The Child Mind BlogBrainstorm
Mental Illness Affects 17 Million Under 18: CMI Children's Mental Health Report
May 5, 2015 Harry Kimball
Last night at the inaugural Change Maker Awards, the Child Mind Institute released its first annual Children's Mental Health Report. Founder and President Harold S. Koplewicz, MD, mentioned just a few of the findings:
• An estimated 17.1 million US children and adolescents now have, or have had in the past, a diagnosable psychiatric disorder
• Two thirds of children with a mental illness do not get treatment
• Anxiety is the most prevalent mental illness among children
• 80% of kids with an anxiety disorder don't get treatment
• The cost to society of untreated mental illness in young people is hundreds of billions of dollars a year
"These numbers defy the imagination," Dr. Koplewicz said. "They are unacceptable." But they do make it more clear what we can do to change things for the better. Dr. Koplewicz hit on three major takeaways. "Access to care is a huge problem," he said, "and public awareness is lacking." Furthermore, "we do far too little research into psychiatric disorders in kids, particularly in the youngest people, where intervening can be so transformative."
The report synthesizes the most reliable data available on the prevalence of mental illness in children and adolescents, the gap between the need and care, and the efficacy of treatment. All numbers include sourcing. The report attempts to gather what we know—but also call attention to what we don't.
Dr. Koplewicz pledged to continue producing the report annually in the hope that "it will raise awareness both of the magnitude of the problem and of the clear benefits of confronting it head on," including the "research dollars, training programs, and public education efforts we need to bring these kids out of the shadows."
But childhood mental illness is not just a public health problem—it's a very personal, family-based struggle, too. We want to assume that our kids are healthy, so sometimes we look the other way when there are signs of trouble, Dr. Koplewicz tells Web MD in an interview about the Children's Mental Health Report. "But this is really one of those times when looking the other way can be detrimental to the child."View Comments | Add Comment
Best Picture Books about Autism
April 20, 2015 Leigh Merryday
This is a guest post from Leigh Merryday, a teacher and librarian who blogs about early childhood autism at Flappiness Is... She tells us she has worked in middle school for 20 years and has seen the difference for autistic kids whose peers have had autism explained to them early.
A few weeks ago, I was asked if I might be willing to come in and talk to a group of kindergarteners about autism. Of course, this isn't just any group of kindergarteners. It's my autistic son's peers. So, I wanted a read aloud one or two books, and I wanted them to be good. Being a school librarian, I know that there are an awful lot of children's books out there. So, I asked the most qualified people I know—my readers—to offer their suggestions on my Facebook page. I got a lot of them.
I couldn't afford to buy them all, so I ordered several that seemed to fit the age group and read them all in one sitting. No, I didn't like all of them. I've included only the ones here I'm recommending. I don't find negative reviews useful to an audience of readers who already have limited time. I tend to shy away from the preachy ones, believing that children are much savvier readers (and listeners) than we give them credit for. And I like books that are a bit subtle and lend themselves to fruitful discussion. Because that's where you reach hearts and minds.
1. Looking after Louis by Lesley Ely, illustrated by Polly Dunbar
Looking after Louis is the story of a little boy, Louis, who is autistic and is a student in a regular elementary classroom. His friend, an unnamed little girl, narrates the story as she and her classmates try to understand Louis and some of his unusual behaviors. Louis repeats what others say. He colors pictures that others don't understand. He runs about through the children's soccer game. Though the children are sweet and generally accepting of Louis, they do begin to notice that Louis is allowed to do some things they aren't—and point it out. But then a moment comes along in which everyone recognizes Louis's effort to communicate something special to him. That leads another child to invite Louis to play with him, but it isn't recess. His teacher, understanding that this is a teachable moment, allows them to go outside with Louis's aide. The little girl at first resents what she views as special treatment, until her teachers gives her a moment to consider her opinion. Ultimately, she decides that sometimes it's okay to break rules and expectations for special people—thus supporting the idea of inclusion in the regular classroom. It's okay that some things are different for students who require it, but everyone can be friends.
I really liked this little story, mainly because the range of emotions for these children is honest. At times, they are encouraging of Louis. Sometimes, they are bewildered. And others they are a little resentful of what they view as unfair. However, because of their teacher's open and accepting handling of Louis, they learn about the true spirit of inclusion. This would make a great read aloud that could lead to a productive conversation about differences. Instead of telling, this book shows what a tolerant and welcoming classroom should look like—a point in its favor and one that distinguishes it from preachier special needs children's literature. Recommended.
