Category Archives: Dr. DeRamus

Setting Boundaries with Grandparents

By Michelle DeRamus, Ph.D.

Setting boundariesRules with our children’s grandparents is hard. We are taught since early childhood that talking back to our elders is not OK. So even when we need to do what we believe is best for our children, setting boundaries with our parents (or our in-laws) can feel like we are being disrespectful, making it very challenging. In addition, because many of us look to our parents as the best example of how to be parents, to go against something they want to do can make us question whether we are really doing the right thing. As children, many of us viewed our parents as superheroes who could do no wrong; as adults, we begin to realize our parents do sometimes make mistakes and incorrect decisions. That can be a tough realization for us. All of these issues can work against our desire of setting boundaries with grandparents or telling grandparents what we like and don’t like about how they are doing things with our children. However, to have a healthy core and extended family, boundaries are necessary. In our society, while we continue to respect and seek advice from our elders and extended family, we generally recognize the parents as needing to have the final say about how to raise their children. So how can parents set boundaries while still being respectful toward grandparents?

Family visits baby

First, communicate your wishes clearly. Sometimes other caregivers do things differently from parents simply because they do not know the parents’ wishes. Having everyone on the same page can often prevent, or quickly resolve, any conflicts about caregiving. State your wishes respectfully and calmly, without attacking or accusing. It’s best to have this type of conversation in private; none of us likes to be “called out” on our mistakes in front of others. Explain your reasoning for your preferences. Often, when others understand the reasons why we do things the way we do, they are much more understanding, supportive, and willing to comply with our requests. Be sure to listen if your parents or in-laws would like to explain why they did things differently or if they have questions. Good communication is key to solving any conflict.

Second, be willing to compromise sometimes, and know when to pick your battles. Just because grandparents do things differently does not necessarily mean it is wrong. Often, if we use good communication skills, we can discuss our differences and meet in the middle for a reasonable solution. We all know that grandparents like to “spoil” their grandchildren, and occasional indulgences are OK. For example, while you might not normally let your child eat French fries for lunch and dinner, having an extra serving of fries once a month while visiting grandma is not going to cause long-term harm. If we turn every difference of opinion about raising children into an argument, it will make for a very unpleasant visit with grandparents and can lead to long-term tension between you and your parents or in-laws.

Stand your ground on the things that are really important to you. While the occasional indulgence with grandparents may be fine, if grandparents are part of the regular, day-to-day caregiving for your children and they consistently let the rules slide, it can have a negative impact on children and family relationships in general. Children need consistency, and when caregivers have different sets of rules, it can lead to confusion about expectations for behavior, which can then lead to behavior problems both at home and at school. If parents feel that grandparents are “undermining” them or not respecting their authority as parents, it can lead to feelings of resentment between parents and grandparents. It’s best to address disagreements head-on (calmly and with good communication) so that long-term problems do not set in. Ultimately, as a child’s parent, you are responsible for making sure they are raised to be fully-functioning, well-adjusted adults. If you believe a grandparent is repeatedly acting in a way that is counter to that goal, you may have to set guidelines about time spent with grandparents. For example, if grandparents are consistently letting children watch scary TV shows that parents know are giving the child nightmares, you may decide that children can only visit grandparents if a parent is also present to provide supervision for TV viewing. Or if you have asked grandparents not to curse around your young children, but they continue to do so, you may decide to take the children home early the next time you hear a curse word.

While setting boundaries with grandparents can be an uncomfortable situation to navigate at times, just remember that at the end of the day, it’s nice to know that your children have so many people to love them and who want them to be happy.

 

Mom with friends

Avoiding New Sibling Jealousy

By Michelle DeRamus, Ph.D.

There’s a lot to think about when preparing for a new baby. For families who already have at least one child, that prep work should include making sure older siblings are ready for the new baby. A little preparation before the baby arrives and following a few guidelines after the baby is born can minimize new sibling jealousy and maximize helpful behavior from older children.

Jealous over new baby

When considering how to prepare siblings for a new baby, it is important to consider the developmental stage of the siblings. Toddlers and preschoolers are very sensitive to changes in their routines, so it can be helpful to make any big adjustments to daily routines (e.g., moving to a new bed/room, starting preschool, potty training) either several weeks before baby arrives or after baby is a few months old. Adjusting to baby will be a big change, and keeping all other routines as familiar as possible will help toddlers and preschoolers feel safe and comforted.

Older children may be less sensitive to minor changes in routine because they can better understand how and why the family is changing. However, older children are often faced with greater responsibilities and an expectation to act more “grown up” when a new baby is born. Be sure to keep expectations reasonable and age-appropriate. There are many websites available that provide suggestions for chores and responsibilities that are appropriate for different age groups. And, just like with younger children, adding responsibilities for older children gradually in the weeks before and after baby arrives can help the transition go smoothly.

Newborns require a great deal of time and attention. It can be a big adjustment for older siblings to have less of their parents’ attention. Many siblings go through a phase of new sibling jealousy. To minimize siblings’ jealousy, help big brother or sister get ready for baby by allowing them to be a part of some of the decisions and preparations before baby arrives, such as choosing a special toy for baby, decorations for baby’s room, or where to put some of baby’s belongingSibling Jealousys.

Siblings might want to “hand down” a special stuffed animal or toy from their own collection to share with baby, although it is OK for siblings to keep some toys as their own and away from baby’s reach. When baby arrives, be sure to praise siblings for all the helpful things they do, from little things like handing you a diaper to bigger responsibilities such as cleaning up their toys. Giving lots of praise is a good way to help siblings feel like they are still getting attention from you even though your hands may be occupied with caring for baby. Finally, even though babies need lots of time from you, it is important to carve out some one-on-one time with siblings on a regular basis. Even 10 minutes a day of special play time where you can give your undivided attention to siblings will go a long way for helping them feel valued and loved, which will cut down on new sibling jealousy of baby.

