By Harold S. Koplewicz, MD
President of the Child Mind Institute

At the start of Black History Month, I like to honor the many contributions Black Americans have made to the field of child and adolescent mental health by featuring Mental Health America’s list of Black Pioneers in Mental Health. Please take a moment to read about the following outstanding individuals, whose work has led us toward a mental health landscape that effectively serves far more children and families.

• Harriette Pipes McAdoo, PhD, an expert in educational psychology and child development, was one of the first researchers to challenge prevalent, harmful racial stereotypes about Black families. She also created and edited the influential anthology Black Families, which highlighted the diversity of experience and strengths of Black family life. Dr. Pipes McAdoo was appointed by President Jimmy Carter to the White House Conference on Families.
• Herman George Canady, PhD, a well-known clinical and social psychologist, was the first to study how the race of a test proctor can create bias in an IQ test. His work helped provide the framework for creating testing environments where Black students could succeed. He was also an active member of the American Teachers Association in the 1930s and beyond, and fought for more spots and training for Black psychologists at universities.
• Beverly Greene, PhD, ABPP, is an educator, clinical psychologist, and pioneer of intersectional psychology. She has significantly furthered our view of how different parts of a person’s identity shape their mental health and experiences. Dr. Greene won the highly prestigious American Psychological Association 2023 Award for Outstanding Lifetime Contributions to Psychology, among many other awards, and has been the author or co-editor of over 100 publications.

Inspired by these mental health trailblazers, we must ask ourselves what we can do to aid their work and carry it into the future, because all children and families deserve to receive the support they need to thrive.

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When a child has a learning disability, parents are typically their first advocates, working with schools to get the services that their kids need to thrive. A child with an LD may have difficulty in learning primary skills such as reading, writing or math. They often need extra support, explicit teaching of skills, and school accommodations to succeed.

But because learning disabilities are so often invisible, and parents aren’t always around to speak up for them, it’s also especially important that kids with LDs learn how to advocate for themselves. Students who struggle with LDs are just as intelligent as other kids, but can be mistaken for lazy or defiant when they struggle to do things that come easily to other students. Being outspoken can help prevent or clear up any confusion.

Self-advocacy is the ability to speak up for yourself to get what you need to succeed. In the context of kids with learning disabilities, it means being able to explain their LDs — how they learn differently than other kids, and what their strengths and weaknesses as learners are. And it means being able to assert themselves in an appropriate way – usually to adults – about what supports they need and why.

“Self-advocacy is a skill that’s part of self-determination, which is the idea that you are in charge and in control of your own life,” explains Taina Coleman, MA, MEd, an educational specialist in the Learning and Development Center at the Child Mind Institute.

This can look like a student reminding a teacher that because they have dyslexia they are entitled to extra time on a test, or asking if they can type rather than take notes by hand, since dysgraphia makes that difficult for them. A student with dyscalculia, the math learning disability, might ask to use a calculator. It can also mean being comfortable asking for help more generally or starting a conversation about their struggles. The idea is to empower students to feel confident, rather than ashamed, about what they need.

Before you can advocate for yourself, you need to have a clear understanding of what you are advocating for. “It’s always a good thing to know more about yourself, even the hard stuff,” says Coleman.

Some parents find it uncomfortable to tell their child about their diagnosis, but hiding the information doesn’t shield them. They know they are struggling and having a hard time doing things that other kids find easy. It’s very important for them to understand why that is. When kids get that everyone has strengths and challenges, and that learning disabilities have nothing to do with intelligence, it can be both a relief and a confidence boost.

Coleman has found that even early elementary students are able to have this conversation, and it should include what they’re good at, as well as what they’re struggling with. “No matter the age, my goal is always to develop a strong sense of strength,” she explains. Not to say that everything is a strength, but to use that as a starting point to discuss the student’s goals, learning styles, challenges, and accommodation needs.

Some kids may need more help than others understanding their learning profile. Learning about how you learn, what experts call metacognition, is an important part of the process. It’s all key to developing a growth mindset, which is based on the understanding that intelligence and ability are not fixed but rather based on effort, experience, and a willingness to learn from mistakes. 

Once kids know what they need, it’s time to give them a sense of what they are entitled to. Coleman says that kids in fifth grade and up are especially ready for these conversations because they are so justice-oriented and interested in what is fair. But even younger kids can and should have a basic understanding of what tools are available.

Emphasize that it’s not cheating to get the support you need. Accommodations are a legal right; students with disabilities are entitled to a free appropriate public education (FAPE) under the Individuals with Disabilities Act (IDEA).

To help drive home the point, Coleman likes to use the example of glasses. Glasses are an accommodation that help people who have vision challenges level the playing field. No one would say that wearing glasses gives someone an unfair advantage. It’s the same thing for kids with learning challenges.

All kids will benefit from a general understanding of what tools are at their disposal, and how they can use them. Tools might include access to a learning center, one-on-one interventions, untimed testing, audiobooks, the ability to record lectures, noise-cancelling headphones, and more. Kids can learn about what specific resources are available to them and where they can go for help. If they have an IEP or 504 plan, let them know what accommodations are outlined and what their rights as a student are.

Learning how to communicate needs and rights is where self-advocacy gets put into practice. Students need to know who to go to and how to effectively and respectfully get their point across.

Kids may feel shame or stigma when it comes to calling attention to their learning differences, or may just be nervous about speaking up to adults. Scripts, practice, and role playing in a safe space can be helpful.

“I practice with students,” says Coleman. “How can we articulate this in an email? How do we persuade if we have to persuade? Because unfortunately there may be educators and adults who don’t think they need what they need. We practice every possible response. Usually the scary responses don’t happen, but the kids still need to practice it.”

Self-advocacy can take place outside the classroom as well, so it’s worth covering a range of scenarios – from summer camp to social situations – in which kids may need to speak up for themselves. Often it can be as simple as saying “Hey, I have a learning disability that makes this tricky for me.” They don’t need to divulge more details than are necessary but can let friends or counselors know what might makes things easier for them, whether that’s making plans by text rather than phone calls or learning the rules to a new game ahead of time.

While a lot of self-advocacy takes place at school, it starts at home. Parents and caretakers can model what it looks like, both for themselves and their children. And they can reinforce the message that it’s important to stick up for yourself to access the tools you need to succeed. This can look like a parent telling a story about requesting an accommodation for themselves at work, commenting on a relevant storyline in a book or movie, or standing up for their kid at school and fighting for what they need.

 “One of the best things I can do to support a child with a learning disability is to support their family to be advocates,” says Coleman. “So if the kid is working on self-advocacy skills, the parent is also working and the learning is happening simultaneously.”

Self-advocacy isn’t a skill that is taught once and that’s it. “It takes time and it’s not linear,” Coleman explains. “So with my little kiddos they get there and then they hit a new developmental stage in their teens and we do it all again. Sometimes the teaching and work happens many times as the kid grows and changes.”

Like so many things, it’s a process, and what self-advocacy looks like for a six-year- old will be different for a tween, teen, or adult. For little kids, learning when to verbalize that something is hard and knowing when to ask for help can be enough. Older kids, meanwhile, can play a bigger role in determining and expressing what they need. When kids feel understood, they’re more likely to feel encouraged to succeed.

Besides learning to stick up for themselves, once kids get comfortable with self-advocacy, it often lead to advocacy more broadly. “Kiddos turn into leaders,” observes Coleman. “They look around and stand up for others, they share their knowledge of the tools, they want to talk to school officials about making things better.”

When kids understand that everyone is different and each student has their own individual challenges and needs, it can be empowering on both a personal and a societal level. It has the potential to create more inclusive spaces in which kids stand up for – rather than bullying – one another.

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You probably remember all too well the heartache of a teen breakup — especially a person you dated for a while and maybe even thought was going to be “the one.” But when your own teen is going through a similar experience, it doesn’t mean words of wisdom automatically come to you. “It was rough for a couple of weeks,” one friend, whose daughter ‘s boyfriend broke up with her by text, told me. “While I could relate to how she felt losing someone who was important to her, I never had to do it under social media scrutiny.”

For sure, the digital age makes teen breakups more traumatic and dramatic. “Teen couples are often in touch with one another all day through text and Facetime,” says Lisa Damour, PhD, author of The Emotional Lives of Teenagers. “Some even do homework with Facetime open. The teens in my care who have romantic relationships are much more in contact with their partners than I am with my spouse. So, when those relationships go away, there’s the pain of the loss and there’s also an enormous hole left in that young person’s day.”

With social media, news of the breakup also travels fast in friend circles. “My son’s friends were texting him less than an hour after his girlfriend broke up with him because she posted about it on Snapchat!” said another mom friend. “He didn’t even have time to process it before his texts started blowing up.”

Social media pressure, more free time, and the fact that teens feel everything more deeply — highs and lows — conspire to make a breakup the not-so-perfect storm. “The emotional intensity during adolescence is higher than other stages of life,” notes Dave Anderson, PhD, senior clinical psychologist at the Child Mind Institute.

 “We can’t prevent emotional distress in our kids, nor can we make it go away as quickly as we want to, but there are some things we can absolutely do and say to help,” says Dr. Damour.

Shock, sadness, anger — your teen is feeling all kinds of intense emotions in the early days of a breakup. Even if they initiated the split or it was a mutual decision, they may still be having a tough time. “As parents we can fall into the trap of trying to help put it in perspective and rush in with stories about our own breakups,” says Dr. Anderson. “But that’s an instinct that we should try to quiet at least for a little while.”

Lead with empathy. Try to resist asking your teen for more details than they want to share, says Dr. Anderson. Instead, give them options, saying something like, “I know this must be incredibly hard for you. If you want to talk about it, great. If you just want someone to be around you when you’re doing your homework or watching TV, I’m also here.” If your teen responds that “I’m fine” but you can clearly see that they’re not, give it a day and follow up with, “Honey, I want you to know, I’m worried about you, and I want you to know that I’m here for support.”

Welcome their friends. Encourage your teen to invite a couple of pals over for a movie night and supply the ice cream. In fact, their friends might have already suggested it. “I’m moved by how naturally and creatively friends help one another,” says Dr. Damour. “The support of friends (and the comfort of ice cream) is more than just a happy distraction. It helps your teen realize that people still want to hang out with them.”

Keep your opinion about the ex to yourself. Perhaps you never thought they were right for each other and are happy that the relationship ended. Or you may have considered the ex a “bonus kid” and will miss having them around. Either way, this isn’t the time to share your feelings with your teen. You can vent to a partner, friend, or therapist.

But speak up about the friend zone. If your teen tells you that they’re going to try to be friends with their ex, gently discourage it at least in the short term. “It’s very hard to go straight from romance to friendship,” says Dr. Damour. “There are still a lot of tender feelings and it’s easy to get hurt.” Instead, she suggests saying something like, “You may be friends down the line, but it’s hard to move such intense feelings right into the friendship.”

Alert their therapist. If your teen is already being treated for depression, anxiety, or another mental health challenge, fill in their therapist so they have another trusted adult to talk to about what happened and help them get over the hump.

After a few days in a funk, it’s time to ease back into routines. Here’s how to help your teen get in the swing of things again:

Tell them they’re not alone. Teen still hunkered down in their room with the door closed? Empathize with what they’ve been through — but also help them look to the future. Dr. Anderson suggests starting out with, “I’m really sorry to watch what you’re going through. I’ve been through it, everybody I know has been through it, and you’re not alone in this.” At this point, you might want to share a breakup story from when you were their age. Then work how to move forward into the conversation. You might say, “I’m not asking for you to be better or recovered or over this person. But there’s a balance between feeling your feelings and getting back to your routines, which will help you feel better.”

Help them reflect. Chances are, some things have made your teen feel better over the last few days and some have made them feel worse, says Dr. Damour. Guide your teen to tease out what’s helped and what hasn’t — and to be totally honest with themselves. “Lots of teens will say, ‘It’s good for me to still be following my ex on social media because it helps me feel still connected,’” says Dr. Anderson. Ask your teen “How does it help?” if they see their ex out having fun with friends. If they’re not willing to sever social media ties entirely, suggest that they temporarily mute them, so their ex’s posts don’t pop up in their feed. On the flip side, urge them to lean more into strategies that have been helpful, whether it’s cuddling with the dog, baking, watching beloved reruns, or going for a run.

Keep them busy. While routines are important, distractions are valuable too. Offer to take them somewhere fun. Opt for hands-on places (like an escape room, bowling, or pottery class) rather than passive options where it’s easy to zone out. Of course, avoid places that may remind your teen of their ex.

Watch for overanalyzing. Sure, it’s a good sign overall if your teen talks about the breakup with their besties. But hashing it out with various friend groups over and over again for days may make things worse. If you notice that happening, it’s even more important to provide one of the distractions above. You can also enforce your regular screen-time rules.

Seek professional support. It’s normal and even healthy to be upset by a breakup. But there are a few red flags that parents should keep in mind. “If your teen is being terrible to themselves and others after a few days, they may need professional support to develop coping mechanisms,” says Dr. Damour. Dr. Anderson adds that it takes most teens about two weeks to start feeling the breakup less acutely and be on their way to returning to normal. If you don’t see signs of that, set up an appointment with a mental health professional. Breakups can be a trigger for a teen’s depressive episode.

Embrace the silver lining. Although it’s difficult to watch your teen be so upset and not be able to “fix” it, “keep in mind that for teens, there’s tremendous value in well-handled psychological distress,” says Dr. Damour. “It shows them that they have the ability to handle painful emotions and find a way through.” She adds that the experience will also foster empathy: “When one of their dear friends gets their heart broken, someone who has been there will be able to offer far better support than a teen who hasn’t walked in those shoes.”

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EMDR — short for eye movement desensitization and reprocessing — has become a go-to technique for treating trauma in adults. And it’s being used to help children, too.

EMDR is a surprising therapy that involves prompting the patient to briefly recall a traumatic experience that’s continuing to disturb them while moving their eyes from side to side or being tapped on alternating sides of the body. The desired result is that the memory becomes less overwhelming.

EMDR is relatively new form of psychotherapy, developed by Francine Shapiro in 1989. And while it’s not entirely clear how it works, it has already amassed quite a bit of support among mental health professionals. In 2017, the U.S. Department of Veterans Affairs included EMDR as one of its top three recommended treatment options for post-traumatic stress disorder (PTSD). It’s also been found to be effective in children who’ve had upsetting experiences and are struggling to recover from them.

In addition to PTSD, EMDR is being used to treat anxiety, depression, eating disorders, and substance use disorders, among other things.

“It’s quite effective for what I refer to oftentimes as emotional splinters,” says William M. Zangwill, PhD, an EMDR expert who trains clinicians in the practice. “If you’ve ever had a splinter, then you know it can cause quite a bit of pain, even when it’s touched gently or accidentally. It’s similar with emotional pain. So what we’re trying to do with EMDR is to gently take the splinter out so that the person can heal.”

EMDR is a type of psychotherapy in which, under the guidance of a specially trained clinician, patients recount memories of a traumatic event while engaging in physical stimulation on alternate sides of the body.

Shapiro developed EMDR using rapid eye movement as the stimulation, in which the therapist directs the patient to quickly move their eyes from side to side. Other stimulations can also be used, such as alternately tapping the patient’s legs or shoulders, specialized lights that flash in a programmed, alternate sequence, or handheld devices that alternately vibrate.

“Alternate stimulation, or what’s called bilateral stimulation, is one of the key components of EMDR,” Dr. Zangwill says. “It helps keep the mind focused on the present.”

Dr. Zangwill says he lets his patients choose which kind of stimulation to use but generally recommends tapping for his pediatric patients, because it’s simple and can be performed by the patient’s parents. That’s helpful so they can use the tapping technique at home as needed between sessions. And older children and adolescents can even do it themselves.

While more than two dozen clinical trials have led researchers to conclude that EMDR is effective, it remains unclear exactly how the therapy works. Researchers believe it has something to do with where and how traumatic memories are stored in the brain as compared with other memories.

Normal memories are processed as they are stored, linked to a network of other memories that puts them in context and locates them in the past. In a traumatic experience, this process may be disrupted. When these unprocessed memories are recalled, the disturbing feelings, thoughts and sensations connected with them can be experienced again.

For people with PTSD, memories of trauma are overwhelming because they are experienced as if they’re happening in the present. The goal of EMDR is to reconsolidate the memory, to overwrite the earlier version, as something remembered, as opposed to something being relived, and in a less overwhelming form.

“So the theory is that what you’re doing by tapping is you’re distracting the brain’s ability to focus, which means it can’t build the memory back up as strongly, and therefore, over time, the person feels less pain,” Dr. Zangwill says.

EMDR is most effective in children when used to treat a singular, well-defined trauma.

“It works best on patients who have been through a specific trauma that has a clear beginning and an end,” Dr. Zangwill says. “For instance, an automobile accident, a loss of a parent or relative, a breakup, a serious illness, but something that had a beginning and an end, especially when it’s a sudden kind of event.”

It can be used with kids of all ages. Dr. Zangwill says he has seen it used effectively with children as young as 2 years old.

“You can simplify EMDR, adjust it, to meet the child where they are cognitively and developmentally,” Dr. Zangwill says. “But in general, the younger the child, the more specific the event should be if EMDR is going to be of help.”

EMDR can be used to treat older kids and teens with trauma situations that stretched over a longer period of time or when they cognitively understand a threat is gone but can’t seem to get past the negative emotions.

“This other area where it’s good is when people understand something perhaps intellectually but are stuck emotionally,” Dr. Zangwill says. “For example, let’s say they witnessed their mother being abused and now the abuser is in jail. Intellectually, they know that person can’t come and hurt them, but they can’t get past the fear. When there’s a discrepancy between what you know and what you feel, 99.8 percent of the time your feelings win out. What EMDR does — in ways we’re not sure about — is connect what we know to what we feel better than anything I’ve ever used.”

EMDR, Dr. Zangwill says, can have truly impressive results. But it’s not a quick fix. “Sometimes parents have the impression that all we do is tap their child and everything will be fixed,” he explains. “That’s not the case.”

And sometimes, EMDR doesn’t work for a child or a particular situation at all. There’s no guarantee. The good news is that you’ll know in a relatively short time — usually after about two sessions, according to Dr. Zangwill — whether or not EMDR is a good fit.

And while it’s possible to find guidelines from professional organizations as to what an EMDR session will look like and how many sessions it will take to overcome a trauma — six to 12, according to this guideline from the American Psychological Association — Dr. Zangwill says it all really depends on the situation and the patient.

“It’s hard to give specifics, because every situation is different,” he says. “Some kids can sit for a 90-minute session, for example, whereas younger patients may only tolerate 15 minutes at a time.”

Some children may require more guidance and emotional handholding through the process whereas other kids may be able to talk about the trauma unprompted.

In any event, Dr. Zangwill stresses the importance of getting the whole family involved. In fact, when treating children, Dr. Zangwill says he will meet with as many family members as possible prior to beginning EMDR so he can gain a fuller picture of what’s going on with the child, which he says is crucial to the success of the treatment.

“In my experience, when there are systemic issues present, the only way EMDR — or any kind of therapy — will be effective is when the whole family is involved,” Dr. Zangwill says.

That’s because therapy can’t address problems in a vacuum. Oftentimes, Dr. Zangwill says, the trauma that brought a parent to seek therapy for their child isn’t the only challenge that needs to be addressed or even the root of the problem.

“You have to remember that when children have been through painful stuff, it happens within the context of a family — before, during and after,” Dr. Zangwill says. “So sometimes it’s not even really about the traumatic thing that happened but the fact that they didn’t feel supported by their family afterward or that the family never talked about it.”

Getting the entire family involved helps guard against “garage syndrome,” an expression he uses for parents who expect to be able drop their child off for therapy and pick them up all fixed, as you would when you take your car to the mechanic.

Another reason Dr. Zangwill insists parents are involved throughout is so they understand how EMDR works and why their child might seem more upset than usual at first. EMDR can trigger upsetting feelings in kids as they work through their traumatic memories.

“The analogy I use when I’m teaching and training people is that when your foot’s been asleep, and it starts to awaken, it hurts,” Dr. Zangwill says. “When you do deeper work, that increases awareness. Initially you can feel more pain, but then it subsides.”

Negative feelings triggered by EMDR typically get progressively better with each session, he adds.

Seeking EMDR from an experienced practitioner is important, especially when considering someone who works with children, Dr. Zangwill says. “An experienced clinician will know how far to take a session, how much handholding needs to be done and when to get out of the way so patients can make realizations and come up with their own answers.”

An experienced therapist will be able to minimize negative feelings that arise from EMDR, he adds, and will also advise parents how to support patients in the event they have difficulty between sessions.

To locate a therapist who practices EMDR, visit the EMDR International Association’s provider directory.

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San Mateo, CA – Child Mind Institute is expanding its Youth Mental Health Academy (YMHA), a program designed to educate teens about the different fields of mental health work, by bringing it to the San Francisco Bay Area and San Diego. The organization also plans to build on the program’s success in the Los Angeles area, where it first launched in the summer of 2023. 

The Youth Mental Health Academy is a paid 14-month program for high school students ages 16+ who come from structurally marginalized communities. The program’s goal is to increase representation in the mental health field amongst those groups who have historically lacked access to mental health care services — including young people of color, LGBTQIA+ youth, and those who have experienced foster care, the juvenile justice system, homelessness, or poverty. It also aims to cultivate a future generation of mental health care workers who more closely align with those groups. 

The YMHA offers opportunities for students to get paid for participating in project-based learning and internships in the summer. The program also provides mentors and college planning workshops throughout the school year. Through the combination of these activities, it aims to inspire and cultivate a group of young people who will, as they mature, consider pursuing mental health careers in psychology, school counseling, social work, research, and other mental health-related fields. 

Junior and senior high school students in the San Francisco Bay Area, San Diego area, and Los Angeles area are encouraged to apply now to be accepted into the 2024-25 program, with all applications due by March 15, 2024. 

HOW IT WORKS 

The YMHA offers each participating student the opportunity to:

• receive up to a $2,000 stipend for completing project-based learning throughout the entire program 
• acquire career skills and knowledge about how the overall mental health care field works
• build their resume toward future careers 
• develop professional networks
• work on a capstone project with a group of their peers during the program’s first year
• work side-by-side as an intern during the program’s second year 
• be inspired to pursue a career in a mental health-related field

The in-person, project-based learning portion of the program will take place from June 24, 2024, through July 22, 2024. Participants will also complete an internship in a mental health-related field during the summer of 2025. During project-based learning and ongoing programming during the 2024–25 school year, students will receive mentorship and support from experienced professionals.

“Our first summer of the Youth Mental Health Academy in the Los Angeles area was extremely well-received, with hundreds of youth participating in our instructor-led workshops,” said Ivette Sanchez, associate program director for Child Mind Institute’s Youth Mental Health Academy. “We knew we had really started something special during our first capstone event when we saw the incredible response that the YMHA presentations had on the 400 friends and family who gathered.”

YMHA ALSO SEEKS YOUNG ADULT MENTORS  

The Youth Mental Health Academy also seeks undergraduate college students, graduate students, and early career professionals to serve as mentors in the program. Those interested can find out more about mentorship here. 

NEW PARTNERSHIP WITH BRING CHANGE TO MIND

To reach more students interested in mental health career paths, Child Mind Institute is partnering with San Francisco-based Bring Change to Mind (BC2M), a national non-profit operating mental health-focused peer-led clubs in high schools across California. The partnership enables BC2M club members to find out more about the YMHA. And those already in the YMHA can learn more about joining or starting a BC2M club at their school. 

Child Mind Institute will support the expansion of Bring Change to Mind by opening 21 new clubs in Southern California, as well as sponsor various student events and workshops throughout the year. The non-profit launched its evidence-based club model nine years ago and now operates in 42 states with more than 100,000 students having participated. 

“With the ongoing youth mental health crisis, these programs are something that structurally marginalized communities are wholly embracing,” adds Sanchez. “The first round of feedback we got from our YMHA students in the Los Angeles area last summer ranged from ‘I really like being able to talk with people who are passionate about psychology like I am,’ to ‘I feel like I made some really good friends here and made really personal connections with the teachers, especially, which I didn’t expect.”

About the Child Mind Institute

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The Child Mind Institute is dedicated to transforming the lives of children and families struggling with mental health and learning disorders by giving them the help they need. We’ve become the leading independent nonprofit in children’s mental health by providing gold-standard evidence-based care, delivering educational resources to millions of families each year, training educators in underserved communities, and developing tomorrow’s breakthrough treatments. Learn more at childmind.org.

For press questions, contact our press team at childmindinstitute@ssmandl.com or our media officer at mediaoffice@childmind.org.

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Pediatrician Dr. Edith Bracho-Sanchez and Dr. David Anderson, from the Child Mind Institute, discuss the practice of parents picking up their kids before bedtime instead of having them spend the night at a friend’s house.

