Category Archives: From the Real Experts at NYU

Splish Splash Safety: Tips for Keeping Your Child Safe Around Water This Summer

swimWater activities are a great way to enjoy the outdoors during the hot summer months. Whether it’s time spent at the pool, a lake, or a fun day at the beach, there are many opportunities for children of all ages to enjoy water activities. It is important, however, to remember that water can be dangerous, and drowning is preventable. Here are some important tips on how to keep children safe around water.

Supervision: Watch children when they are in or around water – even if there is a lifeguard around. If many adults are present, choose one designated person to supervise without distractions. This will assure that an adult is watching at all times without assuming that someone else is watching.

Pool Safety:
• Fence: Install a fence around home pools. The fence should be at least 4 feet high with gates that are self-closing and self-latching. The latch should be placed as high as possible so that young children cannot reach it, and the gate should completely surround the pool, separating it from the house.
• Access: Whether you have an inflatable or above ground pool, make sure to remove any access to the pool (such as a ladder) when not in use. Additionally, remove any furniture that can be used to climb into the pool.
• Toys: When toys are not in use, be sure to remove them from the pool, as they can attract small children.
• Cover: Keep the pool covered when not in use. Make sure the pool cover is on securely to avoid danger of a child falling into the pool and being trapped underneath the cover.

Swimming lessons: The American Academy of Pediatrics supports swimming lessons for most children age 4 years or older. In younger children (ages 1-4) swimming classes may reduce the risk of drowning, but as children develop at different rates, no age specific recommendations are made.

Swimming partner: For adolescents that know how to swim, make sure that they always have a swimming partner with them, whether at the pool, lake or the ocean. Never allow them to swim (even with a partner) without a lifeguard around.

Know what to do in the case of an Emergency. If a child is missing, check the water first and call 911 if needed. Parents, caregivers and pool owners would benefit from learning CPR, as it may help save a child’s life.

When it comes to water safety, prevention is key! Be safe, and have fun in the water!

hassFrom the Real Experts at Hassenfeld Children’s Hospital at NYU Langone:

Doreen Benary, MD, is a pediatric emergency medicine physician and clinical instructor in the Ronald O. Perelman Department of Emergency Medicine and the Department of Pediatrics at Hassenfeld Children’s Hospital at NYU Langone.

Beat the Heat: Tips to Keep Your Child Safe from Heat Related Illness This Summer

heatAs temperatures rise and we find ourselves spending more time outdoors with children this summer, it’s important to remember that high temperatures and too much time in the heat can have negative effects on your child’s body. Here are some tips on preventing heat related illness in children.

HYDRATION:  Staying hydrated is one of the most important things we can do to prevent heat related illness. It is essential to give your child water frequently while they are outside on a hot day. Many children may not ask for water while they are playing outdoors, but it’s important to provide children with water even if they don’t ask for it. Additional and frequent hydration with water or sports beverages is especially crucial while children are playing sports or exercising. Infants less than 6 months of age should not be given water, but they can be given extra breastmilk or formula to keep them hydrated.

SUN PROTECTION: Protecting your children from the harmful effects of the sun’s rays is also important. Dress your child in lightweight and light-colored clothing. A wide-brimmed hat and sunglasses can offer additional protection. Keep children in the shade as much as possible and try to avoid exposure to direct sunlight on very hot days, especially during the sun’s most intense hours (between 10 AM and 4 PM).

Apply sunscreen that is at least SPF 15 to any areas of your child’s skin that are not protected by clothing. Using sunscreen that says “broad spectrum” or UVA/UVB protection is ideal. Sunscreen should be applied at least 30 minutes before going outdoors.  Don’t forget to apply sunscreen on cloudy days as well, as the sun’s rays are still present.

Infants less than 6 months of age should be kept out of direct sunlight as much as possible. If you do take young infants outdoors, be sure to keep their skin protected with lightweight clothing and a hat and to keep them in the shade. You can apply a small amount of sunscreen to your infant’s exposed skin if needed.

STAY COOL: Staying indoors in a location with air conditioning is a great way to beat the heat on days when temperatures are extremely high. If you do not have air conditioning available in your home, think about going to a public location such as a library, museum, or mall. This is a great way to engage in a fun activity for the day while still staying cool. Additionally, a cool bath or shower may help cool your child down on a hot day.