Additionally, it is important to acknowledge and validate the older child’s feelings. I would advise parents to problem solve with the child by saying things like, “I understand that you feel sad that you will have to share Mommy’s attention now; what can we do to help you feel that you are still just as important?” or “I understand that it upsets you when the baby cries and it’s really loud; how can we help you to feel better about this?” On the other hand, I would tell parents not to tell a child “Don’t feel that way.” It is OK for the older child to feel mad, sad or confused, which are all perfectly normal emotions, as long as those feelings are expressed in an appropriate way. For example, it would not be OK for the older child to act aggressively by hitting the baby, breaking baby’s toys, or hitting mommy’s stomach. If those things are occurring, discipline may need to be used, just as it would be used in similar situations when children are not following the rules.

Positive redirection can also be useful; for example, if a child was to say, “I hate the baby and wish he was never born,” parents could interpret why the child is feeling that way in this particular moment and respond by saying, “I understand that you really don’t like how the baby sleeps all the time, and we have to be quiet. What if we went to play outside later, just you and I, and let Daddy watch the baby? Then, you can yell and scream and get all of your energy out.” You are replacing strong words like “hate” and the idea that the baby is the problem and replacing it with the idea that the older child simply does not like a particular behavior and the effect that the particular behavior has in his/her own life. By offering a solution, such as a louder playtime outdoors later that day, the child will hopefully see that his/her life can continue even with baby in the house, and new sibling jealousy will gradually decrease.

After the birth of the baby,Sibling excited about new baby life will never be the same for your older kids, so advance preparation and a few steps taken by the parent can go a long way in easing a family through this major time of transition. Positive redirection and scheduling reserved one on one time for the older child to spend with a parent can go a long way in helping older siblings love and accept the baby. It takes kids different amounts of time to adjust; some love baby from Day 1, and other kids continue to be jealous of their younger sibling throughout their life.

If your child continues to express extreme negative emotions including aggression, extreme sadness, or excessive worrying about the family or even the baby itself, and you as the parent begin to feel that this issue is affecting the child’s quality of life or the overall family dynamic, you may seek assistance from a counselor or therapist.

 

Dr. DeRamus is a child psychologist with Preferred Medical Group and works at the Phenix City Children’s clinic. She specializes in Autism Spectrum Disorder (ASD) and provides diagnostic testing and therapy services for developmental delays, learning problems, ADHD, and behavior problems. She also helps children from infancy through 18 work through anger, anxiety, depression, family problems and peer relationship issues.

Dr. DeRamus Speaks about Autism Spectrum Disorder in Recognition of Autism Awareness Month 2015

A special thanks to Ms. Diane Pope and the Autism Hope Center for inviting us to participate in April’s Autism Support Group Meeting in Recognition of Autism Awareness Month 2015. Dr. Michelle DeRamus, Preferred Medical Group’s child psychologist, located at the Phenix City Children’s office, specializes in Autism Spectrum Disorder.

She earned her Ph.D. from theshutterstock_175559492 University of Alabama. She completed fellowships with the TEACCH Autism Program at the University of North Carolina and the University of Alabama Autism Spectrum Disorders Clinic. While she enjoys working with all children and adolescents and can treat anxiety, depression, anger, ADHD and more, her special area of interest is Autism Spectrum Disorder. Dr. DeRamus will share with parents about the learning style differences that occur in a child diagnosed with Autism Spectrum Disorder and how these differences may affect the child’s behaviors and emotions. She will provide suggestions for how parents can best help their child with Autism Spectrum Disorder by acknowledging these differences and by applying this knowledge to the way that the parents relate to the child.

Childcare is provided for this talk on Tuesday, April 28th from 6:30 to 8:30 p.m., if you call ahead. Details below:

 

support group meeting April

Eating Disorders/Body Image in Teens

By Michelle DeRamus, Ph.D.

The first time I remember being aware of my own body image was when I was in second grade. I was on the bus, and a girl a few years older than me asked with a smirk, “Do you think you’re fat? ‘Cause I don’t… I think you’re skinny as a rail.” I didn’t think I was fat, but I could tell by her sarcasm that she did. And so began the lifelong battle that so many of us face – developing and maintaining a positive body image.

So many things affect our body image, that is, the way we perceive their own bodies and how we think others perceive our bodies. It is influenced by our own personality, our life experiences with peers and family, and of course, what we are exposed to in the media. While most people have some difficulty with their body image at some point in their lives, girls and women tend to have a significantly greater struggle than boys and men, especially during the teenage years. The effects of a negative body image in teens can be devastating, leading to low self-esteem, unhealthy habits, depression, anxiety, and even eating disorders.

As we enter summer (and swimsuit season), following are some tips to help promote a more realistic and positive body image in your child or teenager.

  • Help your children have a realistic understanding of media images. As adults, most of us know that the models we see in the media have been airbrushed and “touched up” in a variety of ways. Several examples in recent years have given us the opportunity to see “before” and “after” pictures of models and actresses to help us understand that the final image we see is not reality. It is important for our teens to realize that the images they see in the media are not realistic. These images are also not attainable by approximately 95% of the population. Just because we see dozens of images of “beautiful people” each day does not mean that is the norm. However, if children and teens do not understand this concept, it can lead to expectations that most people look like those we see in the media, which creates unrealistic expectations for perfect bodies and creates poor body image in teens.body image in teens

 

  • Help your children develop a positive self-esteem. Everyone has strengths and weaknesses. It is important for children and teens to recognize their strengths across different aspects of life, whether it is sports, academics, personality and character traits, hobbies, other extracurricular activities, or social skills. Help your child identify and then strengthen their positive qualities. Guide them in understanding how these positive qualities can help them reach their goals and that success is not dependent on physical appearance.

