Back-to-School Sleep Schedule

logo

 

Many children and teenagers adopt a later sleep schedule over the summer, going to bed later and sleeping longer in the morning.  A deliberate and gradual transition back to an earlier sleep schedule as the first day of school approaches can help kids start the school year well-rested and ready to perform.  The Riley Sleep Disorders Center has created worksheets to help families with this transition, one for IPS students starting school on August 3rd and another that can be customized to any school start date. 

Some tips for helping children with this transition:

  • Start by figuring out how much sleep the child needs.  While the worksheet presents guidelines for recommended sleep amounts, sometimes a better marker is how much a child sleeps when there are no schedule restrictions.  In other words, if a child goes to bed at 11pm most nights over the summer and often sleeps until 8am the next morning, he or she likely needs around 9 hours of sleep.
  • Once the sleep need has been determined, work backwards from the scheduled wake time to determine an optimal bedtime.  Be sure to add 15-30 minutes, as it often takes this long to fall asleep. So, a child who has to wake at 6:30am and needs 9 hours of sleep would have a target bedtime of 9pm.
  • Unless the child’s summer schedule is several hours later, usually a week is sufficient to make a transition.
  • Start by having the child wake up 15-30 minutes earlier the first day, THEN move the bedtime 15-30 minutes earlier that night.  This makes it less likely that kids will be asked to go to bed at a time when they are not yet tired, which can cause insomnia symptoms to develop.
  • Have the child wake at the scheduled wake-up time even if he/she was not able to fall asleep at the scheduled bedtime.  As long as the child wakes on time and does not nap during the day, he or she will often be able to fall asleep at the earlier bedtime after a day or so.

Contributor: Sarah Morsbach Honaker PhD, HSPP, CBSM  Riley Sleep Disorders Center

 

Anxiety and Neurodevelopmental Disorders

logo

 

There is increasing research-based information available in the area of neurodevelopmental disorder and anxiety, as well as other mental health disorders.  Neurodevelopmental disorders include Autism Spectrum Disorders, Intellectual Disabilities, Blindness/Low Vision, Deafness/Hard of Hearing, Cerebral Palsy and other neurologically based conditions, Learning Disorders, and Attention Deficit Hyperactivity Disorder.  The research is confirming what clinicians have known for some time:

  • Those with neurodevelopmental disorders are at higher risk for mental health disorders, including anxiety, than those without these disorders.
  • Those with neurodevelopmental disorders are likely to meet criteria for the mental health disorder for a longer period of time, meaning the symptoms persist longer.
  • Those with neurodevelopmental disorders are less likely to receive mental health services than those without these disorders.

The symptoms of anxiety in individuals with neurodevelopmental disorders are the same as those manifested in the general population and include:

  • Excessive worry
  • Irrational fears
  • Discomfort interacting with or having others look at them
  • Stomachaches and bowel problems
  • Other physical symptoms of stress
  • Sleep difficulties
  • Avoidance of stressful situations
  • Obsessive thinking
  • Compulsive and ritualistic behaviors

Those with neurodevelopmental disorders are under a great deal of pressure to “fit in” and to function in the same manner and in the same time frame as those without these disorders.  These pressures cause anxiety to escalate quickly and too much anxiety often is reflective by a “fight or flight response” and is seen as a behavioral issue.

For those who live with or work with individuals with such disorders, the following strategies may be helpful in decreasing anxiety and increasing more appropriate responses and behavior:

  • Allow more time for any daily routine or task
  • Talk less and use straightforward and direct language
  • Minimize transitions from one place to another, one activity to another, and one person to another
  • Use visual supports to help with schedules and communication even if the individual is highly verbal
  • Decrease stimulation in the environment
  • Establish predictable routines that are not over-stimulating
  • Find alternative ways to include the individual in family, educational, and community activities without over-stimulating
  • Make sure the individual is getting adequate sleep, nutrition, and exercise
  • Recognize the individual’s perspective may not be the same as your own perspective
  • Remain calm when the individual becomes anxious and agitated—so that you may find a solution

The Anxiety Curve illustrated on The Incredible 5-Point Scale (Buron & Curtis) provides an excellent way of representing the relationship between anxiety and behavior in individuals with neurodevelopmental disorders. The lower curve of the illustration represents the need for the staff or parent to remain calm and manage their own anxiety.  For further information, go to http://www.5pointscale.com.

Other references:

 

Contributor:

Julie T. Steck, Ph.D., HSPP

CRG/Children’s Resource Group

Indianapolis, IN

 

 

“PsychBytes” is a weekly educational resource from the Indiana Psychological Association provided for psychologists, their colleagues and their patients. We hope you will use and share this material!

Click here to read last week’s PsychBytes, “Men’s Sexual Health”.

If you would like to contribute a PsychBytes article or recommend a topic for future publication, please reply to this email or contact PsychBytes editors Dr. Aarika White and Dr. Julie Steck at Communications.IPA@gmail.com.