MONITOR: While prevention is the key, it is also important to recognize the signs of heat exhaustion and heat stroke. If your child exhibits any of these signs or symptoms, speak to your child’s pediatrician or take them to be evaluated by a physician immediately.

•Dizziness
•Nausea
•Vomiting
•Headache
•Weakness
•Fatigue
•Confusion
•High body temperature
•Muscle Cramps

Following these tips will ensure a fun and healthy summer and will help you beat the heat!

hassFrom the Real Experts at Hassenfeld Children’s Hospital at NYU Langone:

Kavita Patel, MD, is a pediatric emergency medicine physician at Hassenfeld Children’s Hospital at NYU Langone.

How to Prepare Your Child for Sleepaway Camp

campfireFor some children, heading off to an overnight summer camp is natural and easy, and their parents aren’t too concerned. For others, especially those who are younger, more prone to anxiety, or who have special needs, the approaching first day of camp can be daunting.

Whether your child is spending a week or the whole summer away from home, here are a few tips to help you prepare your child (and yourself!) for a smooth transition to camp.

Manage your own anxiety.
Maybe you’re questioning your decision to send your daughter away to camp at her young age. Maybe you’re nervous that both you and your son will spend the first few nights of camp crying. Fears are natural, but don’t let your kids know how worried you are!

Take care of yourself and your needs first. Speak to friends and family about your anxiety, but make sure that you convey an excited, optimistic attitude when talking to your child. Remind yourself why you wanted to send her to camp in the first place. Making new friends, learning new skills, playing in the fresh air, and gaining a sense of independence are all wonderful experiences that will benefit her. You can also look forward to getting a brief respite from parenting duties while she’s away!

Whatever you do, never tell your tell child that you will miss him too much or that you wish he could stay home. If he asks if you’ll miss him, let him know that you love him, but that you want him to be at camp and that you can’t wait to read his letters and hear all about camp when he gets home.

Preview the camp schedule.
For anxious children or those who have difficulty adjusting to new routines, checking out the camp’s daily schedule together can be beneficial. These are often available on the camp’s website. If you can’t locate it, email the camp and ask for the schedule for your child’s age group.

With your child, review when wake up, bedtime, mealtimes, and activity periods will be. If he has been waking up and going to sleep on a drastically different schedule, slowly adjusting to the camp’s schedule can help make it more likely that he’ll fall asleep easily when he arrives. Taking a look at photos on the camp website to preview the new surroundings can also be useful.

Make sure to read the list of activities that are offered at camp. Generate excitement for both of you by talking about which new things your child wants to try at camp!

Let the camp know about your child’s special needs.
If your child has special needs, chances are that you have already discussed them with the camp director. If not, make a phone call or send an email to the camp administration to let them know. They will be glad that you shared information that will make the start of camp easier for both your child and for her counselors.

Full-time camp staff are childcare professionals who have seen and heard it all, so don’t worry about upsetting them with this information. Many children who require unique diets, have psychiatric diagnoses such as ADHD, or who have behavior problems in school have wildly successful summer camp experiences.

Although you might feel anxious and want to call multiple times, restrict yourself to one or two communications with the camp before the first day, unless the camp indicates that more are necessary, as camp directors are extremely busy just before and during the summer season.

Practice spending nights away from home.
If your child has rarely spent the night outside the comfort of her own bedroom, practice for the camp experience by having her sleep at friend’s and family member’s houses a few times before camp begins. Don’t call her to say goodnight; allow her to become accustomed to doing her bedtime routine under the watchful eye of another adult. When she returns home, praise her for her success at staying by herself.

Your child might ask if he can come home if he changes his mind about a sleepover or about camp. Reiterate that you’re confident that he will have a great time without you. Prepare him for the experience by saying, “A lot of kids feel homesick on their first few nights away. It’s okay if you feel that way or if you don’t feel that way. If it happens to you, don’t worry that it means you won’t have a good summer anyway.” Never promise your child that you will pick him up if he feels homesick.

