Sunday, October 4, 2009

From ASQ to ABCs

Recently, I met up with the good docs at Descanso Pediatrics in La Canada, CA.

In addition to sharing about what I do in my work with young children and families, which focuses primarily on social and emotional development, I asked them about ways they help to make sure the infants and toddlers who come to them are on a healthy developmental path.

One of their answers? Three little letters: ASQ.

ASQ, or the Ages and Stages Questionnaire, is something I use regularly as well. It is an excellent developmental screening tool broken down by age, from 1 to 66-months.

By asking parents a number of questions (which only takes 10-15 minutes to answer), the ASQ allows us to see how a child is doing within a number of areas: communication, gross motor, fine motor, problem solving, and personal-social.

Why is it so crucial to do regular developmental screenings for your child?

High-quality tools such as the ASQ enable us to catch and address problems or delays early. The sooner your child gets further evaluation and any needed extra support and services, the sooner he or she can get back to where he should be.

Remember, every child is different and normal development happens within a range.

To ensure that your young child reaches his or her potential now and moving forward toward learning his ABCs, developmental screenings are essential.

Saturday, October 3, 2009

A Success Story (So Far)

School is well underway now (though it feels like my last post was just written a few days ago). Whether it's preschool or first grade, many kids out there are enjoying success in the classroom, thanks to awesome teachers, teacher's aides, caregivers and most of all -- parents.

Pasadena parents Jackson and Elizabeth are a great example. They prepared their seven year-old son (who tends to be very anxious and dislike change) to enter a Mandarin-immersion class at a brand new school last month. They did this by spending time during the summer talking to him often about it. They were also able to take him by the school beforehand to meet the teacher. In talking to other parents in the neighborhood, they discovered that another child down the street from them would be in the same class too.

Sammy arrived on his first day filled with encouraging words from his parents and knowing what to expect, including who his teacher was. Plus, he had a buddy from the neighborhood! The latest word is that so far, he is learning up a storm and really enjoying the new class and school.

It's wonderful to hear good things like this from parents. It goes to show that when parents prepare their kids for major changes, the pay-off is big. Kids feel more confident and move that much closer to achieving their highest potential.

p.s. I actually wrote about Sammy getting ready to go to school not too long ago at, so check it out!

Friday, August 7, 2009

Get Ready for School Success!

It feels like summer has just gotten going.

But, the calendar says differently. Unbelievably, it’s August already, which means the new school year is nearly upon us. For parents of school-age kids, this is the perfect time not only to get new backpacks, pencils, and notebooks. It’s also a good time to reconsider any concerns you might have about your child’s ability to learn and do well in school.

Evaluation for issues that may be keeping your child from reaching his or her full academic potential is called psychoeducational testing. Our friends at The K5 give a good explanation of what this is. To avoid re-inventing the wheel, we'll let their school psychologist, J. David Carr, tell you more:

In many school districts, psychoeducational testing is done to determine whether a child needs to have an Individualized Education Plan, or IEP. In my local area, parents also have the right to seek out a second opinion – at the school district’s cost. This means that if you are dissatisfied with the school’s testing or IEP results, you may seek out additional psychoeducational testing from a psychologist on your own. To find out more about this, you may contact your local school district.

A great resource for parents in Southern California who want additional (or first time) psychological/educational testing for their child, is Dr. Paula Bruce, who has a great deal of experience, expertise, and is just terrific to work with.

Remember: Identifying and understanding how your child best learns and where he or she needs additional support is one of the best ways to get ready for school success!

Sunday, June 21, 2009

So, What's the Plan?

The first time I met three-year-old James, he tumbled into the playroom, a ball of energy and a huge smile on his face. Without seeming to look where he was going (even though his eyes and head were facing forward), he hurried toward something enticing and promptly fell flat on his face.

Just as promptly, he bounded up, like a real-boy version of Tigger.

James is a boy who (as you already know) doesn't really look where he's going, whether he's walking ahead of you or running across the yard. He's easily distracted. While holding one toy, he will see another and hurl himself toward it so that he can grab it as fast as he can. He loves to jump on furniture, swing, and slap down hard that piece of multi-colored Play Doh.

