Tag: Family


Apr
2022

Children’s Mental Health Week (CMHW)  May 1-7, 2022

categories: Family, Mental Health

This year’s theme is Action Changes Things. One way to advocate for children’s mental health is by lighting up green in support of Children’s Mental Health Week this year.  Parent/Professional Advocacy League has a toolkit for people to use. Toolkit materials are free. Posters can be downloaded.  Some towns and cities will have CMHW public lightings.

Since 2002, the Governor of Massachusetts, has issued an official proclamation for Children’s Mental Health Week. Some Massachusetts  mayors issue proclamations, too. Children’s Mental Health Week is dedicated to increasing public awareness about the triumphs and challenges in children’s mental health.  It emphasizes the importance of family and youth involvement in children’s mental health.

In Massachusetts, Children’s Mental Health Week is sponsored by the Department of Mental Health and the Massachusetts Behavioral Health Partnership (MBHP), a Beacon Health Options company.

Here are some Children’s Mental Health resources that may be helpful. 

Children’s Mental Health Campaign (CMHC) has six highly reputable partner organizations: 

Children’s Behavioral Health Initiative (CBHI) – Helps MassHealth children with behavioral, emotional, and mental health needs.  Families can get integrated behavioral health services and a comprehensive, community-based system of care.

     Find a CBHI Provider 

Massachusetts Department of Mental Health (DMH) HandHold – DMH has a collection of resources that you can try at home today and organizations that we know can help.

Massachusetts Behavioral Health Partnership (MBHP) – MBHP is here to provide you or your loved one with a full range of services to help with medical, mental health, and substance use disorder conditions.

National Alliance on Mental Illness (NAMI) Massachusetts Resources for Children and Teens – Includes family support programs. 

Children’s mental health is important every week of the year. 


Apr
2019

Make bedtime a fun routine

categories: Education, Family, Home, Parenting

Child getting ready to sleep

As a doctor for children, I often talk about sleep during wellness and sick visits.

Sleep is an important life skill. It teaches children how to calm themselves and rest. Parents have an important role in helping children to healthy sleep habits. Improved amount and quality of sleep affect children’s behavior and abilities to think.

Below I will discuss some tips that parents can practice for healthy sleep habits.

  • Decide with your family when is a good time to start sleep training.
  • Decide how many hours of sleep your children need. Infants sleep for 12-14 hours. Hours decrease gradually as children get older. On average, children need 10 hours of sleep. If they nap during the day, do not forget to account for nap time to the total daily sleep time. For example; 2 hours nap in the afternoon will leave your children with only 8-10 hours of sleep at night. That can be a reason why children go to bed late at night or wake up very early and refreshed.
  • Talk to your children about (tonight’s plan). For example “we will take a bath, read a story, and then it is bedtime”. Change the language based on your children’s understanding. Young children would benefit from (first…then strategy). For example “first we take a bath then we read a story”. Use picture books to share stories about sleep.
  • Use a reward system. Rewards can be increased or spaced out. Rewards can be an activity the children will enjoy, for example spending play time with parents, or reading a favorite book together.
  • Do not get discouraged quickly if some attempts are not successful. Experimenting is a key. Some plans do not work the first time or at all. Try different things. For example, some children may prefer bedtime stories and some may prefer bedtime song. Other different options parents can try; white noises, a night light, a security object/blanket or all of them.
  • Avoid high affect games or TV before bedtime. Bath and stories can help to relax your children.
  • Remind your children that bedtime is soon. For example “5 more minutes to bedtime”. Some children do not tolerate transitions quickly. You can use a fun or colorful alarm clock as a reminder.
  • Increase their Melatonin Dark room, with no TV or electronic devices.
  • Create sleep associations. Children like their routines. It is ideal if they go to sleep in similar conditions every night (same bed, room, lights off etc.).
  • For younger children, put them to bed semi-awake. Allow time for them to calm themselves. This way they learn to go back sleep if they woke up the middle of the night.
  • If your children cry in the middle of the night, attend to their needs. Comfort them, but avoid picking them up or bringing them to your bed.