 

Dr. Lowinsky: Building Community Partnerships

by Dr. David Parker

During its 21 years, CRG has always valued learning from and supporting our community partners. We often use the saying here, “It takes a village.” Working with colleagues around the state and beyond, we welcome opportunities to share and gain knowledge about children, adolescents, and adults with behavioral healthcare issues. Building and maintaining networks with respected colleagues allows CRG providers to strengthen the community’s capacity to help people in need.

Dr. Joshua Lowinsky, CRG’s adolescent and adult psychiatrist, wears a number of professional hats. Among these is co-founder of the Primary Care Psychiatry Foundation and current president of the Indiana Psychiatric Society. Dr. Lowinsky will be making presentations this summer at three important professional gatherings. On June 15, he will give the keynote address (“Building a Primary Care Psychiatry Workforce”) at the Indiana Rural Health Association conference in French Lick Retreat and Conference Center. On July 23, Dr. Lowinsky will return to French Lick to speak at the Indiana Academy of Family Physicians’ annual conference. This time he will speak about depression and bipolar disorder in primary care. On July 25, he will give two talks in Michigan on Mackinac Island for Medical Education Resources which will include presentations on adult depressive disorders, anxiety disorders, suicide, and prevention of psychiatric disorders.

In reflecting on opportunities to work with colleagues throughout Indiana, Dr. Lowinsky commented, “If I can begin to share, in a presentation, the excitement and privilege I feel on a daily basis while working at CRG and in IPS schools with individuals and families who courageously fight to make their lives better, then I am hitting my mark.”

Gap Year: A New Service at CRG

by Dana Lasek, Ph.D. and David R. Parker, Ph.D.

A long-standing tradition in the U.K. and other European countries, more American students are taking a Gap Year between high school and college.  This year is a structured time in a young adult’s life that helps him/her meet important transition goals.  It is not a year of sitting on the couch and playing video games.  This time can address each person’s life goals but often focuses on work/volunteer experience (that can help students choose an appropriate major), travel, developing life skills, gaining greater maturity, and possibly even getting a “taste” of college before investing in full-time tuition before the student may be ready to handle that level of commitment.  Students often defer their college admission for a semester or year while pursuing a gap year, then start college a bit later with greater maturity, life skills, and sense of purpose.  Many Ivy League colleges actively support gap years because students who have chosen this transition option tend to do better academically, and graduate on time, compared to undergraduates who start college immediately after graduating from high school.

CRG is working with a growing number of young adults who may benefit from a Gap Year.  It is not a year of sitting on the couch and playing video games.  With the right amount of guidance and support, a Gap Year can be a tremendously wise “next step” immediately after high school graduation to help the student determine and plan for a successful entrance into adulthood.  CRG psychologist, Dr. Dana Lasek, and CRG Postsecondary Disability Specialist/ADD&Life Coach, Dr. David Parker, are planning a pilot approach to new Gap Year services starting in Fall 2015.   They invite you to attend a free pizza dinner at CRG soon to learn more, ask questions, and offer suggestions.  Please call CRG at (317) 575-9111 to register.  Here are the dates:

Parents and students:  Monday, May 11, 2015 (6:30 to 8:00 p.m.)

Educators/Other Professionals:  Monday, May 18, 2015 (6:30 to 8:00 p.m.)

Resilience and the Transition to College

by David R. Parker, Ph.D.

While the number of students with disabilities who attend college is at an historic high (about 11% nationally at the undergraduate level), students with LD, ADHD, Asperger’s, anxiety, depression and related learning issues encounter bigger barriers in college than students without disabilities.  This can include 1) higher drop-out rates, 2) taking on average one extra year to graduate, 3) high levels of stress due to decreased structure and increased demands on independent learning, and 4) new decisions about using formal accommodations such as extended test time.

To help students and families prepare for these challenges, CRG has launched the “Got BOUNCE?” workshop, which we now offer every spring and fall.  We hosted this for the second time on April 23, 2015, to an enthusiastic group of high school and college students, their parents, and educators.  A highlight was the student panel in which Naomi and Dean (high school students) and Meaghan and Nick (college students) described some of their educational or personal challenges and the steps they have taken to “bounce back” from these experiences.  The following comments captured audience reaction to this powerful evening of learning and inspiration:

“The students were very impressive.  I appreciated how open and honest they were.”

“This evening was worth every penny, every minute.”

“It [the workshop] was amazing and made me feel hope for my boys and my family.”

“I am so proud of all the student speakers.  They are life smart, too.  Please tell them how thankful I am and how funny they are!”

Check back on our website and look for future emails about the fall offering of “Got BOUNCE.”  CRG is privileged to work with extraordinarily resilient people.  This workshop helps us celebrate this quality in students and to honor their hard work on this part of their life journey.