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New York, NY – Harold S. Koplewicz, MD, founding president and medical director of the Child Mind Institute, the leading independent nonprofit in children’s mental health, shared the following statement in response to Governor Kathy Hochul’s 2024 State of the State address and proposed legislative agenda:

“We applaud Governor Hochul’s commitment to the defining public health challenge of the next generation – the youth mental health crisis. Elevating mental health in New York state’s 2024 priorities sets the stage for the Hochul administration and the state legislature to support critical mental health tools for children and adolescents, such as educational initiatives to promote safe social media use, access to evidence-based care and resources in schools, and increased funding for brain science research.

“Our research shows that one-third of children reported ‘negative’ online experiences in the last year and 70% of those children reported repeated incidents. In addition to equipping youth with age-appropriate tools to navigate the internet, we need technological safeguards and policy proposals – based on research – that aim to reduce the risk of social media and internet use harming kids.

“We agree with Gov. Hochul that all students should have access to mental health resources. We must look to innovative approaches that focus on scaling the number of mental health providers and educators trained in evidenced-based practices and promote collaborative relationships with school partners to build sustainable access for students throughout the state.

“Missing from her remarks was a call for increased investment in research to advance the field of child and adolescent mental health and strengthen our understanding of the developing brain. One of the greatest barriers to reliably improving mental health interventions is the fact that diagnosis and treatment are subjective. Identifying objective, measurable brain-and behavior-based biomarkers is critical to guide successful care plans. Additional investment is needed into science-based digital tools that connect kids, families, and mental health professionals, or otherwise leverage technology and social media for good.

“We look forward to seeing resources dedicated to mental health support for children across the state of New York in the Executive Budget next week, and the Child Mind Institute stands ready to work with the Hochul administration to advance these priorities.”

About the Child Mind Institute

(Instagram, Facebook, Twitter, LinkedIn)

The Child Mind Institute is dedicated to transforming the lives of children and families struggling with mental health and learning disorders by giving them the help they need. We’ve become the leading independent nonprofit in children’s mental health by providing gold-standard evidence-based care, delivering educational resources to millions of families each year, training educators in underserved communities, and developing tomorrow’s breakthrough treatments.

Learn more at childmind.org.

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The U.S. Surgeon General, the American Academy of Child and Adolescent Psychiatry, and the American Academy of Pediatrics have all declared a crisis in children’s mental health.

As the nation’s leading nonprofit dedicated to transforming the lives of children with mental health and learning disorders, the Child Mind Institute has never been needed more urgently. We’ve been rising to meet this challenge by: 

• Caring for more children in our clinical centers 
• Launching major new educational campaigns to increase knowledge and fight stigma 
• Expanding our School and Community Programs team to train more educators 
• Increasing our Science and Engineering team’s efforts to improve our understanding of the brain and develop the digital tools that will democratize care 

And we’re launching the Stavros Niarchos Foundation Global Center for Child and Adolescent Mental Health at the Child Mind Institute to catalyze a worldwide focus on improving children’s mental wellbeing. 

These initiatives are crucial to increasing our capacity to advance the clinical care, resources and research we provide for children and their families. 

But the benefits of our upcoming move go beyond the amount of space to the quality of the environment we’re creating: 

• The new address remains in Midtown Manhattan and is closer and more convenient to public transportation. 
• Our clinical specialties will occupy distinct “neighborhoods” within the office, each with their own waiting areas. 
• We will have a dedicated entry, with private elevators and internal stairs between the upper floors. 
• We’re building a vibrant and warm environment, including donated artwork from major artists and spaces for contemplation, inspiration, and positive energy.  
• We plan to open a private outdoor space off the first floor where, on nicer days, caregivers can get a breath of fresh air while their kids are seen inside. 

We’re thrilled to begin this next phase of the Child Mind Institute’s history, one where we make even faster progress toward a world where every child receives the care they need to thrive.

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Autism is a developmental disorder that impacts how a child learns to communicate and interact with the world. According to recent data, the average age for diagnosis of autism spectrum disorder (ASD) is about 5 or 6, even though it can be diagnosed in children as young as 12 months. That might sound quite young, but autism is an early-onset disorder that is lifelong. An early diagnosis allows kids to get the support they need during the critical period of development that occurs before a child turns 5.

Dr. Cynthia Martin, a psychologist and the senior director of the Autism Center at the Child Mind Institute says that there can be signs of autism in babies as young as six months old. “That’s not going to be the case for all kids,” she says. “But in general, for the majority of kids, symptoms associated with ASD are going to be present somewhere between six months and three years.” 

But those signs of autism in infants and toddlers can be easy to miss — unless you know what you’re looking for. 

At any age, symptoms of autism are grouped into two main categories: social-communication challenges and restrictive, repetitive behaviors (RRBs). Even in very young children, Dr. Martin says, we can see the absence of typical social-communication skills and the presence of atypical behaviors, or RRBs. Autism shares a number of traits with other disorders, which is why it is frequently misdiagnosed, or diagnosed late. But children with ASD display traits from both categories — like Charlie, who received an autism diagnosis just after he turned three.  

When Charlie’s mom, Jamé, brought him in for his two-year check-up, his pediatrician said Charlie had a speech delay and recommended speech therapy. 

“I was a little surprised, but it wasn’t a bad surprise,” Jamé says. “At that point, he wasn’t quite pointing and gesturing, or even making sounds and intonations. But it wasn’t something that as parents we worried about, really. I guess because neither of us have had kids before.” 

Jamé and her partner may be first-time parents, but they weren’t alone in how they thought about their child’s development. “So often parents don’t know about social communication milestones,” Dr. Martin says. These milestones are subtle, but the skills they demonstrate are the building blocks of communication and language.  

Children with autism develop these prelinguistic, social communication skills at a delayed and inconsistent rate compared to their typically developing peers.  

For instance, infants with ASD may struggle to distinguish the faces of their caregivers from strangers or avoid eye contact — two of the earliest indicators of a social communication deficit. But a wealth of research suggests that a limited use of gesture, as one study put it, is one of the most “robust” signs of autism in infants and very young children.  

Gestures are closely tied to the development of speech and language. Before learning to speak, children typically learn to communicate using gestures to express their thoughts and desires.  

“We should see about 16 gestures or ways of communicating non-verbally to another person by 16 months,” Dr. Martin says. 

So, what are some things parents should be looking for? 

• Pointing: Babies with autism tend to point less than typically developing children — either with an open palm or an index finger, a slightly more advanced skill. One reason a child points at an object is to say, “I want that.” This is called imperative pointing. Instead of pointing, some children with ASD will use an adult’s hand as a tool to communicate to what they want; this is called hand-leading.  

• Showing and Giving: Another reason a child points to an object is to say, “Look at that.” This is called declarative pointing, and it facilitates a very important skill called joint attention. Look at that dog! look at the airplane in the sky! When a child initiates joint attention, they are beginning to understand that communication is an act of sharing. Children with autism can be very interested in objects, but don’t tend to show objects to others. Along the same lines, they might less frequently give objects to others. 

• Gesture + Speech Combinations: Toddlers who have acquired some language skills might begin using word-gesture combinations, like saying the word “more” and pointing to a cup of juice. This is called supplemental gesture, and it is a particularly challenging skill for kids with ASD. 

RRBs are patterns of behavior that occur in greater frequency among autistic people than the general population. RRBs can include hand flapping, spinning, or holding a particular body posture. They can also include the idiosyncratic way a child plays with their toys, a fixation on one particular interest, and sensory processing issues. 

In children with autism, RRBs are intense and narrowly focused behaviors that shape the way they interact with the world. As Dr. Martin puts it, “What is the child missing out on because they are focusing on something more intensely than those around them, rather than what the others in the environment are focusing on?” 

Jamé knew that Charlie liked to stack and arrange his toys, and that he liked the squishy feeling of potting soil in his hands. But when he entered preschool, his patterns of behavior became more pronounced, making it difficult for him to adjust. “His teachers were like, ‘He will not wear his shoes,’” Jamé recalled. “If they had circle time, he would kind of be walking around the room doing something else.” Charlie also struggled to transition from one activity to the next — a common challenge for kids with autism triggered by various factors, including RRBs.

“For some kids, RRBs present at the same time as social communication deficits. For other kids there’s a pretty big lag, which for a younger child means six to 12 months later,” Dr. Martin says.  

“The challenge is that some repetitive behaviors are very common in young kids because their nervous systems are still developing,” she adds. “They can get what’s called motor overflow, where there is some excitement, and you see some brief posturing or some hand flapping.” 

But for young children with ASD, repetitive behaviors persist and present as a pattern.

Some of these patterns can emerge as early as a child’s first year.  

• Unusual interaction with objects: Very young children with autism might show more interest in objects than people or display what is called a “non-functional use of objects” — for example, holding a toy in their hand instead of playing with it. Another sign, says Dr. Martin, is when a child examines an object in an unusual way. “Maybe they’re bringing things up really closely to their eyes or looking at them from the side of their eyes,” she says.  

• Intense Interests: Some toddlers with autism begin to develop unusually intense and specific interests. Perhaps they fixate numbers, letters, shapes, or water. “But the way they show they are interested in water is not just wanting to play at the splash pad, they also want to see the water in the toilet bowl flush,” Dr. Martin explains. “Or they want to see the water in the washing machine, or when they hear the water faucet go on in the bathroom or the kitchen, they go running towards it.” 

• Strong responses to sensory stimuli: Some RRBs are in response to sensory stimuli. Charlie doesn’t like to wear shoes, Jamé theorizes, because shoes make it harder for him to run and climb. “He’s pretty much moving from the moment he gets up until he takes a nap,” Jamé says. Charlie’s compulsion to move is a sensory-seeking behavior, as is his love for squishing potting soil in his hands. But other children with autism, even those that seek sensory stimuli, also exhibit sensory-avoidant behaviors. They might cover their ears, avoid certain foods or have an aversion to certain textures or tags in clothing. 

Jamé had some reservations about pursuing an autism diagnosis for Charlie at such a young age. His needs and behaviors, while unusual to others, seemed only human. But the early intervention and diagnosis has given Charlie access to a needed network of support. “He’s a little kid, but he’s a super clever kid and I am super proud of him,” Jamé says. “I just want him to get whatever he needs to help him be more independent when I’m not with him.” 

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We think of learning disabilities as affecting kids in school, but challenges in skills like reading, writing, math, and language affect all aspects of life, not just academic performance. We are using them all the time — reading street signs, counting change, playing games, and following conversations with friends.

Struggling with skills that appear to come easily to others, inside the classroom or out, can take an emotional toll starting at an early age. Research shows that children with learning disorders are at higher risk for developing depression. This risk increases as children enter their teenage years.

“Kids spend the majority of their waking hours in school,” says Laura Phillips, PhD, a neuropsychologist and the senior director of the Learning and Development Center at the Child Mind Institute. “When you spend eight hours a day engaged in something that’s challenging for you it has a very significant impact on your self-concept — meaning your idea about who you are as a person — and your ability to feel successful.”

Depression can manifest in different ways:

• Appearing sad or irritable
• Trouble sleeping
• Losing interest in things you once enjoyed 
• Being tired all the time
• Gaining or losing a lot of weight

But at its root are feelings of hopelessness and low self-worth. Studies show that for kids with learning disorders, the school environment can contribute to and breed these feelings.

A child with an undiagnosed learning disability is particularly at risk for depression because they don’t understand why they struggle with things that others don’t. Frustration and failure create a sense that something must be wrong with them. A diagnosis can be reassuring and offer them the support they need — but success will still be a struggle. When it comes to a child’s emotions, an LD diagnosis is not a magic bullet.

​​“It doesn’t always feel better right away,” notes Helene Omansky, LCSW, a senior social worker at the Child Mind Institute. “It will get better, but newly diagnosed kids need time to adjust to their support system, and to develop confidence in skills that they may have lacked.”

If you think your child might be depressed, consult a medical professional for help — but know there are ways parents and teachers can offer support, too.

The requirements of school change as you get older, and there’s one shift that can be particularly tough for kids, especially those with reading and language deficits. “From kindergarten through second grade, you’re learning how to read,” Dr. Phillips explains. “By third grade, the emphasis shifts to reading to learn.”

In other words, reading becomes incorporated into every class. Kids who struggled in language arts classes but prided themselves on their math skills are suddenly confronted with math word problems. “And then they lose that confidence in the thing that might’ve been maintaining their sense of self and self-esteem,” Dr. Phillips explains.

This change is the first of many. Kids will continue to wrestle with their challenges in unexpected ways, and this can be discouraging.

“The impact of a learning disorder becomes more widespread as you move through school,” Dr. Phillips says.

It’s important for parents to understand the depth of frustration a child may be feeling and acknowledge it, says Omansky. We’re naturally inclined to dispel negativity with encouragement — “You’re so smart!” — but this can make a child feel isolated and unheard. If a child is saying they feel dumb because they can’t figure out how to solve a word problem, Omansky says, “It’s okay to validate that by saying something like, ‘I can see how frustrating this is for you.’”

Around 8 or 9 years old, kids become less self-focused and begin to understand themselves in the context of — and in comparison, to — their peers. Where before school was merely frustrating, now kids may wonder why certain things appear to come easily to others. They may feel like they’re working twice as hard as those around them, and understandably, they may think this is unfair.

Kids also become more self-conscious at this age and might feel like their deficits are on display. This can look like a kid who doesn’t want to raise their hand in class, but it can also look like a kid who plays by themselves at recess. When a child can’t solve a math problem or gets called out for not finishing an assignment, it’s easy for them to go from “I feel dumb” to “Nobody is going to like me,” Omansky notes.

Kids with learning challenges can also struggle with social skills, such as following the thread of a conversation or finding the right words to respond. They sometimes fumble social cues, and given enough negative feedback, might avoid socializing altogether.

Some kids draw attention away from their challenges by acting out. Being perceived as funny or rebellious might even bolster your self-esteem. But avoiding your challenges doesn’t make you feel any better about them, it just makes you more determined to hide them.

Rates of learning disorders are not significantly different among genders, but boys are more likely to be diagnosed because of their tendency to be disruptive in class — an obvious red flag. Girls, meanwhile, tend to withdraw, making identification harder.

“Girls are much more likely to quietly sit in the back of the class and try to sink into the ground,” Dr. Phillips says.

This translates to girls not receiving a learning disorder diagnosis or being diagnosed late. When LDs are overlooked, a child’s anxiety or depression can be the first recognized signs that they need help. “They might become highly anxious or more academically demoralized,” says Dr Phillips. “So, it might be the anxiety or depression that first brings them to clinical attention.”

It’s important for adults to empathize with this experience, too. “Well-intended parents and teachers don’t want to put a spotlight on a kid unnecessarily, but they may not be asking the right questions that would allow for further intervention or exploration,” says Omansky. When a child is anxious, unmotivated, or depressed, the adults in their lives should investigate if they might be struggling, she adds. “Kids don’t always have the skillset to know how to self-advocate and say, ‘I don’t understand.’”

Depression can actually impact cognitive functions, making learning challenges more acute.

Research shows that depression can:

• Slow information processing
• Slow memory consolidation, or how your brain transforms the things you learn into long-term memories
• Make it harder to pay attention and concentrate
• Interfere with sleep, which can also be bad for your brain

It’s a vicious cycle — learning challenges contributing to depression, contributing to more challenges — but there are ways to interrupt it.

How a child relates to their school environment can also affect how they learn and how they see themselves. This is a particularly important factor for Black children and other children of color, especially if they attend predominantly white schools. “If there’s a difference in skin color between kids and their teachers, they might enter the classroom with a different level of anxious arousal that they have to overcome in order to be fully engaged,” Dr. Phillips says.

If the school environment already makes you anxious, you’re more likely to shut down if learning is also a challenge. You might even develop a fear of going to school at all. Teachers should be aware that kids don’t experience school in a vacuum. They should understand the racial, cultural, demographic factors that impact kids, so kids feel safe enough to learn and ask for help if they need it.

Schools are beginning to embrace emotional supports for children with learning disorders. When kids feel defeated by their challenges, and resist learning because it makes them feel bad about themselves, academic support alone is not enough.

Increasingly, schools are using  social and emotional learning (SEL) techniques to help kids develop an awareness of the emotions that drive their behaviors — whether they are acting out, trying to disappear, or simply avoiding the tasks that are most difficult for them.

Kids can be taught strategies to manage big emotions around learning. Take kids with math learning disorders, who become anxious when asked to solve math problems. They tend to engage in negative self-talk — “I’m so bad at math. I’m going to fail this math test. I’m so stupid, I’m not going to get into college.”

The negative self-talk interferes with problem solving. “It taxes your working memory to the point where you can’t effectively problem solve,” explains Dr. Phillips. “So, you do poorly and then you see yourself as a bad math student.”

But kids can interrupt the cycle with a simple trick: saying the steps of the math problem as they do them. “If you’re verbally working through the steps, you can’t engage in negative self-talk and so you can’t tax the working memory system,” she adds.  “It’s very effective.”

The ability to embrace this kind of creative problem-solving is the secret weapon of having a learning disorder — but when a child shows signs of depression, it’s important to seek professional treatment. Understanding that emotional challenges and learning challenges are intertwined can help parents get kids the support they need.

The post Learning Disabilities and Depression appeared first on Child Mind Institute.

The Symptom Checker gives you a list of behaviors and traits and invites you to mark the ones you are seeing in your child. If they correspond with the symptoms and behaviors associated with autism, it will let you know. If your answers to the quiz suggest another disorder, you’ll see that too.

The Symptom Checker was developed in partnership with expert clinicians and is aligned with the Child Mind Institute’s rigorous editorial standards.

Only a mental health professional can diagnose autism. But if you’re looking for an online autism test, our Symptom Checker can help you know if the behaviors you notice in your child could be signs of autism, or something else. You’ll also find links to articles where you can learn more, and help you prepare for a conversation with a mental health professional who can diagnose your child.

To identify signs of autism at different ages, from babies and toddlers to teenagers, try using our free Symptom Checker.

Autism is called a spectrum disorder because autistic kids may have a wide range of symptoms, cognitive abilities, language skills, and behaviors. They range from nonverbal to highly verbal. But there are some symptoms of autism these children share.

Symptoms of autism are grouped into two main categories: social-communication challenges and restrictive, repetitive behaviors (RRBs). RRBs are repetitive body movements or modes of behavior that “restrict” the way a person interacts with the world.

Children on the autism spectrum display traits from both categories from an early age, including babies and toddlers. Signs can be seen in babies as young as 1 year old, and signs of autism often appear in children who are 2, 3, or 4 years old.

• Failure to respond to their own name
• Disinterest in giving, sharing, or showing objects of interest
• Aversion to displays of affection
• Doesn’t use gestures to communicate 
• Preference for solitary play
• Hasn’t spoken a word by 18 months  
• Cannot say two-word phrases by 2 years old 

• Difficulty carrying on a reciprocal or back-and-forth conversation
• Lack of eye contact
• Difficulty using body language and reading it in others
• Difficulty recognizing others’ emotions, responding appropriately to different social situations, and understanding social relationships
• Aversion to displays of affection
• Preference for solitary play

• Repeats the same action over and over again 
• Focuses on small details and nothing else 
• Lines, sorts, or organizes toys or objects instead of playing with them
• Gets fixated on specific topics or objects 
• Becomes upset by minor changes in daily routine
• Has unusual sensory sensitivities

Kids with autism who do not have cognitive impairment are sometimes described as having high functioning autism. They may be highly verbal, do well in school, in college and in the workplace, and they may be exceptionally bright or talented. But kids with high-functioning autism may struggle with social-communication challenges that make it hard for them to function socially. They may have trouble handling changes in routine, and be extremely sensitive to sensory stimulation such as bright lights or loud noises. They are also sometimes called “neurodivergent,” because their brains work differently from typically developing or “neurotypical” people.

Profound autism is a term for kids on the other end of the autism spectrum. They are cognitively impaired, with an IQ of under 60, and are non-verbal. They are severely disabled, and will require life-long support with the tasks of daily living.

Children as young as 12 months old can show signs of autism, and the signs become more clear as they get older. Some experts consider a diagnosis by a professional reliable by the time a child is 2. But many children are are diagnosed later, as toddlers, elementary school children, or teenagers.

An autism evaluation usually start with a screening questionnaire. If the questionnaire indicates that a child might have autism, then it’s time for a more in-depth evaluation, which will include a set of autism tests in which the clinician watches how the child plays, behaves, and communicates.

A full evaluation should also include interviews with parents, teachers, and other adults who know the child. Structured cognitive tests should be part of the evaluation as well, to show how the child thinks and suggest what kinds of support at school would be helpful.

Read more about autism testing here.

A pediatrician might give the first screener, but the full evaluation should be done by someone specially trained in diagnosing autism. That is because symptoms can be hard to interpret, especially in toddlers. For instance, in a baby or toddler, not making eye contact can be a symptom of autism, but it can also be caused by shyness.

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Dr. Di Martino is the fourth individual to receive this award.  She has a long-standing research interest in autism spectrum disorder, and related neurodevelopmental conditions including how to best understand their underlying neurobiology.  Her research places a particular emphasis on brain imaging and a range of other clinical and cognitive approaches, with the goal of identifying objective biological markers that can one day be used to improve intervention efforts and treatment selection.  The Autism Center at the Child Mind Institute, led by Dr. Di Martino, is an integrated clinical center and research lab dedicated to supporting toddlers, children, adolescents and young adults with autism spectrum disorder and related challenges.

“This award is a powerful reminder of the importance of our collective efforts, and I am honored to be part of a community that is dedicated to making a positive impact on the lives of those touched by autism,” said Dr. Di Martino.  “It’s even more meaningful to receive this remarkable recognition at the home of the Stella Maris Foundation in my home country.”

The Stella Maris Foundation is the only IRCCS — or “Scientific Institute for Research Hospitalization and Health Care” — in Italy exclusively dedicated to research and assistance in child neurology and psychiatry.

To learn more about the Child Mind Institute, and the work of our Autism Center, please visit childmind.org.

About the Child Mind Institute

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The Child Mind Institute is dedicated to transforming the lives of children and families struggling with mental health and learning disorders by giving them the help they need. We’ve become the leading independent nonprofit in children’s mental health by providing gold-standard evidence-based care, delivering educational resources to millions of families each year, training educators in underserved communities, and developing tomorrow’s breakthrough treatments. Learn more at childmind.org.

For press questions, contact our press team at childmindinstitute@ssmandl.com or our media officer at mediaoffice@childmind.org.

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Each researcher selected has authored multiple Highly Cited Papers™ which rank in the top 1% by citations for their field(s) and publication year in the Web of Science™ over the past decade. However, citation activity is not the sole selection indicator. A preliminary list based on citation activity is then refined using qualitative analysis and expert judgement.

Of the world’s population of scientists and social scientists, Highly Cited Researchers™ are 1 in 1,000.

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Andy Saperstein Honored for His Contributions to Advancing the Child Mind Institute’s Mission to Transform the Lives of Children Struggling with Mental Health and Learning Disorders 

New York, NY – The Child Mind Institute, the leading independent nonprofit in children’s mental health, hosted its annual Child Advocacy Award dinner last night at Cipriani 42nd Street. The event raised record breaking funds of over $8 million, the highest in the organization’s history in support of the Child Mind Institute’s mission to improve the mental health of children and families through clinical care, scientific research and public education across the country and around the world. Actress, comedian, and advocate Ali Wentworth served as the evening’s host.

Andy Saperstein, Co-President and Head of Wealth Management at Morgan Stanley, and Child Mind Institute Board Member, was presented with the 2023 Child Advocacy Award by Ben Huneke, Managing Director and Head of the Investment Solutions Group at Morgan Stanley. In his acceptance speech Saperstein said, “The Child Mind Institute is helping children and their families realize they aren’t alone in how they feel, that there are safe places to turn…they help children to know that it’s OK to speak about how they’re feeling…and just as importantly, let them know there are ways to diagnose these illnesses, that there are treatments, and you can get better.”

Comedian Jim Gaffigan performed a special surprise set to open the night. The event was a gathering and celebration of individuals committed to helping children and families overcome mental health challenges and learning disorders. Attendees included Chelsea Clinton, Arianna Huffington, Stephanie Ruhle, Brian Stokes Mitchell, Molly Jong-Fast, Lydia Fenet, Olivier Bron, Jeannie Gaffigan and more. Photos from the evening are available here.

“The COVID pandemic may have receded, but there is more conflict in our nation, and more conflict in the world. Childhood anxiety and depression are rising, and trauma stalks our children relentlessly,” said Harold S. Koplewicz, MD, the founding President and Medical Director of the Child Mind Institute. “Years ago, we experimented with a vision statement for the Child Mind Institute: ‘A future where no child suffers.’ This is a beautiful vision. What we realized, as every parent here knows, is that we can’t remove suffering. What we can do is make sure no child suffers alone — and that suffering is met with the best we can offer in cutting-edge care, open science, workforce development, and compassionate support across barriers of geography, race, and class. That is what the Child Mind Institute stands for, and I commend all of you for standing with us tonight.”

