By Christy Tadros
Widespread use of iPads, iPhones and iMacs meansparents need an “iManual” on managing their kids’ digital use!

Parents, are you often finding yourself facing a tantrum over iPad usage?  In the digital era, asking how much screen time is too much, and how to set limits around it, can be a challenge? Considering that on average a child gets a smart phone at age 10, and has a social media account by age 11, these are important questions.
 
What the research is telling us?
 
Kids who have social media accounts are checking Instagram, Snapchat, Twitter and other platforms up to 100 times a day, anxiously monitoring their popularity status. FOMO (a fear of missing out) is a researched a phenomenon, kids and teens describe as anxiety about missing out on something.
 
What are the pros and cons?
 
Having access to devices at home and in the classroom creates enhanced learning opportunities for our kids. Being connected on social media creates :

• Opportunities for teens to support each other
• Increased community engagement
• The Sharing of ideas

 
On the downside, 50% of teens report being addicted to their mobile devices. This can lead to certain risks, including:

• Cyber-bullying
• Lack of privacy
• Negative effects on sleep
• A need to be perfect, fostered by social comparison

 
What can parents do?
 
Between homework, cell phones, ever changing apps and social media accounts, keeping up with your kids’ digital use is not an easy task. There may be some bumps in the road and tantrums in your future, but here are some helpful tips supported by research.
 

• Go home and talk to your kids. Sometimes we get caught in the trap of telling. Ask then LISTEN. The irony is that texting may be the way to start the conversation! 

• Become better educated about what apps and social media platforms your child is using.
• Develop a family online-use plan. Create a family contract around digital use that makes rules concrete and clear, and outlines child and parent responsibilities.


• Monitor online activities via active participation. Create an Instagram account and follow your child.  (Facebook is no longer cool!)

 
Lastly, here are some helpful resources:
 
https://www.commonsensemedia.org/
 
https://mediatechparenting.net/contracts-and-agreements/
 

By Christy Tadros Clinical Counselor
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How to Prep Your Child for the Transition
 
Going back to school can be an exciting time for kids, and parents! It can also be a time when you notice your child’s anxiety heighten. New teachers, new kids, different schedule and many other changes may leave your child asking 101 questions- what, who, when, and “do I have to?”! It can be just as anxiety provoking for parents to leave their tearful preschooler standing frozen in the doorway to the classroom.
 
The question is how can we best accommodate our kids’ anxiety (without enabling!) and prepare them for a smoother transition.
 
Weeks Before School

• Avoid giving reassurance, for example, “You’re going to be fine, no need to worry!” Instead, listen to and validate their worries. Then, collaborate with your child to create a plan. Your job is not to solve all of their concerns about new friends, a difficult subject or changes in schedule, but brainstorm some coping skills and strategies they can use.
• Take your child to the school playground or cafeteria. Let them play and explore. If there are other kids at the playground, facilitate joint play. Give your child specific praise and positive encouragement!
• If summer routines were whacky, try to normalize your child’s routine the week leading back to school. Some suggestions are:
  • Reestablishing school bedtime routines and morning routines
  • Incorporating some school rituals into their day, such as flashcard practice or daily reading. It is not necessary to go full drive with schoolwork, but a soft start can make the beginning of the year less of an adjustment. 
• Engage your child in back to school activities, such as picking out school supplies or planning lunches for the first week!

 
School is starting!

• If your child has difficulty separating, plan a hand off. If the teacher is unavailable, maybe there is a buddy in the class, the school nurse, counselor or secretary. Have an adult ready to take his hand and engage him in a job or fun activity.
• Goodbye hugs are okay, but avoid lingering! Do the hand off, tell your child, “I love you, I’ll be back at 3pm,” and head out the door.
• If your child has a history of impairing separation anxiety or social anxiety, you may want to take the extra step of reaching out and asking if you can bring your child by the classroom before school starts. Communicate that your child will be much more successful this year if he can stop by, meet the teacher and see the classroom before the chaotic first day. Teachers are very busy before school starts, so this can be tricky! If the teacher gives the OK, bring an activity your child enjoys, play together in the classroom and invite the teacher to come play with you both.