Let go.
Once your child arrives at camp, the staff will take care of her needs. If there’s a problem that you need to know about, they’ll call you. Enjoy your freedom and give yourself time to relax while the children are away. Remember, whatever happens, your child will be home in a few weeks!

hassFrom the Real Experts at Hassenfeld Children’s Hospital at NYU Langone:

Arielle Walzer, MA, PsyM, is a psychology extern at the Child Study Center, part of Hassenfeld Children’s Hospital at NYU Langone, and a doctoral candidate at Rutgers University.

Summer Socializing: How to Help Your Child Make Friends Over Summer Break

summer-friendsAs with times tables, proper spelling, and other academic skills, social skills can decline over summer vacation if children sit at home for months and ignore them. Yet, just as summer school and intensive tutoring in July and August can help kids catch up to their peers academically by September, so too can summertime be used for strengthening kids’ social skills and increasing their circle of friends before the new school year begins.

For children who struggle to make friends during the school year, the summer can be a valuable time to break free from their school-based social circles and form positive relationships with a variety of other peers. Follow these steps to learn how to maximize your child’s chance of success:

Choose the right activity.
Children are most likely to succeed in making friends when they are engaged in an activity that they love. While you might desperately want your video game-loving kid to get some exercise this summer, soccer camp is probably a poor choice if your child can’t stand organized sports. Crying or complaining about the activity is unlikely to attract new friends!

Play to your child’s strengths. What does your son or daughter talk about the most? If your daughter talks non-stop about animals, a nature program is where she’s most likely to find friends who share her passion. There are camps and classes out there for everything – coding, cooking, science, and movie-making camps are all alternatives to traditional sports and swimming summer programs.

Make sure the activity meets often.
Although it might seem like other kids make friends during chance meetings on the playground, these are unlikely to turn into lasting relationships without thoughtful follow-up. Even if your son enjoys splashing around in the pool with a boy he’s just met, it would be hard for him to turn that one-time interaction into a genuine friendship without repeated contact. Friendships tend to form over time when there are repeated opportunities to play together. If your child isn’t attending a daily camp program, try to ensure that the activities she’s enrolled in meet at least once per week to increase the odds that she’ll form a connection.

Identify potential friends.
Kids who struggle to form peer relationships often find it hard to identify potential friends. Even when they do report friendships, parents sometimes can’t help but wonder if the feeling is mutual. When possible, watch your child at the end of a program to see with whom she gets along well. If you can’t watch or if you find it difficult to tell, ask the group leader. Teachers and camp counselors are usually excited about helping facilitate new friendships and are likely to have good insight.

Make the first move.
Once you’ve figured out who might be receptive to an invitation from your child, approach the parents at pick up time or ask the group leader for contact information and call them. Suggest a specific activity and date.

Remember that parents and children often have busy summer vacation schedules, so it might be hard to set a time. Remember, there are many possible reasons that your playdate idea might be rejected! If unsuccessful at first, try again with a different family.

For an older child or teenager, help her brainstorm the activity and encourage her to ask peers herself, as those out of elementary school rarely have adults coordinate their get-togethers. If she’s nervous, role play with her until she feels more comfortable. Remember to rehearse staying calm and shrugging it off if the peer says no.

Keep playdates short and planned.
To help reduce the likelihood that kids will become bored with each other or get into an argument, first playdates should be short and sweet. Aim for two hours or less.

Inviting the child to your home with a vague plan to play can be a great choice once the friendship is established, but it’s not the best move for a first playdate. It might be hard for the kids to choose an activity, and the playdate could quickly become boring or contentious. Instead, choose a specific activity that you know both kids enjoy. Activities such as watching a specific movie or completing a craft project can take place in your home, while visiting a children’s museum or a zoo are good options for outings.

Have realistic expectations.
Summer programs can be a great way for your child to improve his social skills and make friends, but remember that summer vacation lasts only a few months. Celebrate small victories, such as a single successful get-together with a friend or even the exchange of social media usernames. If your child’s summer buddy doesn’t turn into a year-round pal, that’s okay. Even a short friendship is worthwhile if it helps your kid feel less lonely and learn new skills for the next friendship. There’s always next summer!