Ben Huneke and Guy Metcalfe served as honorary co-chairs of the event alongside benefit chairs: Devon and Pete Briger, Lisa Domenico Brooke, Andreas C. Dracopoulos, Elizabeth and Michael Fascitelli, Christine and Richard Mack, Julie and Edward J. Minskoff, Morgan Stanley, Brooke Garber Neidich and Daniel Neidich, Stavros Niarchos Foundation (SNF), Zibby and Kyle Owens, Linnea and George Roberts, Abigail Pogrebin and David Shapiro, Preethi Krishna and Ram Sundaram.

To learn more about the Child Mind Institute please visit childmind.org.

About the Child Mind Institute
(Instagram, Facebook, Twitter, LinkedIn)

The Child Mind Institute is dedicated to transforming the lives of children and families struggling with mental health and learning disorders by giving them the help they need. We’ve become the leading independent nonprofit in children’s mental health by providing gold-standard evidence-based care, delivering educational resources to millions of families each year, training educators in underserved communities, and developing tomorrow’s breakthrough treatments. Learn more at childmind.org.

For press questions, contact our press team at childmindinstitute@ssmandl.com or our media officer at mediaoffice@childmind.org.

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Black children with autism spectrum disorder (ASD) continue to be at a disadvantage in terms of diagnosis and access to care. According to one of the largest U.S. studies to date on Black parents seeking an ASD diagnosis for their child, Black children don’t receive a diagnosis until three years, on average, after their parents have voiced their initial concerns about atypical behaviors. Even after receiving a diagnosis, they continue to face obstacles in nearly every aspect of care and treatment.

This automatically places Black children behind the curve, as evidence of the importance of early diagnosis and intervention for children with ASD continues to emerge. Early intervention has proven to be critical for the development of cognitive and language skills, often resulting in a better long-term prognosis for kids with ASD. The disorder is often characterized by poor behavioral regulation, which can have negative effects on social functioning and academic achievement further down the road. With early intervention, a child’s triggers for behavioral dysregulation can be monitored and targeted with therapy. Kids who’ve received this type of care early on in their development have displayed a reduction in hyperactivity and improvement in their ability to manage everyday tasks and adapt to different social situations.

When children receive a late diagnosis, they miss out on a critical form of treatment. This could have lasting negative effects on their social, academic, and future professional development.

The healthcare system has a longstanding history of implicit bias and racism, resulting in a lingering sense of medical mistrust within the Black community. To this day, Black women are more than twice as likely to die from pregnancy complications than their white counterparts, regardless of socioeconomic status or educational level. Therefore, parents might be hesitant to even bring up their concerns with their child’s pediatrician.

 “Sometimes families experience either shame about asking for help or a sense of hopelessness. They feel like, ‘Well, even if I ask, I’m not going to get the supports that I need,’” explains Alana Telesford, PhD, a psychologist who specializes in autism.

According to studies that examine the experiences that Black parents have with their children’s primary care providers, these fears have proven to be warranted. Families often report their child’s doctor to be dismissive of their concerns, blaming disruptive behaviors on poor parenting or the harmful stereotype of Black children having a propensity for misbehaving. Other parents have described being accused outright of exaggerating to game the system and receive free government-issued services.

But another reason that doctors may fail to recognize the signs of ASD is that they don’t have the expertise. As Dr. Telesford points out, “Not everyone’s a specialist in developmental differences or autism, especially with young kids. Some pediatricians only get a small amount of training in autism during their medical education. So, if a family really has a concern, I think they also need to evaluate how well their pediatrician understands autism.”

Many doctors opt to take the “wait and see” approach to developmental monitoring, which can also result in the child going through multiple rounds of evaluation before settling on a diagnosis. The current literature isn’t clear about why Black children are more likely than white children to be asked to endure more evaluations than usual. But scientists and health care professionals have a few possible reasons for this. For starters, the framework for ASD evaluations relies heavily on research that’s historically used white middle-class kids as their subjects, making it more difficult for clinicians to detect symptoms of autism in Black children. This can also lead to children being misdiagnosed with an intellectual disability or mood disorder, further delaying the process. Additionally, shortages in trained professionals within the community can force parents to look outside their initial healthcare system for evaluations. This can be not only time-consuming but also expensive, posing yet another obstacle for lower-income families.  

Dr. Telesford describes the process as confusing and overwhelming for parents, especially for those who are seeking a first-time diagnosis. “There are so many steps involved. There’s a lot of paperwork, scheduling of different appointments, interacting with multiple healthcare professionals in a whirlwind sort of way.”

This can be especially frustrating for parents who aren’t familiar with the process and do not have a supportive pediatrician. Parents have reported having a much easier time with the evaluation process when their doctors clearly explain what’s going on, offer advice, and keep up with the child’s progress. Unfortunately, it can be a struggle to find doctors who are both willing and have the expertise to do this, even more so for Black parents.  

It’s also important to note that a medical diagnosis is different from an educational classification. Schools might take a medical diagnosis into consideration, but they will most likely require their own process of testing to determine special-education eligibility. The criterion for eligibility varies from state to state. And it’s this eligibility that will allow children to access the services they need within the school system.

“This process must be very parent-driven,” says Dr. Telesford. “So, if a parent has a report from a medical setting, they have to go to the school and formally request, ‘I want my child to be evaluated. This is the data I have.’”

To evaluate if their pediatrician has a firm understanding of autism and its symptoms, parents need to be knowledgeable about the disorder themselves. Many Black parents of children who’ve received a late diagnosis have reported that they had never heard of ASD before and didn’t know what to look for. Had they known, they would have pushed back when their doctor either dismissed their concerns or told them to wait until their child was older.

Stigma has been cited as one of the main reasons why Black people in particular fail to seek proper treatment or resources, regardless of socioeconomic status. Historically, Black people struggling with mental health issues have been more likely to be misdiagnosed, criminalized, or even killed rather than treated with care. As a result, many hesitate to talk about difficulties with mental health for fear of being misunderstood or judged. And for a lot of elder members of the community, mental health struggles are still seen as a sign of weakness or a lack of discipline.

“Families often fear that seeking a diagnosis will cause harm to their child, worrying that teachers, clinicians, or even other family members will make negative assumptions about their child based on the label. They also fear that their own parenting skills will be brought into question,” Dr. Telesford acknowledges.

Black parents are often made to feel isolated, and even if their child’s doctor or teacher raises concerns about early developmental delays, they might be reluctant to follow up in fear of their child receiving the “label” of having a mental health disorder. They decide to wait, resulting in their child either receiving a diagnosis later in life or never getting one at all.

The most important thing for parents to do is to educate themselves on autism spectrum disorder (ASD) and continue to advocate for their child, advises Dr. Telesford. Foundations such as The Color of Autism and Autism in Black provide helpful information and support for the families of Black children with ASD.

And if their pediatrician advises against further evaluation, she wants families to know that they have every right to request the evaluation anyway. “Because really, that determination of whether they need the support or not should be made by the Early Intervention team.”

Each state has its own federally mandated Early Intervention program. Pediatricians can refer patients for an evaluation, but parents can also go to their state’s Early Intervention website for more information on the process and to request an evaluation.

Parents should also be aware that they do not need a referral from their pediatrician to seek a medical diagnosis for their child.

According to Dr. Telesford, “A lot of families who I see have pediatricians who aren’t concerned. But they’ve decided to seek help anyway. So going to an agency outside of your PCP’s referral and outside of the school system, if you can access that, is something that’s also encouraged. You don’t need a referral from your PCP to come to us or go to any other autism testing agency.”

Having social support ─ from family members, community members, or trusted friends ─ can also play an important role in the seeking of care. Families are more likely to seek care if they are given an exact agency or provider to go to whom a trusted person in their life has worked with or heard of, says Dr. Telesford. “Additionally, families caring for multiple children may not be able to bring their child in for an appointment if they have a younger sibling at home who also requires care or an older sibling who needs transportation to and from school or extracurriculars. This can be where a trusted family member or friend steps in to help.”

There’s a consensus within the healthcare community that doctors need more training not only on autism, but also on implicit bias and racism. In an effort to combat discrimination, the American Medical Association introduced a new set of guidelines in 2021 to help medical professionals create a more inclusive environment within the healthcare system. Medical schools like Morehouse School of Medicine and the Ohio State University College of Medicine are not only making efforts to create more opportunities for young Black students to pursue careers in medicine, but are also continuously reviewing and updating school curricula to reflect current social issues and injustices that impact the medical field.

While there remains a deficit in autism training among doctors, there’s a rising number of studies that call for the development and evaluation of autism training programs for healthcare professionals. As the research continues to gain traction, there’s hope that more of an effort will be made to educate doctors about how to detect early signs of autism in children across multiple racial/ethnic groups.

The post Why Do Black Children With Autism Get Diagnosed Late? appeared first on Child Mind Institute.

Being diagnosed with a learning disorder doesn’t mean that a child isn’t intelligent. Getting an accurate diagnosis can make a huge difference for kids who are struggling with learning, and with the right instruction, they can thrive in school and beyond.

Learning disorders are often noticed for the first time when a child is in preschool or elementary school and has trouble building skills that come more easily to their peers. The signs of a learning disorder vary depending on what the child is struggling with.

Several common learning disorders, including dyslexia, dyscalculia, and dysgraphia, fall under the umbrella of a diagnosis called “specific learning disorder.”

Here’s a look at different kinds of learning disorders that kids may be diagnosed with, along with their most common symptoms.

Children with dyslexia have an unusually difficult time learning to read. They often struggle with reading new words, sounding out words, recognizing words they’ve already learned, spelling, and writing. To become strong readers, kids with dyslexia need a particular kind of instruction known as systematic phonics-based instruction.

Signs of dyslexia include:

• Struggling to rhyme
• Difficulty matching sounds with letters
• Trouble putting sounds in the right order
• Talking later than other children
• Trouble remembering words
• Having a hard time following directions
• Leaving out little words when reading (like the, and, in) or reading them twice
• Difficulty sounding out words they don’t know

When kids are diagnosed with dyslexia, their diagnosis is technically called specific learning disorder, with the specification that they struggle with reading.

For more, read our Complete Guide to Dyslexia.

Kids with dyscalculia have an unusually hard time with math. They struggle to understand, learn, and perform math and number-based operations.

Signs of dyscalculia include:

• Difficulty recognizing numbers
• Learning to count later than other children
• Trouble doing math problems
• Frequently making small mistakes in math, like being off by one
• Confusing basic symbols such as “+” and “-“
• Struggling to remember directions
• Trouble using numbers outside of school, like remembering a phone number, telling time, or counting out change

When kids are diagnosed with dyscalculia, their diagnosis is technically called specific learning disorder, with the specification that they struggle with math.

For more, read our article on understanding dyscalculia.

Dysgraphia is a learning disability that makes it difficult for children to write. There are two sides to dysgraphia: motor weaknesses that affect the physical process of writing, and cognitive challenges with written expression. Some kids struggle with just one aspect of writing or the other, and some struggle with both.

Signs of dysgraphia include:

• Difficulty writing letters, including trouble with forming the letters, spacing them correctly, and making them the same size
• Trouble holding a pencil
• Writing fatigue, which can mean finding writing tiring or painful
• Difficulty with spelling, grammar, punctuation, and sentence structure
• Trouble with organization and structure in writing — kids with dysgraphia often have great ideas but struggle to express them in writing

Dysgraphia itself is not an official diagnosis. Children who struggle with the motor skills involved in writing (like forming letters) are often diagnosed with dyspraxia. Those who struggle with the cognitive skills involved in writing (like organizing ideas) are often diagnosed with specific learning disorder, with the specification that they struggle with writing.

For more, read our article on understanding dysgraphia.

Non-verbal learning disorder is a learning disability that causes kids to have trouble recognizing and understanding patterns in body language, visual-spatial information, and other kinds of non-verbal communication. The disorder is sometimes called NVLD or NLD. Kids with NVLD are often good with words but struggle in social situations.

Signs of non-verbal learning disorder include:

• Trouble reading non-verbal social cues, such as facial expressions and body language
• Difficulty understanding sarcasm
• Trouble recognizing other people’s emotions
• Difficulty understanding visual and spatial information
• Seeming clumsy and uncoordinated
• Struggling with higher-level math concepts
• Talking a lot more than other kids
• Trouble breaking down a project into smaller steps
• Poor organizational skills

Non-verbal learning disorder is not a formal diagnosis, and not all experts recognize it as a disorder. Its symptoms can sometimes look like those of other disorders, like ADHD or autism. It also varies a lot from kid to kid, so the first step to getting help for a child with NVLD is figuring out exactly what kinds of learning they struggle with. 

For more, read our article on understanding non-verbal learning disorder.

Auditory processing disorder is a condition in which kids have trouble managing information that they hear. There is nothing wrong with their hearing, but their brains have a hard time making sense of what they hear. They miss a lot of what is said to them and around them, especially in loud or distracting environments.

Signs of auditory processing disorder include:

• Difficulty following spoken directions
• Asking for information to be repeated
• Trouble telling the difference between words that sound similar (like “bat” and “pat”)
• Lack of focus, especially in noisy surroundings
• Trouble remembering things like nursery rhymes or song lyrics
• Mixing up the order of sounds in words or numbers in a sequence (like hearing “48” instead of “84”)
• Struggling to follow conversations

Auditory processing disorder is not a formal diagnosis, and not all experts recognize it as a disorder. Its symptoms overlap with other diagnoses such as ADHD and learning and language disorders, and many kids with auditory processing disorder also have one of these other disorders.

For more, read our article on understanding auditory processing disorder.

Dyspraxia is a condition that causes children to appear clumsy and uncoordinated compared to other kids their age. There is nothing wrong with their muscles, but their brains have a hard time telling their bodies what to do. Dyspraxia is also known as developmental coordination disorder. Some kids with dyspraxia have trouble with fine motor skills, like using scissors or eating with a spoon. Others struggle with gross motor skills, like catching a ball or riding a bike. Some have issues with both kinds of motor skills.

Signs of dyspraxia include:

• In young children, being slow to develop motor skills like crawling, walking, and using utensils
• Trouble with fine motor skills like holding a pencil, using a zipper, or fastening buttons
• Difficulty balancing
• Trouble with physical activities like running and jumping
• Frequently stumbling or tripping
• Avoiding activities like drawing, writing by hand, or playing sports

As a diagnosis, dyspraxia (or developmental coordination disorder) is technically considered a motor disorder rather than a learning disorder.

For more, read our article on understanding dyspraxia.

The post What Are the Different Kinds of Learning Disorders? appeared first on Child Mind Institute.

Keep in mind that the way you deliver the information is just as important as the information itself because it will shape how your daughter will interpret it. Try to speak in a calm, neutral, and confident tone. Do your best to avoid showing too much of your own distress; this can lead her to experience the information as something “awful.” When you share the information, be brief, honest, and clear so that she understands what you’re saying. It might also be helpful to speak slowly and pause, giving her time to process and ask questions. You’ll want to be prepared for a range of potential responses. Some children may not seem fazed, while others may become very upset or withdrawn, or ask a lot of questions. 

After you’ve told her, avoid asking leading questions, like, “Are you sad or angry?” Instead, ask more general questions, like, “How are you feeling about what we talked about?” It’s important to validate and normalize your daughter’s reaction — whatever it may be — and let her know that any feeling she experiences is acceptable. For example, if she’s angry, you can let her know that you understand, and that it’s okay to feel angry. Follow your daughter’s lead and answer her questions as clearly as you can, but also be mindful not to overshare details that may be difficult for her to understand. If she asks a question that you don’t have the answer to, it’s okay to say that you don’t know. It’s even okay to give yourself time to respond. Let your daughter know that she asked a great question, and that you’ll need some time to think about how to best answer her. Just make sure to check back in to discuss the question.

With regard to your son, it may be helpful to speak with each child individually, so that they each have time to ask their own questions.This is a big and important step, but your children’s responses will be a process. Let them know that this is an ongoing conversation, and that they can ask more questions later. Be mindful to take care of yourself during this time so that you are best prepared to support your children as new thoughts, feelings, and emotions arise.

The post How do I tell my 8-year-old daughter that the man she’s always known as her father isn’t her biological father? appeared first on Child Mind Institute.

Nearly one in two Americans plan to take a trip this season, according to a recent survey. If your child has anxiety, autism, sensory issues, or other special needs, the travel industry has stepped up to make traveling less challenging for you. The Child Mind Institute tapped its own experts, as well as travel pros and families who travel frequently, to create this guide to help you sleigh, er, slay flights and road trips this holiday season and all year long. 

Research potential airports. More than 15 U.S. airports — including those in Atlanta, Miami, and Seattle — have dedicated sensory or quiet rooms that families can retreat to rather than waiting at the gate or in a crowded lounge. Some rooms have bean-bag chairs, quiet music, and dim lights while others offer a more tactile experience and even include a small aircraft mock-up for kids to explore. Before booking flights, check the website of your nearby airports and those in your travel destination to see if a sensory room is available. Note the location of the room within the terminal as well. While sensory rooms are open to all flyers, they may be located in a concourse that is used primarily by a specific airline. In that case, you may want to prioritize booking on an airline that operates out of that concourse. 

Try to avoid layovers. Direct flights will reduce the chance of delays and cancellations and minimize the number of transitions that your child will experience, says Margaret Dyson, PhD, a psychologist in the Autism Center at the Child Mind Institute. She also recommends avoiding flights that take off after your child’s bedtime. On major travel booking sites, it’s easy to filter the results by the number of stops and the hours of departure. If you can’t avoid a flight with a layover, be sure to explain to your child in advance that you’ll need to take two planes as part of your adventure.

Do a test run. Airports in Atlanta, Minneapolis-St. Paul, and Kansas City offer travelers the opportunity to schedule a familiarization experience. In Atlanta and Minneapolis-St. Paul, Delta volunteers guide families through TSA security procedures, exploring the terminal, and boarding a plane. Earlier this year, the newly remodeled airport in Kansas City opened an “air travel experience room” inside a section of a retired plane so future passengers can practice buckling seatbelts, putting luggage in overhead bins, and opening the lavatory door. Additionally, the Arc Wings for Autism/Wings for All program hosts dozens of events throughout the year at various airports; check thearc.org to see if there’s one near you.

Practice at home. If you can’t take your child to a familiarization experience, you can watch videos so kids “can see and hear how a new experience might pan out,” says Kayla Castro, a special-education teacher and travel agent specializing in trips for families with mental health challenges. It’s a strategy that has helped her teen son who has autism navigate airports as well as attractions they plan to visit on vacation. The Federal Aviation Administration has a well-done “Kids’ First Flight” video on its YouTube channel. Reading children’s books, such as Bearplane! (ages 2–5) and Emma Every Day: First Flight (ages 5–7), may also be helpful. JetBlue and Autism Speaks also partnered on a downloadable travel guide that takes kids through each step in the airport process. Print it out and bring it with you to the airport or create your own visual list of “jobs” your child can focus on when they get to the airport, like getting a bin while going through security or walking through the metal detector. “They’ll know what to expect and can direct their energy in an independent way,” says Cynthia Martin, PsyD, a clinical psychologist and senior director of the Autism Center at the Child Mind Institute.

Sign up for the Sunflower Lanyard Program. Staff at more than 230 airports worldwide have been trained to recognize that people who wear this lanyard have a disability that isn’t visible. For information about how to purchase a low-cost lanyard and which U.S. airports participate in the program, go to hdsunflower.com.

Alert your airline. If you’d like to board early with a child who has mental health challeneges, it’s best to notify the airline in advance rather than make the request at the gate. If you didn’t do it at the time of booking, go to your airline’s website to find out how to add it to your reservation. Generally speaking, children with mental health disorders will feel more comfortable in a window or middle seat rather than the aisle, where they may be accidentally bumped by other passengers or the beverage cart. If you feel your child may have a better experience boarding toward the end of the process, alert the gate agent and, if possible, send one member of your family in advance to secure overhead luggage space. 

Simplify the security line. Download the MyTSA app on your smartphone, where you can check the current and average wait times to get through the security line. It will give you an idea about what days and times ares the most and least crowded at your airport. Regardless, travel experts recommend that families enroll in TSA PreCheck. Ninety-nine percent of TSA PreCheck passengers wait less than 10 minutes. If adults are enrolled in TSA PreCheck, their children ages 17 and under can join them in the line. Go to TSA.gov/precheck to find out how to enroll; new enrollment costs $78 per adult for 5 years but keep in mind that some credit cards issue a statement credit to help offset the cost. The TSA notes that most applications can be processed in 3 to 5 days. Whether or not you have TSA PreCheck, you can call the TSA Cares helpline at 855-787-2227 about 72 hours before your flight to request special assistance through security.

Strategize luggage. Pack a small backpack for each child to use as a personal item. You might want to include fidget toys, easy-to-contain creative items like Wikki Stix and sticker books, and snacks. In addition, consider designating an adult backpack for the family’s electronics, medications, and a change of clothes per family member. Check most or all of the remainder of the luggage and put an Airtag inside each so you can more easily locate lost luggage.”

Consider the airport size. While regional airports don’t require much walking, those in major cities have a considerable distance from the entrance to the gates. If walking long distances is hard for your child, consider bringing a stroller, which you can check at no charge at the gate. Or you can use children’s luggage that allows for sitting or movement, like a ride-on suitcase or suitcase with a flip-down scooter, says Dr. Martin.

Prepare for delays and cancellations. On December 23, 2022, nearly 1 in 5 flights at the 20 major U.S. airports were canceled, according to FlightAware and the Bureau of Transportation Statistics. Before you fly, think about what your options are if your flights don’t take off as planned. Investigate if hotels in the airport itself or on airport property offer “day use” rooms, which could be helpful if you’re faced with a delay of several hours or longer. And be sure to download the app for the airline you’re flying; it’s generally the quickest way to rebook a canceled flight.

Look for inclusive playgrounds. Make a note of playgrounds that are near your route. If your child is starting to get antsy in the car, a half-hour stop at a playground may head off a major meltdown. To search inclusive playgrounds by state, go to http://www.accessibleplayground.net.

Charge power banks. Most cars just have one charging port — and it always seems like all the passengers run low on battery at the same time. To prevent having to decide  who gets to use the charger, have a few power banks at the ready to hand out when needed.

Research attractions you’ll be passing by. If your family is a member of your local children’s museum, zoo, or aquarium, you might be able to visit others at no cost or a significantly reduced rate through a reciprocity program. Create a list of what might be open for a stop, so you’ll have options at the ready if traffic gets bad or your child gets restless.

Explore the airport. If your airport doesn’t have a sensory room, it may have a children’s play area or other fun novelties to see. For instance, in the Houston airport, there’s a large statue of a cow dressed as an astronaut. Once you’re ready to settle down, look for a nearby gate that’s relatively empty. “Stay there for as long as possible so your child can run around. Bring a beach ball — they can easily inflate and deflate to offer gross motor play,” says Dr. Martin.

Play to your child’s interests. If your child loves maps, for instance, print out an airport map in advance and allow the child to help direct you where to go. Or you can use the map as a distraction while waiting in a long line. While you’re in line to check bags, for instance, you might say, “Help me figure out where the train is to our terminal.”

Bring their own seat. If your child is under 40 pounds, bring an FAA-approved car seat for them to use on the plane. “The familiarity of being in a car seat can make the flight less stressful and it will be easier for your child to remain seated,” says Dr. Martin.

Utilize family restrooms. Many airports and rest stops have family restrooms that offer more space. However, they may have loud automatic flushing toilets and hand blowers that could bother a child with sensory issues. “When possible, carry supplies like sticky notes that can be placed over the sensors of toilets and extra wipes or towels to dry off hands,” says Dr. Dyson. 

Relax screen time rules. “We give up rules around devices when traveling,” says Phillipa Martin, who flies several times a year with her 7-year-old daughter who has autism. Carrie McLaren does the same for her special-needs daughter on road trips. “She can watch movies on the iPad the whole time we’re in the car and then I collect the device when we get to our destination,” says McLaren, who writes about family vacation experiences at carrieontravel.com. Dr. Martin suggests creating a set of apps and videos that are only used during travel. “This way, your child will look forward to traveling because theye get access to a set of special games and videos,” she says. Another option: Listening to an audiobook — especially one that’s set in a place you’re headed — is a fun and sneakily educational way to keep kids entertained.

Help them doze off. Nothing passes the time faster than a nap! Try to re-create your child’s pre-nap routine as closely as possible, even if it means changing them into PJs at a reststop, bringing their favorite blankie or eye mask on the trip, snuggling with them until they drift off, or all of the above.

Bring their favorite foods. “My daughter is very particular about what she eats, and it’s easiest to carry it with us,” says Martin. While you have more flexibility on a road trip where you can pack a well-insulated cooler, create a snack bag for the flight because airlines have limited options and airport lines are often long. Plus, hangry kids (and parents!) are often extra cranky. 

Find hotels with staff who have special-needs training. A growing number of hotels and resorts have become Certified Autism Centers. To receive the designation, at least 80 percent of the guest-facing staff at the hotel or resort receive training in autism and sensory disorders from the International Board of Credentialing and Continuing Education Standards. You can search member properties at autismtravel.com.