Helpful Resources


Mar
2019

Guardianship and Alternatives for Young Adults with Disabilities

categories: Education, Family
  • When people turn 18, they are legally adults.
  • They make their own medical, legal, and financial decisions.
  • This can be scary for families and young adults.
  • Parents want to stay involved with decision-making and meetings.
  • Guardianship is one way to address this.

Family discussion

 

Guardianship

  • A court decides if a person needs a guardian.
  • A Guardian will  make decisions for them
  • Guardians are a good idea for people who may never be able to make their own decisions.
  • Guardians should get training to learn their role.

Alternatives to Guardianship

 Power of Attorney:

  • A person can choose to have one and what areas they want them to help with.
  • A person can remove them when they are ready.
  • This is a good choice for people who need help now but will be able to make their own decisions one day.

Money Supports

  • Conservators, rep payees, and joint bank accounts can help manage money.

Health Care Proxy

  • The person chooses who will make medical decisions for them if they are unable to make them.

Supported Decision Making

How to Decide What Supports are Needed

Recommended reading:

 

Reversing a Guardianship Agreement

The Arc- Guardianship and Alternatives

 


Mar
2019

My child does not want to go to school

categories: Education, Family, Parenting

Children walking to school
Children walking to school

As a doctor for children, I often talk to parents about school refusal. There are many reasons  why children do not want to go to school and the reasons change with age.

Here I summarize a list for the most common causes of school refusal. Some are typical for age and some require help and support.

Separation anxiety. Children who become very sad and worry when their parents leave. It can start at 6-7 months of age. Peaks at age 15-18 months. Most children cry when parents leave, but can calm fast and they are happy to see their parents at pick up time. Children who cannot calm down, refuse to play with other kids, may need help.

Light bulbWhat parents can do;

  • Talk to your children about school in simple words “its School time, play time”.
  • Remind them of things they like to do at school.
  • Use rewards. A reward can be a fun activity that you do together.

Performance Anxiety. Definition: Children who escape certain class activities. Examples are; reading in front of the class or being called on to answer questions.

Light bulbWhat parents can do;

  • Talk to teachers, they will give important information about how your children are doing in the classroom.
  • Work with the teachers to make a plan, for example; allow time for them to raise hand or practice reading before the class starts.
  • Use stars reward system for “reading out loud”.
  • Tell them you are happy with their hard work, even if they were not successful.

Learning Disability (LD). Definition: difficulties with school academics. Difficulties can be in; reading, writing, math or in more than one topic.

Light bulbWhat parents can do;

ADHD. Definition: It is a medical condition that makes it difficult to listen and pay attention. It is due to changes in the brain chemicals. ADHD is more noticed when children move to higher grades. Children with ADHD can be misunderstood. As a result, making friends can be hard.

Light bulbWhat parents can do;

  • Talk with the teachers. Ask if your children act same at home and school?
  • Talk to your doctor. ADHD is very common and can be treated with medications and some additional help at home and school.
  • Schools can help and support children with ADHD. Know your rights, students with ADHD

Bullying. Definition: when a person or a group repeatedly harm someone. It can be; physical, calling out names or using the social network to post bad things.

Light bulbWhat parents can do;

  • Ask Children if they ever get hurt in school or called names.
  • Ask the school counselor and the teacher to help you find out more if you have any reason to think about your children being bullied.
  • Get children help through therapist, share with your school and your doctor.

 

Depression. Definition: low mood and loss of interest in fun activities. It is more common among older children/teenagers. Depressed children can be irritable or angry not sad. It is important to notice any other changes to your children mood and behaviors at home.

Light bulbWhat parents can do;

  • Talk to the school counselor, your doctor or someone in your community to help you with resources.
  • Always look for expert help.