Does your child have social communication difficulties? The Child Study Center’s Social Learning Program offers a wide array of social skills group therapy services for children as young as 3 through young adults up to age 35. Groups are appropriate for individuals with social communication difficulties related to attention deficit hyperactivity disorder (ADHD), autism spectrum disorder, anxiety, depression, or other challenges. Both children and parents participate in separate weekly groups that run concurrently for 12-16 weeks. Clinical faculty and staff use evidence-based interventions based on research that shows positive long-term outcomes. For more information about our social skills group sessions in Manhattan, please contact our Social Learning Program intake team at 646-754-5284 or email csc.sociallearning@nyumc.org.

hassFrom the Real Experts at Hassenfeld Children’s Hospital at NYU Langone:

Arielle Walzer, MA, PsyM, is a psychology extern in Autism Spectrum Disorder service at the Child Study Center, part of Hassenfeld Children’s Hospital at NYU Langone. Rebecca Shalev, PhD, BCBA, is a clinical assistant professor in the Department of Child and Adolescent Psychiatry at NYU Langone.

Tips to Get Your Teen on a Regular—and Healthy—Sleep Schedule

teensleepI hear from many parents that they struggle to get their teens to go to bed at a reasonable hour. Consistent sleep schedules are difficult for teens because there are many environmental factors—including school schedules, homework, extracurricular activities, and jobs—that regularly force teens to adjust their schedule in an unnatural way. The biological clock or circadian rhythm of a teen is actually designed to shift toward a delayed schedule; that is, teens naturally want to go to bed late and wake up late.

We notice this circadian shift starting around puberty, and we think it happens for two main reasons.  First, teens are the strongest, fastest, have the best immune response, tolerate pain and extremes of temperature better than adults, and they are more likely to take risks (like put themselves in harm’s way).  As a result, teens and those in their early twenties (“adolescents” in today’s parlance) are the best suited to protect the cave and clan while others sleep.  So, the adolescents stay up until the wee hours, while the adults sleep.  The oldest among us then awaken early and relieve the young protectors, who can now go to sleep as the dawn is breaking and the threat of predators has considerably lessened.

Second, teens have reached puberty and so are ready, by evolutionary standards, to begin coupling and reproducing.  And so, they need time alone with other teens, without the watchful eyes of parents, to get to know one another, measure up, and decide who belongs with whom; there’s no better time for this than late at night when the parents are asleep.  For these two reasons, teens and young adults typically have a delayed sleep schedule.

While studies show that teens actually benefit from later high school and college start times—and the CDC actually has advised that high schools not start before 8:30AM—fewer than 20% of American schools adhere to this recommendation. If your family is struggling with getting your teenager on a consistent sleep schedule, here are some helpful tips:

Learn about sleep and teach your kids. There are many great books, and the data on getting more sleep is compelling. I teach a college class on sleep at NYU, and I’ve learned that young people really do want to understand their sleep and get better at it. I talk with my own kids about the effects of not getting enough sleep, from the physical to the neuropsychological. Things like immune system functioning, digestion, height, concentration, muscle growth, skin strength, decision-making, memory, anxiety and mood, and so many more factors all improve when you get a good night’s sleep. And on the flip side, illnesses, wrinkles, weight gain, exhaustion, and irritability are all side effects of not getting enough sleep.

Take away screens an hour before bed and limit their use. Screens are distracting and keep us awake. Remember, moms and dads, you own the phone.

Limit sleep-disrupting light exposure. Try eye masks and/or heavy curtains to keep the light out of their eyes while they sleep. Download apps like lux or use ‘nightshift’ on their smartphone so that the blue light that blocks melatonin is removed from their screens. Light is the most influential factor in setting our internal circadian clocks, so we want to control light and make sure that we live in dim light for about 3-4 hours before bed, at the least.

Keep the last few hours before bed calm. Try and do something that’s not stressful before bed, at least for the last 30 minutes. Don’t watch a thriller or action adventure movie before bed—it will jazz your kids up.  Instead, read something relaxing, watch something easy like the food channel, or do something else that eases your mind.

Figure out a schedule that allows for sufficient sleep. As parents, try to help schedule your children’s lives so that they can get sufficient sleep. Make sure homework gets done as early as possible. Make it clear to your kids that while school performance is important, they shouldn’t pressure themselves to stay up all night long to work or study. In fact, we know from lots of data that people remember and learn much better when they’ve slept 8-9 hours than when they sleep less. Students who get more sleep do better in school.