It's never a dull moment with James around, which can be frustrating for his parents. And, unless we help him now, he will have a difficult time in pre-K and Kindergarten. He may become labeled as that boy who never follows directions or that kid who causes disruptions. Saddest of all, he will likely have a hard time learning.

One of the best ways to help a child like James think a moment ahead (like where he is walking) or to stay on task, is to make a plan.

"So what's the plan?" is a great question to ask. A plan needs to have steps, three maybe even four, and should be clarified at the beginning of an activity.

For example, today we're going to make pizza. 1. First we roll out the dough. 2. Second, we put the sauce. 3. Third, we put on the cheese. 4. Then we put it in the oven and wait!

If your little one forgets a step or jumps ahead, remind him again of what the steps were. "Hey! You jumped ahead. That's not step 2! What is step 2?"

If he has a hard time waiting, remind him that you're right there with him. It doesn't hurt to empathize, either: "I know, I know! It's so hard to wait, isn't it? So let's wait together."

Making and following a plan can be fun when you do it together. And, it sure makes staying on track a lot easier.

Saturday, June 13, 2009

The Hard Stuff

One of the most common questions I get from parents is how to talk to their children about difficult things. These are things that make mommy and daddy so uneasy that they often want to do it in the therapy setting with the support of a professional like me.

I call it talking about "the hard stuff." This may include parents having to tell their child about mommy and daddy's separation, divorce, or the loss of a loved one.

Although you might find it hard, you don't necessarily need a therapist to help you talk about the hard stuff with your child. With the right tools, it's possible to navigate the waters just fine.

Tools you will need: Some quiet time without distractions, the willingness to be honest with your child, wording that fits the child's age, and a loving and supportive attitude.

I've found that kids have an uncanny ability to know that something is going on before they receive an actual explanation from an adult. They are constantly reading our expressions and picking up on other cues that we don't realize we are putting out to the world.

This means that talking to your child directly about daddy moving out or the reason why grandma stopped visiting may come as a big relief rather than as something frightening or scary.

Using words that are age-appropriate is important too. A four or five year old who may not yet understand the concept of time will not grasp a wordy, abstract explanation of death. He will, instead, understand something more concrete, such as, "She died because her body was broken...And we will miss her so much."

Once the truth is out, you can also begin preparing your child for the next step, whether it's moving to a new house, getting used to seeing a parent only on the weekends, or saying goodbye to someone they loved very, very much.

Friday, June 12, 2009

How to Deal with Aggressiveness In Young Children

A parent came to me this week concerned about her fifteen-month-old child being aggressive in daycare. Anxious and upset, this mom shared that she was worried that her daughter would be expelled.

Biting, kicking, pushing, hitting...These are behaviors that most parents don't want to see their kids engaging in.

It feels even worse when other parents, teachers, or caregivers give you a disapproving look, then tell you about something "bad" that they saw your child do today.

When it comes to aggressive behaviors in young children, here are some important factors to consider:

1. How old is your child? In other words, is your child exhibiting behaviors that are developmentally appropriate for his or her age?

For wobblers, and toddlers up to about age four who are not yet able to express overpowering emotions such as frustration or anger, and who may not yet have full command over how to touch softly versus roughly, behaviors such as hitting and pushing are not only not pathological, they are within the range of what is expected and normal.

2. What triggered your child to hit, push, grab, or bite? It's important to notice this so that you can be on the look out. Next time you observe the trigger, you can intervene to prevent or change unwanted behaviors.

For instance, did your son hit another child who grabbed his toy? Next time you see this about to happen, you can remind them both that they are friends and need to share. If hitting has already happened, tell them that hitting is not okay and point out who had the toy first. You can show them how to be "nice" and touch "soft" or "gentle."

3. What does your child's overall behavior look like? If your child is usually well-behaved, is responsive to you and other adult caregivers, and generally isn't aggressive -- except for this one time -- then he still remains an overall well-behaved child.

4. If your child is in daycare, preschool, or other structured settings during the day, be willing to work with staff to help identify triggers and address problem issues. The more consistently problems are addressed in different environments (home and school versus home only), the greater the likelihood you'll see improvements in your child's behaviors.