Resources:


May
2013

The Massachusetts Act Early Campaign: Because Early Identification is Important to Us

categories: Autism, Education, Family

Female and baby girl reading book, baby is pointing at bookThroughout the month of April, we’ve heard from members of the Massachusetts Act Early state team who have shared heartfelt stories about why identifying autism and other developmental disorders matters to them.

Who We Are

Our team is made up of parents, medical professionals, educators, autism resource specialists, human services program managers, public health practitioners, university faculty and many others.

We lead an interdisciplinary, collaborative statewide effort “to educate parents and professionals about healthy childhood development, early warning signs of autism and other developmental disorders, the importance of routine developmental screening and timely early intervention whenever there is a concern.”

What We Do

Our statewide coalition works to strengthen state and community systems for the early identification and intervention of children with signs of developmental disabilities, such as autism spectrum disorders.

The coalition envisions a future that uses a family-centered model that overcomes geographic, socioeconomic, cultural, and linguistic barriers to assure equal access to developmental screening for all children in the Commonwealth. This mission and vision drives every action Mass Act Early takes to make a critical difference in the lives of children and their families.

Our current goals include:

    1. Public outreach to increase awareness of autism spectrum and related disorders.
    2. Training for early childhood, health care, and educational professionals.
    3. Shortening the wait times between screening and diagnosis as well as diagnosis and intervention.
    4. Developing culturally competent autism screening materials and training curricula for early childhood educators, community health centers and pediatric practices across Massachusetts.

How We Do It

Our web site at www.maactearly.org  contains free downloadable materials about healthy developmental milestones in young children for families, early childhood professionals, and health care providers.

Most of these materials were developed by the Centers for Disease Control and Prevention (CDC). The CDC developed them for the national “Learn the Signs. Act Early” public awareness program, of which the MA Act Early initiative is the local state chapter.

Additionally, the CDC‘s online Autism Case Training (ACT) course covers identifying, diagnosing, and managing autism spectrum disorders.
There are three modules, which can be taken separately or together. They are based on real-life scenarios and include up-to-date information, illustrative videos, and pertinent references and resources.

Free continuing education credits (CME, CNE, and CEU) are available for each of the modules.

Our Priority: Cultural and Linguistic Equity in Massachusetts

The MA Act Early state team has set a priority of reducing early identification disparities for families who are from culturally, ethnically, and linguistically diverse backgrounds, particularly if their primary language is not English.

To that end, we have developed the “Considering Culture in Autism Screening” guide and toolkit which includes a clinician’s tips guide, a Massachusetts resource sheet “Referrals at a Glance”, and the validated M-CHAT screening tool in five languages. It also comes with instructions, a scoring sheet and the follow-up interview.

Make Early Identification Your Goal Too!

Visit the MA Act Early website often. “Like” us on Facebook and help spread the word!

Early identification may be important to any of us. It could be due to skyrocketing prevalence rates, a beloved family member living with an autism spectrum disorder, a sense of profound professional purpose to improve the quality of life or any number of other reasons.

Whatever raises your own concerns about early identification, please join us in making a lasting difference. Positive outcomes are within our reach!

About the AuthorElaine Gabovitch

Elaine Gabovitch, MPA serves as state team leader for the Massachusetts Act Early program and as one of 25 national ambassadors appointed by the Centers for Disease Control and Prevention (CDC) to promote the “Learn the Signs. Act Early.” public health program in Massachusetts. For more information, visit www.maactearly.org . She is also the Director of Family and Community Partnerships for the UMass Medical School-Eunice Kennedy Shriver Center, family faculty in the Shriver Center’s LEND program, and an instructor in the UMMS Department of Family Medicine & Community Health.


Apr
2013

Early Identification Makes a Difference: An Educator’s Perspective

categories: Autism, Family

ToddlerThis week we are pleased to introduce Jason Travers PhD, BCBA-D, an Assistant Professor of Special Education at the University of Massachusetts Amherst. Jason will share his personal experience with early identification and the impact it made on his life.