Start going to bed earlier yourself.
Parents are the role models—when we take sleep more seriously, our kids will as well.

hassFrom the Real Experts at Hassenfeld Children’s Hospital at NYU Langone:

Jess Shatkin, MD, MPH, is a professor in the Departments of Child & Adolescent Psychiatry and Pediatrics at the Child Study Center, part of Hassenfeld Children’s Hospital at NYU Langone. He also serves as the Vice Chair for Education in the Department of Child & Adolescent Psychiatry, and the Director of Undergraduate Studies for Child & Adolescent Mental Health Studies (CAMS) at NYU College of Arts & Science. He’s also the author of Born to Be Wild: Why Teens Take Risks, and How We Can Help Keep Them Safe.

Skin Deep: Understanding Body Dysmorphic Disorder

body

Body Dysmorphic Disorder (BDD) is a condition that affects more than 1 in 100 people.  Though it can appear in children as young as five, it often begins in teen years and continues into adulthood if it’s left untreated.  Unfortunately, many people with BDD are too ashamed to speak about it, leaving them without ever receiving support. If you’re a parent with concerns about your own child showing signs of body dysmorphic disorder, here are some important facts about this widely misunderstood yet common condition:

  1. BDD is not a typical concern about weight. Seeking weight loss and supermodel looks is far from unusual in our culture and prevalent in individuals with eating disorders.  However, individuals with BDD are convinced that one or more specific areas or aspects of their body are deformed or extremely flawed, despite looking normal to others.  People with BDD often fixate on the areas around their head, such as their nose, hair, or the skin on their face, but any aspect of the body can become a focus.  In one type of BDD called “muscle dysmorphia,” individuals believe that they look too small and continuously obsess about having a more muscular body.
  2. BDD is related to Obsessive Compulsive Disorder (OCD). Individuals with BDD spend hours each day obsessing about particular areas of their body and then engage in behaviors that are similar to compulsions in response to their concerns.  Their compulsions typically involve either frequently looking at or avoiding looking at an area of the body, repeatedly seeking reassurance from others about how they look, and/or getting multiple cosmetic procedures to try to correct the imagined flaw.  They may go to dermatologists and cosmetic surgeons often as they try to improve their appearance, however no procedure can address their psychological experience.
  3. BDD can affect anyone. Cases of BDD have been reported in children as young as 5 and adults as old as 80.  Although it occurs slightly more often in women, it is almost as common in men as it is in women.  BDD has also been found in people across different cultures and ethnicities.
  4. BDD can interrupt all aspects of a person’s life. Individuals with BDD may be so self-conscious about how they look that they completely avoid social interactions.  This may mean that they remain home and do not go to work or school.  Adults with BDD have a higher rate of unemployment than the general population.  They often have limited contact with friends and family.  When they are with others, they continue to be preoccupied with their perceived flaw.
  5. BDD takes a large emotional toll. Most people with BDD will also experience depression secondary to their body image concerns.  Many also experience thoughts of suicide and are between 6 to 23 times more likely to attempt suicide than the average person.  People will BDD also are more vulnerable to struggle with anxiety and substance use problems.  The high-likelihood of additional psychological concerns with BDD further highlight the need for these individuals to receive treatment.
  6. BDD is treatable.  People of all ages with BDD can benefit from Cognitive Behavioral Therapy (CBT).  However, as there are a number of complicating factors in BDD, such a suicidality, it is important to find a therapist with expertise in this condition.  In addition, serotonin reuptake inhibitors (SRIs) such as Prozac, have been found to be effective in treating BDD.  If your child is showing signs of BDD, you can ask your pediatrician about obtaining an evaluation by a mental health professional with expertise in this condition, who can help determine whether they require treatment.

hassFrom the Real Experts at Hassenfeld Children’s Hospital at NYU Langone:

Michelle Miller, PsyD, is a licensed psychologist and clinical assistant professor in the Department of Child and Adolescent Psychology at NYU Langone Health. She practices at the Child Study Center, part of Hassenfeld Children’s Hospital at NYU Langone, in the NYC and New Jersey locations.  Dr. Miller specializes in the treatment of body dysmorphic disorder, eating disorders, obsessive compulsive disorders, tic disorders, and selective mutism.