2. Andy and His Yellow Frisbee by Mary Thompson
Andy and His Yellow Frisbee is the story of Sarah, a new girl at Andy and Rosie's school. Sarah has noticed Andy, who is autistic, each day at recess, spinning the same yellow Frisbee over and over. She decides to try to connect to Andy by inviting him to spin her pink Frisbee, which she has clearly brought from home in an effort to engage him. Andy's sister Rosie, playing soccer nearby, faithfully watches over him. She becomes concerned when she sees Sarah sit down next to Andy, knowing that others do not always understand him. She leaves the game and comes over to observe them, seeing Sarah's gentle effort to interact with Andy and her acceptance that perhaps he'll choose to do so on another day. Sarah and Rosie decide to play Frisbee together.
I loved this subtle story of acceptance, probably because Sarah reminds me of my daughter. Between Sarah's effort and Rose's calm but protective wait-and-see, this story gently conveys to typical children that there is no magic formula for interacting with someone who is autistic. What's important is to realize that effort does make a difference, even if there isn't an immediate reward. Andy did notice Sarah's Frisbee offering, though he continued to play by himself. Sarah's acceptance of that is beautiful and will serve as a model for typical students wanting to interact with their autistic peers, but unsure of how to do so. Andy and His Yellow Frisbee isn't what I would choose as a first read aloud when introducing the concept of autism to typical students, because its focus is narrower. But I think it's ideal as a follow-up later to reinforce lessons on differences and to help students learn to engage with their autistic peers. It is also a lovely story for protective siblings of children on the spectrum. Recommended.
3. Ian's Walk: A Story about Autism by Laurie Lears, illustrated by Karen Ritz
Ian's Walk is the story of siblings Julie, Tara, and Ian—who is autistic—and their walk to the park. Julie initially doesn't want Ian to tag along, but gives in when he whines. Her mother admonishes Julie that she must be sure to keep a close eye on Ian. As they head out on their walk, Julie observes the different ways that Ian hears, sees, smells, and feels things. Even though she makes these observations, she finds herself frustrated with the inconveniences of Ian's differences and loses her patience. When the girls stop to get pizza, Tara reminds Julie to watch Ian. But Julie is distracted and suddenly realizes that Ian has disappeared. The sisters race about, frantic to find their vulnerable little brother. Then Julie focuses and decides to think and experience their surroundings like Ian—where would he be? Sure enough, that's how she finds him, making the big bell at the park gong back and forth. Julie is so grateful he is safe that she now has a new perspective on their walk back. This time, she allows Ian to enjoy the walk as he wants to experience it, allowing him to stop and immerse himself in the sights, smells, and sensations he loves.
Ian's Walk is a beautiful story with a simple plot, but one that conveys the complex sibling relationships inherent in special needs families. It's an obvious story to share with siblings of autistic and special needs children (or even in support groups for such). But because the story also describes so well many aspects of autism and sensory integration disorder, it would also be a great introductory read aloud for the topic. My 7-year-old loved this story and recognized both her brother in the story as well as her own emotions in it. Recommended.
4. My Friend with Autism, Enhanced Edition with CD by Beverly Bishop, illustrated by Craig Bishop
My Friend with Autism isn't a story so much as a narration by a peer, who tells readers about his friend, who is autistic. It begins with an explanation of all the things his friend is good at—hearing, seeing, touching, tasting, being smart, etc. For each thing his friend is good at comes an explanation of how that affects the friend (examples: extra-sensitive ears that hear before others but cause him to sometimes cover his ears). This part is a positive outlook on autism, but matter-of-fact. There is a shift about halfway through when the narrator explains that—while his friend is good at many things—there are some things that are difficult (talking, understanding feelings, sharing, etc.) What's good about this part is how the narrator makes suggestions of what can be done to help the friend when these things occur.
My Friend with Autism is a practical and positive introduction to autism for typical students. It treats autism as something children shouldn't worry about and conveys to them that they really can be friends with their autistic classmates. This enhanced edition comes with a guide for adults that includes factual information about autism as well as tips for working with children on the spectrum. The CD includes coloring sheets of pages from the book for children to enjoy after the read aloud. I would suggest this book as a first read aloud for an inclusion classroom to be followed by one or more of the other stories in this list.
Leigh Merryday is a teacher and librarian who blogs at Flappiness Is... about navigating the world of early childhood autism. She has a daughter with ADHD and a son who is autistic. You can also follow her on Twitter, where she recently tweeted that her son just spoke his first complete sentence.View Comments | Add Comment
Study Shows Many Doctors Stalled Autism Diagnoses
April 20, 2015 Beth Arky
New analysis of a national 2011 survey showing that many healthcare providers were mistakenly dismissing parents' early concerns that their children might be on the autism spectrum comes as no surprise to moms and dads of kids who went on to receive an ASD diagnosis.