 
When to reach out for help?
 
Going through a transition year such as Kindergarten or middle school, having a best friend leave, or moving to a new home, are stressors for most kids. Discomfort during this transition is normal and will likely subside a few weeks into school.
First ask, am I sticking to the routine, giving a lot of positive reinforcement and have I communicated with my child’s teachers?
 
If it is a yes to all these questions, and weeks into school your child is having major meltdowns each morning, or refusing to go to school, it may be time to reach out for support from your pediatrician or a mental health provider.
 
Signs That Anxiety Might be Impairing
 
When children experience internal anxiety about school, it can manifest in many different ways. If your child is prone to anxiety and struggling to adjust to school, here are some behaviors or symptoms to keep an eye out for:

• Refusal to go to school for several days in a row. The longer a child refuses and avoids school, the more her anxiety is reinforced. If the resistance is strong and your child is missing days of school, it may be time to reach out to a mental health professional.
• At drop off your child is crying and clinging to you, even weeks into school. After drop off, your child is taking hours to return to baseline and sometimes she is unable to join the class throughout the whole day. She is sitting by herself, unable to speak or socially interact with teachers and/or peers.
• Your child does not have the flu or a cold, and is reporting several stomachaches and/or headaches on a daily basis.

 
Even though anxiety can be scary and impairing, children are resilient! With the right support and accommodations, your child will find the tools to be ready to happily, jump right back into class.
 
 
 
 

Summer Regression
Judy Cohen; Learning Specialist
 
As we round the corner into spring, the end of another busy school year comes into view.  How do you make sure that the hazy, lazy days of summer don’t turn into a time when those hard-earned skills and information slip away? 
 
Of course, some regression is normal.  But just as the amount of regression varies from child to child, so do the options for preventing that slippage!  The first step is to speak with your child’s teacher to make sure you agree on which areas, if any, your child finds challenging.  If your child is already struggling or has an IEP, he or she may be eligible for a formal summer session offered by your district, often known as Extended School Year (ESY).  A more individualized approach would be an independent tutoring program or an individual tutor.  Still another option would be to enroll your child in a camp with an academic focus, ensuring that the subject matter is approached in a fun, positive way.
 
If a less structured approach is warranted, check out the many online choices of educational apps, games, and programs. These fun options are especially useful to review already learned skills, such as math facts.  To be useful however, an adult needs to monitor the activity to ensure it is done in a consistent and methodical way.  For more skills practice, check out your local bookstore or teaching supply store to find an array of workbooks, some quite appealing, for your child’s use.  Don’t forget the stickers!
 
No matter the approach you choose, consider looking for opportunities for learning in your everyday routines.  Going to the grocery store provides an opportunity to learn new vocabulary (names of vegetables, cuts of meat), rounding and estimating costs, adding up the bill, or figuring the sales tax, depending on your child’s age.  No matter the errand, you can incorporate time-telling skills: What time are we leaving? What time did we get home?  How long were we gone?  Opportunities for writing abound, from making shopping lists (bonus points for alphabetizing!) to writing an email to Grandma, to starting an illustrated journal.  A family vacation provides opportunities to learn facts about geography, map reading, nature, and history, along with calculating miles per gallon and distances.
 
Of course, one of the best things you can do is to read, read, read!  The slower summer months allow us to savor every word of a delicious story together.  Make a weekly or bi-weekly trip to the library a habit, and ask your librarian for reading suggestions.  Be sure to find out if your library has a summer reading program.  And if your child does not already have a library card, now’s the time!
 