 

  • Help your children develop good social skills. Much of our desire to look a certain way is driven by an underlying desire to fit in. Society, peers, and sometimes even family tell us that we will be more successful or better liked if we are a certain size or shape. However, the reality is that there are other ways to make friends and feel like you belong to a group. Children who know how to get along with others and have a positive peer group that supports and encourages them may be better able to keep their body image concerns in perspective.

 

  • Help your children learn how to focus on being healthy rather than focusing on looking a certain way, weighing a certain amount, or eating a certain number of calories. A focus on overall health can help children learn moderation in all things, both the excesses (e.g., desserts, sedentary activities) and the restrictions (e.g., limiting food intake). A focus on health also takes the emphasis off the image in the mirror and back onto how your child feels. Point out that your body is an amazing tool that can help you reach your goals, rather than something to be scrutinized and criticized.

Body Image 2 Mom and Teen

  • Help your children learn positive stress management techniques. Many unhealthy habits develop in response to stress. Teaching children and teens to manage stress appropriately with fun activities, social support, problem solving, exercise, and relaxation can prevent unhealthy habits from developing.

 

  • Be an example. Children, and even teens, learn the most about how to “be” from their immediate family members. Even at a very young age, children notice when adults are critical of their own bodies in front of their children. If children see other family members modeling poor body image, they will grow to think that is the norm. One of the best ways to teach the above strategies to your children is to follow them yourself.

While almost everyone struggles with body image at some time, most people are able to ultimately keep appearance in perspective as only one part of who they are as a person and do not develop serious consequences as a result of their perception of ideal body image. However, for some individuals, body image becomes so distorted or such a priority, that significant problems develop, such as depression, anxiety, or eating disorders. Some warning signs of body image issues in teens that preclude a more serious condition include:

  • Changes in eating patterns (e.g., decreased intake, binging, vomiting after meals) Body Image 1
  • Preoccupation with weight, food, calories, exercise, etc.
  • Dramatic changes in weight
  • Frequent comments or anxiety about being “fat” or overweight
  • Development of rigid food or exercise rituals
  • Withdrawal from friends, family, or previously enjoyed activities

If you are concerned your child may be experiencing emotional problems or an eating disorder as a result of poor body image, it is important to get help right away. Early treatment leads to better outcomes. Talk to your child’s doctor about resources in your area.

Dr. DeRamus is a child psychologist with Preferred Medical Group’s Phenix City Children’s clinic. She specializes in Autism Spectrum Disorder (ASD) and provides diagnostic testing and therapy services for developmental delays, learning problems and ADHD. She also works with kids with anger, anxiety, depression, family problems and peer relationships.

 

Helping Your Child Deal With a Break Up

By Michelle DeRamus, Ph.D.

Breaking off a romantic relationship is difficult at any age… Parents, here are some ideas about helping your child deal with a break up!

Breaking up is hard to do. Helping your child deal with a break-up is hard in a very different way. As parents, we want to protect our children and make their pain go away. Unfortunately, the older and more independent they get, the harder it can be to give that protection and remove that pain. Most parents want their children to eventually find happy, healthy relationships, but to reach that goal, almost all people go through a break-up (or two, or three…). While we cannot prevent this painful experience, we can help our children through the challenge of a break up by showing them LOVE.

L= Listen

One of the most helpful things a parent can do for a child going through a break-up is to be available. For some teens, this means being available to listen as they talk about what happened and how they feel about the break-up. Other teens may not want to talk about it with their parents, but they still may need support in other ways. If a teen does not want to talk, parents can be supportive and available by spending extra time with their teen doing other things, such as watching a movie, going on a walk, or playing ball together.Break Up 2 Dad and Son Fishing

Even if teens don’t want to talk, the presence of a parent can be comforting. During this time it is especially important to be fully “present;” give your teen your undivided attention (i.e., no phone calls, texting, etc.). This will help them know they are important to you and you are truly available with your full support. Let them know they can talk to you about the break-up when (and if) they are ready.

O= Offer Support

If a teen does want to talk, parents can be supportive by listening and acknowledging their pain. For example, saying things like, “I know you’re really hurting right now” or “It sounds like you’re dealing with a lot of different emotions” can be very helpful.

V= Veer away from minimizing the pain

It is usually not very helpful to say things like, “You’ll find someone else” or “It was only puppy love.” This can minimize a teen’s feelings. As adults we are better able to see the bigger picture, but to a teen, a break-up can be devastating. For many, this may be the first time they have experienced the loss of a significant relationship. It is also not typically helpful to join your teen in saying negative things about the ex. If parents say negative things about the ex, such as, “He was not good for you anyway,” it can make teens feel like their parents think they do not make good decisions. This can be particularly harmful if the couple gets back together.

E= Equip your child with coping skills by modeling them yourself

Finally, parents can help by modeling good coping skills. Staying involved in enjoyable activities, talking to friends and family, and taking good care of oneself physically (e.g., exercise, sleeping enough, eating healthy) are all good ways to get through a difficult time. If teens see their parents use these strategies when they experience difficult times, teens will be more likely to use them during a break-up.

When a child at any age is going through a hard time, whether it is a break up from a romantic relationship, loss of a friendship, or death of a loved one, he/she is going to experience grief at varying levels. As a parent, you must remember to LOVE your child through it:

Break Up 1

Listen attentively

Offer support

Veer away from minimizing the pain

Equip your child with coping skills by modeling them yourself

 

Dr. DeRamus is a child psychologist with Preferred Medical Group and works at the Phenix City Children’s clinic. She specializes in Autism Spectrum Disorder (ASD) and provides diagnostic testing and therapy services for developmental delays, learning problems and ADHD. She also works with anger, anxiety, depression, family problems and peer relationships.