The results, published in the Journal of Pediatrics, also found that parents of autistic children were more likely to have their first concerns dismissed than were parents of children with other developmental delays, including intellectual disability. Autism is now diagnosed at a rate of 1 in 68 children in the United States.
On average, parents reported first raising concerns about possible signs of autism when their children were around 2 years old. Meanwhile, the average age of an autism diagnosis was close to age 5.
Parents on Autism Speaks' Facebook page reported that they were often told that "boys speak late" or that their child wanted to cuddle too much or had too much eye contact to be on the spectrum, leading to a lack of early interventions such as educational, behavioral, speech, occupational, and physical therapies that have been shown to improve outcomes in autistic children.
One mother on AS's Facebook page put it this way: "I was one of those parents. I pushed and got a new Doctor. If I listened to the first doctor my son would not have gotten the early intervention treatments and he wouldn't be where he is now. Go with your gut as a parent, you know your kids better than any professionals out there."
We hope that with better, earlier screening tools that have been developed in the ensuing years, fewer autistic children are now being allowed to slip through the cracks.View Comments | Add Comment
Mental and Physical Health Care: Equal Under Law, Still Separate
April 7, 2015 Harry Kimball
A report from the National Alliance of Mental Illness casts a pall on the dream of mental health parity—the federally legislated mandate that insurers reimburse mental health care providers at the same rate as those health professionals who treat physical illness. A key NAMI finding (based on a survey of consumers) is that insurance companies deny mental health claims twice as often as they do physical illness claims, based on questions about "medical necessity."
From NPR: "Basically, they look at someone's care and ask is it really medically necessary. And advocates say they're applying those sorts of cost-control techniques way more stringently on the mental health side and the substance abuse side than they are on the physical health side."
However, according to NAMI, there is no reason to think that the "medical necessity" of mental health care should be any different from physical care. The Mental Health Parity and Addiction Equity Act was intended to erase this disconnect. As the NAMI report says, "the reasonable expectation is that reported denials of care for mental health, substance use, and medical care would be roughly equal."
Not so. The survey shows that 29% of families "had been denied mental health care on the basis of medical necessity, more than twice the percentage who reported being denied general medical care."
The law (or the difficulty enforcing it) is not all to blame for the poor state of mental health care in the United States, NAMI admits. There aren't enough professionals; the ones we have are understandably wary of working with stingy insurance companies; and the lack of a robust mental health system means that many needy children and families go unrecognized.
But for the families who do reach a professional, we hope we can do better than turning them away because treating a mental illness isn't a "medical necessity."View Comments | Add Comment
Why It's So Hard to Say Yes to Help
March 31, 2015 Danielle Veith
This is a guest post from Danielle Veith, who blogs about staying sane while raising kids at Crazy Like a Mom.
For new parents, one of the best things ever invented is the date-night-swap.
My husband and I discovered this when our daughter was two, swapping nights out with the parents of our daughter's closest friend. My preferred trade was when it all happened in the same weekend: "I'll watch your daughter while you go out on Friday night and you'll watch mine while we go out on Saturday night."
Parents save money on hiring a sitter, get to spend time together and the kids get to see each other two days in a row. Win-win-win. I liked when it was clean and neat and we were all even at the end of the weekend.
When it wasn't all wrapped up in a weekend, I was less fond of the arrangement. I hated feeling like I owed someone. Or worse, like someone owed me (who wants to feel both slighted and petty?).
Then, something happened that changed everything.
A few months after our son was born, my husband had a procedure that meant he couldn't pick up anything more than 10 pounds for two weeks. Which meant the daily kid-rearing duties were all on me. And taking care of my husband. And the nighttime parenting. My son had never been a great sleeper, but at that age, he was waking up six times a night. All on me.
I tried to do everything—for the kids, for my husband—and am usually at my best when this kind of rallying is needed. That lasted about two weeks. Then I crashed. I was so tired, I could not function. My arms were so weak, I could hardly lift my heavy little boy and was afraid of carrying him up and down the stairs. I hid in the kitchen and cried a lot.
I stink at asking for help. At least I used to. When we had our second baby, someone gave me the best-advice-ever: "If someone offers help, don't say no." I made a vow to follow it, no matter how hard. Many times, I even had to say aloud, "I'm only saying yes, because I promised myself I won't say no to help."
So, when my daughter's preschool offered to organize other families to bring dinners while my husband recovered, I said yes. When they let us out of our fundraising obligation, which would be taken on by other families, we said no at first. We could manage. Their response was amazing, "Even if you think you could do it, it's more important to spend time together as a family at a time like this." So, we said yes. And thank you.