Prioritize a kitchenette. If your child’s diet is limited, look for a hotel that has a microwave and a fridge in the room. “Minibars don’t usually get as cold as mini-fridges, so you might not be able to safely keep yogurt drinks or cheese in them,” Martin warns. If a mini-fridge doesn’t come standard, you can call the hotel directly to see if they offer them upon request. Better still, book a room that has a mini kitchen as well as a table and chairs so you don’t have to eat every meal out. 

Opt for keyless entry. Being able to head straight to your room and bypass the line at the front desk is being offered by a growing number of hotels, including chains like Hilton and Accor. Take advantage of the tech and save your family another wait.

Pack a reminder of home. Since kids love routines and familiar items, consider bringing a scent you use at home, their own pillowcase, and a favorite bedtime story to help them relax.

The post 24 Tips for Traveling With Children appeared first on Child Mind Institute.

A new report from the Child Mind Institute, produced with support from Morgan Stanley, finds that teen internet addiction is more concerning to parents than drug addiction. The report draws on a large survey of U.S. parents of children aged 9 to 15, which sought to identify trends in excessive or problematic internet use (PIU) among teens.

“The primary goal of this survey was to characterize parental perceptions and concerns about internet use associated with child and adolescent development, well-being, safety, family connectedness, and potential for PIU,” said Giovanni Salum, MD, PhD, Program Director at the Child Mind Institute and a member of the research team. “Understanding parent perceptions is important both to gauge the extent of problematic internet use as a public health issue, and to better understand the family dimension of problematic use.”

While half of parents surveyed reported a positive view of internet usage and confidence in their child’s ability to use the internet responsibly, half also expressed specific concerns about how internet use was affecting their child’s development. Parents reported concerns about substance addiction, but twice as many expressed concerns about internet addiction.

The report identifies links between PIU and both negative parenting styles and parent internet use, but also — quite strikingly — a link between adolescent use of social networking and family connectedness. The nuances of the findings, revealing both perceived benefits and concerns among parents, provide critical insight when it comes to intervention.

The report’s lead author, Michael P. Milham, MD, PhD, Vice President of Research at the Child Mind Institute, said: “The perception of enhanced familial interconnectedness afforded by internet use in this study should be leveraged into family interventions designed to enhance open communication and monitoring of potential dangers of internet use in youth.”

Access the press release
Read the full article

Related Reading

How Using Social Media Affects Teenagers

Is Internet Addition Real?

Does Social Media Use Cause Depression?

Education at the Child Mind Institute

Our Education Mission

We believe that knowledge empowers families and communities to promote kids’ mental health. That means supporting children when and where they need it most. Whether we are sharing evidence-based information in our Family Resource Center or training educators and mental health professionals, we bring life-changing care within reach.

Learn More

Family Resource Center

The Child Mind Institute’s Family Resource Center is committed to providing up-to-date, authoritative and actionable information about children’s mental health and well-being.

Find information to help you support children who are struggling with mental health, behavior or learning challenges.

Explore Our Resources

Topics, Conditions, and Concerns

Whether you’re investigating your concerns or researching a particular diagnosis, we offer advice from experts and families who’ve been through it.

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The post Teens and Internet Addiction appeared first on Child Mind Institute.

]]> https://childmind.org/blog/black-patients-receive-highest-rates-of-psychotic-disorder-diagnoses/ Fri, 03 Nov 2023 15:47:10 +0000 https://childmind.org/?p=39361 Scientists assess inequalities in the incidence of psychotic disorders among different racial and ethnic groups Systemic racism is an ongoing issue within the U.S. and continues to place people of color at a disadvantage in the health care system. Previous studies have shown Black patients to be significantly more likely than White patients to be … Continued

The post U.S. Study Finds Black Patients to Receive the Highest Rates of Psychotic Disorder Diagnoses appeared first on Child Mind Institute.

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Scientists assess inequalities in the incidence of psychotic disorders among different racial and ethnic groups

Systemic racism is an ongoing issue within the U.S. and continues to place people of color at a disadvantage in the health care system. Previous studies have shown Black patients to be significantly more likely than White patients to be diagnosed with a psychotic disorder (e.g., schizophrenia).

Winston Chung, MD, and his research team at UCSF recently collaborated with the senior investigator and chief of the Genetic Epidemiology Research Branch of NIMH, Kathleen Merikangas, PhD, and the Child Mind Institute’s vice president and director of Research, Mike Milham, MD, PhD. Together, they conducted a study to examine the disparities in the incidence of both nonaffective (schizophrenia spectrum disorders) and affective (psychosis associated with depression or bipolar disorder) psychotic disorder diagnoses among different racial and ethnic groups within the U.S. They were able to do so by collecting data from the medical records of patients who received care within the Kaiser Permanente Northern California (KPNC) healthcare system between January 1, 2009, and December 31, 2019.

Results found Black patients to have received notably higher rates of psychosis diagnoses than any other racial/ethnic group included in the study. While American Indian or Alaskan Native (AIAN) and Black patients showed a higher risk of receiving a nonaffective psychotic disorder diagnosis than White patients, Asian patients consistently received the lowest rates of psychotic disorder diagnoses across the board. Study findings also noted that those who had been diagnosed with psychotic disorders were at a much higher risk of also having serious health issues, dying by suicide, or dying prematurely. The risk was even higher for those with both psychotic disorders and other psychiatric disorders like depression.

Researchers speculate that unequal distribution of resources, implicit bias, and differences in attitudes towards mental health care across racial/ethnic groups may be among the many factors that contributed to the study findings.

 “I think this study underscores the importance of actively monitoring, understanding, and addressing inequalities in mental health and the provision of care. Inaction will allow disparities to persist or potentially worsen,” Dr. Milham concludes.

Access the press release
Read the full article

Related Reading

Misdiagnosis of Mood Disorders in Black Teenagers

Early Treatment for Schizophrenia Improves Outcomes

Education at the Child Mind Institute

Our Education Mission

We believe that knowledge empowers families and communities to promote kids’ mental health. That means supporting children when and where they need it most. Whether we are sharing evidence-based information in our Family Resource Center or training educators and mental health professionals, we bring life-changing care within reach.

Learn More

Family Resource Center

The Child Mind Institute’s Family Resource Center is committed to providing up-to-date, authoritative and actionable information about children’s mental health and well-being.

Find information to help you support children who are struggling with mental health, behavior or learning challenges.

Explore Our Resources

Topics, Conditions, and Concerns

Whether you’re investigating your concerns or researching a particular diagnosis, we offer advice from experts and families who’ve been through it.

Explore Topics

The post U.S. Study Finds Black Patients to Receive the Highest Rates of Psychotic Disorder Diagnoses appeared first on Child Mind Institute.

]]> https://childmind.org/blog/us-study-finds-black-patients-receive-highest-rates-of-psychotic-disorder-diagnoses/ Wed, 01 Nov 2023 19:30:55 +0000 https://childmind.org/?p=39322 Scientists assess inequalities in the incidence of psychotic disorders among different racial and ethnic groups. Systemic racism is an ongoing issue within the U. S. and continues to place people of color at a disadvantage in the health care system. Previous studies have shown Black patients to be significantly more likely than White patients to … Continued

The post U.S. Study Finds Black Patients to Receive the Highest Rates of Psychotic Disorder Diagnoses appeared first on Child Mind Institute.

]]>

Scientists assess inequalities in the incidence of psychotic disorders among different racial and ethnic groups.

Systemic racism is an ongoing issue within the U. S. and continues to place people of color at a disadvantage in the health care system. Previous studies have shown Black patients to be significantly more likely than White patients to be diagnosed with a psychotic disorder (e.g., schizophrenia). While there are a multitude of possible explanations for this, such as socioeconomic disadvantages, clinical bias, and a lack of access to proper mental health care, more research needs to be done to fully understand the patterns of psychosis diagnoses across different racial and ethnic groups within the U.S.

Winston Chung, MD, and his research team at the University of California San Francisco (UCSF) recently collaborated with the senior investigator and chief of the Genetic Epidemiology Research Branch of The National Institute of Mental Health (NIMH), Kathleen Merikangas, PhD, and the Child Mind Institute’s vice president and director of Research, Mike Milham, MD, PhD. Together, they conducted a retrospective cohort study investigating the trends in psychotic disorders among several racial and ethnic groups within the U.S.

“Our aims were to quantify the incidence of nonaffective and affective psychotic disorder diagnoses among different racial and ethnic groups over time; to estimate disparities in incidence by race/ethnicity; and to demonstrate the negative health burden associated with psychotic disorders generally, including psychiatric and medical comorbidities and causes of death,” explains Dr. Chung, first author, psychiatrist at the Kaiser Permanente Honolulu Medical Center.

Data was collected from the medical records of patients who received care within the Kaiser Permanente Northern California (KPNC) healthcare system between January 1, 2009, and December 31, 2019. Patients self-identified as African American or Black, American Indian or Alaskan Native (AIAN), Pacific Islander, Latino or Hispanic, non-Hispanic White, Asian American, or other were included in the study. Researchers were able to identify if patients had received diagnoses for either nonaffective psychotic disorders (schizophrenia spectrum disorders) or affective psychotic disorders (psychosis associated with depression or bipolar disorder) by using the ICD-9 and ICD-10 diagnostic codes recorded in the KPNC system. The data collected was used to assess the overall linear changes in annual incidence rates of psychosis disorder diagnoses over time during the 10-year study period. The association of receiving diagnoses for psychotic disorders with other psychiatric disorders like depression or bipolar disorder was also assessed. In addition, researchers looked at the association of psychotic disorder diagnoses and health issues such as diabetes, obesity, or even premature death.

Results found that Black patients had a notably higher incidence of overall psychosis diagnosis rates than any other racial/ethnic group. However, both Black and AIAN patients shared a higher risk of receiving a nonaffective psychosis diagnosis than their White counterparts. Asian patients consistently received the lowest rates of both nonaffective and affective psychosis diagnoses. Additionally, the study found that those who had been diagnosed with psychotic disorders were at a higher risk of also having health issues such as diabetes and were more likely to commit suicide or die prematurely. Patients who had both psychotic disorders and comorbid psychiatric disorders were at an even higher risk.

Researchers speculate that factors such as unequal distribution of resources, and differences in attitudes towards mental health care across racial/ethnic groups may have contributed to lower rates of clinical diagnosis among some groups. The results of this study may have also been affected by implicit bias, changing the way in which symptoms were perceived in patients from different racial/ethnic groups. Furthermore, it’s important to note that the consistent high rates of psychotic disorders among Black populations in the U.S. highlights the negative effects of systemic racism and its resulting societal disadvantages. More research must be done on this topic.

“Our findings on the stability of incident psychosis in a large registry, the pervasive comorbidity, and the negative health consequences ─ particularly suicide and premature death ─ highlight the urgency of preventive interventions for individuals presenting with psychosis in health settings,” Dr. Chung concludes.

In agreement with Dr. Chung’s sentiments, Dr. Milham adds, “I think this study underscores the importance of actively monitoring, understanding, and addressing inequalities in mental health and the provision of care. Inaction will allow disparities to persist or potentially worsen.”

To read the full article, click here: https://pubmed.ncbi.nlm.nih.gov/37789743/

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About the Child Mind Institute
(Instagram, Facebook, Twitter, LinkedIn)
The Child Mind Institute is dedicated to transforming the lives of children and families struggling with mental health and learning disorders by giving them the help they need. We’ve become the leading independent nonprofit in children’s mental health by providing gold-standard evidence-based care, delivering educational resources to millions of families each year, training educators in underserved communities, and developing tomorrow’s breakthrough treatments. Learn more at childmind.org.

For press questions, contact our press team at childmindinstitute@sunshinesachs.com or our media officer at mediaoffice@childmind.org.

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]]> https://childmind.org/blog/teen-internet-addiction-is-now-a-more-frequent-concern-among-parents-than-substance-addiction/ Wed, 01 Nov 2023 19:25:28 +0000 https://childmind.org/?p=39319 Child Mind Institute researchers explore the benefits and harms of adolescent internet use in a new paper published in JAMA Increasing dependence on the internet, on display during the COVID-19 pandemic, has created deep concerns about the negative impact of internet use in youth. Identifying and intervening with young people who are particularly vulnerable to … Continued

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Child Mind Institute researchers explore the benefits and harms of adolescent internet use in a new paper published in JAMA

Increasing dependence on the internet, on display during the COVID-19 pandemic, has created deep concerns about the negative impact of internet use in youth. Identifying and intervening with young people who are particularly vulnerable to developing excessive or problematic internet use (PIU) are central to recent research on this topic. However, small, non-diverse samples and limited information on key familial and offspring characteristics have been barriers to putting research into action.

To provide the field with more insight into adolescent internet use, parent perceptions, and how parenting styles may impact PIU, Child Mind Institute scientists ran a large survey of US parents of children aged 9 to 15. The survey revealed that parents perceive benefits of internet use, like family connectedness, and concerns, like cyberbullying and addiction. Twice as many parents reported specific concerns about internet addiction than substance addiction.

“The primary goal of this survey was to characterize parental perceptions and concerns about internet use associated with child and adolescent development, well-being, safety, family connectedness, and potential for PIU,” explains Giovanni Salum, MD, PhD, Program Director at the Child Mind Institute and a member of the research team. “Understanding parent perceptions is important both to gauge the extent of problematic internet use as a public health issue, and to better understand the family dimension of problematic use.”

Using previously validated questionnaires, expert stakeholders including psychiatrists, psychologists, and epidemiologists, designed a 20-minute, English-language survey. In 2022, a diverse sample of 1,005 US parents of youths ages 9-15 completed the survey anonymously via Ipsos, an online survey platform. 1,005 US parents of youths ages 9-15 were recruited and weighted to be representative of the US population. About half of parent felt that internet use can increase family bonds and most reported confidence that their child can use the internet responsibly; nevertheless, about one-half of parents expressed specific concerns about internet use on their offspring’s social (51.1%), cognitive (46.2%), and physical development (46.7%). Approximately one third of the participants in this study reported concerns about addiction to both internet and substances. Equivalent proportions expressed concerns about one of these types of addiction in their offspring, whereas another third did not have worries about addiction at all. Internet addiction concern outweighed that of substance problems. In particular, the potential for addiction was most evident for social networking programs and video gaming. This survey highlights the growing influence of internet use in children’s lives and the importance of monitoring for potential harmful use in youth.

Additionally, the researchers’ analysis of responses found that problematic internet use among adolescents was associated with negative parenting styles and parent internet use. And intriguingly, there was a positive association between adolescent use of social networking and family connectedness.

These results open the door to several ways forward. Parents indicated that internet use improved the sense of family connectedness through an ability to share positive experiences, an increased sense of family closeness, an increased ability for family flexibility, and positive benefits on family time spent together. The association of social networking platform use in youths with family impact scores suggests that enhanced within-family network communication may be a benefit of internet use. Perceived benefits of internet use were balanced by parental concerns about the potential of social networking platforms to contribute to internet addiction, echoing recent warnings by the US Surgeon General.

“This research strengthens and extends the literature on correlates of PIU among adolescents, including parenting styles and parental internet use,” says lead author Michael P. Milham, MD, PhD, Vice President of Research at the Child Mind Institute. “The perception of enhanced familial interconnectedness afforded by internet use in this study should be leveraged into family interventions designed to enhance open communication and monitoring of potential dangers of internet use in youth.”

This work was supported by a grant from Morgan Stanley; gifts to the Child Mind Institute from Phyllis Green, Randolph Cowen, and Joseph Healey; awards R01MH124045 and R01MH091864 from the National Institute of Mental Health (NIMH) (Dr Milham); and grant ZIAMH002953 from the Intramural Research Program of the NIMH (Dr Merikangas).

The full article can be found here.

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About the Child Mind Institute
(Instagram, Facebook, Twitter, LinkedIn)
The Child Mind Institute is dedicated to transforming the lives of children and families struggling with mental health and learning disorders by giving them the help they need. We’ve become the leading independent nonprofit in children’s mental health by providing gold-standard evidence-based care, delivering educational resources to millions of families each year, training educators in underserved communities, and developing tomorrow’s breakthrough treatments. Learn more at childmind.org.

For press questions, contact our press team at childmindinstitute@sunshinesachs.com or our media officer at mediaoffice@childmind.org.

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]]> https://childmind.org/blog/the-child-mind-institute-announces-two-key-leadership-hires/ Wed, 01 Nov 2023 14:00:00 +0000 https://childmind.org/?p=39192 Demetrios Kadenas joins as Chief Development Officer and Charles Fieldstakes on Chief of Staff role New York, NY – The Child Mind Institute announced today that it has made two key hires, appointing Demetrios Kadenas as Chief Development Officer (CDO) and Charles Fields as Chief of Staff (COS).  The leading children’s mental health non-profit will … Continued

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]]> Demetrios Kadenas joins as Chief Development Officer and Charles Fields
takes on Chief of Staff role

New York, NY – The Child Mind Institute announced today that it has made two key hires, appointing Demetrios Kadenas as Chief Development Officer (CDO) and Charles Fields as Chief of Staff (COS).  The leading children’s mental health non-profit will welcome both individuals to the organization in November 2023.  Kadenas and Fields join the Child Mind Institute at a time of significant growth.  The organization has more than tripled its staff since 2018 and announced earlier this year that they will soon move their headquarters to an 82,000 square foot new office space at 825 Third Avenue.

Kadenas, currently the interim CDO, came to the Child Mind Institute in May.  He previously served as Head of Advancement at Success Academy, focusing on principal and major gifts and working to grow the team and establish new work standards and best practices. Prior to Success Academy, Demetrios held leadership positions in healthcare development for 10 years at Northwell Health and NYU Langone Health. He launched his career in non-profit development two decades ago at CCS Fundraising, consulting for organizations on strategic vision planning and major fundraising campaigns.

Kadenas has already made substantial contributions to the Child Mind Institute as interim CD­O, working with leadership to build strategic development initiatives, diversify funding streams, and expand major and principal gift outreach. He is managing the launch of the Child Mind Institute’s next comprehensive campaign and a crucial digital fundraising program expansion.

“We are so pleased that Demetrios has joined us as Chief Development Officer. He arrives with an incredibly strong background in development and a remarkable enthusiasm for our work and mission,” said Child Mind Institute Founding President and Medical Director Harold S. Koplewicz, MD.  “He has an extensive plan for expanding our development work and planned giving, and for continuing to grow our major gifts programs.”

“It has been an honor to serve as interim Chief Development Officer at the Child Mind Institute, and I’m excited to continue working with Child Mind’s leadership and our generous community to build a development enterprise and scale our fundraising to support the Institute’s next chapter of strategic and philanthropic priorities, so we can reach even more children and families,” said Kadenas.

Fields is a global strategic operations executive with recognized expertise in project portfolio management, corporate planning, execution, and organizational management.  As a strategic operations consultant, he has transformed businesses in the technology, healthcare, pharmaceutical, insurance, energy, financial services, and public sectors. He has also solved long-term business challenges and reshaped key divisions of large corporations, government agencies, and non-profit organizations.  From 2015 to 2018, Fields served as New York’s Deputy Secretary of State.

Fields will be responsible for partnering with the Institute’s President on the roll out of strategy and growth, management of key relationships and oversite of the executive office.  He will also serve as a liaison with senior leaders and staff, and support engagement with the board of directors and key donors.

“With Charles’ impressive experience enabling large organizations to build innovative programs and best respond to challenges, we are confident that he is the right person to take on the role of Chief of Staff.  We all look forward to working with him,” Koplewicz shared.

“I’m thrilled to be joining the Child Mind Institute at such an exciting time as they develop far-reaching programs and campaigns to help children and families struggling with mental health and learning disorders here in the US and around the world,” said Fields.  “It’s a privilege to contribute to this crucial mission during a time of significant growth for the Child Mind Institute.”

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About the Child Mind Institute

(Instagram, Facebook, Twitter, LinkedIn)

The Child Mind Institute is dedicated to transforming the lives of children and families struggling with mental health and learning disorders by giving them the help they need. We’ve become the leading independent nonprofit in children’s mental health by providing gold-standard evidence-based care, delivering educational resources to millions of families each year, training educators in underserved communities, and developing tomorrow’s breakthrough treatments. Learn more at childmind.org.

For press questions, contact our press team at childmindinstitute@sunshinesachs.com or our media officer at mediaoffice@childmind.org.

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]]> https://childmind.org/blog/the-global-crisis-in-youth-mental-health-a-dialogue-with-world-mental-health-experts/ Mon, 30 Oct 2023 15:59:35 +0000 https://childmind.org/?p=39202 Watch experts from around the world discuss the global crisis in youth mental health, identify barriers to progress, and explore collaborative solutions.

The post The Global Crisis in Youth Mental Health: A Dialogue with World Mental Health Experts appeared first on Child Mind Institute.

]]> Watch the Recording

About the Symposium

This scientific symposium featured experts from around the world and discussed the global crisis in youth mental health, identified barriers to progress, and explored collaborative solutions. Hear how the Child Mind Institute and the Stavros Niarchos Foundation (SNF) partner to support progress.

Moderated by

• Juju Chang, Co-Anchor, ABC’s Nightline

Featured Experts

• Dévora Kestel, MSc, Director of Mental Health and Substance Use, World Health Organization
• Sarah Kline, MA, CEO and Co-Founder
  United for Global Mental Health
• Tom Osborn, Co-Founder and CEO, Shamiri Institute
• Eva Quintana, Statistics Specialist with Multiple Indicator Cluster Surveys, UNICEF
• Shekhar Saxena, MD, Professor of Global Mental Health Practice, Harvard T.H. Chan School of Public Health

• Shirley Reynolds, PhD, Director of Psychosocial Interventions SNF Global Center for Child and Adolescent Mental Health at the Child Mind Institute

• Giovanni Salum, MD, PhD, Program Co-Director, Child and Adolescent Mental Health Initiative SNF Global Center for Child and Adolescent Mental Health at the Child Mind Institute

More Information

Learn more about how we’re addressing the global crisis in youth mental health through our global program The Stavros Niarchos Foundation (SNF) Global Center for Child and Adolescent Mental Health.

About the Child Mind Institute's Global Programs

The Child Mind Institute’s Mission

We’re dedicated to transforming the lives of children and families facing mental health challenges and learning disorders by giving them the help they need. We’ve become the leading independent nonprofit in children’s mental health by providing gold-standard evidence-based care, delivering educational resources to millions of families each year, training educators in underserved communities, and developing tomorrow’s breakthrough treatments.

Together, we truly can transform children’s lives.

Read More

About the SNF Global Center

The Stavros Niarchos Foundation (SNF) Global Center for Child and Adolescent Mental Health aims to systematically expand access to, quality of, and equity in child and adolescent mental health care worldwide.

We envision a world in which children struggling with mental health or learning disorders, and their families, can readily access high-quality information, resources, and care. To do so, we propose collaborating with experts and community leaders around the world to breakdown barriers to care.

Learn More

Our Global Programs

The child and adolescent mental health crisis is a global problem. Seeing this need, the Child Mind Institute is partnering with local organizations and individual experts to promote meaningful change.

Learn More

Meet the Global Programs Team

Explore our directory to get a sense of the wide-ranging talents, expertise and backgrounds of our dedicated staff.

Meet Our Team

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]]> https://childmind.org/blog/child-mind-institute-and-snf-celebrate-center-to-address-global-youth-mental-health/ Fri, 27 Oct 2023 19:15:00 +0000 https://childmind.org/?p=39166 Symposium with World Mental Health Experts Build on Global Center’s Collaborative Strategy New York, NY – As millions of young people across the world grapple with mental health challenges, the Child Mind Institute and the Stavros Niarchos Foundation (SNF) have come together to inaugurate the Stavros Niarchos Foundation (SNF) Global Center for Child and Adolescent … Continued

The post Child Mind Institute and Stavros Niarchos Foundation (SNF) Celebrate Center to Address Global Crisis in Youth Mental Health at Expert Dialogue appeared first on Child Mind Institute.

]]> Symposium with World Mental Health Experts Build on Global Center’s Collaborative Strategy

New York, NY – As millions of young people across the world grapple with mental health challenges, the Child Mind Institute and the Stavros Niarchos Foundation (SNF) have come together to inaugurate the Stavros Niarchos Foundation (SNF) Global Center for Child and Adolescent Mental Health at the Child Mind Institute. An event this week on “The Global Crisis in Youth Mental Health: A Dialogue With World Mental Health Experts” brought global experts to discuss the barriers to progress in the field and collaborative solutions.

The SNF Global Center brings together the Child Mind Institute’s expertise as a leading independent nonprofit in children’s mental health and SNF’s deep commitment to supporting collaborative projects to improve access to quality health care worldwide. The center will build partnerships to drive advances in under-researched areas of children’s and adolescents’ mental health and expand worldwide access to culturally appropriate trainings, resources, and treatment. SNF’s founding support is part of its ongoing Global Health Initiative (GHI).