5. If hitting, biting, kicking, or pushing continue or worsen so that your child's overall behavior becomes unmanageable, consider seeking the support of a child therapist.

Friday, May 29, 2009

Getting Creative - This Summer and Beyond

Two more weeks 'til school's out!

Are you ready?

It's the time of year when kids are looking forward to year-end field trips, parents are thinking about daycare and activities to keep little hands (and minds) occupied, and teachers are propelling themselves toward the finish line and...summer break!

Summer is a great time for parents to encourage kids to be creative -- to let go of the constraints of assignments, expectations, and the limitations of each school day.

While summer is an ideal time for this, actively using each day throughout the year to foster creativity is even better.

When we encourage our young children to follow their interests, to be silly and playful, to take chances and not worry about making mistakes, we inevitably help them learn how to be creative.

Leading creativity expert, Sir Ken Robinson, defines creativity as "the process of developing new ideas that have value." If we think about it further, creativity is what leads to improved problem solving skills, gray area thinking, and the ability to be visionary adults.

Who doesn't want that for their children?

For kids, creativity gives birth to a world that is filled with possibilities, options for making choices both now and when they grow older. It brings into being a sense of flexibility and hope, which our children will need to surmount life's smaller challenges as well as its major obstacles.

There are many good reasons beyond this, and ways, to foster creativity at an early age. Dr. Stanley Greenspan writes about this in his book, Great Kids: Helping Your Baby and Child Develop the 10 Essential Qualities for a Happy, Healthy Life.

Yes, creativity matters no matter what path your child takes someday. In his funny and passionate talk at this year's TED conference, Sir Ken Robinson discusses this as he makes a moving case for reforming our educational system, placing creativity at the top of the priority list for our children. Watch him here:

Monday, March 9, 2009

Daring to Share

Lately, every time I turn on the television, the radio, or pull up my favorite online news site, what I am seeing and hearing is grim. Hundreds of thousands of people losing their jobs. Millions, their homes.

It certainly is sad, anxiety-provoking, and for some families and individuals, absolutely tragic.

But in the midst of all this, there is one positive thing we can do: Share.

As parents and caregivers, teachers and therapists, we are constantly asking, telling, or teaching our kids to share. Share your toys, share your favorite bouncy ball, share that video game controller, share your room, and ad infinitum.

If we look to our kids during this difficult time, there is quite a bit that they can teach us -- especially about sharing.

Think about when your child runs up to you and gives you his perfect, crooked smile that fills you with that sunshiny feeling: it's better than a million bucks! Or, about those times when your toddler says something so cute and funny that you feel richer than the richest man or woman on earth and can't wait to share it with the next person you see.

We can follow our children's examples. We can call up the old friend we miss to say, "I just wanted to let you know I was thinking of you." We can smile at our neighbor, who unbeknownst to us, was until a minute ago, having a really hard day.

If you're willing to try it, I promise you will get something back. A good feeling, a greater sense of connectedness. And, the more you share, the better you'll feel.

Bottom line: Sharing creates abundance. Maybe that's what we've been trying to teach our kids all along.

Thursday, March 5, 2009

DIR/Floortime: Support for Parents with Developmentally Challenged Children

For local parents who have children with developmental delays, there is a very helpful workshop coming up in Pasadena, California on April 4th.

An "Introduction to Floortime" will be presented by Diane Cullinane, M.D. of Pasadena Child Development Associates, Inc.

Dr. Cullinane is a Developmental Pediatrician, a Certified DIR Clinician, and an ICDL (Interdisciplinary Council on Developmental & Learning Disorders) Faculty Member. She is one of the few experts with advanced DIR/Floortime training in the area. I've attended this workshop of hers before. It is highly informative and will give parents more knowledge and tools for helping their developmentally challenged children.

For those of you unfamiliar with it, The Developmental, Individual Differences, Relationship-based/Floortime model was developed by Dr. Stanley Greenspan and his colleagues for working with kids on the autism spectrum. It takes into account the individual differences of each child, including temperament and sensory issues. DIR/Floortime focuses on helping children to improve their overall development (including communicating and relating, problem-solving, and logical thinking) rather than only on skills and isolated behaviors.

