Teaching Kids Gratitude & Generosity

By Faith Rowland, M.D.

Happy New Year! Are you working on your 2013 resolutions? A popular one is being more thankful (like starting a daily gratitude journal). There is definitely a link between thankfulness and mental wellness. I hope to encourage you to not only focus on gratitude in your life but also help you inspire your kids to do the same. If you were raised by parents who valued this quality, you might just smile as we reflect on how to teach our children and teens to be more thankful in 2013.

Let’s review some timeless parental guidance passed on to me by my wise mom and dad.  

     “Say Thank you”

I remember the excitement of getting Christmas gifts from my grandmother’s co-workers in addition to those from my parents and other family members. I’d open and shake each card, smile from ear to ear, set it aside and rush to rip open the next one. My mother would ask me, “Who gave you that gift?” I would never know because I had opened the card too quickly. My mother would make me collect every envelope that I’d impulsively ignored and sit at the dining room table to write thank you cards to every person who took their time and hard-earned money to be kind to me. The question “Do I have to?” crossed my mind (but not my mouth), and I’d write individual notes to each person. Eventually, I actually understood the joy that others received when reading my notes and the value of saying “thank you.” This lesson helped me to understand and appreciate the generosity of others.  

     “Please take care of what you have.”

Moms and dads who demonstrate good stewardship and encourage their kids to do the same will eventually get good results.  We forget that children have to actually be taught how to care for their things. There is no substitute for a parent who is a good example in the area where they want their child to grow. Explaining the value of stewardship and complimenting children when they take care of what they have helps to instill a sense of organization and responsibility. Kids who value what they have will one day become adults who do the same.

     “Save your money if you want it.”

This old-school principle is time-tested and works wonders. There is something about paying for an object ourselves that makes us respect hard work and develop a proper appreciation for money.  I will never forget that my first paycheck as a teenager went to pay for a dental retainer I’d lost. Although I first felt sad about “wasting” my money on a boring retainer, I also realized the lesson my parents wanted to teach me. When MY hard-earned cash went to replace something so mundane, I was sure to take better care of my belongings and recognize all that my parents provided for me.

     ** “Share, serve, and give to others.” **

I saved the most important advice for last; this one puts the previous three into perspective. Showing kids the significance of sharing your resources and serving others remind them that “wants” and “needs” are completely separate. Developing an attitude of service and generosity enhances our mental wellness. Teach your children and teens by being a role model and making service work and donating family traditions (volunteering together at shelters, participating in toy and clothing drives).  

Remember that gratitude and generosity are traits we can and should teach our children. Wishing you and your family a happy and thankful year!

Faith Rowland, M.D., is a child and adolescent psychiatry fellow at the University of Pittsburgh Medical Center/Western Psychiatric Institute and Clinic where she completed her adult psychiatry residency.

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Tips for Talking to Children about the Connecticut School Shooting

By David Fassler, M.D.

Parents and teachers are faced with the challenge of discussing the recent tragic school shooting in Newtown, Connecticut with young children. Although these may be difficult conversations, they are also important.

There are no "right" or "wrong" ways to talk with children about such traumatic events. However, here are some suggestions that may be helpful:

• Create an open and supportive environment where children know they can ask questions. At the same time, it's best not to force children to talk about things unless and until they're ready.
• Give children honest answers and information. Children will usually know, or eventually find out, if you're “making things up.” It may affect their ability to trust you or your reassurances in the future.
• Use words and concepts children can understand. Gear your explanations to the child's age, language, and developmental level.
• Be prepared to repeat information and explanations several times. Some information may be hard for them to accept or understand. Asking the same question over and over may also be a way for a child to ask for reassurance.
• Acknowledge and validate the child's thoughts, feelings, and reactions. Let them know that you think their questions and concerns are important and appropriate.
• Remember that children tend to personalize situations. For example, they may worry about their own safety or the safety of friends or siblings when going to school.
• Let children know that lots of people are helping the families affected by the recent shooting.
• Don't let children watch too much news coverage with frightening images. The repetition of such scenes can be disturbing and confusing.  