The center marked its global efforts with an event that brought together a distinguished panel of speakers from the World Health Organization, UNICEF, United for Global Mental Health, the Child Mind Institute, Harvard T.H. Chan School of Public Health, and Shamiri Institute. The discussion highlighted the importance of global cooperation in addressing youth mental health challenges; strategies for improving access to mental health services for children and adolescents worldwide; the role of research, policy, and advocacy in promoting youth mental health; and the goals of the partnership between the Child Mind Institute and SNF for championing progress in this critical field.

“We’re very proud of the work we’ve done in Greece through the Child and Adolescent Mental Health Initiative, and prouder still that it has laid the groundwork for the expansion of our partnership and the global work that we’re discussing and celebrating here tonight: the Stavros Niarchos Foundation Global Center for Child and Adolescent Mental Health at the Child Mind Institute,” said Harold S. Koplewicz, MD, Founding President and Medical Director of the Child Mind Institute, in his remarks. “The global need for mental health services has never been greater: Suicide is now the fourth leading cause of death for 15- to 19-year-olds worldwide. One in seven 10- to 19-year-olds has a mental health disorder.” 

“For too long, our collective efforts on this front have been at best reactive and uneven,” said SNF Co-President Andreas Dracopoulos. “The SNF Global Center seeks to help turn the tide with an approach that is proactive, equitable, and collaborative.”

The symposium, which took place at the Stavros Niarchos Foundation Library (SNFL) in New York City, was hosted by Juju Chang, co-anchor of ABC’s Nightline, and featured experts offering insights from a wide range of perspectives, including:

• Dévora Kestel, MSc, Director of Mental Health and Substance Use, World Health Organization
• Sarah Kline, MA, CEO and Co-Founder, United for Global Mental Health
• Tom Osborn, Co-Founder and CEO, Shamiri Institute
• Eva Quintana, Statistics Specialist with Multiple Indicator Cluster Surveys, UNICEF
• Shirley Reynolds, PhD, Director of Psychosocial Interventions, SNF Global Center for Child and Adolescent Mental Health at the Child Mind Institute
• Giovanni Salum, MD, PhD, Program Co-Director, Child and Adolescent Mental Health Initiative, SNF Global Center for Child and Adolescent Mental Health at the Child Mind Institute
• Shekhar Saxena, MD, Professor of Global Mental Health Practice, Harvard T.H. Chan School of Public Health

The SNF Global Center for Child and Adolescent Mental Health at the Child Mind Institute builds on the longstanding partnership on youth mental health between SNF and the Child Mind Institute, and includes the Child and Adolescent Mental Health Initiative (CAMHI) in Greece, as the first constituent program of the center. The CAMHI was established in 2021 under SNF’s GHI and has grown into a nationwide initiative with a strong institutional network working to enhance mental health care capacity and to strengthen the infrastructure for the prevention, assessment and treatment of mental health challenges faced by children and teenagers all across Greece.

The Child Mind Institute and SNF remain dedicated to forging a brighter, stigma-free future for the mental health of children and adolescents worldwide.

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About the SNF Global Center for Child and Adolescent Mental Health at the Child Mind Institute

The Stavros Niarchos Foundation (SNF) Global Center for Child and Adolescent Mental Health at the Child Mind Institute seeks to systematically increase access, quality, and equity in child and adolescent mental health care. Established with a foundational grant from the Stavros Niarchos Foundation (SNF), the center works to accelerate global collaboration on under-researched areas of children’s mental health and expand worldwide access to culturally appropriate trainings, resources, and treatment. In 2023, the team will initiate its first activities with local partners in Brazil and South Africa.

About the Child Mind Institute

(Instagram, Facebook, Twitter, LinkedIn)

The Child Mind Institute is dedicated to transforming the lives of children and families struggling with mental health and learning disorders by giving them the help they need. We’ve become the leading independent nonprofit in children’s mental health by providing gold-standard evidence-based care, delivering educational resources to millions of families each year, training educators in underserved communities, and developing tomorrow’s breakthrough treatments. Learn more at childmind.org.

For press questions, contact our press team at childmindinstitute@sunshinesachs.com or our media officer at mediaoffice@childmind.org.

About the Stavros Niarchos Foundation (SNF)

The Stavros Niarchos Foundation (SNF) is one of the world’s leading private, international philanthropic organizations, making grants to nonprofit organizations in the areas of arts and culture, education, health and sports, and social welfare. SNF funds organizations and projects worldwide that aim to achieve a broad, lasting, and positive impact for society at large, and exhibit strong leadership and sound management. The Foundation also supports projects that facilitate the formation of public-private partnerships as an effective means for serving the public welfare.

Since 1996, the Foundation has committed over $3.7 billion through more than 5,300 grants to nonprofit organizations in over 130 countries around the world. The ongoing $1 billion-plus Global Health Initiative (GHI) is SNF’s largest-ever grant initiative. It includes the design, construction and outfitting of three new hospitals in Greece, procurement of critical equipment such as air ambulances, training programs for health care providers, efforts to expand access to quality mental health care such as the Child and Adolescent Mental Health Initiative in Greece, and collaborations with institutions like The Rockefeller University, Columbia University, the Child Mind Institute, and the National Children’s Alliance in the United States; Sant Joan de Déu Barcelona Children’s Hospital; King Hussein Cancer Foundation and Center in Jordan; and Yorkshire Cancer Research in the United Kingdom.

See more at snf.org and snfghi.org.

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]]> https://childmind.org/article/how-to-work-well-with-your-childs-teacher/ Tue, 24 Oct 2023 20:15:24 +0000 https://childmind.org/?post_type=article&p=39100 We know that it’s important for parents to communicate well with their child’s teacher, but it can be hard to know exactly what that means. What kinds of information should you share with the teacher? How do you know which questions to ask? And what do you do if disagreements arise? When your child has … Continued

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We know that it’s important for parents to communicate well with their child’s teacher, but it can be hard to know exactly what that means. What kinds of information should you share with the teacher? How do you know which questions to ask? And what do you do if disagreements arise?

When your child has a learning disorder, the answers to these questions are especially important. Kids with LDs often struggle with self-esteem and social challenges, so working well with your child’s teacher is a crucial part of supporting their mental health as well as their academic learning.

Here are a few tips that parents of kids in elementary and middle school can use to build a strong connection with the teacher and keep the lines of communication open throughout the school year. And for kids who work closely with a learning specialist, school counselor, or other school staff member, these same collaborative strategies can be helpful.

Start early

Taking a little time at the start of the school year, or even right before, can be a powerful way to establish a relationship with your child’s teacher and set everyone up for a successful year.

Whether it’s in an email or a conversation at a welcome event, give the teacher some basic information about your child and where they stand in school. “Establishing a partnership from the beginning is really important,” says Heidi Wheeler, PsyD, a neuropsychologist in the Learning and Development Center at the Child Mind Institute. She recommends letting the teacher know any relevant details about:

• Concerns you have about your child going into the school year, whether academic, social, or emotional, including any specific mental health or learning diagnoses
• Notable strengths and what has worked well for them in the past (for example, if they love math or do a great job working in groups)
• Anything your child is working on at home that could be reinforced at school (like taking deep breaths when they’re experiencing big emotions)

“If you have a goal that you would like to establish for your child and see them make progress towards, then the teacher can be supportive in that,” Dr. Wheeler adds.

The idea is to get on the same page about your child’s key strengths and challenges, so that you can work together to help them build on what’s working and make progress in areas that are more difficult.

It’s also a good idea to use this first communication to establish the best way to get in touch later. Would the teacher prefer an email or a phone call? What are the best times to set up a meeting or stop by in person? How far in advance do they like to plan? Getting a sense of the teacher’s preferences and schedule (and sharing your own) will make it easier to communicate later on.

Keep them in the loop

It can be hard to know whether to fill the teacher in on something that’s going on in your child’s life, especially when you know how busy they are. But Dr. Wheeler says to err on the side of sharing information: “Important events that are happening in the family are likely to impact your child’s social emotional functioning, and thereby indirectly impact their academic functioning, so it makes sense to share.”

If you experience a death or illness in the family, or if your child is experiencing a medical illness themselves, let your child’s teacher know it’s affecting your child and also fill them in on any schedule changes that might happen as a result. It’s up to you how much detail to share, but the important thing is to consider how the change might impact your child at school and let the teacher know how they can be supportive.

Any changes in your child’s living situation or family structure are worth bringing up too, like a divorce or a move. Even seemingly smaller changes, like a parent traveling more for work or an older sibling leaving home, can have a significant impact, especially on young kids. Definitely tell the teacher if you notice your child struggling with a specific change, but even if you don’t, it can still help to keep them in the loop—with a clearer idea of what’s going on in your child’s life, they may notice challenges coming up at school that you’re not seeing at home.

Be proactive

It’s common for kids to behave differently at school and at home, so teachers may have insight into your child that you wouldn’t get just from seeing them at home. For instance, your child might be cooperative at home but act out at school due to social anxiety, frustration with academics, or any number of other reasons. Or they might stay focused within the structure of the school day and then struggle to behave at home when the pressure is off.

That’s why it’s helpful to ask your child’s teacher directly about how they’re functioning in different areas, says Dr. Wheeler. “You can ask, ‘Is my child making friends? What do their social skills look like at school? Do you have any concerns about how my child is behaving at school or performing academically?’”

By asking questions proactively, even when you don’t have any specific worries about your child, you can catch early signs that something might be amiss while also reinforcing to the teacher that you’re available and interested in working together if issues do come up.

Plan ahead

Teachers are busy — and so are you! A little planning can make the time you do have to talk more productive and focused on your child’s needs.

Whether you’re meeting with the teacher to address a specific concern or just checking in about how your child is doing in general, write down what you want to say ahead of time. Try to pick just a few key points to focus on to make sure you don’t forget anything major, and keep less significant issues on the back burner in case you end up with extra time.

At the start of the conversation, you can set a quick, informal agenda together: “I want to make sure we go over Lydia’s progress with reading, and I’d also like to touch on how she’s doing with handling her feelings when she gets frustrated. Is there anything else you wanted to talk about today?”

And if you’re working together to solve a particular problem, it’s helpful to leave the meeting with a clear action item or two: “Okay, I’m going to reinforce those reading strategies when she does her homework, and we’ll check in again in two weeks to see how it’s going.”

Focus on collaboration

Especially if your child has a learning disorder and is struggling with academics, it’s common for tensions to arise with your child’s teacher. Maybe you’re not convinced your child is getting adequate support in the classroom, or maybe your child is even convinced that their teacher doesn’t like them.

When you find yourself navigating one of these tricky situations, “showing them that you’re not coming from a place of blame or accusation, but rather concern for your child” is key, says Dr. Wheeler. Instead of pointing out what you think the teacher might be doing wrong (“You’re making Charlie feel like he’s not smart!”) try to frame your concerns in terms of working together to find a solution: “Charlie has been coming home feeling discouraged about his schoolwork lately. I’d like to talk about strategies we can both try to help him build confidence.”

If your child is expressing concerns to you directly, it can help to share their perspective with the teacher while also making it clear that you know there may be more to the story. You might say something like: “The other day Desiree told me that she thinks you’re mad at her. I’m guessing there was some kind of miscommunication, but I’d like to talk about what might have made her feel that way and how we can help her feel more secure in school.”

Teachers want your child to excel as much as you do, Dr. Wheeler notes, and “and if they hear that your child is hurting, they want to know how to help too.”

Support your child’s autonomy

With older children, it often makes sense to involve them in your communication with teachers. That can mean anything from just keeping them in the loop to helping them participate in the conversation themselves.

“If they’re comfortable speaking up for themselves, then the more we can support their autonomy, the better,” says Dr. Wheeler. You might talk to their teacher together or support them through the process of setting up the conversation and planning what to say.

Supporting older kids “behind the scenes” when there’s an issue can often be more helpful than talking to the teacher directly. “They may need to practice being able to assert themselves and choosing their words carefully. And so it’s good to have those discussions and practice in advance,” notes Dr. Wheeler. “And if there are obstacles that they can already foresee, that might get in their way, practicing how they would handle those.”

But there will also be situations where it’s more appropriate for you to step in and handle the conversation on their behalf. The important thing is to make sure your child has a voice in the process of working with the teacher, even if it’s just talking with you about what the best way for them to handle a given challenge might be. “Let them know that you’re there to support them, and that you can work together to come up with ideas if they feel stuck in how to handle a situation,” Dr. Wheeler says.

Keep things positive

As much as it’s important to work well with teachers when your child is having a problem, it’s also helpful to keep in touch when all is well. Sharing a quick positive anecdote when you see them at school (“Robin loved that creative writing project last week!”) or sending them notes of appreciation when you see your child making progress are easy ways to express your gratitude and keep the lines of communication open.

Above all, says Dr. Wheeler, remember that you and your child’s teacher are on the same team: “Both of you are there because you want to support your kids, and remembering that common goal can get you pretty far.”

The post How to Work Well With Your Child’s Teacher appeared first on Child Mind Institute.

]]> https://childmind.org/article/what-is-bulimia-nervosa/ Thu, 19 Oct 2023 16:58:07 +0000 https://childmind.org/?post_type=article&p=39017 Bulimia nervosa is an eating disorder that involves a pattern of frequent binge eating and then purging to avoid gaining weight. Binge eating is when a person consumes an unusually large amount of food in a short period of time, often feeling out of control or unable to stop while doing so. They will then … Continued

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Bulimia nervosa is an eating disorder that involves a pattern of frequent binge eating and then purging to avoid gaining weight. Binge eating is when a person consumes an unusually large amount of food in a short period of time, often feeling out of control or unable to stop while doing so. They will then purge, which is usually done by throwing up, but can also include misuse of laxatives, diuretics, or extreme exercise.  

Bulimia nervosa generally starts in adolescence, and in this age group it’s actually thought to be more common — by one estimate more than twice as common — than anorexia nervosa. And like anorexia, it’s treated most effectively with family-based treatment (FBT).

But bulimia is harder to spot than anorexia. Kids with bulimia usually are not underweight and they may appear to eat a healthy amount at family meals. Bingeing and purging are most often done in secret. When kids go into treatment, many parents are shocked to find out how often they’ve been vomiting after meals, notes Daniel Le Grange, PhD, director of the Eating Disorders Program at the University of California, San Francisco.

Despite its prevalence, far fewer teenagers get treatment for bulimia than anorexia. That may be because bulimia is easier to hide from parents, Dr. Le Grange explains, and because kids are often embarrassed to admit that they have it.

But bulimia is just as life-threatening as anorexia, though the causes of death are perhaps different in the two disorders.

The key symptoms of bulimia are recurring episodes of binge eating, followed by purging, at least once a week for no less than three months at a time. As is the case in anorexia, young people with bulimia also have an intense focus on body weight as the basis for self-esteem.

Binge eating is defined as eating an amount of food that’s larger than what most individuals would eat in a similar period of time under similar circumstances. Dr. Le Grange notes that what’s considered an unusually large amount is relative to the person’s culture. The eating episode is accompanied by a feeling of loss of control over eating. It’s common for teens with bulimia to binge on calorie-rich foods they would otherwise avoid and consume only low-calorie foods between episodes.

Purging involves the use of compensatory behaviors to prevent weight gain, such as self-induced vomiting, fasting, excessive exercise, or the misuse of laxatives or diuretics.

Accompanying the bingeing and purging is an intense focus on weight and body shape as the basis for the teenager’s self-esteem. Like those with anorexia, kids with bulimia are obsessed with their appearance and very worried about gaining weight. Bulimia is 10 times more prevalent in girls than it is in boys.

While kids often hide symptoms of this disorder, there are behaviors that can be signs of bulimia that parents might notice, especially if they occur frequently. These behaviors include:

• Worrying or complaining about being fat
• Having a distorted, negative body image
• Eating large quantities of food in one sitting, including foods they usually avoid
• Strict dieting or fasting
• Being secretive about eating
• Going to the bathroom right after eating
• Disappearance of large amounts of food
• Drinking excessive amounts of water or beverages  
• Using excessive amounts of mouthwash, mints, and gum  
• Exercising too much
• Having sores, scars, or calluses on their knuckles or hands
• Having damaged teeth and gums

One important difference between anorexia and bulimia is how kids feel about what they are doing to avoid weight. Anorexia is what Dr. Le Grange calls “ego syntonic,” meaning that it is aligned with the person’s values and self-image. As a result, kids with anorexia don’t think there’s anything wrong with them, and they often resist treatment.

Bulimia, by contrast, is by and large “ego dystonic,” meaning that behaviors such as bingeing and purging conflict with the person’s values and sense of self. “Most young people with bulimia nervosa,” Dr. Le Grange notes, “do not like the fact that they have bingeing episodes and then compensatory behaviors like self-induced vomiting that are unpleasant ways of getting rid of excess calories. Such episodes are often followed by guilt, disgust, and/or self-loathing.”

While kids with anorexia may be proud of their ability to resist eating and even be admired by other kids, those who binge and purge often see it as a sign of weakness and feel ashamed of these behaviors. It’s common for kids in treatment for bulimia to say they started out meeting criteria for anorexia and then resorted to binge eating because they found restricting calories too difficult. Some of these young people, Dr. Le Grange adds, even describe themselves as “having failed at anorexia.”

Due to the many dangerous health risks associated with this disorder, bulimia is associated with an increased likelihood of an early death. Unfortunately, these medical risks are often underestimated because they’re not visible, and at least half of the young people with the disorder are at a healthy-looking weight.

But frequent purging, whether by vomiting, laxatives, or enemas, can damage multiple organs in the body and cause electrolyte imbalances and other health risks. This can lead to irregular heartbeats and possibly heart failure, which is one of the main causes of death in people with bulimia. Repeated vomiting can cause a sore throat and chest pain from esophagus burns, and in some instances even esophageal tears. It can also lead to tooth decay, gum disease, and damage to the salivary glands. A weakened gut lining can make it hard for the body to absorb nutrients, causing one’s bones to become brittle and weak, resulting in higher risk for osteoporosis. Digestive disruption can cause stomach pressure and nausea. Abuse of laxatives can irritate the bowels and lead to constipation and diarrhea. Additionally, dehydration from purging can result in kidney stones and infections.

To prevent or reduce long-term damage from this disorder, it’s important to seek treatment as soon as possible.

Family-based treatment (FBT) has been shown in studies to be the most effective treatment for adolescents with bulimia, and is recommended by the American Psychiatric Association. In the case of bulimia, the main goal is usually not gaining weight but helping the patient eliminate the bingeing and purging episodes and maintain healthy eating habits.

The parents’ role is to supervise the child carefully enough to inhibit bingeing and purging behaviors. That might mean, for instance, sitting with the child after meals to prevent purging, monitoring trips to the bathroom, and being the one to flush the toilet.

“These are all very intrusive steps,” Dr. Le Grange admits. “But without that level of vigilance, there’s no way you’re going to get a handle on the behaviors. So, we say to the parents, ‘This is what would happen if Amanda was in an inpatient unit. Do you think that you could adopt some of those levels of supervision? This may be what’s necessary to help her overcome these urges and these behaviors that are not just unpleasant, but life-threatening.’ And so parents will usually agree.”

Parents also support their child by what experts call “externalizing the disorder”— identifying the bulimia as separate from the child. “Young people do not choose to develop these illnesses, and illness-related behaviors are not willfully engaged in, even if it seems so at times,” notes Dr. Le Grange.

To avoid being critical or angry, parents are encouraged to keep in mind that the child is in the grip of a powerful disorder that is influencing their thoughts, feelings, and behaviors. They are coached on how best to support their child through this ordeal. “The parents’ task is to battle the bulimia,“ notes Dr. Le Grange, “not their healthy child, who is still there but may be overshadowed by the disorder.”

One challenge in FBT for bulimia is that progress is more difficult to track than with anorexia, because it depends on reports from the patient regarding binge eating and purging episodes, corroborated by their parents, rather than a scale that reports weight gain. The therapist depends on the patient accurately reporting the weekly count of binging and purging.

Sometimes the young person feels so embarrassed that they won’t acknowledge the true extent of their binging and purging. “When that happens, the clinician needs to help parents share the real frequency of these behaviors without being critical,” notes Dr. Le Grange. “They need language that they can use to express sympathy that the illness has gotten the hold of the young person in this way, rather than saying, ‘Oh, no, that is just blatantly untrue. She vomited at least six times,’ and you can just hear the criticism rolling from the parents’ tongue.”

What works in the favor of FBT for bulimia is that kids with the disorder tend to be less resistant to participation in treatment than those with anorexia. In part, Dr. Le Grange says, that’s because kids may actually want help to stop these behaviors that they find embarrassing and distressing. This can give parents some leverage in the treatment process, and the child can help articulate how they think parents can best support their changing these behaviors.

But Dr. Le Grange also notes that, for the most part, kids with bulimia tend not to be as emotionally impacted as those with anorexia. For instance, “You don’t typically see someone with bulimia nervosa declining time with their friends or not wanting to go out anymore, isolating themselves. They would still find a way to really be out there in the world with their friends.”

“At least eighty plus percent of young people with bulimia can and should be treated as outpatients,” notes Dr. Le Grange. “If they really have to be admitted to a hospital, then it’s because the degree of engagement in binging and purging is such that parental effort has not made any impact on these behaviors.”

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Leading children’s mental health experts and educators came together for a special webinar focusing on the evidence-based approach to reading and how parents and educators can support kids with reading challenges.

• How to know when a child’s reading struggles could indicate a reading disability and where to find help 
• Simple steps parents and educators can take to support their child’s reading struggles  
• How to know if your school uses a Science of Reading approach  
• How to help kids with the mental health challenges that co-occur with a learning disorder   

• Matthew M. Cruger, PhD, Clinical Director, Senior Neuropsychologist, Learning and Development Center at the Child Mind Institute   

• Nanci Bell, MA, Co-Founder and Director of Lindamood-Bell® Learning Processes   

• Laura Phillips, PsyD, ABPdN, Senior Director, Senior Neuropsychologist, Learning and Development Center, Child Mind Institute   
• Jennifer Louie, PhD, Psychologist, Anxiety Disorders Center, Child Mind Institute  

For more information on how kids learn to read, and what brain research tells us is the most effective way to teach them, please see our  2023 Children’s Mental Health Report: Evidence-Based Reading Instruction and Educational Equity. 

Please take a few minutes to provide feedback on the webinar.

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New York, NY – In recognition of World Mental Health Day, the Child Mind Institute, the leading independent nonprofit in children’s mental health, released the 2023 Children’s Mental Health Report: Evidence-Based Reading Instruction And Educational Equity. The report highlights the pressing need for improved reading proficiency among our nation’s youth and underscores the importance of science-based reading instruction to address the growing crisis. Reading, a fundamental skill essential for academic achievement, professional success, and societal participation, is currently challenging a significant number of children across the nation.

“Mental health and literacy are linked,” said Harold S. Koplewicz, MD, founding president and medical director of the Child Mind Institute. “Children who struggle with reading are at higher risk for mental health challenges, such as low self-esteem, anxiety, depression and behavioral problems. And with only 34% of fourth graders last year reading proficiently, we centered this year’s report around identifying solutions for schools and parents to adopt in hopes of increasing literacy and ensuring children’s mental wellbeing and academic success.”

The report’s analysis shows that, especially in the wake of the pandemic, reading instruction in the United States is not currently meeting children’s needs. It’s also clear that the greatest impacts of inadequate reading support are felt by the children, families, and communities that are already the most vulnerable. There remains an alarming disparity in literacy levels among various ethnicities and socioeconomic groups. While learning disorders pertaining to literacy, like dyslexia, are prevalent across all demographics, only 17% of Black students, 18% of American Indian/Alaska Native students, and 21% of Hispanic students demonstrated proficiency in reading, compared to 42% of white students.

“Science-based reading instruction is the proven solution to get children from ‘learning to read’ to ‘reading to learn’,” said Laura Phillips, PsyD, ABPdN is the senior director and a senior neuropsychologist in the Learning and Development Center at the Child Mind Institute. “Most children benefit from explicit, systematic reading instruction. Neuroimaging shows that we can literally reshape the system the brain uses for reading by employing systematic phonics instruction, which is a step-by-step approach for teaching letter-sound relationships.”

Systematic phonics instruction entails learning to recognize the most common and consistent letter-sound patterns and working towards more difficult and less consistent sounds. This helps with word identification, building up sight-word vocabularies, and promoting fluent reading. It is most often discussed in relation to young children who are first learning to read, however, it works with older kids as well, who did not develop strong reading skills.

Numerous states, including Mississippi, New York, and California, are working to align their education systems with the scientifically proven strategies to improve reading outcomes. Mississippi’s Literacy-Based Promotion Act has led to consistent improvements in fourth-grade reading scores since its enactment.

Moreover, the Child Mind Institute calls for advocacy efforts at the state, local, and school administration levels to promote science-based reading instruction and expanded funding for professional development and classroom materials. Parents and educators can advocate for administrations to adopt systematic phonics instruction. And Pediatricians can recommend early screening for language development and reading skills to ensure early intervention for children in need.