 

 

Dr. Parker Represents CRG in Kuwait

CRG’s Postsecondary Disability Specialist and ADD/Life Coach, Dr. David Parker, was invited to visit Kuwait last month.  The Kuwait Association for Learning Differences (KALD) supports the development of educational services for students with LD and ADHD in that country and throughout the Middle East.  Dr. Parker made three presentations to nearly 300 teachers, school administrators, psychologists, and pediatricians about executive functioning disorders, ADD coaching, and techniques classroom teachers could use to help students with attentional difficulties.  The KALD sponsored a reception at the United Nations House on the final evening.  Dr. Parker was deeply honored to receive a hand-carved wooden pearling boat (a national symbol) by His Excellency, Marzouq Al-Ghanim (Head of Kuwait’s National Assembly) and Mrs. Amaan Al-Sayyer, the founder and chairwoman of KALD and mother of a college student with ADHD.

 

DP in Kuwait

 

CRG Connects with the Community

CRG providers will be out in the community this spring, sharing current knowledge about evidence-based practices for children, teens, and young adults with disabilities.  On Saturday, March 14th, three providers will represent CRG at the 2015 Inspiring Abilities Expo in Greenfield, IN.  Dr. Julie Steck (psychologist) will present a talk on “Recognizing and Addressing Anxiety in Individuals with Developmental Disabilities.”  Beth Waite (AT Specialist) will present a talk entitled, “Social Skills for Real Life.”  Beth and Elise Montoya (Psychiatric Nurse Practitioner) will also represent CRG at an information booth during the Expo.  Stop by to say ‘hello’ and hear more about CRG’s latest services if you are attending!

Dr. David Parker, CRG’s Postsecondary Disability Specialist and ADD/Life Coach, will present “Got BOUNCE?  Promoting Resilience and Grit in College Students with Disabilities” at the Indiana AHEAD spring conference on the Purdue campus on March 26th.  This annual conference for college/university disability service providers will focus on ways that college students with disabilities can gain equal access to the college environment.  This presentation is an outgrowth of CRG’s Got BOUNCE? Workshop, first presented in December 2014.  Campus professionals expressed an interest in learning more about these human qualities and their relationship to student persistence and success in college.

2015 Summer Camps and Programs

As we near the end of winter, many parents and care givers are starting to think about summer plans. Finding a summer camp or activity that will provide a rewarding experience, while meeting the unique needs of a child with special needs, can be a challenge. The Indiana Resource Center for Autism has compiled a list of summer camps and activities that can accommodate children with special needs. Please click here to read this helpful article.

For Physicians: Diagnosing Autism Spectrum Disorders and Working with Schools

When parents are concerned about their child’s development, their child’s physician is often the first person they reach out to for help and guidance.  Because early diagnosis and programming of Autism Spectrum Disorders can provide the best outcomes for these children, it is important that physicians understand how to best help these families.  The Indiana Resource Center for Autism has provided an article on how physicians can help families find the resources they need.  Please click here to read the article.

Culture and Behavioral Healthcare

By David Parker, Ph.D.

America is widely respected for being a country that embraces diverse cultures. We are all, as the saying goes, from somewhere else.   At CRG, we endeavor to understand each client’s “whole” story, including the role of family, school or work setting, and even that person’s culture.  Culture can play a huge role in how an individual thinks about and responds to behavioral health needs.

In a publication entitled, “Culture Counts,” the Surgeon General’s office provides helpful information about this topic. A person’s culture can have a significant influence on how he or she recognizes, reports, seeks treatment for, and copes with mental health issues.  Some families, based on their culture, continue to feel such stigma about issues like depression or substance abuse that individuals in that cultural group refrain from acknowledging these problems or seeking help for them.  Read more here.

Two CRG providers are currently involved in unique, global activities that seek to better understand the intersection of culture and disability. Psychologist Dr. Sandy Burkhardt, as part of her work at St. Xavier University in Chicago, is a co-editor of the new book, “Special Education International Perspectives:  Practices Across the Globe” (Emerald Group, 2014).  This very readable textbook explains how special education practices developed and work today in 24 countries around the world, starting with the U.S.  It’s fascinating to read how cultural beliefs have shaped the way different countries think about children with disabilities and how their teachers are being trained to meet their needs.

Postsecondary Disability Specialist and ADD/Life Coach Dr. David Parker will travel to Kuwait in early February to give several talks on high school and college students with ADHD. He will also discuss research findings about ADD coaching to a group of 500 educators, administrators, and government officials.  Kuwait is currently considering revising its disability laws to include people with ADHD for the first time.

Like all providers at CRG, Dr. Burkhardt and Dr. Parker are actively involved in their professional organizations in order to teach and learn on an ongoing basis. They bring “outside” knowledge to CRG and are available to share that knowledge with schools, organizations, and groups through CRG’s Speaker’s Bureau.