Then I told my friends we were having a really hard time. I swear to you that moms came out of the woodwork.
There were dinners, playdates, help with bedtime, grocery shopping, offers to pick up whatever we needed from Target. A friend came over and gave me a massage. My best mom friends moved a moms' night out to my living room floor, because I couldn't leave the kids alone, even after bedtime, with a husband who couldn't pick them up if they cried. They helped with bathtime and even read my kids bedtime stories.
It was amazing. And humbling. And I had to say yes. I needed help.
For a while, I couldn't envision ever being able to function on my own again. To take care of my kids, to make meals, do laundry, it all seemed quite unbearable. Life felt so overwhelming that the idea that I would ever me able to manage my day-to-day and also help someone else was unimaginable.
So, I said yes. I accepted help from people knowing I couldn't return the favor. I had never been in that position before. I owed people, and I couldn't repay.
And it's all that got me through. Impossibly, somehow that time passed. Life isn't like that now. Honestly, I wasn't sure I'd make it. I did, but not on my own.
So now, it's different. Every time I can make someone dinner, take someone's kid for an afternoon, offer whatever help is needed, I say yes. It's not as if I never made dinner for a new mom or helped out when a friend was sick, but it's not the same as before. I want to help in ways that will never be repaid.
It's really just a basic way that communities function, but it was all new to me. I'd never lived in one place very long or attended church or any of those things that give people a community.
Of course, I'd heard all the "It takes a village" talk, but suddenly I knew what it felt like to have a village, to be a village.
I'm not saying I suddenly turned into Mother Theresa, but I did stop counting. No one owes me a thing.
Danielle Veith is a poet and writer who blogs at Crazy Like a Mom about staying sane while raising kids. She lives with her two small children and husband in the Washington DC area.View Comments | Add Comment
Demi Lovato Does It Again
March 20, 2015 Caroline Miller
In the past we've admired the way Demi Lovato has talked openly about her struggles with addiction, bulimia, and cutting. When the singer and former Disney star went into treatment in 2010, she was diagnosed with bipolar disorder, and she went public about that, too. This week she celebrated 3 years of sobriety and did it in a spectacular way—with a benefit concert in Los Angeles for her scholarship fund to help people get care for mental illness.
Lovato has courage to match her big voice and killer smile, and the support she extends to other young women who are struggling is priceless.
And there's more: To celebrate her 3-year milestone, Lovato and her boyfriend Wilmer Valderrama exchanged romantic Instagram posts. Hers read:
I wish I could put into words how grateful I am for this man right here. But my love has grown to a level that words could never possibly express how much this man completes me. He's loved me the way I never thought I deserved to be loved and with this day marking my 3rd year sober. After sharing my ups, putting up with my downs and supporting my recovery... he still never takes credit and I want the world to know how incredible his soul is. I really wouldn't be alive today without him. I love you Wilmer.
Lovato is only 22 years old, but she already understands that no one survives these challenges alone. She's needed help—everyone needs help—and the empathy and support she's gotten has been critical in her recovery. Maybe that's why she's been so generous about extending a hand to other people who are struggling.View Comments | Add Comment
Depression in Comics
March 17, 2015 Beth Arky
There is nothing funny about depression, but comics are a uniquely effective way to communicate what depression feels like. Proof can be found in this BuzzFeed post featuring 21 comics that capture the frustration and real pain the disorder brings to adults, children, and teens.
While the majority of the cartoons cover depression in a general sense—the way it's poo-poo'd as if it weren't a "real" disease, the loss of interest in things one once enjoyed, the struggle to just get out of bed, let alone function—a couple focus directly on what it's like to be depressed as a young person.
One comic, about the difficulties of trying to share your feelings with family by Moose Kleenex, shows a teen trying to open up by saying, "I'm feeling depressed lately..." to which her mom responds, "Oh don't be silly. You have everything in the world going for you," effectively shutting down her child. A week later, the picture is entirely different. As the kid stares out the car window, listless and disengaged, the now worried-looking parent asks, "How come you don't tell me anything?"
In another, about the struggles of being a student dealing with depression by Paralanalysis, the character says, "I found it so very stressful when depression made it difficult to go to school.... The experience was quite jarring for me, because I had always been a bit of a teacher's pet. But I fear there are thousands who felt a little like I did. Who don't turn in essays...not because they want to misbehave...but because it is taking all of their strength not to run and cry."
These eloquent cartoons speak volumes as to the importance of keeping the lines of communication open with kids about their feelings—and taking these feelings seriously.