The Child Mind Institute will be hosting a webinar on Tuesday October 17th, which will feature a discussion between the Child Mind Institute’s Laura Phillips, Jennifer Louie, Matthew Cruger, as well as Nanci Bell, Co-Founder and Director of Lindamood-Bell® Learning Processes, an organization dedicated to enhancing learning for all people, who will be moderating.

The Child Mind Institute is committed to promoting evidence-based reading instruction and ensuring every child has the opportunity to unlock the door to a healthy mind, and a thriving future. For more information, visit childmind.org/2023report to download the full 2023 Child Mind Institute Children’s Mental Health Report with the best ways to teach children to read, and practical resources that parents and educators can use to support struggling readers.

About the Children’s Mental Health Report
The Child Mind Institute’s annual Children’s Mental Health Report brings together thought-provoking, incisive and practical information on child and adolescent mental health care, based on reliable studies and emerging research. Each year the Report takes on a new focus in children’s mental health; the goal is to spark conversations from kitchen tables to the halls of Congress and promote effective solutions.

About the Child Mind Institute
(Instagram, Facebook, Twitter, LinkedIn)
The Child Mind Institute is dedicated to transforming the lives of children and families struggling with mental health and learning disorders by giving them the help they need. We’ve become the leading independent nonprofit in children’s mental health by providing gold-standard evidence-based care, delivering educational resources to millions of families each year, training educators in underserved communities, and developing tomorrow’s breakthrough treatments. Learn more at childmind.org.

For press questions, contact our press team at childmindinstitute@sunshinesachs.com or our media officer at mediaoffice@childmind.org.

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New York, NY – The Child Mind Institute will host its13th annual On the Shoulders of Giants Scientific Symposium, a yearly celebration of scientific achievement in child and adolescent psychiatry, psychology, and developmental neuroscience on Thursday, October 12th. The virtual event will explore the impact of race, income disparities and other social structures on the effectiveness of mental health interventions. In addition, the symposium will honor the work of exceptional high school students from across the country during the 12th Annual Rising Scientist Awards.

The symposium celebrates the spirit of scientific collaboration and stewardship, and highlights seminal contributions to our understanding of the brain and behavior. The 2023 Sarah Gund Prize for Research and Mentorship in Child Health will be presented to Dr. Mary Jane Rotheram-Borus, PhD, professor of clinical psychology and Director of the Global Center for Children and Families at the University of California, Los Angeles. Dr. Rotherham-Borus is a leader in the recent push to use disruptive technologies to overcome healthcare disparities and will present her work on her groundbreaking programs to prevent a range of negative health outcomes for children and families who face structural marginalization. She will be joined by two of her mentees who will also present their work: Dr. Marguerita Lightfoot, PhD, professor at the University of California, San Francisco School of Medicine, and Dr. Chadwick K. Campbell, PhD, assistant professor at the University of California, San Diego. Following these presentations, there will be a roundtable discussion of technology’s ability to break down barriers to mental health care delivery in low- and middle-income communities. The panel includes Kathleen Merikangas, PhD, Senior Investigator and Chief, Genetic Epidemiology Research Branch, National Institute of Mental Health, Giovanni Salum, MD, PhD, Program Director of the Child and Adolescent Mental Health Initiative, Child Mind Institute and Stavros Niarchos Foundation, Peter Szatmari, MD, professor at the University of Toronto, and Alison Bryant, PhD, Chief Research, Data, and Impact Officer, Sesame Workshop.

“We have the amazing opportunity to witness cutting-edge research and the brimming potential of future scientists. The Child Mind Institute is honored to celebrate the accomplishments of these renowned researchers and the next generation,” said Harold S. Koplewicz, MD, founding president and medical director of the Child Mind Institute. “The Rising Scientist Scholarship recipients remind us that the future of neuroscience discovery lies in the hands of these bright students. Together, we stand on the shoulders of giants, reaching new heights in our pursuit of understanding and supporting children’s mental health.”

The Child Mind Institute awards the 2023 Rising Scientist Scholarship to five exceptional high school students who show exceptional promise in research in the fields of psychology, neuroscience or biomedical engineering. The winners have the opportunity to present their work at the awards ceremony. This year’s winners are:

• Ryan Lee, Plainview-Old Bethpage John F. Kennedy High School – Plainview, NY 11803
• Maya Krishnan, La Jolla Country Day School – La Jolla, CA 92037
• Natasha Kulviwat, Jericho UFSD – Jericho, NY 11753
• Manas Kandath, Eldorado High School – Albuquerque, NM 87111
• Denise Rojas, Western High School – Anaheim, CA 92804

For more information and to register for the event, please visit here.

About On the Shoulders of Giants

The On the Shoulders of Giants Scientific Symposium is the Child Mind Institute’s annual celebration of scientific achievement in child and adolescent psychiatry, psychology, and developmental neuroscience, bringing together world-class researchers with children’s mental health care experts, educators, parents, and young people interested in the advances in these fields. This symposium celebrates the spirit of scientific collaboration and stewardship, and it highlights seminal contributions to our understanding of the brain and behavior.

About the Child Mind Institute

(Instagram, Facebook, Twitter, LinkedIn)

The Child Mind Institute is dedicated to transforming the lives of children and families struggling with mental health and learning disorders by giving them the help they need. We’ve become the leading independent nonprofit in children’s mental health by providing gold-standard evidence-based care, delivering educational resources to millions of families each year, training educators in underserved communities, and developing tomorrow’s breakthrough treatments. Learn more at childmind.org.

For press questions, contact our press team at childmindinstitute@ssmandl.com or our media officer at mediaoffice@childmind.org.

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We’re grateful to the Second Gentleman, Dr. Murthy, and Alexis and Wyatt from our Youth Council for their candor and leadership, and to the United Nations International School for hosting the event.

The post Child Mind Institute Convenes Youth Panel With the Second Gentleman and U.S. Surgeon General on World Mental Health Day appeared first on Child Mind Institute.

Guided by Dr. Whitehouse, the panelists answered questions about how to talk with youth about balanced digital media use, impacts of active vs. passive screen use, and managing school-related device time. Panelists also gave advice on how to balance smartphone use to create healthy sleep patterns and finding a community that values healthy use as well. The panelists wrapped up the webinar by providing recommendations for online safety and emphasize the importance of having open, curious conversations about technology.

The post Children and Screens: Anxiety: Youth Mental Health and Digital Media  appeared first on Child Mind Institute.

“I’m afraid I’m going to die alone in Ottawa.”

Members of the audience shift uncomfortably in their seats, laughing nervously as Graham Kay stares back at us with a deadpan expression. He stands with a bit of a hunch, making himself smaller and easier to digest.

Graham explains that his parents are getting old and frail, and it makes him worried about his 39-year-old brother, Pete, who has autism spectrum disorder (ASD) and will need to be looked after for the rest of his life. He knows that when his parents die, he’ll have to take over as caregiver and this most likely means that he’ll have to move back to his hometown in Ottawa, Canada.

Graham, a stand-up comedian who also hosts an autism awareness podcast, doesn’t let the room fall into somber silence for long before he starts to crack jokes about his loud (often bickering) parents, who’ve been forced to buy Pete sunglasses because he won’t stop staring at people on the street. They’re afraid someone will call the cops.

Pete and Me is a clever and achingly raw look at what it’s like to grow up as the sibling of someone with a severe disability. The “one without autism,” whose mental health struggles are often misunderstood or overlooked altogether. Graham touches upon his own struggles with OCD and dyslexia, recalling an instance when his teacher misinterpreted his OCD symptoms as a sign of drug use, resulting in his shipment off to an intense bootcamp for troubled teens during his last two years of high school.  

Through laughs and a few tearful anecdotes, Graham educates the audience about ASD. He notes the differences between being high-functioning and having a more severe form of the disorder. He describes the act of stimming and how it’s often used by people like his brother to self-soothe during a stressful situation. Graham explains that many individuals with ASD are highly sensitive to sensory stimulants, making simple tasks like going to the grocery store an overwhelming experience.

Using his brother as an example, Graham does a good job at explaining the dichotomy of being an adult with severe autism. Although Pete is a towering balding man approaching forty, inside he’s really a 10-year-old child who enjoys watching shows like Power Rangers and COPS, a Canadian animated show about a police task force.

It’s clear that Graham cares deeply for his brother, and he closes the show by sharing his belief that people like his brother are placed on this earth to teach people to be kinder and more patient. Caring for Pete has shown him how to be a decent human being and he’s no longer scared of being alone, because he knows that his brother will be by his side no matter what.

For more information about the show, Pete and Me, and where to see Graham Kay comedy, click here.

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San Mateo, CA – The Child Mind Institute hosted its 2023 Fall Luncheon on Wednesday, September 27 at the Sharon Heights Golf and Country Club in Menlo Park — raising more than $523,000 to help support youth and families struggling with mental health and learning disorders.

The event’s guest speaker, award-winning author and journalist Donna Jackson Nakazawa, shared her insights into the causes of pervasive stress in our nation’s young people, how it can derail healthy emotional development and — most importantly — how mindful parenting, strong family bonds, and community connections can help kids thrive despite these challenges. Nakazawa’s most recent book, Girls on the Brink: Helping Our Daughters Thrive in an Era of Increased Anxiety, Depression, and Social Media, was named by the Washington Post and Mashable as one of the best health books of 2022.

Nakazawa was joined by Lauren Allerhand, PsyD, the co-director of Dialectical Behavior Therapy Programs and a psychologist in the Mood Disorders Center at the Child Mind Institute’s clinic in San Mateo. Dr. Allerhand specializes in evidence-based assessment and treatment of youth struggling with depression, anxiety, trauma, eating disorders, ADHD, and oppositional defiant disorder.

The Child Mind Institute’s founding president and medical director, Harold S. Koplewicz, MD, moderated the discussion.

During the talk, Nakazawa shared important insight: “The main job of parenting is not for your kid to get accolades or awards or go to Harvard, the main goal is to help them develop resiliency. That requires not fixing everything for them; if we take away opportunities for them to build resiliency by doing things for them like taking the paper that they left at home to school, or talking to their coach when they should do that themselves, we are not allowing them to build resiliency.”    

She added, “We all share this desire for our kids to succeed — we all know it’s competitive out there — but don’t mistake your desire for your kid to succeed by helping them out when in reality the best chance for them to succeed is when they help themselves.”

Panelists agreed that the mental health fallout from the Covid-19 pandemic is still taking its toll: the number of youth struggling with mental health disorders is at an all-time high, and many of those youth aren’t getting the help they need due to financial barriers, societal barriers, and a shortage of mental health professionals. The National Alliance on Mental Health (NAMI) reports that 64 percent of Californians aged 12–17 who have depression did not receive any care in the last year.

The Child Mind Institute is dedicated to transforming the lives of children and families struggling with mental health and learning disorders. It also supports public education about mental health and learning disorders through initiatives such as the California Healthy Minds, Thriving Kids Project, and helps build the mental health workforce of tomorrow through mentorship programs like the Youth Mental Health Academy.

Luncheon co-chairs included Devon Briger, Lisa Domenico Brooke, Kristin Noto, and Linnea Roberts.

About the Child Mind Institute

The Child Mind Institute is an independent, national nonprofit dedicated to transforming the lives of children and families struggling with mental health and learning disorders. Our teams work every day to deliver the highest standards of care, advance the science of the developing brain, and empower parents, professionals, and policymakers to support children when and where they need it most. Together with our supporters, we’re helping children reach their full potential in school and in life. We share all of our resources freely and do not accept any funding from the pharmaceutical industry. Learn more at childmind.org.

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This article was first appeared in Attention, the magazine published by CHADD, which graciously agreed to share it with childmind.org readers.

In recent years, many new stimulant medications have been approved by the FDA for treatment of ADHD.  These new formulations vary in their duration of benefit, and many offer new ways that the medication is administered or “delivered.” Although this expanded range of stimulant medication options has been a significant benefit for many families, challenges arise when families are unable to get the specific medication that they think is best for themselves or their child.

Perseverance, flexibility, and creativity are key to success in dealing with the ongoing shortage of various ADHD stimulant medications.  Here are some helpful tips and strategies:

If your preferred pharmacy does not have the medication that was recommended by your healthcare provider:

• Speak with the pharmacist (not a pharmacy tech) and ask what they recommend.  Some chain pharmacies can check inventories at other locations, and they may also be able to advise you as to when they may get the desired medication from their distributor.

• Call other pharmacies that are not affiliated with your preferred pharmacy. In addition to calling other chain pharmacies, you should call non-chain pharmacies as well. As with your preferred pharmacy, ask the pharmacist what they recommend and when the desired medication will likely be available.

• If you call multiple pharmacies and cannot find the specific preferred medication, then wait a few days and repeat this same process of making multiple phone calls. This will be easiest if you keep a written list of pharmacies along with their phone number; you can also use this list to take written notes about what they advised.

• Unfortunately, some pharmacies may not provide information over the phone to families calling to check on the stimulant medications that they have in stock. This is sometimes due to pharmacist concerns about drug-seeking behaviors. If a pharmacist does not want to disclose information about in-stock medication options over the phone, parents can ask the pharmacist to look up their child’s name in a state “prescription monitoring program” to verify that this is not a drug seeking behavior.  Parents may have more success at getting this information from a pharmacist at a local, non-chain pharmacy − especially if you have been a longstanding customer of that pharmacy. In some instances, pharmacists may only share this information with a healthcare provider or their staff.

• Pharmacists may, in some instances, be more responsive to the needs of “regular customers” – families who have had many other prescriptions filled at their pharmacy in the recent past. Although it is impossible to know how all pharmacies will prioritize customers when they receive a limited supply of a specific stimulant medication, it is not unreasonable for a pharmacist to give priority to meeting the prescription needs of their longstanding customers. Thus, having a nice relationship with a local pharmacist may be helpful not just in terms of them possibly sharing information over the phone with you about inventory, but also possibly prioritizing your prescription needs for a specific stimulant medication when they have it available.   

• Courtesy counts. Although it is understandable that families may get very frustrated and upset when they cannot obtain the stimulant medication that they need, parents need to remember to not verbally assault the pharmacist since it is not their fault, and they are generally very sympathetic to your situation. Kindness toward the pharmacist will likely increase the likelihood that your pharmacist will do everything possible to help you and your family.  

• Lastly, you may wish to contact the manufacturer of the medication you are seeking. In some cases, the manufacturer’s website for the medication may be able to provide you with information about availability; if not, you can try calling the manufacturer directly for help in finding the medication.

If you are unable to get the medication that your healthcare provider has prescribed and you are not able to wait for it to become available:

• Speak with your healthcare provider about what stimulant medication alternatives exist and also speak with your pharmacist about what stimulant medications are in stock. Although no two stimulant formulations are exactly the same, there are many stimulant formulations that are extremely similar.  And, although there are shortages of many different stimulant formulations, availability can vary day-to-day and can also vary in brand vs. generic, formulation, and even strength.

• Generic stimulant medications are typically less expensive than their branded counterparts; for this reason, generic formulations of stimulants are more likely to be in short supply.  Many of the newest stimulant formulations that are not available generically may be more available in pharmacies. And, although they are generally more expensive, their manufacturers often offer patient savings coupons to reduce a patient’s out-of-pocket costs.

• Consider your priorities when choosing the right alternative stimulant medication!  If your preferred stimulant medication is not available, you may need to consider trying a different stimulant medication. In these instances, consideration should be given to what are the priorities in selecting an alternative stimulant formulation — is it the medication’s means of administration, its duration of action, or its costs? The accompanying table shows all of the FDA-approved medications organized by means of administration and duration of benefit. Keep in mind that a combination of long-acting and short-acting medications is sometimes needed to achieve the desired duration of benefit or clinical response.

• If you are flexible and willing to try a similar stimulant medication – knowing that it may or may not as good, but it may even be better – then discuss with your healthcare provider what stimulant medications may be a suitable alternative. It would be especially helpful if you can inform your healthcare provider with the name and strength of the medications that are presently available in stock.  

• The accompanying chart, “Stimulant Medications for Treatment of ADHD” shows virtually all of the different FDA-approved stimulant medications for treatment of ADHD based on means of administration.  Thus, for example, if a child has trouble swallowing a pill or capsule and needs a liquid formulation, then you can look at the different short-acting and long-acting liquid formulations as options.

• Since there are many long-acting formulations that differ in their general duration of benefit (8 vs. 10 vs. 12 hours), recognize that a medication with a somewhat different duration of action may be an adequate (if not perfect) treatment choice.

• Since most children will respond well when treated with either methylphenidate or amphetamine, do not limit yourself to one active ingredient versus the other. The Stimulant Medications Chart shows you various possible options and alternatives.

• If once daily dosing with a stimulant for 12 hours of benefit is not an option, then consider using a combination of medications (if available) to cover that extended time period. For example, an 8-hour medication before school and a 4-hour medication after school will approximate the benefit of the 12-hour medication that may not be available. 

Speak with your healthcare provider about “creative” solutions with respect to prescribing based on availability. For example:

• If a patient uses a 15 mg. transdermal Daytrana patch but the pharmacy only has 30 mg patches in stock, perhaps your physician can write a prescription for the 30 mg patch and then guide you to cut the patch so that you only apply one-half of the 30 mg. patch. The unused half can be saved and used the following day.

• Similarly, if a patient is on a 20 mg dose of Vyvanse and the pharmacy only has 40 mg capsules in stock, discuss with your healthcare provider if they are willing to prescribe the higher dose and then have you dissolve a 40 mg capsule in water but have you give only half the medication solution.  

Please note that, although these strategies are safe and effective if properly implemented, the FDA does not recommend cutting transdermal patches in half or giving less than a complete Vyvanse capsule when mixed in water.

Don’t wait until the last minute to request a refill. If you receive a 30-day supply of medication, then mark your calendar as a reminder to when you should request a new prescription, which is typically 25 – 28 days from when the last prescription was filled by the pharmacy (not picked up by you). If your child does not take medication every day, you should still pursue a prescription refill at least three-and-a-half weeks after your most recent prescription was filled rather than wait until you only have a few pills or capsules left. You can even call your healthcare provider for a new prescription three weeks after the last prescription; although the pharmacist may not be able to fill the prescription after just 21 days, at least it will be on file and available for when a prescription renewal can be approved by your insurance company.

If you cannot find one or more acceptable stimulant medications, then speak with your healthcare provider about possibly using a non-stimulant medication (such as atomoxetine, viloxazine, or guanfacine) instead. Although these medications are not always as effective as stimulants, they are approved by the FDA for treatment of ADHD and can often play an important role when used alone or in conjunction with a stimulant for treatment of ADHD.

The post ADHD Medication Shortage: Tips for Getting What Your Child Needs appeared first on Child Mind Institute.

At this year’s event, the Child Mind Institute research team, in a remarkable display of academic prowess, was invited to make an unprecedented 17 first-author poster presentations, six oral session presentations at the main event or satellite events, and three oral session chairs or symposium organizers! A number of research team members had two, or even three presentations.

Furthermore, team members played key roles in the organization of five events at the conference, including the Hackathon, in which 11 Child Mind Institute employees participated, and an open science gala attended by hundreds of scientists. Child Mind Institute team members also hosted a workshop for the Child Mind Institute’s International Neuroimaging Data-Sharing Initiative (INDI) data set PRIME-DE. PRIME-DE (short for PRIMatE Data Exchange), launched in 2018, pools magnetic resonance imaging (MRI) data of non-human primates from more than 25 institutions worldwide to form the largest neuroimaging data set for non-human primates available to researchers to date.  

Three Child Mind Institute research teams accounted for all of this activity: the Autism Center Research Lab, the Center for Integrative Developmental Neuroscience (CIDN) and the center for Data Analytics, Innovation & Rigor (DAIR). The Child Mind Institute congratulates and thanks each of its scientists who figured prominently at this meeting for their contributions to the field of brain mapping:

The post Child Mind Institute Research Team Makes Strong Showing at 2023 OHBM Meeting appeared first on Child Mind Institute.

The program, developed for the California Department of Health Care Access and Information, as part of the California Child and Youth Behavioral Health Initiative, launched this year with a pilot program in the greater Los Angeles area. Plans are to expand throughout the state of California next summer.

In June, over 160 high school students, plus mentors, instructors and support staff, convened at four locations around Los Angeles. For five weeks, the students participated in an intensive learning experience and developed innovative projects. On July 22 we hosted an inaugural capstone event in which each group presented their work. Nearly 400 students, family members, mentors, and program staff attended to celebrate this first cohort’s accomplishments! 

We are grateful to and proud of these students, whose work was nothing short of inspiring. They represented their unique perspectives and ideas through creative mediums such as paintings, poetry, podcasts, children’s books, and 3D-printed models. Seeing their dedication gives us hope for the future of child and adolescent mental health.  

Now EdSurge, a digital magazine about education, has published an article about the Youth Mental Health Academy. The article goes beyond what kids did in the program to tackle head-on the subject of why such a program is needed.

Read the full article to gain a better understanding of how and why the Youth Mental Health Academy seeks to change the landscape of mental health care.

The post Youth Mental Health Academy Pilot Program an Overwhelming Success! appeared first on Child Mind Institute.

No one likes to be told that they did something wrong, but for kids with mental health or learning challenges, receiving criticism can feel particularly painful.

Michelle, an adult who was diagnosed with ADHD at an early age, says she still remembers when her fourth-grade teacher told her that she wasn’t watering the classroom plants the right way. “I felt embarrassed and dumb,” she said. “I felt like I wanted to cry.” Michelle says she still struggles to receive criticism, even when she wants constructive feedback. “I still obsess over it,” she says. “I’ll just go in my head and be like, why did I do it that way?”

It’s not that criticism is a bad thing. Learning from mistakes, missteps, or misunderstandings is an important part of life. But for some kids, intense emotions can drown out what is actually being said.

Kids who are struggling with ADHD, anxiety, depression, or a learning disorder tend to fall into negative thinking patterns. For them, even the smallest mistake can translate to: “I’m not good at anything.” This makes them more sensitive to feedback. When even the mildest critique feels like a personal attack, kids might shut down or lash out.

While a parent can’t dispel these emotions entirely, you can help kids learn to recognize them and manage their response. This article will explore how parents can course-correct their kids’ behavior in positive ways, and also prepare them to receive criticism from others.

The value of constructive criticism is to “build insight,” says Jerry Bubrick, PhD, a clinical psychologist at the Child Mind Institute. “We’re wanting kids to take a step back and say, ‘Well, maybe I didn’t handle that so well, or maybe I could do that differently, or maybe I could change the way I’m doing this.’”

If kids are open to hearing what an adult has to say, they are more likely to follow through on it. So adults should consider how the criticism they deliver is being heard, observes Helene Omansky, LCSW, a licensed clinical social worker at the Child Mind Institute. She makes a distinction between criticism and feedback, which feel very different when you are on the receiving end of them. Criticism can feel like judgment, as in, “My teacher hates my essay.” But feedback can feel like support: “My teacher helped make my essay better.”

Dr. Bubrick says parents can help foster an open mind for feedback by offering comments within a “positive framework.”

A positive framework is not necessarily about changing what you say, but how you say it. Saying, “You’re not focusing on your homework,” for instance, is a negative framing that opens the door to conflict. This could be rephrased as a positive by saying something like, “I see that you have a good start on your homework. Just hang in there a bit more, and you’ll have the rest of the evening free.”

Part of building a positive framework means giving regular, positive feedback. It’s important to tell your child when they are doing something well — even if the task might seem routine or expected. Kids with ADHD, for example, often struggle with basic tasks, like cleaning their room or consistently finishing their homework. Giving them positive feedback when they do can soften the blow for criticism, later.

“It’s helpful to think about a ratio of five to one. So, for every one time you give criticism, there should be five different instances that you can name where you gave positive feedback,” says William Benson, PsyD, a clinical psychologist at the Child Mind Institute.

Positive feedback helps build confidence. If a child has confidence in their abilities, they will feel more secure admitting that they do not understand something, or could do something better. This can be particularly important for kids with learning disorders, who might feel embarrassed that they struggle with things that others do not. A diagnosis can help, but feeling comfortable with one’s challenges  can take time. “It’s almost like a stigma until they can start to integrate it into their daily functioning,” Omansky says. If kids are confident enough to see their LD as “just another part of themselves,” she says, “they have room to receive whatever the criticism may be.”

But sometimes, even the most well-intentioned criticism can bring about an intense response. Some kids might shut down. Some might get angry or blame others for their mistakes — in their eyes, a bad grade might automatically become an inescapable truth: “My teacher hates me.” 

Whatever the case, try to help the child identify the feelings behind the response. Encourage kids to talk about how they feel, even when it’s uncomfortable. But keep in mind that learning to process emotions can be, well, a process. When Michelle was asked to describe her reaction to her teacher’s criticism, she at first said that the feelings were so intense she could not name them. When pressed, she described feeling vulnerable, “embarrassed and dumb.” 