My Work Begins

I began my work in autism while studying for my Bachelor’s degree in Special Education at UNLV in 2000. I had quit a construction job to return to college and the decision was taking a financial toll on me and my new wife.

There were many fliers in the hallways of the College of Education requesting candidates to help with early intensive behavior intervention in home-based programs for children with autism. I figured it would be a great way to get some experience and make a little money.

Soon I was working for and with three families which included sons with autism. It was a decision that would come to define me as a professional.

Meeting Alex

Perhaps the most influential moment was my experience with Alex and his family. Alex had recently been diagnosed with autism when his parents contacted me about starting up an intervention program.

A couple of weeks later, I arrived at their home with a few other behavior therapists and an experienced consultant. The family was desperate for help and needed support.

For several months prior to our arrival, Alex struggled to communicate with his parents and relied primarily on inappropriate behavior to get his needs met. I could tell they were a loving family, but they were also unsure of what to do to improve the situation.

Beginning Our Treatment

I was eager to begin our effort and over the next couple of days we began teaching play, communication, and other behaviors. Initially I found it very challenging as Alex refused hand over hand prompting.

The other children I had been working with had established these skills before my arrival. I was unsure what to do and so were Alex’s parents.

The consultant, however, continued with the procedures and by the morning of the second day things had changed dramatically.

Making A Breakthrough

There were six of us in a small bedroom when Alex began to respond to our spoken directions. We spread around the room and took turns asking him to “come here.” We cheered every time he went to the person who called him and he loved our cheering.

A few minutes later he completed a puzzle, played with some blocks, and said “buh” to request bubbles. Alex’s parents were overcome with tears of joy as they felt they were witnessing nothing short of a miracle.

Just two days before their son was unable to answer to his name, had never “asked” for anything, and couldn’t follow simple directions. I was amazed at the quick transformation and still get emotional whenever I think about it.

Committing To Help

I was immediately convinced that day that I would base my career around autism and began planning accordingly. I continued to teach Alex for 9 months and documented his progress before leaving to start a job as a special education teacher.

During those months, Alex began speaking to communicate, drawing and writing, playing appropriately, and went to the movies and other places in the community with his family.

Goals for the Future

This experience was a defining moment in my life and has fueled my career. While working as a special educator for students with autism, I earned my Master’s degree in special education with an emphasis on autism and developmental disabilities. Eventually I earned a PhD in special education. I now conduct research and teach courses related to behavior analysis and autism at UMass Amherst.

After 13 years, the memory of those first days with Alex remains vivid and powerful. Alex and many other children like him have inspired my professional goal: to help all families affected by autism gain access to quality services that will allow their child to achieve their full potential.

Early identification and early intensive behavior intervention is critical to this goal and the reason why I am involved with Massachusetts Act Early.

About the author

Jason Travers, PhD, BCBA-D is an assistant professor of special education at the University of Massachusetts Amherst. He researches the efficacy of technology to prevent contextually inappropriate behavior and promote early literacy skills of learners with autism. Jason also investigates the disproportionate representation of diverse children with autism.


Apr
2013

One in a Million: A Physician’s Perspective

categories: Autism, Family

Baby-in-green-bathThis article is the next in our series on Early Identification and was written by Dr. Stephanie Blenner. Dr. Blenner is from Boston Medical Center and is a member of the MA Act Early Steering Committee. She is also a LEND alum.

Three in One Thousand

She had long hair and unyielding eyes. I was only a resident at the time, so I sat to the side while the attending physician told the mother that her child had something called autism.

He explained it was a neurodevelopmental disorder. When she asked what to do, he told her to spend time with her at home.

At 3, she was too young for school or formal intervention. When we left the room, he told me I was lucky to meet a child with autism because it was so rare.