Rewarding Kids for Good Behavior: A Bad Idea? (Part 2 of 2)

Close Up Of Girl Eating Iced Donut

Two weeks ago, we began a two-part series that aims to provide information to parents about rewards and how to use them strategically and systematically to teach children skills and modify behaviors. Our first post discussed common parental concerns about rewarding kids for good behavior. This week’s will focus on how to use a reward system effectively.

1. Define the target behavior and set up attainable goals. This involves planning what behavior(s) you want to target over time and then defining the behavior so it is specific, observable, measurable, positively-stated, and attainable:

Specific and Observable:
Avoid using vague terms that cannot be measured such as “Behaving,” “Listening,” or “Being nice.” Instead try “Staying next to parent outside of home,” “Using kind words with brother and sister.” Make sure the target behavior can be observed directly by anyone observing including a parent, nanny, or sitter.

Measurable: The next step is to make sure the goals are measurable. Make sure to focus on behavior and to avoid using thoughts and feelings in the goal because these internal states can’t be quantified by an observer. Also, make sure your goal has parameters like a time of day, number of reminders, or quantifiable amount. For instance, “Completing homework accurately,” could be defined as “Completing homework with at least 75% accuracy.”

Positively-Stated: After goals are specific and observable, they should be reworded if needed to ensure they are positively-stated. Positively-stated goals tell a child what to do instead of what not to do. For example: “Using a big boy voice,” or “Using an appropriate tone of voice,” can be used instead of “Not whining.”

Attainable: 
It’s important to set the target so it’s an improvement over where your child started but not so hard that it’s impossible. You want to find the right balance so you don’t reward things they are already doing and also don’t make it so difficult that they lose interest and your chart starts to collect dust. Adding a set number of reminders or specifying a small timeframe can help make challenging goals more attainable. Then when a child is successful, parents can make the target harder, which shapes the goal closer to the parents’ desired outcome. For instance, a goal of “Keeping hands and feet to self with 2 or fewer reminders in the afternoon,” can be changed to “1 or fewer reminders” after a child is consistently successful with 2 reminders.

2. Select Appropriate Rewards. Once targets are set, parents need to establish rewards based on their child’s preferences. Parents should brainstorm privileges, activities, and tangible items that would be enjoyable for their child. Examples of privileges or activities are extra screen time, extra story time, a board game with a parent, a craft or activity with a parent, a later bedtime, or an outing. Tangible items can include stickers, small prizes in a grab bag or treasure chest, a special treat, or items a child wants such as Pokemon cards, Legos, downloading a song or game, or gift cards. Parents should make sure the reward is something the child does not already get for free, such as offering an additional 20 minutes of screen time when current screen time is unlimited. They will also want to make sure they are comfortable withholding the rewards if the child does not earn them. For instance, a parent who is trying to help a child make more friends may not want to use play-dates as a reward. In general, younger children and children who have trouble waiting respond best to daily rewards and older children can wait for larger rewards.

3. Preparing Your Child: It’s important to prepare your child in advance by discussing briefly during a calm time. In this discussion you would want to let your child know what he or she will be working on and why, review how rewards can be earned and what types of rewards will be provided. You will also want to get input from the child about rewards.

4. Starting the Program, Giving Feedback, and Monitoring Progress: Once you start the system, it’s important to monitor and give feedback consistently after every opportunity to earn. Feedback should be praise when your child meets the goal and neutral feedback when he or she does not. For instance, positive feedback could be, “Great job getting dressed on your own with only one reminder.  You earned something from your reward list.”  Alternatively, on a tougher day, feedback could be, “I had to give you three reminders to get dressed today so you didn’t earn your reward.  We’ll try again tomorrow.”  You could also help problem solve with your child any difficulties depending on their age and ability.  In addition to regular verbal feedback, formally tracking progress is important to assess the effects of the program and determine next steps.  Having a visual such as tokens, a marble jar, or a behavior chart with stars or stickers helps the child understand the system and their progress. Visuals also can be important cues to busy parents that remind them to use the system.  In addition to providing a visual cue, behavior charts are particularly helpful for tracking progress over time to help parents decide when to make the goal easier or harder.

