijuana regularly, clear thinking and good judgment are often affected. This can cause school work (and grades) to falter, and can lead to bad decision-making. The AAP states that marijuana users are more likely to engage in “unwanted or unprotected sex” because their judgment is impaired. Also, “Those who drive or take other risks after smoking marijuana are much more likely to be injured or killed.”

According to the same article, because teens are still growing and developing, marijuana usage “can lead to a wide range of serious health problems, including heart and lung damage, cancer, mental health problems, and addiction. Depression, anxiety, and schizophrenia occur more often in marijuana users.”

How to prevent addiction to marijuana and other drugs in your teen?

Educate. Make sure you know about drug usage and its signs, and educate your teenager. When you see someone else acting irresponsibly, or hear about a situation of driving under the influence, initiate a calm discussion.
Monitor. Don’t assume your child will never try drugs. Marijuana, say teens, isn’t that hard to come by. Watch for signs. Pay attention to the people your kids hang out with.
Be an example. Don’t abuse drugs or alcohol. Make sure illegal drugs have no place in your home.
Get help. Make sure your teen sees a counselor if needed—not just if she is using drugs, but for any emotional or educational issues. This is a serious concern and outside help is sometimes needed.
Be aware. If you think your child could be using drugs, you may contact our office for a drug screen.

Your teen needs you to keep an eye on his total well-being, and that includes making sure he stays away from addictive substances.

Back in School, Part 4: Friends

Leave a reply

While you are worrying about your child’s academic year, he is probably more concerned about friends. Honestly, he has a point. While academic skills are an important part to future success and happiness, so are the social skills that help us make and keep friends.

Children at a very young age are usually too self-centered to have friends. This isn’t their fault; it is just a normal developmental stage. If you watch a couple of toddlers on a play date, they will usually engage in what is called “parallel play,” meaning they play side-by-side, but not really together. Even so, you can start to teach them to share, not to grab toys away, etc.

By school age, most children want friends, whether it is just one or many. Good social skills are learned from parents, teachers and peers. Here are some behaviors you can teach your kids that will serve them in school and throughout their lives.

Kindness. Use kind words and tones around the house. Don’t allow your children to be unkind to their siblings, to pets or to adults. Everyone responds positively to kindness, and no one likes a bully.
Politeness. (See our post on manners.)
Assertiveness. You don’t want your child to be aggressive toward others, but you want her to be able to assert her opinions and express her feelings without being overbearing. This takes practice, and it can be something you encourage through conversation, questions, and even role playing. For example, “What will you say if your friend wants to play kickball and you’d rather swing?” They can learn from you the give-and-take of good relationships.
Meeting and greeting. Teach your youngster to introduce himself and to ask questions about another person. They can learn to shake hands, make eye contact, smile.
Listening. Hearing what another person has to say is as important as expressing your opinion.

Here’s a really nice FREE online resource entitled 101 Ways to Teach Social Skills to Children. While the games and activities are designed for groups, many of them can be adapted for use within the family—a fun way to learn appropriate ways of behaving in different settings.

Every school in Scott County has a counselor who can observe behavioral issues both in and out of the classroom, and who can meet with your child and/or other students if needed.

A final word: pay attention to the friendships your child/teen is forming. Get to know his friends and their parents. Make sure their behavior isn’t out of line with what you expect from your own kids.

The friendships we form in childhood and adolescence may or may not last a lifetime. But they teach us skills and behaviors that are timeless.

Back in School, Part 3: Teachers

Leave a reply

Every morning when you send your child to school, you are putting her into the educational, social, emotional and physical care of other adults. This can be intimidating at times, but it doesn’t have to be.

The vast majority of teachers are in classrooms because they want to be, because they care about the students and love the material they teach, and because they want to make a difference. They spend time in the classroom trying to instill in youngsters the love of learning. And they spend time outside the classroom preparing lessons, grading work, and keeping the mountains of records and paperwork required by the school system.

Most of all, they want every child—your child—to be successful. That success is far less likely without your support.