Should Children Be Paid for Doing Chores?

Should Children Be Paid for Doing Chores?

Here is some insight from Preferred Medical Group’s Child Psychologist, Dr. Michelle DeRamus.

– Positive reinforcement (i.e., rewards for behaviors you want to see happen again) always goes a long way for developing good habits. It’s important to provide some kind of reinforcement for children doing chores, whether it’s money, a chance to do something fun on the weekend, or a high five or “Nice work on the dishes!”

 

– Just as positive reinforcement is important, so are consequences for not completing responsibilities. Whether the consequence for not completing chores is not earning money, losing privileges, or being grounded, it is important to be consistent and for both children and parents to be on the same page about what the expectations (and consequences) will be.

Paying Children for Chores

 

– The reward should be proportionate to the chore and age-appropriate. Paying children lots of money for daily tasks is unreasonable, and for most families financially not possible. If you choose to pay children for chores, it should be reasonable for your families finances and the difficulty of the chore.

 

– The “right” reward varies from family to family, and sometimes from child to child. Some children are very motivated by verbal praise, and it’s enough just to know they have made their parents proud by completing a chore. Other children are more motivated by activities (e.g., earning a chance to ride a bike, play a game, or go to the park), and others are more motivated by money. To maximize the chance your child will do chores with minimal complaining, get your child’s input on what he or she would like to work toward.

 

– Every family has “house rules” and expectations for responsibilities. Of course, we would like our kids to do everything we want them to do with smiles on their faces, but this doesn’t always happen! If your child is having trouble getting chores done, it might be time to add in a more motivating reward. Or, if you’re adding a new responsibility to the lineup, providing a little incentive might help get the new routine to become a habit; you can always increase expectations to get the reward down the road.

 

– Bottom line, there are certainly pros and cons to using money as a reward for doing chores. As one of my college psychology professors liked to say, the answer to almost every question is “it depends”! Ultimately, parents must be in tune to what motivates their child and what the balance of rewards and responsibilities will be for their family.

Parents, we want to hear what you think, too. Please comment below, or connect with us on Facebook.
Dr. Michelle DeRamus is a licensed child psychologist at Phenix City Children’s. She specializes in Autism Spectrum Disorder (ASD), and also helps kids who are experiencing anger, depression, anxiety, ADHD, behavioral problems, developmental delays and more.

Top 5 New Year’s Resolutions for Parents in 2015

By Michelle DeRamus, Ph.D.

New Year Resolutions Parents

At the start of a New Year, many have extensively planned rigid weight-loss diets, to spontaneously eradicate unhealthy habits, to achieve personal greatness or to conquer the world in 2015. The sky is the limit. While intentions may be pure, inevitably many of the difficult benchmarks set on January 1st are long forgotten by February. Parents, particularly, tend to make unrealistic resolutions centered on their children. They may be planning to never argue with their children in the coming year, to give their children everything they ask for, or to push them beyond their comfort zones to make straight A’s, to get onto all of the sports teams, or to get into an Ivy League school. Again, these may be great goals to strive for, but may prove to be unattainable in the long run. Parents and children may end up feeling high pressure and a sense of failure when they don’t measure up to the proverbial bar.

Instead, I encourage both children and adults to take a step back and reflect on all aspects of their lives during 2013 to determine the areas that they would most like to improve upon or change. Then, create realistic shorter-term goals to be carried out throughout the year. An important factor is finding accountability for meeting these short-term goals through a spouse, a friend or a co-worker.

In my office, I sometimes hear from parents who want to develop an entirely different approach for parenting their children but simply don’t know what or how to change. Because many look upon the New Year as a clean slate and a chance to start fresh, I have devised a list of my “Top 5 Parenting Resolutions for 2014.” You won’t become Super Mom or Dad overnight, but committing to LEARN throughout the year may help you to develop a more positive and open relationship with your child(ren) gradually.

(L)isten – really listen – to your child(ren).

Families are busy and constantly rushing from work to school to extracurricular activities. Sure, parents want to spend more one-on-one time with their children, but many believe there just aren’t enough hours in the day.

Long-term resolution:

Commit to giving your child your undivided attention for a period of time every single day.

Short-term steps:

Make sure that you allocate a realistic amount of time for each child. As little as five minutes each day can go a long way. This time can be spent at the dinner table, playing a game together or during bath time. It can be in the morning, in the afternoon or at night. The when and where don’t matter so much as the fact that you are making it a habit to talk with your child and to listen to the things that they think are important, worrisome or exciting. You are teaching them that what they have to say is valuable. In turn, by taking the time to listen to your child, your child may also be more likely to listen to you.

(E)stablish consistency.

When you’re busy trying everything and nothing seems to be working, frustration can build for parents and children.

Long-term resolution:

Decide on a comprehensive parenting strategy and discipline style and implement it throughout your day-to-day interactions with your child. Make sure that other key people in the child’s life are on the same page with this strategy, such as your partner or the child’s grandparents.

Short-term steps:

If you feel that you don’t have a solid approach for adopting an overarching parenting strategy, break it down. Choose one new technique to test. You could select a discipline strategy to implement, such as time out, taking away privileges, or positive reinforcement. You may also create a sticker chart to track rewards for good behavior. Stick with whatever strategy that you choose for at least two weeks so that you will see if it works well for you and your child. Research shows that it takes a full 30 days for a new habit to stick. If the strategy that you chose seems to be ineffective after the trial period, try something else for two weeks. Eventually, you will discover the strategies that you believe will work toward your long term resolution.

(A)djust your expectations.

No, your five-year-old won’t be able to write that college level essay. And, your teenage daughter (believe it or not) probably won’t want to come home right after school to do her homework. It’s normal.