5. Troubleshooting: A number of problems can come up with reward systems. It’s important to consider several causes if your child is not responding or was responding and then stopped. One possible problem is your child’s motivation. Consider whether they are motivated by the reward, if the reward is too far in the future, and if the reward is something they already get for free. Sometimes refreshing the reward menu periodically can significantly help motivation and prevent a child from getting bored of the system. For children who are hard to motivate, pay attention to how they are spending their free time and what they are asking for. Some children are very motivated by parent attention and respond best to individual time with a parent or parent-child activities.  If it’s not a motivation problem, parents should consider whether they are giving regular and clear feedback consistently and should take steps to improve consistency by using reminders on a phone and/or placing the chart in a visible area. For parents with children who argue about their behavior, parents should make sure their feedback is given right when they see a behavior, let their child know that parent decisions are final, and then ignore arguing consistently.

Behavior charts can be very effective in changing behavior over time when used correctly. If you’ve tried these steps without positive results, you may want to consider professional guidance.

hassFrom the Real Experts at Hassenfeld Children’s Hospital at NYU Langone:

Stephanie M. Wagner, PhD, is a licensed clinical psychologist and clinical assistant professor in the Department of Child and Adolescent Psychiatry at NYU Langone Health. She serves as the co-director of the Early Childhood Clinical Service at the Child Study Center, part of Hassenfeld Children’s Hospital at NYU Langone.

April is Autism Awareness Month

autismimageApril is Autism Awareness month as many organizations such as Autism Speaks and Autism Society promote awareness and acceptance of Autism Spectrum Disorder (ASD), which is the fastest growing developmental disorder and now affects about 1 in 68 children (according to Autism Science Foundation). Considering this prevalence, ASD likely affects a family you know or your child knows. This is why Kidz Central Station is committed to helping educate our parents and community about both the challenges and the joys of children with Autism.

The Quad Manhattan is a top NYC school for children with learning differences. Teachers and clinicians work with students both one-on-one and in small groups to allow kids to move at their own pace of learning. Quad Manhattan offers a six-week summer camp for children ages 5+. Enroll in a free open house to learn more.

Music for Autism hosts FREE concerts for kids with autism and their friends, family, and loved ones. The Kidz Central team attended the March event and came away with a new appreciation for music in a loving and interactive setting. Our kids especially enjoyed dancing and playing instruments along with the music, as well as the tasty snacks. Two April events are upcoming in Park Slope and Manhattan.

Our partner NYU Child Study Center, a part of Hassenfeld Children’s Hospital at NYU Langone, offers many well-researched and FREE webinars for our parents on a range of helpful topics, including strategies for helping kids with social anxiety, safety awareness for kids with ASD, medication management for ADHD, or dating with ASD.

Please join Kidz Central Station this month and throughout the year by promoting understanding and acceptance of all of our children! Take a class, participate in a walk, donate, educate yourself with a webinar, or just spend time with someone with Autism.

Rewarding Kids for Good Behavior: A Bad Idea? (Part 1 of 2)

Close Up Of Girl Eating Iced Donut


This is the first post of a two-part series that aims to provide information to parents about rewards and how to use them strategically and systematically to teach children skills and modify behaviors.

Most parents have found themselves uttering something to the extent of, “If you are good, I’ll buy you a piece of candy,” at one point or another.  Although rewarding appropriate behaviors can help modify behavior over time, parent concerns about rewarding and incorrect use of rewards often get in the way.

Frequently, parent concerns center on the principle of rewards. Common concerns along with considerations for these concerns include:

“I don’t want to reward my child for something he/she should be doing.” This concern often arises when there is a mismatch between parent expectations and the reality of child behavior. While this can happen for a number of reasons, parents ultimately have a choice here of accepting the behavior as is or working to change the behavior over time. For instance a parent whose 3 year old tantrums in stores when she is told no could simply accept the tantrums as the reality of shopping with a young child. However, most parents will be compelled to either try things in the moment that may make the behavior worse or avoid stores with the toddler, which does not teach the skill of staying calm and listening in these settings. Rewards used strategically can help turn a behavior that a child is not doing but “should be” into a routine habit.

“My child will become dependent on rewards.” This concern revolves around the idea that a child will need rewards in order to do anything and may even refuse tasks in absence of a reward. Here, it’s important to remember that rewards help facilitate skills and change habits over time. Once habits are formed, rewards are no longer necessary. Many parents have experience with this if they used small prizes for toilet training and can chuckle at the absurdity of giving their teenager M&Ms for using the potty. It is true that some children try to negotiate for rewards once they understand how rewards work. Negotiation can be reduced by having a clear and specific reward plan in place from the beginning.