Speak positively about your child’s teachers. If you hear complaints from your young student, listen with an objective mind.
Establish a relationship with a teacher. If you can volunteer at the school, wonderful. Your schedule may not allow that, so find other ways to be in touch.
- Stay connected. Most teachers and classrooms have a website. Send the teacher an e-mail when you appreciate something he’s done for your child or if you have a question. If there’s ever a problem, you will have built a positive base for your relationship, and the problem will be easier to deal with.
- Attend parent-teacher conferences. These are important for everyone concerned: student, teacher, family. You will learn things about the classroom and how your child interacts with adults and classmates, and will come away with a much more rounded picture of the education process in that particular class.
- Make appointments. Don’t wait for a conference if you have questions or concerns. Face-to-face meetings are helpful and teachers want to be available to you. They will want to hear from you sooner rather than later.
- Reinforce at home what’s happening in the classroom. From spelling tests to chemistry homework, from learning how to talk out problems with fellow students to deciding what to eat for lunch, the teacher and you are on the same team.
- Of course, if there is ever concern about inappropriate or illegal activity by a teacher or any other adult, notify the authorities immediately.

Teachers are on the front lines of helping your child develop in age-appropriate ways. Support them, connect with them, and thank them.

Back in School, Part 1: Staying Healthy

Leave a reply

Now that your child is back in school, the sometimes easy-breezy days of summer have turned hectic with schedules, deadlines, homework, complex relationships. For the next few weeks we’ll be running a series about things to keep in mind during the school year ahead.

Today we start with how best to insure a healthy year at school.

You already know the best way to stay healthy, but it bears repeating: prevention is always the best medicine. Here are some pointers.

Checkups. Has your child had her annual well child checkup? If not, now is the time to schedule it. The doctor will look at health history, height and weight, and will discuss age-appropriate health topics with you and your child. If you have a specific concern (social behaviors, learning difficulties, chronic ear infections, etc.) to discuss, you’ll want to let the office know when you call for the appointment to make sure they schedule a longer visit for you.
Immunizations. Yes, we harp on this a lot, but it’s for good reason. Immunizations protect children, families, and even whole communities from dangerous diseases. The state requires that you keep certain ones up to date; we have others we recommend. Check with our office (or on the patient portal) for your records.
Exercise. Sitting all day at school, then coming home and sitting in front of the TV or at the computer and homework desk is not good for your kid. He needs to get moving. Don’t expect physical education classes to provide all the exercise he needs. Unstructured play is good for all children, and organized sports are a great way to learn things like discipline, teamwork and a sense of accomplishment.
Germs. Let’s be honest. There’s no way to avoid germs at school. Uncovered coughs and sneezes, shared desks and close quarters give viruses all sorts of opportunities to infect students. Some exposure is good to develop immunity, but keeping hands clean is a great way to stave off colds and flu. Send hand sanitizer to school in your children’s backpack, and remind them to clean their hands before eating and after they use the restroom. Every time. Don’t share drinks or eating utensils. And, while we’re at it, remind them not to share combs, brushes or hats, which is the most common way to spread head lice.
Sleep. A good night’s sleep is an essential ingredient in the learning process. Sleep also helps mood and strengthens the immune system. Set a regular bedtime and stick with it, making sure your child or teen has an age-appropriate amount of sleep.
Balanced diet. Eating right feeds both body and brain. This webpage at the American Academy of Pediatrics site lists several of their articles regarding diet. Don’t forget we have a dietician on staff who can help you come up with an action plan for your young athlete, picky eater, diabetic, or can help you plan easy lunches and snacks to pack for school.

Keep these things in mind throughout the school year and they will help your child have a successful and healthy school year.

Reading is fun, but what if your child has dyslexia?

Leave a reply

Many people delight in reading a good book over the summer and families often take trips to the library or virtual trips to Amazon. But for some, reading is a chore or nearly impossible.

Dyslexia, also known as Developmental Reading Disorder (DRD), is a learning disability that starts with the brain, though it doesn’t at all mean that the affected person has lower intelligence. It’s simply the inability to process words properly and can involve auditory and oral issues as well as reading. A person with DRD might have trouble distinguishing letter and word sounds when someone is speaking, as well difficulty recognizing written words. DRD may sometimes be clustered with learning disabilities that inhibit writing and/or arithmetic skills.

If you’re concerned that your child may have dyslexia or another learning disability, speak with your pediatrician. She’ll ask questions about family history and the particular difficulties your child is having, and may schedule (or refer for) a neurological exam or other testing.

Treatment involves specific types of tutoring and coping skills, depending on the type and severity of the learning disability. The pediatrician or an educational psychologist can help you find the right program for your specific situation.

Learning disabilities often lead to boredom, behavior problems, and low self-esteem. The frustrations of not being able to read at grade level or perform schoolwork correctly and in a timely manner can be very stressful. For that reason you may want to arrange some counseling for your child as well. Psychological coping skills are just as important as educational coping skills.

For more information, this National Institutes of Health article is very helpful, and the source of much of the information in today’s blog.