Long-term resolution:

Discover age-appropriate “norms” that may help you to understand your child better. Correlate your expectations for their behavior with their stage of development. Become familiar with your child’s personal strengths and weaknesses.

Short-term steps: (Pick any of the following options): 

  • Observe your child’s class at school and see what the other children are doing. Are they following directions properly? Do they know how to sit in their seats quietly, or are many children up and running around? If you are not typically around other children, you may not know what is “normal” and what’s not.
  • Read an article or book, if you are an avid reader, on the stages of child development .
  • Subscribe to websites like babycenter.com or healthychildren.org, which will provide you with periodic updates on child development stages.
  • Ask your friends or your parents what their children were doing at certain ages to get a better handle on whether your child seems to be doing things at a similar pace as other children. They may also be willing to share ideas for rewards and punishments that worked for their family in a particular stage
  • Take an hour and watch your child at play without trying to direct his/her play. See what your child is naturally drawn to and where he/she excels. On the other hand, you may observe areas of weakness and learn where you can support your child.
  • Seek counsel from a psychologist if you are struggling to set age-appropriate goals and expectations. Your child’s teacher can also be a great source of information about age-appropriate goals.

(R)emember to follow through.

A classic example is when Mom says, “Clean your room or Santa won’t come to see you this year.” What really happens? The child doesn’t clean his/her room out of defiance, but Santa comes anyway with lots of toys for the child. The child has just learned that he/she doesn’t have to clean up because the threatened consequences were not implemented.

Long-term resolution:

Follow the age-old saying “Say what you mean, and mean what you say.” This goes for both positive and negative interactions with children. Follow through on threats for punishment as well as promises of rewards.

Short-term steps:

Take it one day at a time. When you wake up in the morning, decide to be mindful of what you say that day, including any promises or threats that you make to your children. When children see that you follow through, they are more likely to trust what you say and to listen to you more often. When parents don’t follow through on what they say, kids may eventually learn to tune their parents out.

(N)otice the good.

Families often come to my office because they need help dealing with a difficult problem or situation. Sometimes parents spend too much time and energy telling their child over and over again about all of the negative behaviors that need to be changed. However, research shows that positive energy is better for the relationship in general and may go a lot further in helping a child to overcome a difficult situation.

Long-term resolution:

Improve your relationship with your child while simultaneously building up your child’s self-confidence and self-esteem.

Short-term steps:

Acknowledge one good thing that your child does every day. Mix it up by praising them privately and in front of others, such as extended family or friends. Acknowledgement for positive behaviors each day can make the behaviors more likely to happen again and will boost your child’s confidence that he/she can make good choices in the process.

Parents, as the New Year rolls in, don’t forget to LEARN. These parenting recommendations require dedication and commitment, far beyond January 1st. Know that it’s OK to break these up into even smaller steps, such as committing to following one letter of LEARN each month.

And, as with any New Year’s resolution, please recognize that it’s OK to mess up, and that inevitably you probably will mess up at some point. Treat each new day as a fresh start, and try again. As an added bonus, you will be modeling goal-setting for your children throughout the year. Encourage them to set their own New Year’s resolutions. It’s OK to think outside the box and get creative here. You can help them to break bigger resolutions down into smaller, more manageable goals, so that you may LEARN together.

I wish your family a safe and Happy New Year.

Dr. Michelle DeRamus is a child psychologist at Phenix City Children’s. She specializes in Autism Spectrum Disorder (ASD) and also helps kids with depression, anxiety, anger, ADHD and more.

This blog was first published on http://www.muscogeemoms.com

Common “Military Family Challenges” Children Experience- Part 2

 By Michelle DeRamus, Ph.D.

It is no secret that the lives of military service members and their families differ greatly from civilian life in a variety of ways. For kids – often deemed military “brats” – the life changes and transitions that come every couple of years when the parent is assigned to PCS – move to a new post or duty station – may be extremely difficult or challenging. Kids are not as emotionally mature as adults and may experience additional difficulties as a result of the unique sets of circumstances that come with the military lifestyle.

As a licensed child psychologist in Phenix City, I work with many kids and families, both those who are in the military and those who are not. From my experience working with all children over the course of my career, and from talking with military family members in the area, I have identified a list of common questions or concerns that families may have due to the unique nature of the military lifestyle. This not a comprehensive list, but rather a guideline for some steps that military families may take to ease the effects that a transient lifestyle may have on their children. Of course, each individual child and circumstance is different, so please do not hesitate to consult a physician or child psychologist if you believe that your child is experiencing physical or emotional difficulties.

Last week, we looked at coping with and embracing PCS (permanent change of duty station) and helping kids to understand training and deployments when a military service parent may be absent from the home. You can find that blog here.

In Part 2, we will address “reacclimation” after a lengthy absence, managing expectations and helping kids to understand and cope with the inevitable broken promises that can arise due to an abrupt change in the military service schedule.
3. Reacclimation
The service member is coming home after months away! Everyone is thrilled. The kiddos make a banner and pick out special outfits to meet Mommy or Daddy at the airport. BUT then, (s)he is home, and the routine is again disrupted. While this is certainly an exciting time for everyone, one of the best ways to help everyone in the family transition is to keep expectations realistic. While I don’t want to be a “Debbie Downer,” the reality is that the return of a service member and the weeks and months that follow a long period of absence often do not follow the picture-perfect reunificationMilitary Homecoming- Kids plan that was expected. Everyone in the family has changed during the time of separation – kids have gotten older, the parent at home has adjusted to being more independent, and the service member has sometimes experienced very challenging situations that can affect his or her whole outlook on life, including physical, mental, emotional, and spiritual changes. Sometimes it seems as if family members no longer know one another, and it can feel as if you’re learning to live with a whole new person.
Expect changes and be prepared to take time to adjust to one another. Be patient with each other. Some children react to a parent’s absence by wanting to tell them everything that has happened within the first few hours of their return, and the parent may not be ready for such an overwhelming greeting. On the other hand, some children cope with the separation by keeping the period of absence separate, not wanting to talk at all about what happened during the parent’s time away. While this can seem hurtful to some parents, it can be helpful to focus on the present and future for these children. Ultimately, however a child responds to the reacclimation process, remember that kids are going to take their cues from their parents. If parents model patience and appropriate coping, children will be more likely to follow suit.