Children learn from watching their parents. They are very interested in how you respond to local and national events. They also learn from listening to your conversations with other adults.

Children who have experienced trauma or losses in the past are particularly vulnerable to prolonged or intense reactions to news or images of violent incidents. These children may need extra support and attention.

Children who are preoccupied with ongoing questions or concerns about safety should be evaluated by a trained and qualified mental health professional. Other signs that a child may need additional help include sleep disturbances, intrusive thoughts or worries, or recurring fears about death, leaving parents or going to school. If these behaviors persist, ask your child's pediatrician, family physician, or school counselor to help arrange an appropriate referral.

Although parents may follow the news with close scrutiny, most children just want to be children. They may not want to think about or discuss violent events. They'd rather play ball, climb trees, or ride bikes.

Senseless, violent crime is not easy for anyone to comprehend or accept. Understandably, some young children may feel frightened or confused. As parents, teachers and caring adults, we can best help by listening and responding in an honest, consistent, and supportive manner.

Fortunately, most children -- even those exposed to trauma -- are quite resilient. However, by creating an open environment where they feel free to ask questions, we can help them cope with stressful events and experiences, and reduce the risk of lasting emotional difficulties.

David Fassler, M.D., is a child and adolescent psychiatrist practicing in Burlington, Vermont. He is also a clinical professor in the Department of Psychiatry at the University of Vermont, College of Medicine.

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Grief and Loss Never Take a Holiday

By Joshua Reiher, Medical Student

Reviewed by Claudia Reardon, M.D.

The holiday season is in full swing. This time of year is meant to celebrate life, love, family, and friends. However, the holidays can also be difficult, especially if you or someone you know has lost a loved one. Maybe you are grieving the loss of a grandparent, parent, child, sibling, spouse, friend, or pet. Loss is a normal part of being human, and we will all face it at some point. Other causes of grief that you may not have considered:

• A loved one suffering from severe mental illness
• Divorce or breakup after a long term relationship
• Miscarriage during pregnancy

When a person experiences loss, he or she is said to be grieving. Grief is a natural emotional and physical response to any loss.

• People feel a wide range of emotions such as sadness, anger, disbelief, denial, guilt, loneliness, regret, anxiety, acceptance, and many others.
• Physically, people may undergo weight and/or appetite changes, decreased energy, lack of concentration, disturbances in sleep, loss of interest in sex, headaches, and so on.

Grief is a personal and individual experience—no two people grieve the same way. There is no one right or wrong way of grieving as long as it does not lead to behaviors that harm yourself or others. Bereavement is the period of time a person goes through grief following the loss of a loved one. Bereavement varies in duration and intensity, but it can last a year or longer in some cases.

Everyone is different, and reactions to loss are influenced by many factors such as:  

• Cultural beliefs and religious traditions
• Access to support and community resources
• Relationship with the person who left / passed away
• Personality and mental health history  

When to ask for help

While coping after a loss is painful and challenging, most people eventually find effective ways to heal and return to their daily life activities such as school or work. Some people, however, have more difficulty with recovering from a loss, and their emotional and physical symptoms do not improve. They may develop a psychiatric illness called depression. If you are concerned about yourself or someone you know, there are many treatments available including:  

• Talk therapy
• Community support groups with other people who have similar experiences
• Medications such as antidepressants

Additional resources to consider:

• Mental Health America: Coping with bereavement
• Substance Abuse and Mental Health Services Administration: How to deal with grief
• American Cancer Society: Coping with grief during the holidays

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Sleep Hygiene: 5 practical tips for more refreshing sleep

By Arshya Vahabzadeh, M.D. Follow @VahabzadehMD

Sleep is an essential part of our lives. Unfortunately, a growing number of Americans are not getting enough quality sleep. Some 70 million Americans have diagnosable chronic sleep problems. Key symptoms include reduced daytime alertness and disturbed sleep at night.