One in Eighty-Eight

Over 15 years later, we see children with autism every day in our clinical program. We never tell families it is rare or that they should wait to intervene. Instead we talk about how common autism is, how many other families have sat in their shoes, and the importance of early intervention.

We do this in English, in Spanish, in Vietnamese, sometimes with both parents, sometimes with just the mother or another family member. As clinicians, we do this so often the packets of printed information for families need to be restocked weekly.

This is our job as health professionals, to assure children are screened, diagnosed and receive the intervention that can make such a difference.

One in Fifty

Autism awareness requires more than just describing what autism is, explaining that it is common and that early treatment is critical.

We also need to to let people know that while autism is all too common, children with autism are not.

That each is singularly unique and special. That the chance to identify a child with autism early means that, through intervention, their community will have a unique opportunity. They will be able to know and appreciate that child as possibly only those closest know them; as the individual behind the disorder.

In this way, as we work together on autism awareness, we remind ourselves why this work is important. That the most recent sobering 1 in 50 statistic belies what each of us privileged to do this work knows, that each child is more truly one in a million.


Apr
2013

Why Early Identification is Important to Me: A Parent’s Point of View

categories: Autism

Picture of a BabyThis month we are pleased to introduce Elaine Gabovitch, a respected professional in the field of disabilities. Elaine has many titles; State team leader, Faculty Member, and Director to name a few. Yet this month, she shares a personal view from one of her most important roles in life, parent of a child with autism.

It’s personal

Every year in April, people who care about autism observe and even celebrate Autism Awareness Month. One thing I personally celebrate is how far we’ve come in identifying autism spectrum disorders in young children.

It was 18 years ago when early identification became vitally important for our son. Back then, I didn’t know a thing about autism, but I knew our son wasn’t meeting his developmental milestones on time. When we shared our concerns with his pediatrician, he advised us to “wait and see.”

Instead, I self-referred to Early Intervention who evaluated my son and sent us to specialists. Soon he received a diagnosis, Early Identification services started, and our long trip forward began. Over time, I met other parents whose pediatricians also reassured them to “wait and see.”

It was a growing problem in need of a solution.

That was back in the 90’s, and while early identification has come a long way since then, it still has a long way to go with heightened public awareness.

It’s Prevalent

Only last year, the CDC estimated that every one in 88 children has an autism spectrum disorder. That’s one in every 54 boys and one in every 252 girls. This past month, a parent telephone survey study reported one in 50 children may be diagnosed on the spectrum.

That’s 2% of all children!

It’s Urgent

Early intervention works. The earlier the screening, the better the results for children and families. But for children who have families from diverse cultural and racial backgrounds, real disparities exist. We can and must do better.

By teaching all families about healthy developmental milestones and what to do when concerned, we can do better. And by training all pediatric clinicians about screening, we can change the conversation from “let’s wait and see,” to “let’s do a routine screen,” leveling the playing field for all children.

It’s Treatable

Take it from me, autism spectrum disorders are treatable. Over the years I have met many children with autism and their families and each has a different story to tell. Early intervention was a crucial part of those stories, as it helped beyond what those families could possibly have imagined at the time of diagnosis.

Identification is the key to getting help. Let’s build awareness here in Massachusetts by getting everyone on board through education, participation and identification.

Over the month of April, we’ll hear from other members of the Massachusetts Act Early state team about why early identification is important to them too.

About the authorElaine Gabovitch

Elaine Gabovitch, MPA is the Director of Family & Community Partnerships for the UMass Medical School-Eunice Kennedy Shriver Center, family faculty in the Shriver Center’s LEND program, and an instructor in the UMMS Department of Family Medicine & Community Health. She currently serves as state team leader for the Massachusetts Act Early program and as one of 25 national ambassadors appointed by the Centers for Disease Control and Prevention (CDC) to promote the “Learn the Signs. Act Early.” public health program in Massachusetts. For more information, visit the Massachusetts Act Early Web Site