​By Hadas Pade, PsyD
Does my child have ADHD?  As an assessment psychologist working in a pediatric clinic I hear that question quite often.  I understand the reasons behind it, but find it’s not exactly the most useful question to ask when trying to understand and help a child who might be having difficulties. 
While we have various measures and methods of assessing for ADHD, getting a Yes or No answer to that question doesn’t necessarily provide much insight into effective interventions for home or school.  ADHD, which stands for Attention Deficit Hyperactivity Disorder, is a clinical diagnosis that can be provided by qualified providers.   The diagnosis provides an overarching label to multiple behaviors or symptoms that can potentially open the door for various services such as formal accommodations at school via a 504 Plan or an IEP.  But that is probably where the usefulness of the label ends. 
ADHD is a diagnosis that covers a wide range of behaviors and issues including, but not limited to short attention span, increased distractibility, increased activity levels and hyperactivity, impulsivity, and poor executive function skills such as planning, organizing, and self-regulating.  ADHD is comprised of three types: 1) Primarily inattentive, 2) Primarily hyperactive/impulsive, or 3) Both.  Children who have the same primary diagnosis may not necessarily “look” the same or need the same intervention plan.  There are different degrees of severity and accompanying issues to consider.  Other individual factors such as self-awareness and insight, anxiety, sensitivity, self-esteem and many more are relevant. In addition, a child’s environment both at home and at school is critical to fully understand the impact of an attention/self-regulation based disorder. 
Therefore, when looking for help with your child’s possible attention deficits, limited regulation, or impulsive behaviors, it is far more helpful to consider the specific behaviors, symptoms, issues, and struggles that you and your child are experiencing and ask the following:

1. What might be causing, contributing, or helping maintain such difficulties?
2. How do such difficulties impact my child’s functioning? (This may be at school and home including learning, interactions with others, sense of self, etc.)
3. What are some recommended interventions to address these difficulties and to reduce any negative impact they might have?

An ADHD diagnosis may be a part of the answer to the first question but won’t be very helpful for the other two, which are as important if not more so.  Every child is a unique individual regardless of an ADHD (or other) diagnosis.  Thus, while there will be some overlap in interventions recommended, the plan for each child will differ. There are certainly some well-recognized interventions for children with ADHD that can indeed be helpful.  However, it’s necessary to consider the multitude of individual and diverse factors relevant to each child in order to recommend or provide truly helpful interventions. 

​by Trenna Sutcliffe, MD FAAP
 
OK, if you are like me, you look forward to giving your kids some downtime when the end-of-year holidays hit. But let's face it. Having school-age kids home for a two-week break is certainly a blessing – but it can also be a little bit difficult.
 
This is often due to a need for structure. Busy and overscheduled kids, when faced with two weeks and nothing planned, may go a little nuts. The transition and its aftermath could stress the whole family out.
 
My three kids are not immune. They, like the majority of children, do best with predictability and a set routine. So, what do we do in our household?
 
I’ve found that a calendar or visual schedule is helpful. Whether a child is excited or laid back in nature, we need to manage their expectations. This doesn't require scheduling every second. Instead, we aim for balance. This means maybe a little computer time, maybe some free choice, maybe cleaning their room, and maybe a shopping trip. Putting these activities into a schedule and creating some structure can help kids regulate their body and emotions.
 
It’s all because a certain amount of predictability is very good for developing minds. (Come to think of it, it’s good for adults, too!)
 
For our family, we love hikes. Certainly, we’ll schedule some shopping and visiting friends over the holidays, but what works best in our home is knowing we are doing something together that is healthy and fun. This type of physical activity provides a grounding for the kids. Sort of an anchor, and one that’s very life-affirming.
 
Of course, if you celebrate Christmas, there’s that post-holiday crash. The kids are all revved up, which means that putting together an after-Christmas schedule is extremely important. The excitement and emotion of the big day can be overwhelming, and most kids need a schedule that brings them back to reality soon after.
 
We hope you can find the structure that’s just right for you and your family during the break. In the meantime, everyone at Sutcliffe Developmental & Behavioral Pediatrics wishes you a very happy holiday season, and we’re looking forward to a fantastic 2017.

by Kelsey Petithomme, Behavior Specialist

When your child has special needs, play dates can be a daunting experience. Many parents have expressed their concern to me that they cannot find play dates for their child who has social challenges, or that they are disappointed that their child’s ability to have a successful play date. Parents want their children to be socially included and it can be heartbreaking when this is not happening naturally. However, working to create successful play dates for your child can go a long way in helping them make friends and find increased social success!
 