Read more about how to help depressed teenagers here.View Comments | Add Comment
Stop Worrying About Those College Rejection Letters
March 16, 2015 Caroline Miller
New York Times columnist Frank Bruni has written a terrific piece on the experience millions of high school seniors are about to have in the next few weeks: being rejected by their first choice colleges. And sometimes their second, third, and fourth.
It's a particularly good column because Bruni nails how brutal the experience can feel to these kids, and yet how being forced to depart from the script they had imagined for the next chapter of their lives can actually help them thrive.
For one thing, being in a somewhat less competitive and entitled atmosphere can enable them to develop more confidence and enterprise. There can be an advantage to being around kids not, to use his rather delicate phrase, "as showily gifted."
For another thing, the experience of rejection itself can turn out to be surprisingly liberating. He quotes one student who said she felt "worthless" after her top five schools turned her down. But she discovered that rejection, like a lot of pain, was fleeting. And once she found her footing at her fallback school, she had lost the fear of rejection that holds so many of us back.
"As a result, she told Bruni, "I applied for things fearlessly." This young woman went on to be accepted into Teach for America and recently launched a new charter school. "I never would have had the strength, drive or fearlessness to take such a risk if I hadn't been rejected so intensely before," she said. "There's a beauty to that kind of rejection, because it allows you to find the strength within."
Bruni argues that rejection can help kids develop grit—that quality of perseverance and resourcefulness that has been linked to success in life, not just in school. But he's also arguing that that it's a fallacy that elite schools are the fast track (or the only track) to a rewarding and successful life. It may come from our worship of brands, or our tendency to measure our own worth by our kids' achievements. But it does our kids a disservice to make them think their lives hinge on this particular lottery.
Bruni urges parents to let kids know, before the rejections and acceptances roll in, that they won't be a measure of their worth or their future potential.
Read more about how to help kids deal with rejection.View Comments | Add Comment
#TheDress and Autism
Feb. 27, 2015 Rachel Ehmke
The thing everyone and their mother was talking about on Thursday (besides the escaped llamas) was the dress. You know the one. At first I thought it was whitish/goldish, but then I decided it was probably blueish/blackish after all. I hear Taylor Swift and Kanye agree. Wired has posted a scientific explanation of the controversy, which has to do with how we interpret light and color. They also give what they say is a definitive answer.
The cool thing about the dress, and what made it the enigmatic Mona Lisa of the week, wasn't the dress itself but how we each interpreted it. It was a very effective reminder that we all can be stumped by our senses at times, and we are all capable of experiencing the same things very differently. Which is nothing new to those who think a lot about sensory processing and autism.
Emily Willingham, a science writer we admire, thought the controversy was pretty familiar. She posted to Twitter:
Ari Ne'eman, president of the Autistic Self Advocacy Network, agreed. Ne'eman said Dressgate is "a really good way of acknowledging that people see things differently, perceive things differently, and one way is not necessarily superior to the other." Which is an unexpected—and welcome—revelation to come out of the latest internet craze.View Comments | Add Comment
New York's First Lady Gets Real About Mental Health
Feb. 27, 2015 Caroline Miller
Chirlane McCray is one of the things New Yorkers liked about Bill DeBlasio when they elected him mayor of New York City in 2013. The family made such an unforgettable picture—the very tall white guy with the very short black wife and two quite colorful children. Bill and Chirlane seemed like real people who were comfortable being different and letting their kids be different.
Of course Bill and Chirlane also had a record of being fierce and fearless advocates. And we're thrilled that Chirlane has decided to use her role as New York's first lady to focus on mental health. She's speaking out about, and collecting data about, the disturbing number of New Yorkers who don't have access to good mental health care. And she's being real about it: She published a piece today in the New York Daily News in which she writes about her struggles to find the right care for their daughter Chiara, who has struggled with anxiety, depression, and addiction.
Like so many parents we hear from, she found it daunting to understand what Chiara needed and to respond effectively. "Our child was in terrible pain, but because it originated in her brain and not another part of her body, there wasn't an established series of steps to follow."
The DeBlasio family is lucky, she notes, because they had the resources to get good treatment for Chiara, who she reports is doing well in recovery. But she hasn't forgotten what it was like:
Even after our crisis ended, I couldn't forget how scared and helpless I felt during those first frantic weeks. So I continued my research, wanting to understand how other people manage in these situations, especially those who don't have the same advantages as us.
Read the rest of her piece to see what she learned, and what she plans to do to help New York City develop a more inclusive system—one that acknowledges the very real obstacles that prevent people from getting care. As she puts it, "When I say a 'more inclusive' system, I mean one that meets—and treats —people where they live."View Comments | Add Comment