The effects of poor sleep can impact every aspect of our lives. Lack of sleep has been associated with problems at work, difficulties in relationships, medical and mental conditions, and an overall reduced quality of life. While some of these problems would benefit from a visit to your doctor, there are practical tips you can try for improved sleep. In this post on “sleep hygiene,” I discuss a useful set of practices for better sleep.

1. Resist coffee & other caffeinated drinks close to bedtime.

Caffeine is a stimulant and will keep you awake. Caffeine can be found in a range of products including coffee, tea, soft drinks, herbal supplements, and chocolate. Some people find it difficult to stop drinking coffee or soda. In that case, consider reduced or caffeine free versions. Also, drinking these products earlier in the day may reduce the effects of caffeine when it’s bedtime.

2. Don’t watch TV in bed.

Your body needs to associate your bed with sleep. Working, watching TV, or playing computer games in bed can disturb this association. This may lead to confusion for your body about what you want to do when you lie down in bed.

3. Keep your bedroom comfortable.

Make sure you have a suitable bed that’s comfortable; check the temperature of your bedroom; and remove any sources of bright lights or loud sounds. Bright lights close to bedtime can breakdown melatonin, a chemical which helps to regulate the sleep-wake cycle.

4. Exercise!

Being physically active or exercising can help to tire you out so you fall asleep more easily. But you should not do any strenuous exercise right before bedtime because this may be counterproductive. If you want to exercise close to bedtime, try something relaxing like yoga.

5. Establish a sleep routine & stick to it.

Go to bed and wake up at the same times every night and day. Avoid daytime naps or staying up late and sleeping in on weekends.

If you’ve tried these tips and still struggle with sleep, you should talk to your doctor. Depression and anxiety can cause disturbances in sleep. Your primary care physician or a psychiatrist can help find a solution.

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Safety Tips for Children with Autism Who Wander

By Arshya Vahabzadeh, M.D. Follow @VahabzadehMD

Resident Psychiatrist and Research Assistant, Emory & Marcus Autism Centers

With 1 in 88 children in the United States having autism, an increasing number of parents and caregivers face the challenges of caring for an autistic child. One of the most difficult areas is dealing with a child who repeatedly wanders away. This can be particularly dangerous for children with autism, as they may have little understanding of their own safety and have a limited ability to communicate to others for help.

Close to half of children with autism have attempted to wander away from a safe situation, and many parents report "near misses" that could have easily resulted in their child drowning or being injured by a vehicle. Sadly, injuries to children with autism are all too common.

In this post, I'll share several ways to help keep your child with autism safe when dealing with wandering behavior.

Understand what causes your child to wander away

This is much easier said than done! Look for subtle clues in their environment. Is the wandering / running aimed at going towards something your child is interested in, like a toy or place; or is your child escaping from situations like a room with many people, a loud TV, or something which is unfamiliar to them? Also look at the response of other people to the behavior -- if wandering / running away results in your child getting something he or she wants, like a candy bar, then this "rewarding" may cause the behavior to happen again.

Increase awareness and identification

Other family members and neighbors should know to get help if they see your unaccompanied child wandering. Some parents give their children medical ID bracelets or plastic wristbands with their child's information and condition. Parents may also use monitoring devices for their child like a personal GPS tracking device.

Keep the house safe

Many parents invest in extra locks and safety latches for the house. Some install window locks and have fencing around their yards. Especially important, because of the risk of drowning, pools and other water containing structures should be fenced or emptied if possible.

Talk to the school and local police

Make school staff aware of your child's risk for wandering or running away so they can keep a closer eye on your child. If possible, attend field trips or make a special plan with the school. Informing local police about your child's condition makes it easier for them to take action if they see him or her walking around unaccompanied. You should carry around a recent photo of your child and pay close attention to what your child is wearing on a daily basis in case you need to describe his or her clothing to a third party.

Sleep is important too

Parents often worry about what could happen to their child when they are asleep. This may be a bigger problem if their child is staying awake during the night. Decreasing the amount of caffeine your child drinks can help. Setting a sleep routine and avoiding daytime napping may also be useful. Sleeping disorders are common among children with autism. If your child's sleep continues to be a problem, talk to your family doctor or see a specialist.

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