4. Minimizing Resentment over Broken Promises/Missed Occasions
In the military, there is rarely a true routine. You must be prepared for everything. Dad missing dinner may be common. Moms get called in for all hours of the day and night. It can be hard to make plans for vacations. The service member most likely will miss at least some events that are special to your child, such as the dance recital, school play or ball game. This could be a routine event or a major event, such as the state playoffs, prom or graduation. It can be tough to prevent resentment in families where inconsistency is the norm. The most important way to minimize resentment is to keep the lines of communication open between everyone in the family. Acknowledge feelings of disappointment and anger rather than telling children they are wrong for feeling a certain way. And from the other end, it is important for parents to tell children they are also disappointed, sad, and sometimes angry that they have to miss family events. When parents are honest with kids about their own feelings, it gives you an opportunity (again!) to model good coping skills and problem solving. Another way to prevent resentment is to be sure to spend some one-on-one time with each child as well as whole-family time when work allows. Find ways to connect with children around their interests. Finally, be sure to show and tell children you love them. While this may seem obvious, in too many families, parents assume their kids know they love them or are proud of them. But it is extremely important for kids to hear parents say it out loud. Supplement words with actions, too. Find ways to show your children you love them, even if you can’t be with them as often as you’d like.

5. None of these tips are working. How Can I Help my Child?
The tips above can go a long way for helping children cope with the stressors of being part of a military family. But what do you do if these tips don’t work? What if your child isn’t adjusting to the changes despite preparation? What if family relationships remain strained despite attempts at open communication? What if the stress becomes so overwhelming that your child begins to show extreme behavior problems, grades drop and don’t come back up, or significant signs of anxiety or depression appear? In addition, the strategies outlined above are not always sufficient if you have a child with special needs. Sometimes families need some outside help. Some children are predisposed to having poor coping skills, perhaps if anxiety or depression runs in the family. The stress of a move or a deployment can reveal underlying challenges that had gone unnoticed before. If it seems like your child is not adjusting as well as he or she has in the past, or if the challenges of a transition linger beyond a few weeks or months, it may be time to seek help. The military offers some support to families who need help. The Army Community Service Center, Family Counseling Center, and your own unit’s Family Readiness Group (FRG) are great places to start when looking for external resources to help your child. Tricare also covers mental health services for children of military families. A therapist can offer individual or family therapy services to help children and families cope more effectively with the challenges of military life. If you are interested in therapy services, you can contact Tricare directly for a list of providers in your area, or you can ask your child’s pediatrician for referrals.
At the end of the day, while kids may be part of a military family, keep in mind that they’re still kids. Children are resilient and often stronger than we expect. As noted above, most chKids Patriotic Photo-American Flagildren will take cues from their parents about how to handle situations. So be sure that you model for your kids not a lack of emotion, but an appropriate way to cope with all the emotions — both positive and negative — that go along with life in the military. Try not to let the hard parts about military life define your family. There are so many exciting and positive things about being a military family, too. Emphasize the strong values, patriotism, sense of community, and commitment that come from being a military family. Reminding each other of these positive qualities of being a military family can help you remain strong in the face of whatever challenges await.

Dr. DeRamus is a child psychologist with Preferred Medical Group and works at the Phenix City Children’s clinic. She specializes in Autism Spectrum Disorder (ASD) and provides diagnostic testing and therapy services for developmental delays, learning problems and ADHD. She also works with anger, anxiety, depression, family problems and peer relationships. She accepts Tricare Prime and Standard.

Common “Military Family Challenges” Children Experience- Part 1

By Michelle DeRamus, Ph.D.

Each day more and more families are finding homes at Fort Benning and the surrounding areas, including Phenix City, AL, Fort Mitchell, AL and Columbus, GA, in large part due to the military. At Fort Benning, soldiers find the opportunity to join some of the most distinguished U.S. Army units, including: the 3rd Brigade Combat Team of the 3rd Infantry Division, the 11th Engineers Battalion, and the 75th Ranger Regiment. Along with the soldier, spouses and children also find new places to live and often begin new jobs, new schools, and even find new friends along the way. They soon become familiar with the River Walk, look forward to Friday night concerts on Broadway, and experience the local cuisine at restaurants such as Minnie’s, Ezell’s, and the Loft, as Fort Benning truly is home–for now.Baby American Flag

It is no secret that the lives of military service members and their families differ greatly from civilian life in a variety of ways. For kids – often deemed military “brats” – the life changes and transitions that come frequently may be extremely difficult or challenging. Kids are not as emotionally mature as adults and may experience additional difficulties as a result of the unique sets of circumstances that come with the military lifestyle. As a licensed child psychologist in Phenix City, I work with many kids and families, both those who are in the military and those who are not. From my experience working with all children over the course of my career, and from talking with military family members in the area, I have identified a list of common questions or concerns that families may have due to the unique nature of the military lifestyle. This not a comprehensive list, but rather a guideline for some steps that military families may take to ease the effects that a transient lifestyle may have on their children. Of course, each individual child and circumstance is different, so please do not hesitate to consult a physician or child psychologist if you believe that your child is experiencing physical or emotional difficulties.