“Rewards ruin a child’s intrinsic motivation.” This concern comes from research on rewarding and motivation. Findings from this research have fueled a backlash against incentive systems. When considering rewards for your child, it’s important to remember that there are more details to these studies that have been overlooked at times. Specifically, one of the major studies examined motivation for tasks that were enjoyable to participants before they were rewarded. If you are considering rewards for your child, there’s a good chance that your child does not find the task enjoyable and motivating on its own.

“Rewards are unnatural and not the way the world works.” Some parents worry that rewards do not prepare children for adulthood. While there are a number of examples of rewards in everyday life including working for a paycheck, another consideration here is that the use of rewards to form positive habits in childhood helps increase the likelihood of success in adulthood.

“Reward systems don’t work.” Parents will often say that they’ve tried rewards and they don’t work.

Stay tuned for our second post on rewarding kids for good behavior, which will discuss tips to help you use incentives effectively to address problem behaviors.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Stephanie M. Wagner, PhD, is a licensed clinical psychologist and clinical assistant professor in the Department of Child and Adolescent Psychiatry at NYU Langone Health. She serves as the co-director of the Early Childhood Clinical Service at the Child Study Center, part of Hassenfeld Children’s Hospital at NYU Langone.

How to Support Your Transgender or Gender Expansive Child

transGender is not as simple as boy or girl and is composed of many parts. A child’s sex assigned at birth is an assignment or classification given to an infant based on physical anatomy. Gender identity is an individual’s sense of being male, female, neither, both, or other genders. For many individuals, their sex assigned at birth and gender identity match (i.e. they are cisgender). For other individuals, sex assigned at birth and gender identity do not match (i.e. they are transgender or gender expansive).

Transgender and gender expansive youth face a number of challenges in the community due to stigma and discrimination. They are at high risk for mental health issues including suicidal thoughts, anxiety, and depression when they are not supported in their identities.

Here are some suggestions to help parents and caregivers best support their transgender and gender expansive youth. Regardless of where your family is on the gender journey, these ideas can help you provide the most supportive environment for your child.

1. Listen, validate, and accept: Parental acceptance is the single largest protective factor for transgender and gender expansive youth. Youth who have support from their families have similar mental health rates and diagnoses when compared to cisgender peers. Provide a space for your child to have open conversations. Ask open ended questions like: “How do you describe your gender?” or “What does gender mean to you?” Follow your child’s lead and provide a supportive stance. Use the name and pronouns that your child prefers.

2. Find support for your child (if needed): Your child might feel like they would like support from the community or from mental health providers, though it is certainly not required. If they do, look for clinicians who provide gender affirmative care. You might want to find a team of gender affirming providers including primary care, psychology, and endocrinology if your child is medically transitioning.

3. Require respect within the family and promote pride in your child’s gender identity: Always promote that family members and friends use preferred name and pronouns for your child. Celebrate your child’s identity and encourage others to do so.

4. Advocate: Transgender and gender expansive youth have a number of different challenges that they face on a day to day basis. For example, these children and teens might not know how to talk to their school about their preferred name and pronouns, what restroom to use, or how to correct someone who is misgendering them. Parents can play a huge role in helping advocate for their child by talking to the school administration or becoming more involved within the transgender community. Learn as much as you can through reading and take part in advocacy groups.

5. Find support for you: It is normal for parents to have their own emotional processes around their child coming out as transgender or gender expansive. It is important for parents to find their own support if they feel as though they are struggling with their own reactions. Parents can join support groups aimed towards parents or confide in friends and family.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Samantha Busa, PsyD, is a licensed psychologist and clinical assistant professor in the Department of Child and Adolescent Psychiatry at NYU Langone Health. She sees patients for evaluations, individual therapy, and group therapy as part of the Gender & Sexuality Service  at the Child Study Center, part of Hassenfeld Children’s Hospital at NYU Langone. She also conducts individual and group therapy for anxiety disorders, mood disorders, tics and Tourette disorder, trichotillomania and body-focused repetitive behaviors, and school refusal using cognitive behavioral therapy (CBT), dialectical behavioral therapy, and habit reversal training.