1. Mental Health issues in Children COMMON DIAGNOSIS’ AND CLASSROOM INTERVENTIONS

2. Stigma  How many of you would feel comfortable talking about a health condition such as diabetes with your colleagues?  How many of you would feel comfortable talking about a mental illness? Your child’s mental illness?

3. Mental HEALTH  Mental health is a continuum from healthy to unhealthy, and problematic behaviours are not ‘proof’ that a student has a mental health disorder. *environmental factors can lead to what we see as “dysfunctional/problematic” behavior.

4. What causes child and youth mental health problems? Mental health problems are believed to result from a combination of factors :  Problems in the brain’s ‘wiring’ process during early development  genetic influences  chemical imbalances  Brain trauma  severe life stress

5. How common are child and youth mental health problems?  In a classroom of 30 students, about 5 to 6 students will be facing a mental health problem  3 to 4 of them will have a problem that interferes with their daily life Ontario Child Health Study, 1985, Waddell and Shepperd, 2002

6. What are the most common Mental Health Issues in Children and youth?  ADHD  Anxiety  Depression  ODD and CD  Other disorders in children: Autism Spectrum Disorders Tourettes

7. Consider 3 things if you are concerned that one of your students may be struggling with a mental health problem: Frequency: how often does the student exhibit the behaviours of concern? Duration: how long do they last? Intensity: to what extent do the behaviours interfere with the child’s activities? Also consider if the behavior of concern is not typical for that child.

8. OCD & Anxiety Disorders: Crash Course Psychology #29 https://www.youtube.com/wat ch?v=aX7jnVXXG5o

9. Mental Health Disorders  Diagnosis of Mental Health Disorders require assessment by Mental Health Professionals and/or physicians  Diagnosis is based on symptoms and assessment tools  frequency, duration, intensity of observable and reported symptoms are used in making a diagnosis

10. Anxiety  Roughly 6% of children and youth have an anxiety disorder that is serious enough to require treatment DSM-5 Anxiety Disorders  Separation Anxiety Disorder  Selective Mutism  Specific Phobia  Social Anxiety Disorder (Social Phobia)  Panic Disorder  Panic Attack (Specifier)  Agoraphobia  Generalized Anxiety Disorder  Substance/Medication-Induced Anxiety Disorder

11. DSM V Disorders Obsessive-Compulsive & Related Disorders Obsessive-Compulsive Disorder Body Dysmorphic Disorder Hoarding Disorder Trichotillomania (Hair-Pulling Disorder) Excoriation (Skin-Picking) Disorder Substance/Medication-Induced Obsessive-Compulsive and Related Disorder Obsessive-Compulsive and Related Disorder Due to Another Medical Condition

12. DSM V Trauma- and Stressor-Related Disorders Reactive Attachment Disorder Disinhibited Social Engagement Disorder Posttraumatic Stress Disorder Acute Stress Disorder Adjustment Disorders Other Specified Trauma- and Stressor-Related Disorder Unspecified Trauma- and Stressor-Related Disorder

13. What you may see in the classroom: common signs a child may be struggling with anxiety  Extreme need for reassurance  Somatic complaints (headaches, stomach aches)  Avoidance of stressful situations (tests, public speaking)  Refusal/severe reluctance to participate in eating or dressing in public  Leaving without any notice

14. Common Signs con’t Avoidance of school, locations in school, or of certain people Persistent perfectionism – schoolwork erased and rewritten many times Repeating rituals Working exceedingly slowly to feel it has been done properly Frequent absences Easily frustrated Decline in grades or unable to work to expectations

15. Strategies to support students  Educational programs for children with mental health challenges need to include attention to developing social skills, increasing self-awareness (mindsight), self-control, and self esteem in order to succeed academically.  mental health problems often interfere with developing these skills at the same pace as other students.

16. Classroom Strategies  Be mindful that reassurance alone may not  be enough to resolve the anxiety  Establish down-to-earth expectations  Encourage physical exercise and relaxation

17. The Importance of Downtime  https://www.youtube.com/watch?v=iaaOm0Gpk1o https://www.youtube.com/watch?v=iaaOm0Gpk1o

18. Strategies con’t  Check in with the student at the beginning of each day  Create a ‘things to do’ checklist  Encourage the use of a study schedule  Provide brief, clear, explicit directions  Create a ‘coping’ book  Gradual desensitization – small steps – start where the student experiences no anxiety

19. Strategies  Do not force the student to speak in front of the class  Provide options (small group, multimedia)  Reassure the student that he/she is not alone in feeling embarrassed  Pair the student up with ‘friendly’ classmates  Help the student identify symptom onset  Permit the student to leave the classroom if a panic attack occurs; set a time for return (5-10 minutes )

20. Model calm behaviour Use humour Try not to respond to the student’s obsessive need for reassurance Do not criticize obsessive behaviours

22. Supporting Children with Anxiety  Slow steps are absolutely the key to sustaining progress  avoid ‘buying into’ the anxiety, but on the other hand, don’t push too hard  Reward brave, nonanxious behaviour: Catch them being brave doing something they normally wouldn’t, acknowledge it  Label the action as fighting fear

23. Supporting con’t  Recognize small improvements  Modify your expectations at stressful times  Give advance warnings  acknowledge mistakes as a natural part of learning

24. Supports con’t  By avoiding feared situations, children learn they are not able to cope with the situation or their worry. Encourage them to take little steps toward accomplishing the feared task.  Check-in with student at the beginning of the day.  Learn what situations the student can handle and how you can respond when they are unable to cope.  For school refusal, formulate a plan for when the student first arrives at school, such as providing an immediate reward for coming.