Getting Ready to Play
 
Before you begin planning play dates, I suggest truly assessing if your child is ready for peer interactions. When children are ready I see that they are interested in their peers and they can appropriately play with several different types of toys. If your child is not quite there, practice these foundational skills. Also, it is important to find a peer who is a good fit. Your child’s teacher or care provider can help guide you to the a peer that is a good match.  Sometimes the children that your child naturally gravitates towards may not be the best match. Finally, reach out to the other child’s parents and explain why you are looking for a play date partner. Be honest about the strengths and challenges that your child has. In my experience, I have found that sharing your concerns and expectations with other parents goes a long way in creating more successful social situations.
 
Let’s Play! Tips for Preschool Aged Children
 

1. Create a schedule for play. Keep the activities short, and make sure they are activities that your child is familiar and independent with. Create a visual representation of your schedule by drawing a simple picture schedule. When children know what to expect, and that there will be a clearly defined end, they are more likely to successful.
2. Avoid large open places for play dates. While parks are fun, they are not ideal for trying to facilitate social interactions. Having a play date at home, or in a neutral, small space is a better option.
3. If sharing toys is a challenge, talk with your child about toys that are “share toys” and “no share toys.” Have them put away toys that they will be unable to share with their friend and remind them that they picked the “share toys” if challenges arise.
4. Practice, practice, practice! Before the play date, work together on the activities that they will be playing so that your child is confident. If the play date is at someone else’s house, bring along those games and toys.
5. Keep the play date short. For a child this age, 30 minutes would be plenty of time. That may be even too long for some children. The important thing is to end on a positive note. If you sense things are becoming overwhelming, it is best to wrap up. Parents often tell me that they do not like having 15 minute play dates because they feel “bad” that a parent brought their child over and such a short play date could be an inconvenience. However, I find that most parents are okay with this if they are told upfront and that you are honest with them.
6. Stay engaged! Children with special needs require adult support for social facilitation. It will help keep your child engaged and it will help the peer as well if your child is having trouble responding or maintaining play.
7. Lastly, preview a “Play Date Social Story” with your child before all play dates. This can be easily created to include what will happen, what are the expected behaviors, and what your child can do if he or she is feeling stressed. Make sure to end your story with language that play dates are FUN!

 
Additional Resources:
 
Social Story Support
http://carolgraysocialstories.com/
 
Creating a Visual Schedule
http://do2learn.com/
 
Developing Play Skills for Children with Communication & Social Needs
Make Play R.O.C.K: Booklet Series
www.hanen.org

​by Hadas Pade, PsyD
 
     As the first round of school progress reports quickly approaches, academic achievement is on the minds of parents and students.  Thoughts of the impact of current success or challenges on future achievement are at the forefront.  “Is my child learning and doing as well as everyone else? Better? Worse? What does it mean if they are or are not? How can they do better?”  In some areas of the San Francisco Bay Area, over-achievement seems to be the norm.  School is a competition, finishing at the top is the goal, and sometimes anything but the best is simply not an option.  The word "average" is frowned upon.  
     This blog hopes to help put things in perspective.  While grades and achievement are indeed important, it’s necessary to strive for some balance. Persistently pushing your child to being at the top, as far from average as possible, can take a toll on their emotional well-being, the parent-child relationship, and a multitude of other aspects of daily life at home and at school. 

​by Jessica Corinne, Educational Specialist

by Sandy Reader, Advocate/Behavior Specialist

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​Your child has just spent the last six hours at school trying hard to do his work and listen attentively to his teachers. You can see that he or she is tired, but you know there is a lot more work in that backpack. Let the homework battle begin!  

by Trenna Sutcliffe, MD FRCPC FAAP

Just like you, my husband and I sometimes struggle when trying to explain world events to our kids. It seems like almost each week, some tragedy occurs that makes us wonder, “Do we need to talk to our children about this?”
 
My kids are 8, 6, and 5. You would assume they’re somewhat immune from hearing the bad news adults hear – news of bombings, terrorist attacks, shootings and more. But through classmates, media, parents or other adults, they usually have at least a little information.