It might feel natural to dismiss these feelings — “you’re not dumb!” — and focus on resolving the issue. But it’s important to take time to listen and validate what a child is feeling.                

“As parents, we sometimes jump into problem-solving mode rather than just say, ‘Oh, it seems like you’re having a tough time with that,’” Omansky says. “Allow space for them to feel heard and understood versus jumping to something which might be felt as criticism rather than support.”

Giving kids space to unpack their feelings and asking questions might lead to a better understanding about what’s really bothering them. For example, a child with an undiagnosed learning disorder might avoid doing their homework and act out in school. It’s easy to make these behaviors the focus, the problem itself rather than a symptom of a larger one. Listening and asking questions can be helpful for both parents and kids, too, who might not even realize that their own actions are rooted in something as simple as, “I didn’t understand the assignment.”    

But as important as it is to encourage kids to talk about their feelings in response to criticism, there is also an appropriate time to do it. Instead of approaching a kid when their emotions might be raw — say, right after they failed a test — wait until the hurt or anger has settled. “As parents, we’re not supposed to discipline when we’re emotional,” Omansky says. “It’s the same concept.”

Talking about feelings can be particularly helpful for kids with ADHD, who often struggle to regulate their emotions. Signals in an ADHD brain tend to bypass the stop-and-think sign in the prefrontal cortex, producing an impulsive, emotional response. Say, for example, a child yells, and blames someone else for their mistake. Parents can help kids manually “pump the brakes,” Dr. Benson says, by creating awareness around the feelings driving those behaviors. If a child can come to understand that, in the past, they have lashed out because they felt embarrassed or dumb, they can begin to address those feelings, not simply yell and point fingers.

Kids with ADHD or learning issues might also be extra sensitive to criticism because they tend to receive more negative feedback about their behavior. They might be used to hearing things like: “Pay attention,” “Stop talking,” “Stop fidgeting,” or “You’re not trying!” 

“Then other criticism is colored by that lens,” Dr. Benson says. “And it might be perfectly reasonable and constructive, but to a person who’s felt like they get these negative messages all the time, they’re hearing that the real message is, ‘I’m bad at this like I’m bad at everything else.’” 

Over time, learning to talk about emotions can help quiet these voices of self-doubt, and rein in outbursts. The child might not be able to respond perfectly calmly, but they might learn to take a deep breath or a mental timeout before they react.

Kids are especially vulnerable to self-doubt when they are learning something new. Maybe a child just joined the swim team, and they lost a race. Even helpful critique from a coach — “It looks like you lost your footing on that flip turn” — might feel like an attack on their abilities as a swimmer. Like Michelle, they might get stuck on the idea that she did something the wrong way — “Why did I do it that way?” — instead of learning from the experience.

Dr. Bubrick says that such feelings of self-doubt can come from outsized expectations, and advises parents to help their kids set manageable goals to build confidence.

It’s not reasonable to expect to win every race, or ace every test. Better to focus on nailing a flip turn, or getting a B instead of an A. “It’s not lowering our standards, but making our expectations more attainable,” Dr. Bubrick says.

Teachers and coaches are supposed to help kids learn and grow. If they didn’t offer feedback they would probably feel like they weren’t doing their jobs. Criticism is a necessary part of learning, but if you know your child is sensitive to criticism, you can help them anticipate it by describing what it might look like. Teachers will give grades and challenge you with tough questions. Coaches might yell to be heard; they might sound mean or rough.      

And, of course, adults aren’t perfect. They might get frustrated, and lose patience. They might have a bad day and say the wrong thing. Reassure kids that they shouldn’t take negative criticism too personally. It certainly doesn’t mean an adult doesn’t like you, doesn’t think you’re smart, or doesn’t want you on their team.

Criticism from peers can be trickier to navigate. Kids can be cruel to one another. They are still maturing, and learning that what they say can hurt someone else. But fostering an environment where kids feel comfortable talking about their feelings can prepare them to better get along with friends and classmates.

If a child can talk with a parent about how criticism made them feel, they will be better equipped to stand up for themselves with friends — crucially, Dr. Bubrick says, without being critical in return. “So instead of saying, ‘You were a jerk for saying it the way you said it,’ a child might be assertive enough to say something like, “’I didn’t like the way you talked to me yesterday.’”

Parents won’t always be there to help their kids, but they can encourage them to develop tools to help themselves. “Over time they might hear the voice of parents in their head,” Dr. Bubrick says. “They might be able to feel more nuanced feelings about the situation rather than just jumping from zero to one hundred.”

The post How to Help Kids Deal With Criticism appeared first on Child Mind Institute.

Ketamine, a drug that’s been used as an anesthetic for 50 years, is getting a lot of attention as a promising new treatment for adolescents who haven’t responded to other treatments for depression and suicidality.

Ketamine is what’s called a “dissociative” anesthetic, which means that it can make you feel detached from your body and surroundings, and have hallucinations. It was a popular party drug in the 1990s and 2000s, known as “Special K.” In the last decade ketamine has been used with success for treatment-resistant depression (TRD) in adults — those who haven’t responded to two or more trials of antidepressant medication. It’s increasingly being used for teenagers who haven’t gotten relief from other treatment for depression, too.

In 2019 the FDA approved a form of ketamine called “esketamine” for adults with treatment-resistant depression. Esketamine is delivered in the form of a nasal spray, brand name Spravato.

Esketamine is not currently FDA approved for anyone under 18, but small studies have shown it to be safe and effective for adolescents, and it’s being used off-label for kids who are still depressed after trying other treatments. Insurance companies require proof of two previous trials of antidepressant medication before they will cover ketamine treatment.

One of the advantages of ketamine is that it produces symptom relief very quickly, in less than an hour, rather than the weeks it takes for antidepressants to take effect. “The upside of ketamine is that it’s rapid acting,” says Lucian Manu, MD, a psychiatrist and the founding director of the Stony Brook Treatment Resistant Depression Program. Dr. Manu has treated many patients, including teenagers, with ketamine. “You see results, you see improvements very soon. I don’t want to say right away, but almost.” The immediate response makes ketamine especially attractive for patients who are at high risk for suicide.

Ketamine appears to work by binding to receptors in the brain, Dr. Manu explains, including those called NMDA receptors. When ketamine binds to those receptors, it increases connectivity among neurons, which is thought to affect mood. “There’s a lot of research going on, but somehow it stimulates the formation of new synaptic buds, and the proliferation of new synapses,“ says Dr. Manu.

Because ketamine can affect a patient’s blood pressure and heart rate, it is delivered in a supervised setting, to allow doctors to monitor vital signs. It’s also monitored because ketamine is a controlled substance — a Schedule III drug, which means it has medical use but also a risk of dependence or misuse.

With patients starting on ketamine, Dr. Manu introduces the drug in a prep session before the first treatment. “I give them a very tiny dose of the medication, the smallest amount,” he says, so they will know what to expect.

A treatment session with esketamine, in the form of a nasal spray, usually takes about two hours. The first effect of the drug the patient experiences after taking it is what Dr. Manu calls a psycholytic effect. “The psycholytic experience is basically when your defense mechanisms start to diminish and you start to feel a little bit freer to talk about things,” he explains. “People feel less anxious, less uptight, less guarded.”

During the psycholytic phase, Dr. Manu sees adolescent patients who tend to be reticent to open up. “It’s like a dam is broken. They start talking and free associating.” The clinician guiding and monitoring them has an opportunity to do a little psychotherapy.

Then as the drug continues to take effect, the patient moves into the psychedelic phase. The term psychedelic is derived from the Greek words “psyche” (mind) and “deloun” (to make visible or reveal). With ketamine, as Dr. Many puts it, “the deeper part of the mind is manifested.”

As the patient goes into the psychedelic phase, they turn inward, Dr. Manu says. They may experience intense introspection, as well as hallucinations, “out-of-body” experiences, or a sense of being in a different reality.

The clinician’s role is just to keep an eye on them to make sure they’re safe. After about an hour the patient begins to emerge and talk a bit more with the clinician. “Then they integrate with their therapist,” Dr. Manu adds. “Or we integrate at the next session, the next treatment.”

By integration, Dr. Manu means discussing what the patient has taken from the session. “I encourage them to look back and see what they can extract from the experience, what they remember visually or conceptually or sensorially, and be curious about what that means for their life.”

Because of the anesthetic effect, at the end of a ketamine treatment session, the patient needs a ride home.

A course of ketamine is split into two phases: induction and maintenance. In the first phase patients usually take ketamine twice a week for about four weeks. Then, when the treatment response is thought to be as strong as possible — the patient’s depression symptoms are reduced or in remission — the frequency of sessions is gradually cut during the maintenance phase.

“So we go from twice a week to once a week. And then if that goes well, we go to every other week and then we try every three weeks,” explains Dr. Manu. “Sometimes patients may have little bumps — their mood may be reactive to different stressors. We may decide to go back up to every two weeks. But essentially the trend is to try to, if possible, wean them off or at least keep them at the lowest number of treatments.”

Dr. Manu describes one patient who began treatment when she was 13 and so depressed, she was unable to function in school. She’s now in college and looking at law schools, and she continues ketamine treatments once every eight weeks.

Ketamine is safe to take with antidepressant medications — in fact esketamine was FDA approved along with an antidepressant. “The original FDA approval was for patients who didn’t respond to one or two antidepressants, and those patients were actually treated with a new antidepressant with ketamine added to it,” Dr. Manu explains. There is a study in progress looking at esketamine as a standalone therapy, he adds, but that’s still in the works.

Ketamine was discovered and synthesized in 1962 by a scientist at Parke-Davis who was looking for a better anesthetic— one that worked without weakening the patient’s vital signs. Although the original patent on ketamine expired in the 1980s, a pharmaceutical company wanting to develop it as a drug for depression can’t get a patent on it. “Some people call ketamine an orphan drug,” says Dr. Manu, “because nobody owns it. Everybody owns it.”

But patents are available for new formulations, and Jansson, the pharmaceutical company, found a way to make it patentable. Ketamine is made up of two molecules, called isomers, that are mirrors of each other, called S-ketamine and R-ketamine. Jansson researchers found that the S-ketamine is the stronger isomer and the R-ketamine is a bit weaker. So Janssen got a patent on that S-ketamine part of the molecule. Hence the name esketamine, marketed as Spravato. It’s currently the only form of ketamine that is FDA approved for depression, so it’s the most mainstream in the U.S.

The most dramatic side effect of ketamine is the dissociative symptoms that characterize it. It can also cause nausea, which can be managed with anti-nausea medication. Some patients report dizziness or fatigue. Blood pressure and heart rate should be monitored by a doctor during a session.

But most adolescents like the experience, Dr. Manu says. “Most of them are very engaged with it. They like what the ketamine brings and what the ketamine provides. They look forward to the treatment because it gives them relief.”

Ketamine is rapid acting, but how long the symptom reduction lasts is unpredictable. The maintenance period, in which sessions are farther and farther apart, tests how durable the effect is. “Everybody’s different,” Dr. Manu explains. “We have patients who have difficulty going from once a week to every other week. So I keep them on the once a week longer. Patients who have difficulty going from every other week to every three weeks. So I keep them on the every two weeks longer. So different patients are at different stages of their maintenance treatment.”

Dr. Manu finds that ketamine treatment is more effective alongside evidence-based psychotherapy like CBT. “The treatment is much better when we use psychotherapy as part of it,” he says. “And there are a few studies showing that the treatment response from ketamine can be improved and prolonged when you use even small forms of cognitive behavioral therapy, for example.”

Dr. Manu also believes combining treatment modalities can help patients who are not reaching remission with one type of treatment. 

“If we start ketamine and we see that we can’t get them to a lower frequency than what we’re doing today,” he explains, “then I may add TMS.”

TMS, or transcranial magnetic stimulation, is another relatively new treatment for depression that has been shown to help patients who haven’t responded to therapy and medication. TMS works by using high-frequency magnetic pulses to stimulate a brain region that is underactive in people with depression.

And if a patient is doing TMS and still having symptoms, Dr. Manu may also offer the option of switching to or adding ketamine.

Dr. Manu sees combining treatments as becoming more common. “I think it’s the way of the future — instead of trying them sequentially, one after another, after another, you try to try them in synergy.”

The post Ketamine Treatment for Depression appeared first on Child Mind Institute.

Starting therapy can be scary and uncomfortable, especially if your child isn’t used to talking about their emotions or if they don’t think they need help in the first place.

How you talk to your children about starting therapy can make them feel more comfortable, open, and prepared to go into the first session.

Getting kids accustomed to talking about feelings is important to set the stage for what goes on in therapy. “If we’re going to normalize talking about emotions and mental health conditions, notes Karol Espejo, LCSW, a clinical social worker at the Child Mind Institute, “we need to have open conversations.”

Talk about therapy as something that will help the child rather than making them feel like something is wrong. By talking openly about some of the concerning behaviors that you see, you are modeling that it’s not something to be embarrassed about. Espejo compares this to a toothache –– if your tooth hurts, you go to a dentist. Likewise, if a child is having issues regulating their emotions, a therapist can teach them how to do so more effectively. In both cases, the goal is to feel better.

Therapy, especially for children, is about learning new skills to help them throughout their lifetime. The therapist is like a coach –– their job is to teach, support, and help your child be the best version of themselves.

Timing for bringing up therapy is not one-size-fits-all, but Karol says a meal with the child, a drive in the car, or during the weekend when things are less busy are all good times to begin the conversation about going to therapy.

How far in advance the child should know about the session depends on how they will handle it. While every kid deserves a heads-up, kids with anxiety may worry themselves sick leading up to the appointment. “I would suggest about a week in advance for most children, but for anxious kids, the timeline should be shorter –– about two days before the first session.”

There are also specific times when bringing up therapy could do more harm than good. “I would avoid talking about it at bedtime as increased anxiety can impact sleep or lead to rumination ahead of sleeping,” Karol says. Another big thing is to never bring it up during an emotional conflict or argument or use therapy as a punishment –– “See, this is why you’re going to therapy!” The role of therapy is not to punish or shame.

Using developmentally appropriate language that connects to something your child is already familiar with is important in preparing them for therapy. Espejo advises being honest, direct, and simple for toddlers and preschool-aged children. Parents can say things like, “We’re going to see a doctor,” or “A support person who talks about feelings and emotions.” It’s important to clarify that this isn’t the kind of doctor who will give them a shot; this is a doctor who’s more interested in talking, possibly playing a game, or doing something fun together.

Also, try to avoid over-promising. Rather than saying, “We are going to meet a new friend today,” try, “We are going to see somebody who helps with emotions, and they will ask you some questions.”

Young kids also benefit from repetition and reminders to help them internalize their understanding of what’s happening. So, if you have the initial conversation a week before their first session, you might remind them a few times throughout the week leading up to the appointment. For example: “Remember, on Wednesday after school, I’m going to pick you up, and we’re going to see that adult I told you about. The one who helps us with our feelings.”

For elementary-aged kids, comparing a therapist to their school counselor can be helpful. Even if they don’t see the counselor regularly, they likely know who the person is. And they’re familiar with the idea of kids speaking with that adult about feelings and behaviors. You can say something along the lines of, “You know how Ms. so-and-so in your school talks about feelings? We’re going to see someone like that who has their own office and will talk to you about the emotions that have been coming up for you.”

If your child seems reluctant or nervous about the appointment, you might say, “We’re going to meet someone new, and I know it can be scary. I know sometimes you feel nervous. But I’ve spoken to Ms. Espejo, and she told me I could be in the room with you initially. And I won’t leave until you’re ready for me to leave.”

It can also be comforting to let your child know that the whole family wants to support them through whatever is going on and that they aren’t alone.

There are things you can do before the appointment to help your child feel prepared. The therapist will likely send several questionnaires for both the parent and child to fill out before the first session. This can be a good segue into therapy, as the child can see what questions the therapist might ask.

“We want to lessen any anticipatory anxiety,” Espejo says, “so if your therapist has a website with pictures or videos of themselves, that can help make the child feel comfortable.”

Tweens and teenagers are generally much more aware of what’s happening and might be more resistant to therapy. Whereas younger children may not understand why their parents are seeking treatment, older kids have their own opinions and often object to outside intervention in their lives. So, what if your teen doesn’t want to go to therapy?

“We need to normalize therapy as a safe place to talk about emotions and feel better,” Espejo says. “I think sometimes parents approach the conversation from a problem. ‘There is this problem; let’s go to therapy to fix it.’ That can make kids defensive and feel targeted.” It’s important to talk about the therapist as an expert who teaches us how to process emotions to, for example, communicate better or not feel so nervous. In other words, focus on how therapy can help them.

No one wants to start therapy feeling blindsided by the process, especially not a teenager, who typically is starting to feel a little more control over their life. As with younger children, it’s important to be direct and honest with your teen about why you’re seeking treatment and how it can help them. If parents can get their children to try therapy, it will likely be more effective. You can say, “Let’s explore the possibility of therapy because I noticed that you’ve been sad more days than not,” or, “I noticed that you’re not interested in some of the things you were interested in before.” These conversations allow parents to model emotional recognition, and rather than blaming the teen –– “you need therapy because we’re always fighting” –– it shows an awareness that the child is struggling.

First and foremost, you can assure your child that whatever is said in therapy is confidential, and they can feel comfortable sharing information with their therapist. The therapist will not share any of what is said in the session with their parents. However, therapists must break confidentiality if the child is in danger of harming themselves or another.

Therapy success depends on the relationship and rapport between therapist and child. And every therapist isn’t going to be the right match for every kid. If your child didn’t connect with a particular therapist in the past, it can be difficult to convince them to try again. Espejo suggests reassuring them that they just haven’t found the right match and encouraging them to try this new person. You can also urge them to be patient and give the new therapist a few sessions before judging the connection. Parents can say, “If after a few sessions, you still feel like this is not going to work with this person, we will find somebody you will connect with.”

Some kids are open and comfortable about seeing a therapist, while others may want to keep it private. Kids may feel uneasy about explaining why they go to therapy, whether it’s to friends, extended family, or siblings. So, it should be up to them if and how their siblings or other kids in their social circle are told. Espejo suggests asking the child in therapy what language makes them comfortable –– therapist, counselor, feelings doctor, etc.

When explaining to a child that their sibling is in therapy for anxiety, for example, you could say, “Your brother gets really nervous every day, so we’re going to see somebody that helps reduce some of the nerves.”

If you and your child’s therapist think your child will benefit from medication, you will need to see a psychiatrist or other medical doctor. Ask the person prescribing medication any questions, and ensure you and any other parents are comfortable with the medication route before presenting it to the child. Medication may seem frightening to a child, and hearing conflicting opinions between caregivers will add to their confusion.

When discussing medication with your child, the goal is to emphasize that medication can make learning new skills easier. Espejo uses anxiety as an example: Sometimes, we are so anxious and constantly uncomfortable that we can’t practice the coping skills we’re trying to learn in therapy, like deep breathing.

It’s important that the child knows this isn’t their fault; instead, something is going on in their brain that they can’t control. Espejo does a lot of psychoeducation with the kids she sees so they understand that medication is there to help reduce the symptoms of their condition. If they are anxious, for example, medication may be used to help reduce panic attacks and extreme worry.

The post How to Talk to Kids About Starting Therapy appeared first on Child Mind Institute.

There are several different kinds of therapy that are considered evidence-based for treating depression, which means that they have been studied and clinically proven to be effective. Here is a breakdown of some of them:

Cognitive behavioral therapy is the gold standard for treating children and adolescents with depression. CBT works by giving people skills to cope with symptoms like depressed mood and unhelpful thoughts (like “no one likes me” or “things will always be like this”). In CBT, the child and their therapist collaborate to meet goals, like catching those unhelpful thought patterns and improving problem-solving ability.

Central to the treatment is teaching kids that their thoughts, feelings, and behaviors are all interconnected, so changing one of these points can change all three.

For example, one technique called behavioral activation (BA) encourages them to participate in activities, even if they don’t feel like it, and then observe the effect it has on their mood. Getting active can boost mood, and the activity can generate more positive thoughts and feelings.

In BA, therapists work with the child or teenager to identify things they value doing and steps they would need to take to do those things. The child and the therapist make a detailed schedule for the child’s activities, and parents are enlisted to help make sure the schedule is followed.

Identifying what they value helps kids see how withdrawal and avoidance are not working for them and how small steps toward goals that reflect those values can make them feel better. It can also counter the isolation that teenagers with depression often experience, which can reinforce their depressed mood.

For teenagers with more severe depression, dialectical behavior therapy can be helpful. DBT is a form of CBT adapted for people who have trouble managing very painful emotions and may engage in risky behavior, self-harm like cutting, and suicidal thoughts or attempts.

To manage intense emotions, people participating in DBT learn to practice mindfulness (being fully present at the moment and focusing on one thing at a time, without judgment) and develop problem-solving skills like tolerating distress, handling difficult situations healthily, and interacting more effectively with friends and family. DBT is a highly structured treatment that includes individual therapy and skills groups. DBT for adolescents includes sessions with parents and their child learning skills together.

Social relationships can sometimes influence and even maintain depression. When a person is depressed, their relationships can also suffer. Interpersonal therapy addresses a child’s relationships to make them more healthy and supportive. In this therapy, children learn skills for better communicating their feelings and expectations, they build problem-solving skills for handling conflicts, and they learn to observe when their relationships might be impacting their mood.

IPT has been adapted for adolescents with depression to address common teen relationship concerns, including romantic relationships and problems communicating with parents or peers. Called IPT-A, this specialized form of interpersonal therapy is typically a 12- to 16-week treatment. Parents will be asked to participate in some of the sessions.

While its efficacy is still being measured in adolescents, mindfulness-based cognitive therapy is another treatment that has been shown to work for young adults and adults with depression.

MBCT works by combining cognitive behavioral therapy (CBT) methods with mindfulness. Mindfulness teaches people to be fully present in the moment and observe their thoughts and feelings without judgment. This can help them interrupt undesirable thought patterns that can maintain or lead to a depressive episode, like being self-critical or fixating on negative things in ways that are not constructive.

MBCT was initially developed to help people with recurring episodes of depression, but it can also be used for treating a first episode of depression.

Acceptance and commitment therapy, or ACT, is an offshoot of CBT that has also been effective for older kids with depression. CBT is about recognizing negative thoughts and then changing them. But in ACT, you observe negative thoughts and accept them as valid so you can work past them.

“Acceptance” here means accepting that you have negative thoughts and feelings. You accept that they don’t need to be avoided or changed, but they don’t need to stop you from doing what you need to meet your goals. “Commitment” means agreeing to take concrete steps to make positive changes in your life towards those goals.

With ACT, teens learn to be aware of uncomfortable or painful emotions without allowing themselves to get caught up in them. That allows them to keep the focus on their values — what matters to them — and take positive steps that move them closer to their goals.

The post Therapy for Depression appeared first on Child Mind Institute.

TMS, or transcranial magnetic stimulation, is a treatment for depression and other mental health disorders that has been shown to help patients who haven’t responded to therapy and medication. TMS works by using high-frequency magnetic pulses to stimulate a brain region that is underactive in people with depression.

The FDA approved TMS for use in adults with what’s called treatment-resistant depression in 2008. It hasn’t been approved for use in adolescents. But a substantial number of studies have shown TMS to be safe and effective for adolescents, and it is increasingly being used to treat adolescents off-label.

TMS is a non-invasive procedure that directs a series of electromagnetic pulses at a brain region called the DLPFC, or dorsolateral prefrontal cortex.

Lucian Manu, MD, the founding director of the Stony Brook Treatment Resistant Depression Program, is a psychiatrist with extensive experience using TMS to treat people, including adolescents, who haven’t responded to other treatments for depression. Dr. Manu explains the effect of TMS to patients and parents, by showing them a picture of a neuron connecting to other neurons. “When you image the brain of depressed patients, these neurons are atrophied. They’re shriveled. They’ve lost connections with other neurons. When a critical mass of connections is lost, that’s when people start having symptoms.” The TMS creates a weak electrical field around the brain cells in the target area, he adds, and that revitalizes them.

He compares underactive neurons to trees in winter that have lost their leaves. TMS reinvigorates those neurons, he explains, prompting them to create more active connections.

A patient treated with TMS sits in a chair with a cap or helmet fitted on their head that places the stimulator, containing a magnetic coil, close to their scalp. In a session that usually lasts from about 20 to more than 30 minutes, the patient receives hundreds of magnetic pulses targeted at the DLPFC. In standard treatment, these sessions are repeated 5 days a week for a total of 30 to 36 sessions over 6 or more weeks.

Magnetic imaging, such as an MRI or fMRI, is sometimes used at the start of TMS treatment to locate the target area.

The most widely used and extensively tested TMS technology in the US (brand name NeuroStar) uses a figure-8-shaped coil. But there is a newer technology called deep TMS (brand name BrainsWay), which uses an H-shaped coil. The H-shaped coil is said to reach a larger area, deeper in the brain than the figure-8-shaped coil, and it does not require imaging to target the correct area.