25. Supporting con’t  Have the student check with the teacher or have the teacher check with the student to make sure that assignments have been written down correctly.  Reduce school work load or homework when necessary.  Keep as much of the child’s regular schedule as possible.  To prevent absences consider modifying the child’s class schedule or reducing the time spent at school.  Ask your student’s parents what works at home to relieve their child’s anxiety.  Recognize and reward small improvements; e.g., finishing a task on time without continual erasing to make it perfect.  Provide a learning environment where mistakes are viewed as a natural part of the learning process.  Encourage and reward all positive steps in fighting anxiety.  Provide advance warning of changes in routine.

26. Self- Awareness

27. The Amygdala Highjack Https://www.youtube.com/watch?v=Lr-T6NAV5V4&index=4&list=PLNbC- DkqGJda0Ra5ha5WSL2UG6JSb19I4

28. Impulsivity

29. DSM V Depressive Disorders Disruptive Mood Dysregulation Disorder Major Depressive Disorder, Single and Recurrent Episodes Persistent Depressive Disorder (Dysthymia) Premenstrual Dysphoric Disorder Substance/Medication-Induced Depressive Disorder

30. How common are mood problems?  Roughly 3.5% of children and youth have an mood disorder that is serious enough to require treatment

31. Mood Problems The most common mood problem (affective disorder) is depression Even very small children can experience depression, although the way they express the feeling may not be the same as an adult

32.  Very young children show that they are depressed by the way they behave  They may not be able to tell people how they feel  Instead, they will say they have a stomachache, a headache, or other aches and pains

33. What causes depression? https://www.youtube.com/watch?v=InNhDfDfl 5c

34. What to look for  Children and adolescents who are depressed may seem as though they are not paying attention in class  They may seem like they are ignoring what people say  In the classroom they may appear sad or withdrawn  They may avoid other students at break, and in the  playground  They may complain of feeling tired, or of not having any energy  If combined with other behaviours, like feeling sad all the time, crying easily, or out of character aggression is often a symptom of depression  Other symptoms of depression: include irritability and loss of interest in activities the child used to enjoy (like sports or going out with friends) and changes in sleep and/or appetite

35. What causes mood problems?  Symptoms of depression in children and adolescents can be related to a number of things. It can be triggered by a sad or painful event like a death in the family.  It can develop in children who observe constant fighting between their parents.  It can also result from the child experiencing parental neglect or abuse.  However, being prone to more serious kinds of mood problems also is passed along genetically.  The combination of a genetic pre-disposition and a triggering event may bring about the depression

37. Supporting Students with Mood Disorders  Eliminate less important work until the student is in recovery  Make positive statements that reflect his/her own past successes  Make a special contact with the student each day, maybe a specific greeting at the door  followed by a question about something that has been of interest to the student  Give more time, break assignments into smaller pieces, offer extra help in setting up schedules or study habits, or pair the student with others who express an interest in helping  Depression impairs students’ ability to learn and concentrate. They may work more slowly than other students. Shorten assignments or allow more time for them to be completed

38.  Children and adolescents who are depressed are more sensitive to criticism.  Corrections should be put in the context of a lot of praise and support.  Depressed students often feel as if they have little to contribute.  It is helpful to show confidence, respect, and faith in the student’s abilities.  Ask open-ended questions in class for which there is no clearly correct answer. These kinds of questions minimize any chances for embarrassment.

39. Understanding the Biology of Mental Illness  https://www.youtube.com/watch?v=LLUoG9Se77 w https://www.youtube.com/watch?v=LLUoG9Se77 w

40.  Despite mental health problems affecting one in five young people, less that 15% of those young people with mental health problems ever receive any help.  Many parents and young people say that stigma about mental health problems is the main reason they don’t seek help.

41. Sites and Resources  http://www.kidsmentalhealth.ca/parents/resources_parents.php http://www.kidsmentalhealth.ca/parents/resources_parents.php  http://www.anxietybc.com/resources/generalized.php http://www.anxietybc.com/resources/generalized.php  http://youth.anxietybc.com/anxiety-101 http://youth.anxietybc.com/anxiety-101  National Institute of Mental Health National Institute of Mental Health http://www.nimh.nih.gov/index.shtml  Positive Mental Health Toolkit: Positive Mental Health Toolkit: http://www.gov.pe.ca/photos/original/eecd_pmhtoolkit.pdf

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