Common Military Family Challenges Children Experience and Some Basic Steps Parents May Take

1. PCS (military lingo for moving to a new duty station).

Every few years and sometimes more frequently, families pick up and move to follow the military service member’s career. For kids, this means leaving behind the familiar – school, teachers, coaches, friends, even the geography and favorite places of an area, such as playgrounds or restaurants. Kids may understandably struggle with this. Young children may not even understand what is happening and cannot comprehend why their best friends can no longer come over to play. While families may not have much advance notice when it is time to move, taking a moment to prepare kids for what to expect can go a long way in making the transition as smooth as possible.

  • Use the internet to learn a few fun facts about your new city. See if your family’s favorite restaurant is in the new city. Look up the name of the principal at your child’s new school. If your child plays sports or is in scouts, check to see if your new city or your child’s new school has a local team, chapter, or club. Learning what might be familiar about your new location can help your child look forward to the move rather than see it as something scary.
  • Also take a moment to acknowledge the sadness of leaving familiar people and places behind. Take pictures of favorite playgrounds, people, and other memorable things about your current city and make a memory book. Be sure to get phone numbers, addresses, or e-mail addresses from your child’s best friends so the kids can stay connected after the move.
  • Finally, remind kids, especially young kids, of the things that will not change with the move. While you will live in a new house, they will still have their favorite stuffed animals and toys. The furniture will stay the same, you will still have family game night, and you can still walk to the mailbox every day. Continuing daily routines in your new location can be very comforting, especially to preschoolers and younger children.

2. Training, Deployments, and more

When military service members are away from the home for extended periods or are in a dangerous place such as a war zone, kids may experience anxiety or fear and will feel the disruption in routine. Again, preparation can be helpful. If kids know a parent will be leaving, whether it is for a couple weeks or a couple years, knowing ahead of time can give them time to prepare emotionally. With the military, advance notice may be in short supply, but you can prepare together a day or two or even the night before, if necessary. Take advantage of whatever time and notice is given to develop a family plan for coping with the upcoming absence.

  • Show children how to take concrete steps to feel connected to parents while they are away. Before leaving, each child in the family should have a special one-on-one time with the parent who is leaving to do something fun together and give kids a chance to talk individually if they want to.
  •  Children can make or choose something special for their parent to take with them, such as a picture, a craft, or a special toy.
  • Having a keepsake box to keep at home can also be helpful. Kids can put things in the box that help them remember special times with their parent or think positive thoughts about their parent. Items for the box might include a ticket stub, a picture, a piece of jewelry Mom wears at home, or one of Dad’s t-shirts.

Parents may wonder “How much do I tell my child about where the deployed parent is going and what might happen there?”

  • Answering this question is kind of like answering the “where do babies come from?” question; the answer depends on the child’s age and emotional maturity. Younger children need simpler, more concrete answers, while teens need a more thorough understanding of what is truly happening and what might happen. A good rule of thumb is to let your child’s questions guide how much you share about the details.

Once a parent leaves, developing a new daily routine at home will be helpful in allowing children to feel “normal” despite a parent’s absenceSoldier chats with family computer.

  • Keeping in touch through phone calls, video chats, e-mails, and even letters can help kids stay connected to the parent who is away.
  • Keep in mind, though, that it’s probably best not to “schedule” phone calls or video chats at very specific times. Often circumstances arise (on either end) that can prevent the call from happening at a set time, which can lead to unnecessary anxiety, frustration, or disappointment.
  • The caregiver left at home must prioritize self-care. If you’re used to being a two-parent household and you’re suddenly a single parent for an extended period of time, it can be overwhelming. Remember that you will best be able to care for your children and model appropriate coping skills for them if you are taking care of yourself. Ask for help from family or friends if you need it, take advantage of any support systems that are available to you, and be sure to take some time for yourself to recharge and deal with your own emotions.
  • Be sure to find outside resources in your local area if you feel that your child needs additional help. For example, for testing and therapy services near Fort Benning, GA you could find the best child psychologist you know who accepts Tricare Prime and Standard 😉 Other resources might include Fort Benning parent support groups. Many of these resources may be located by contacting your FRG leader.

Next week in Part 2, I will address “reacclimation” after a service member’s lengthy absence, managing expectations and helping kids to understand and cope with broken promises that may arise due to an abrupt change in the military service schedule.

Dr. Michelle DeRamus is a child psychologist with Preferred Medical Group and works at the Phenix City Children’s clinic. She accepts Tricare Prime and Standard, as well as other insurances. She specializes in Autism Spectrum Disorder (ASD) and provides diagnostic testing and therapy services for developmental delays, learning problems and ADHD. She also works with anger, anxiety, depression, family problems and peer relationships.

 

 

What to do when your child/teenager won’t talk to you, and when to seek help: a Child Psychologist’s Perspective

By Michelle DeRamus, Ph.D.

As children get older and move into the teen years, it is natural for them to want to spend more time with their friends and open up to them more than to their parents. However, it is remains very important for parents to be involved in their teens’ lives and continue to set boundaries. Studies show that even as teens, children still value their parents’ input above anyone else’s.

What to do when your teen won’t talk to youTeenage Problems, Social Issues and Bullying

Some ideas for fostering communication between parents and children at any age include modeling good communication skills for your kids, making time for open communication as a part of your regular routine, and having more positive than negative interactions.

1. Model good communication skills

To model good communication skills, tell your children about your day, including information that is age-appropriate. When they talk to you, give them your undivided attention to foster better listening skills in them.

2. Make time for communication

Try to eat at least one meal a day together as a family, with a no electronics rule during the meal to encourage open communication. Some families have “conversation starter cards” or routine questions that they all ask one another to make sure everyone gets a chance to share their ideas or experiences.

If you find that your family is very busy and you’re struggling to find a time that you can be together, schedule “appointments” with each other regularly and treat them as seriously as doctors’ visits or work meetings.