The machines that generate magnetic pulses for TMS make a lot of noise, so patients are advised to wear earplugs. Unlike electroconvulsive therapy (ECT), TMS doesn’t require sedation, so the patient can drive home after the treatment. The strength of the magnetic field is comparable to that of an MRI, and the TMS energy exposure is only half that delivered by ECT.

During TMS treatment, a patient taking antidepressant medication can continue it, although some choose to stop. “Sometimes patients don’t like taking medication, or their parents don’t like giving it to them,” Dr. Manu reports. “So if patients feel better with TMS, parents, in general, tend to want to take them off their medications, and I think that’s fine.” Dr. Manu encourages patients to continue in psychotherapy during TMS treatment.

It’s usually clear whether TMS is reducing a patient’s symptoms of depression by the midpoint of treatment — 15 to 18 sessions. If patients report improvement very quickly, it can be a kind of placebo response, Dr. Manu notes. “You want to make sure that the early response is real response, not a wannabe.”

How long the results will last is difficult to predict. “I’ve had patients who got better and stayed well for many months — over a year,” says Dr. Manu. “And I’ve had patients who relapsed weeks after they stopped the treatment. There’s just no way to foresee that.”

Some clinicians recommend that patients who have gotten good results from a course of treatment with TMS continue with a schedule of several “maintenance sessions” a month to forestall relapse.

What percentage of patients respond to TMS? “If you look at all the studies done with standard-protocol TMS, regardless of whether it’s deep TMS or conventional TMS, the take-home message is that about one third of people go into remission,” explains Dr. Manu, which means their symptoms are gone. “Then you have another third who go into what we call ‘full treatment response,’ which is at least 50 percent reduction in symptoms. Then you have about a third of people who don’t get either of those.”

Treatment of depression is the most thoroughly studied and widely adopted use of TMS. TMS is also FDA-approved for OCD and for quitting smoking. Some very small trials have shown promise for alleviating symptoms of autism.

For his patients with depression, after an initial evaluation, Dr. Manu offers them a choice of several treatments, including TMS, ketamine, ECT, and vagus nerve stimulation. He explains the pros and cons of each to give the patient — and in the case of adolescents, the parents — a good sense of how each option might affect them and how it would fit into their life.

Dr. Manu says it’s important to follow the patient’s lead. “What do they see themselves engaging with? What do they think appeals to them? Because it’s very important for patients to invest a lot of capital — a lot of faith, emotion, and hope that these treatments will work. It ensures that the patient will be diligent about treatment.”

This is especially important in teenagers, he adds. “With adolescents, I want them to take ownership of this. I don’t want their parents to push them through the motions.”

Since having as many as 36 20–30-minute TMS treatment sessions is inconvenient for many patients, researchers have been devising ways to shorten the time required for treatment.

One innovation shortened the length of each session to as little as 3 minutes. It’s called iTBS — intermittent theta burst stimulation –– which is another form of repeated magnetic pulses. Research has shown outcomes to be roughly similar to standard treatment.

In 2018, the FDA approved iTBS to treat depression in adults. Both NeuroStar and BrainsWay technologies are FDA approved for iTBS as well as standard TMS.

Another innovation has been to do multiple sessions in a single day to shorten the overall treatment length and see results sooner.

In 2020, researchers at Stanford University tested a new protocol called SAINT (Stanford Accelerated Intelligent Neuromodulation Therapy for Treatment-Resistant Depression) on 22 patients. In SAINT, the researchers delivered an iTBS session of 10 minutes — each involving 1,800 pulses — 10 times per day, with 50 minutes between sessions, for 5 consecutive days.

SAINT is also unusual in that it uses fMRI brain scans — rather than less accurate MRI scans — to identify the exact target of the treatment in the DLPFC and another technology called neuronavigation to deliver the pulses more accurately to the target area.

The net result is a higher dose of magnetic stimulation delivered more accurately over a shorter period of time, and the results appear to be better than those of standard TMS treatments. In the original SAINT study, as well as a double-blind, randomized controlled follow-up, this protocol showed substantially better results than standard TMS for TRD — as high as 87 percent remission. Remission is said to have lasted about 12 months with no further treatment.

Dr. Manu sees a good deal of excitement in the clinical community for innovations to make TMS workable for more patients by modifying the SAINT protocol. “People are using it in all kinds of modified versions in different locations.”

TMS is generally well-tolerated and has no cognitive side effects.

The most common side effect is headaches, which are reported by about half of the patients receiving TMS. These usually fade throughout treatment, but over-the-counter pain relief can be taken if needed. “Out of many, many patients, I haven’t had anybody who stopped treatment because of headaches,” Dr. Manu reports.

Some patients also experience scalp pain or aching, which usually fades after the treatment. Other possible side effects include fatigue and nausea.  Temporary hearing loss can result if earplugs aren’t worn during the treatment.

Other rarer side effects of TMS include seizures, but there are no known lasting effects from a seizure related to TMS.

While Dr. Manu recommends that all his patients continue with psychotherapy while doing TMS, he also sometimes combines different TMS protocols to maximize patient response.

With a new patient, Dr. Manu begins with a standard 20-minute session with deep TMS once a day. “Everybody starts with standard because it’s the most non-controversial and has the most evidence behind it,” he notes. If by the mid-mark of treatment, the 15th to 18th session, he doesn’t see a sign of improvement in the patient’s symptoms, he may add 3–5 minutes of iTBS at the beginning of each session to prime or enhance treatment.

With patients who are not responding, or only partially responding, to TMS, Dr. Manu may also offer the option of switching to or adding ketamine — another promising new treatment for depression. “If I see that you’ve had a response, even a small response to TMS, then I would say, ‘Let’s continue,’” he says. “Maybe ramp it up a little bit, and add that 3-minute iTBS, and let’s start ketamine.’”

Dr. Manu sees combining treatments as becoming more common. “I think it’s the way of the future — instead of trying them sequentially, one after another, after another, you try to try them in synergy.”

The post TMS Treatment for Depression appeared first on Child Mind Institute.

Since over 17 million young people in the US will have a mental health disorder by age 18 — in a country where 70% of counties do not have a single child and adolescent psychiatrist — the Child Mind Institute is developing innovative solutions that reach far beyond clinical settings. Our Healthy Minds, Thriving Kids project does just that, and this month it has gained nationwide attention in a National Governors Association (NGA) Playbook and on the PBS LearningMedia platform.

Thanks to Governor Gavin Newsom and First Partner Jennifer Siebel Newsom, Healthy Minds, Thriving Kids was generously funded by the state of California as part of a historic investment in children’s mental health. Healthy Minds, Thriving Kids focused on the needs of kindergarten-to-12^th-grade students, and includes free, evidence-based video and print resources, in both English and Spanish, that educators can use to teach kids critical mental health and coping skills. Resources are tailored for three developmental ages: elementary, middle, and high school. The California Healthy Minds, Thriving Kids project reached over 72,500 California educators, representing over 8,400 schools and 100% of California school districts, ultimately reaching an estimated 1.8+ million students in the nine months after launching in January 2022.

Meanwhile, the NGA has focused on youth mental health as their 2022-2023 Chair’s Initiative, led by NGA Chair and New Jersey Governor Phil Murphy. With the sponsorship of Child Mind Institute supporter Carrie Walton Penner, Dr. Dave Anderson, a senior clinical psychologist and Vice President of School and Community Programs at the Child Mind Institute, moderated panels for multiple NGA roundtable convenings on youth mental health and attended the July NGA summer meeting.

All told, during this initiative 500 stakeholders on the front lines of the crisis nationwide, including Dr. Anderson, came together across four NGA convenings “to discuss innovative approaches, thoughtful programs, and effective models for addressing youth mental health,” according to Gov. Murphy. At the NGA summer meeting, Gov. Murphy unveiled the resulting “Strengthening Youth Mental Health: A Governor’s Playbook,” which highlights 35 policy recommendations and features around 125 such approaches, programs, and models from across the country. We are proud to announce that Healthy Minds, Thriving Kids is one of the successful programs highlighted.

In a powerful video about the NGA’s youth mental health initiative, featuring experts and leaders from across the country, including Dr. Anderson, Michigan Governor Gretchen Whitmer said, “These are not issues that are confined to a state line or a party line.” We couldn’t agree more. Thankfully, teachers across the country can soon benefit from the Healthy Minds, Thriving Kids resources, just as so many teachers in California already have. The video and PDF resources are available on the PBS LearningMedia educator platform, which attracts 1.6 million educators per month, and will be further promoted in the Fall via the PBS LearningMedia homepage and newsletter.

At the Child Mind Institute, we are heartened by such widespread discussions of youth mental health, and grateful that the NGA is prioritizing the issue. We look forward to seeing how governors in all states and parties apply Gov. Muphy’s recommendations, and we applaud all four pillars of the Playbook:

• Addressing prevention and building resilience
• Increasing awareness and reducing stigma
• Ensuring access and affordability of quality treatment and care
• Training and supporting caregivers and educators

Our own mission and programs—such as our School and Community Programs, our Youth Mental Health Academy, and our partnering to build Fort Health—cover similar ground.

The first step to reversing the worrying recent spike of mental health disorders and suicide attempts in youth is making sure every family knows that these disorders are real, common, and treatable. Next, we must make sure preventative and treatment resources, like Healthy Minds, Thriving Kids and our Family Resource Center, are available and known to all. The NGA raised awareness about our resources, underscored the critical importance of our mission to transform children’s lives, and sowed seeds for state-level collaborations beyond California. This collective commitment to improving youth mental health nationwide is much needed.

Child and adolescent mental health statistics are still trending in the wrong direction, but with such increasing national focus on this crisis, the children and families struggling are finally getting the attention and resources they deserve.

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– Dave Anderson, Vice-President of School and Community Programs.

Watch the Video on YouTube

The post National Governer’s Association: Youth Mental Health – Promoting Access And Affordability Of Quality Treatment And Care appeared first on Child Mind Institute.

In recent years, research in the neuroimaging field has grown in both scale and complexity. And yet scientists have been frustrated to discover that the robust and validated tools they need aren’t easily accessible. This hinders the ability to reproduce crucial findings and could be a detriment to the neuroscience community.

Researchers at the Child Mind Institute have proposed the NMIND consortium, which includes a tool marketplace that allows researchers to explore and compare data libraries. Its goal is to establish common standards for code quality, testing, documentation, terminology, and dissemination of software tools across the scientific community. Scientists believe that a collaborative model like the NMIND consortium is essential to the advancement of neuroimaging research.

Read the Press Release

Read the Full Article

The post NMIND: A Proposed New Initiative to Advance Reproducible Research appeared first on Child Mind Institute.

There has been a startling uptick in mental health challenges among children worldwide, prompting a race to improve early detection of mental health disorders. Studies suggest that early detection in youth plays a critical role in minimizing the severity and progression of these disorders and improving access to care.

Using existing literature and professional expertise, researchers at the Child Mind Institute conducted a novel multinational survey to examine overall views toward pediatric mental health screenings. While research on pediatric screenings has been mostly centered around the preferences of medical staff and patients, this study sought to examine the attitudes of parents and caregivers.

Results were eye-opening, with over 90% of participants reporting that they wanted their child regularly screened for mental health issues. Most preferred for the screenings to be conducted in health care offices, and the results to be interpreted and discussed by physicians or psychologists. Many caregivers showed discomfort with the idea of the screening including topics like gun violence, gender identity, and suicidal thoughts.

The results from this study have opened the door to bigger discussions about the importance of educating parents and caregivers about mental health. Given that most participants were more comfortable with physicians conducting these assessments, schools may benefit from either having medical or psychological professionals on site or referring children to their primary care provider for mental health screenings.

Read the Press Release

Read the Full Article

The post Parents Around the World Show Support for Pediatric Mental Health Screenings in New Survey appeared first on Child Mind Institute.

New York, NY – There has been a startling uptick in mental health challenges among children worldwide, prompting a race to improve early detection of mental health disorders. Studies suggest that early detection in youth plays a critical role in minimizing the severity and progression of these disorders and improving access to care. Many health care systems have already made an increased effort to provide mental health screenings in primary care settings. However, more work needs to be done regarding patient accessibility, and the problem may lie in who’s been the focus in previous studies.

Using existing literature and professional expertise, researchers at the Child Mind Institute conducted a novel multinational survey to examine overall views toward pediatric mental health screenings.

“To date, much of the research on pediatric mental health screening has focused on the attitudes and preferences of medical staff and of patients, rather than of parents and caregivers. Additionally, implementation of these screenings [has] often been blocked by barriers, such as time and cost. This survey study aimed to assess the comfort levels of parents and caregivers towards pediatric mental health screening and to identify factors that may influence their preferences,” explains Mirelle Kass, first author and research projects coordinator at the Child Mind Institute.

The data for this survey was collected in 2021 through Prolific Academic, which is a widely accessible online survey recruitment service. Participants from 19 English-speaking countries were included in this study. All were required to be fluent in English, be a parent or caregiver to at least one child (5–21 years old), and report about the oldest child currently living at home.

Results were eye-opening, with over 90% of participants reporting that they wanted their child regularly screened for mental health issues. There was a strong preference for annual screenings to be completed in health care offices, although comfort levels for at-home screenings were also high. Most preferred to have physicians and psychologists interpret and discuss results of the screenings, showing significantly less comfort with social workers, general office staff, or teachers.

In terms of topics, parents and caregivers preferred to discuss their child’s sleeping habits, social media use, and learning disorders. They were the least comfortable with discussing topics like substance abuse, gun violence, gender identity, and suicidal thoughts. Many showed strong discomfort at the idea of their children taking mental health assessments on their own, but showed more leniency if their child was older. A majority of participants agreed that early detection, early intervention, and learning more about their child were the biggest benefits to mental health screening.

These results have opened the door for several topics of discussion. Regarding more internalized mental health disorders like anxiety and depression, parents and caregivers may be less aware about what’s going on in their child’s head. Because of this, discomfort toward allowing their child to self-report may hinder early detection. Additionally, parents’ hesitation to discuss key topics like gender identity and suicidal thoughts indicates the need for more efforts toward educating parents about mental health. Based on participants’ overwhelming preference for physician expertise, schools may benefit from either having medical or psychological professionals on site or referring children to their primary care provider for mental health screenings.

“The study findings aim to add to the research of youth mental health screening in order to aid in implementation efforts. The study also offers potential areas for optimization of screenings that could potentially resolve or address the barriers that have been previously identified by other researchers,” says Kass.

This work was supported by a grant from the Hearst Foundation; gifts to the Child Mind Institute from Phyllis Green, Randolph Cowen, and Joseph Healey; awards R01MH124045 and R01MH091864 from the NIMH (Dr Milham); and grant ZIAMH002953 from the Intramural Research Program of the NIMH (Dr Merikangas).

To read the full article, click here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2806290

About the Child Mind Institute

The Child Mind Institute is dedicated to transforming the lives of children and families struggling with mental health and learning disorders by giving them the help they need to thrive. We’ve become one of the leading independent nonprofits in children’s mental health by providing gold-standard evidence-based care, delivering educational resources to millions of families each year, training educators in underserved communities, and developing breakthrough treatments. Together, we truly can transform children’s lives. Learn more at ChildMind.org.

Visit Child Mind Institute on social media: Instagram, Facebook, Twitter, LinkedIn

For press questions, contact our press team at childmindinstitute@sunshinesachs.com or our media officer at mediaoffice@childmind.org.

Kass M, Alexander L, Moskowitz K, et al. Parental Preferences for Mental Health Screening of Youths From a Multinational Survey. JAMA Netw Open. 2023;6(6):e2318892. doi:10.1001/jamanetworkopen.2023.18892

The post Parents Around the World Show Support for Pediatric Mental Health Screenings in New Survey appeared first on Child Mind Institute.

New York, NY – In recent years, research in the neuroimaging field has grown in both scale and complexity. And yet scientists have been frustrated to discover that the robust and validated tools they need aren’t easily accessible. This hinders the ability to reproduce crucial findings and could be a detriment to the neuroscience community.

Researchers at the Child Mind Institute, in a new article first published in Nature, have proposed a way to improve the reproducibility of research and increase accessibility to valuable tools. The NMIND consortium includes a tool marketplace that allows researchers to explore and compare data libraries. Its goal is to establish common standards for code quality, testing, documentation, terminology, and dissemination of software tools across the scientific community. The team hopes to increase engagement through hackathons and events meant to train junior researchers in best practices of software development. Additionally, they plan to collaborate with large-scale data generation and informatics initiatives, such as INCF, ReproNim, the NIH ABCD, and HBCD Studies.

“This work will improve accountability, transparency, reproducibility, and efficiency in brain imaging research,” says Greg Kiar, PhD, first author and research scientist at the Child Mind Institute. “We believe that the initial success of NMIND requires community buy-in, a key demonstration of value, and the formalization of a governance structure. Looking forward, a collaborative model such as NMIND will be essential for the field to take the next major step in its evolution towards a science capable of delivering critically needed theoretical advancement and clinical deliverables.”

This work was supported by a grant from NIMH (1RF1MH130859-01).

To read the full article in Nature, click here: https://www.nature.com/articles/s41562-023-01647-0

The Child Mind Institute is dedicated to transforming the lives of children and families struggling with mental health and learning disorders by giving them the help they need to thrive. We’ve become one of the leading independent nonprofits in children’s mental health by providing gold-standard evidence-based care, delivering educational resources to millions of families each year, training educators in underserved communities, and developing breakthrough treatments. Together, we truly can transform children’s lives. Learn more at ChildMind.org.

Visit Child Mind Institute on social media: Instagram, Facebook, Twitter, LinkedIn

For press questions, contact our press team at childmindinstitute@sunshinesachs.com or our media officer at mediaoffice@childmind.org.

Kiar, G., Clucas, J., Feczko, E. et al. Align with the NMIND consortium for better neuroimaging. Nat Hum Behav (2023). https://doi.org/10.1038/s41562-023-01647-0

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The entire morning on Thursday, June 22, was led by the Child Mind Institute. Our president and medical director, Dr. Harold S. Koplewicz, followed SNF Co-President Andreas Dracopoulos’ opening remarks with a speech on the current state of child and adolescent mental health, available here.

Dr. Giovanni Salum then moderated an impressive panel of experts who discussed the Child and Adolescent Mental Health Initiative (CAMHI) experience in Greece. Next, Dr. Michael Milham was joined by international experts to discuss the work of The SNF Global Center for Child and Adolescent Mental Health at the Child Mind Institute.

As Dr. Koplewicz noted in his speech, mental health disorders are disorders of childhood: Half of all mental health disorders begin before age 14, and 75% by age 24. Left untreated, they become adult disorders. And, as we note on our Global landing page, the current youth mental health crisis is a global problem. It was an honor, and an important acknowledgement of this fact, that SNF devoted such a large portion of the event to child and adolescent mental health and our organization’s work and collaborations in helping children and families worldwide. As Dr. Koplewicz also mentioned, our reach is now global, but our impact remains deeply personal.

Other speakers at the conference included former President Barack Obama, Bring Change to Mind co-founder Glenn Close, Former U.S. Representative and Co-Founder of The Kennedy Forum Patrick J. Kennedy, and MindUP founder Goldie Hawn. In a wonderful confluence of important Child Mind Institute supporters, two of our key partners from California — First Partner of California Jennifer Siebel Newsom and California Secretary of Health & Human Services Dr. Mark Ghaly — also spoke.

This multi-day event clarified that the Child Mind Institute is not alone in recognizing the need for international solutions to the child and adolescent mental health crisis. We must continue to spread this message of hope and, most importantly, continue to come together to fight for change.

The post Connecting With World Leaders at Stavros Niarchos Foundation Nostos 2023 appeared first on Child Mind Institute.

New York, NY – The Child and Adolescent Mental Health Initiative (CAMHI), a partnership between the Stavros Niarchos Foundation (SNF) under the SNF Global Health Initiative (GHI), the Child Mind Institute, and a Greece-wide Network of mental health providers in the public sector, released the results of a comprehensive landscape analysis outlining the state of mental health of children and adolescents in Greece. A Synthesis Report on the process and findings describes the multi-pronged research effort to better understand the needs of children, adolescents, and their families/caregivers, as well as educators and professionals working with them. This includes, for the first time, a review of all the scientific papers published in the field of mental health pertaining to children and adolescents in Greece, a summary of laws and policies substantiating a rights-based approach to mental health, and a nationwide survey of almost 4,000 people, including parents, teenagers, teachers, and a variety of mental health professionals. It is also accompanied by an effort to map mental health services currently available within the public healthcare and educational systems for children and adolescents.

The report offers insights for enhancing child mental health in the country, focusing on evidence-based interventions and culturally specific training and psychoeducational resources for parents, teachers, and physicians, as well as insights for combating existing and deep-rooted mental health stigma. The findings of the research suggest a need for CAMHI to prioritize and address three critical elements of the mental health landscape: the widespread need for greater mental health awareness, the demand for mental health training, and the need for a diverse, pluralistic approach to psychosocial interventions.

This analysis found:

• The most frequent mental health conditions among the youth surveyed in Greece include attention-deficit/hyperactivity disorder, anxiety, disruptive behavior, depression, and bullying.
• Educators agree on the scarcity of training and support that would aid in identifying and addressing students’ mental health problems, as well as instances of child abuse and neglect.
• Parents agree that stigma is a barrier in Greek society, but they do not recognize their own stigmatized attitudes towards mental health.
• Τhe daily practice of 22% of all health professional respondents involves assessment of suspected child abuse and neglect.

The members of the CAMHI Scientific Steering Committee emphasize that the need for greater science-backed mental health care and support in the country is obvious, but not insurmountable. They add: “There is tremendous buy-in from and passion among professionals working with children across all sectors to increase access to quality resources, as well as a deep understanding of the complexity of systemic challenges that impede children and families from having access to the mental health services they need. We hope this report will serve as a first step towards achieving our mission of supporting and strengthening mental health care offered by the public health sector throughout the country.”

By offering not only insights into the greatest areas of need for the provision of child and adolescent mental health care in Greece, but also extensive details about the methodological approaches to secure this data, the landscape analysis can also offer a blueprint for how to create a foundation for programs that can be effective, relevant, and targeted to the real needs on the ground.

The findings from the landscape analysis informed the design of trainings that will be widely shared with multiple professionals supporting children across Greece. These trainings, along with guides with information on the most common mental health difficulties, will be available online and in person starting January 2024.

The expansion of SNF’s support through the establishment of the SNF Global Center for Child and Adolescent Mental Health at the Child Mind Institute will allow the organizations  scale and adapt components of the CAMHI model to other locations, including South Africa and Brazil, with hopes of reaching more countries in the future.

With the utmost respect and gratitude for the community of mental health researchers and practitioners in Greece, the CAMHI team is releasing the Synthesis Report in English today and will be publishing the full analysis in Greek in the coming days.

About the Child Mind Institute

The Child Mind Institute is dedicated to transforming the lives of children and families struggling with mental health and learning disorders by giving them the help they need to thrive. We’ve become the leading independent nonprofit in children’s mental health by providing gold-standard evidence-based care, delivering educational resources to millions of families each year, training educators in underserved communities, and developing tomorrow’s breakthrough treatments. Together, we truly can transform children’s lives. Please learn more about the Child Mind Institute’s impact here.

Visit Child Mind Institute on social media: Instagram, Facebook, Twitter, LinkedIn

For press questions, contact our press team at childmindinstitute@ssmandl.com.

About the Stavros Niarchos Foundation (SNF)

The Stavros Niarchos Foundation (SNF) is one of the world’s leading private, international philanthropic organizations, making grants to nonprofit organizations in the areas of arts and culture, education, health and sports, and social welfare. SNF funds organizations and projects worldwide that aim to achieve a broad, lasting, and positive impact for society at large, and exhibit strong leadership and sound management. The Foundation also supports projects that facilitate the formation of public-private partnerships as an effective means for serving the public welfare.

Since 1996, the Foundation has committed over $3.5 billion through more than 5,300 grants to nonprofit organizations in over 130 countries around the world. The ongoing $750 million-plus Global Health Initiative (GHI) is SNF’s largest-ever grant initiative. It includes the design, construction and outfitting of three new hospitals in Greece, procurement of critical equipment such as air ambulances, training programs for health care providers, efforts to expand access to quality mental health care such as the Child and Adolescent Mental Health Initiative in Greece, and collaborations with institutions like The Rockefeller University, the Child Mind Institute, and the National Children’s Alliance in the United States; Sant Joan de Déu Barcelona Children’s Hospital; King Hussein Cancer Foundation and Center in Jordan; and Yorkshire Cancer Research in the United Kingdom.

See more at snf.org.

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Robinson is not a natural orator, which only enhances his appeal. There are no rehearsed answers, no dramatic flourishes, no rousing crescendos. He came across as just a dude opening up about some stuff. His entourage consisted of a 6-year-old goldendoodle named Ellie, his service dog.

Read the Full Article

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