3. Focus on positive interactions

Throughout your day-to-day activities, be sure to look for ways to have positive interactions with your children. It will be more fun for both of you, and you each will feel more like communicating if you’re not always fussing at one another. A good ratio to strive for is 5 positive comments for every 1 negative comment you make.

4. Recognize the symptoms of teen depression

However, sometimes a teenager will withdraw well beyond the range of “normal,” and parents can be doing all of this and more and still not seem to reach their teen. In these circumstances, your teenager could be suffering from depression and/or anxiety. Recognizing when a child or teen is depressed or anxious can be difficult because the symptoms are subtle, and all people experience sadness and worry at times.  It can be normal for children, just like adults, to feel sad in response to difficult circumstances, even for a few days at a time.

Major depression, however, includes symptoms that are persistent over time. In children, symptoms of depression can include:

  • Feelings of sadness
  • Increased irritability
  • Thoughts about suicide
  • Preoccupation with death or dying
  • Decreasing grades
  • Increasing physical symptoms (e.g. stomachaches, headaches)
  • Withdrawal from family and friends
  • Loss of interest in things they used to enjoy

5. Recognize the symptoms of anxiety

There are a variety of anxiety disorders, and the symptoms of specific anxiety disorders can vary widely. However, in general, children with clinically significant levels of anxiety often worry about performing well in school, the health or safety of family members or themselves, environmental factors (e.g., the weather), and the future. This worry can, just like depression, affect social relationships, lead to a drop in grades, and cause physical aches and pains.

Know When to Seek Help

If your child or teen is suffering from depression or an anxiety disorder, it is important to understand that he or she cannot just “snap out of it” or “stop worrying.” While it can be frustrating, one of the best things to do as a parent is to try to be patient, understanding, and supportive. Listen to what your child has to say, even if it doesn’t make sense to you. Try to help your child see things from a different perspective, but take care to avoid telling your child he or she is “wrong” for feeling the way he or she does. If your child seems to be getting worse instead of better, or you’re not sure how to help your child, seek professional help from a therapist or physician.

Without treatment, depression and anxiety in young people can have long-term harmful effects on the child’s development in a variety of ways. Therefore, it is important for adults to recognize the symptoms of depression and anxiety and act quickly to get treatment for children or teens with these conditions. Research studies have shown that both therapy and medication can be helpful in treating anxiety and depression. Some families prefer one treatment approach over another, while other families find a combined approach to be most useful.

Here are two examples of patients I have worked with in psychotherapy who improved over time with treatment. (Names have been changed.)

Joe’s Story (Anxiety)

“Joe” and his mother had always been very close, and his mother knew Joe tended to worry about things a little more than other kids his age. However, as a little boy, he still played with friends and made the transition to school pretty well. As he went on through elementary school, his mother noticed that Joe started turning down invitations to birthday parties and sleepovers, saying he’d rather just stay home and hang out with her. He became more irritable, and at times, even angry, when she pushed him to do things apart from her.

When he started therapy, Joe said that he often worried that something bad was going to happen to his mom. He was afraid she might get in a car wreck, get sick, or that someone might break into their house and hurt her. He felt safer when he was with her and could “watch out” for her.

In therapy, we identified the situations that made him least scared of being away from his mom (e.g., her walking to the mailbox without him) and the situations that made him most scared of being away from his mom (e.g., going to a sleepover). After learning some coping skills to help him relax when he started to get scared and think more realistically about the likelihood of something happening to his mother, Joe gradually started practicing being away from his mother for short, then longer, periods of time.

By the end of therapy, he was able to spend the night with friends without calling his mother to come get him. While he still sometimes worries about his mom, he was able to relax and not let the anxiety keep him from doing the things he really wanted to do.

Sally’s Story (Depression)

When “Sally” turned 14, her parents noticed that she was spending more time in her room and less time with the family. She said she still had friends, but her parents didn’t hear her talking about them much, and she no longer asked to go do things with them. Her grades started dropping, and Sally, who was once an A/B student, was failing a couple of her classes. Her appetite decreased, and she seemed tired all the time. She also started complaining of headaches, and she spent much of her time lying in bed to rest. When her parents asked if anything was wrong, Sally just said she was tired and wanted to be left alone.

In therapy, Sally revealed that she felt overwhelmed by her schoolwork and worried that she was not as smart as her friends. She believed she was stupid and that she was going to feel this way forever. Over time, Sally learned that she often interpreted situations in a negative way and assumed that the worst was going to happen.

Once she identified these negative thought patterns, she was able to remind herself that there is usually more than one way to view a situation. She practiced coming up with multiple solutions to her problems and developed a list of several things she could do to help herself feel better when she was upset. Sally’s depression became less intense and she felt sad less often. She began participating in the things she used to enjoy, and her grades improved. 

According to the National Institute of Mental Health, depression affects about 11% of young people, and anxiety affects about 8% of young people. The rates of both depression and anxiety are similar in boys and girls as children, but in the teenage years, girls are more likely than boys to experience symptoms of each. There are also differences in the prevalence across ages, with depression and anxiety occurring more frequently in older adolescents.

Left untreated, children and adolescents with depression and anxiety are at higher risk for low self-esteem, substance abuse, suicide, mental health issues in adulthood, and physical conditions such as heart disease and diabetes as adults. However, many children and teens who get appropriate treatment in the early stages of depression and anxiety can significantly reduce their risk of these long-term effects.

Talk to your child’s doctor

If you suspect your child may have depression or anxiety, it is important to talk to your child’s doctor so that he or she can get treatment. More information about depression and anxiety in children and teens can be found on the websites for the National Institute of Mental Health (www.nimh.nih.gov) and the National Alliance on Mental Illness (www.nami.org).

This blog was also published on www.muscogeemoms.com and can be found here.

New Patient
Registration
Patient
Portal
Virtual
Tour