While DIR is the part that helps the clinician to assess the child's overall functioning, Floortime provides a framework for how to "be" with the child in school, daycare, home, and other settings. It includes how to interact, energize up to engage with the child, and play in such a way to both support and challenge him or her. It's a great tool that parents with developmentally delayed children can use!

I am a huge fan of DIR/Floortime and have found as a child therapist that it can also be successfully used with kids with emotional problems who are not necessarily delayed.

"Introduction to Floortime" (For Parents and Professionals)
Date: April 4, 2009
Location: Huntington Hospital/Braun Auditorium, 100 W. California Blvd., Pasadena, CA

Dr. Cullinane will present an overview of Floortime, including:
* What is Floortime and the DIR approach (as described by Dr. Greenspan and Serena Wieder, Ph.D.)
* The six Functional Emotional Developmental Milestones
* Basic steps and strategies of Floortime.
* Video examples of Floortime intervention.
* Time for questions and discussion.

To register over the phone, please contact Amber at 626-793-7350 x229 or Barb at 626-793-7350 x219.

To learn more about DIR/Floortime itself, visit the ICDL website, which includes a free video showing Dr. Greenspan and Dr. Weider explaining what DIR/Floortime is. There are also useful links and resources for parents on the site.

Friday, February 20, 2009

In the Know

The other day, I was working with a teenage mom and her 10-month-old baby who was fussy and irritable. The mom tried rocking the baby, soothing her with her voice, patting her gently, and distracting her with a toy. But, baby kept fussing. Mom kept trying. And, tears where starting to roll down both their faces.

The mom's frustration was palpable. She turned to me and said, "I don't know what to do!"

The same day, while I was talking to another mom with three children, she began telling me that sometimes she just doesn't know what to do when her kids get upset and tantrum.

"They don't explain how to do it all in books I've read!" She said.

Later, I thought about these two very different moms, one a first-time parent and the other with three kids' worth of experience. I was struck by how no matter what your level of experience, it is impossible to know exactly what to do every time, especially when your child is irritable, fussy, or throwing a headache-inducing tantrum which seems to have no end in sight.

Here are some thoughts:
1. It's okay to not always know how to make everything better instantly. If you could do this, then you would be Super Parent. And, you would have to run around the world wearing tights and a cape. Do you really want to do that?
2. It's important to stay calm. Even if you are completely frustrated and ready to scream, remember that your child will pick up on your emotional state and this may make him more upset that he already is. Remember that no matter how bad the situation, there will be an end to it. It will not last forever.
3. Offering empathy always helps. Acknowledging the way a child feels helps him or her to feel understood, validated, and calmer.
4. Dare to try different things. Don't always rely on only one thing (such as a time out for older children, or a bottle for infants) to deal with challenging behavior. Be flexible and willing to try a range of ways to soothe your child.

And again, remember that as a parent it's okay and quite normal to not always be in the know.

Monday, February 9, 2009

Eensies: A Giant Help for Parents

In these tough economic times, many parents I know have been feeling not only worried and concerned, but understandably stressed and overwhelmed.

It's a good time to remember certain important things, including that children can easily pick up on a parent's state of mind. Younger children who tend to be more egocentric may feel that "Mommy isn't happy," or "Something is wrong with Daddy," and blame themselves. If you see your child responding in such a way, this is a great time to remind him that you love him.

If you are feeling stressed or overwhelmed, you are not alone. Now is the perfect time to reach out to friends, family members, or professionals such as teachers and counselors for support. Remember that no matter where you live, there are free local resources available.

One of the best online resources for parents (and one of my new favorites) is eensies. Started by two teachers (and parents), eensies is chock full of tips, activities, and advice. And, every Thursday is dedicated to answering parents' questions about everything from homework and reading to how to help your child make clean up time fun. Not only is eensies enjoyable to read and a giant help for parents -- it's also absolutely free.

Speaking of free, don't forget that love and hugs don't cost a cent. So give your favorite child a hug today and remember to check out eensies.

Friday, February 6, 2009

Eight Is Too Much

Like many of us, I've been following the story about the Bellflower, California octuplets with interest and curiosity. This morning, the mother, Nadya Suleman, was on the Today Show, insisting that she will provide her babies with unconditional love and attention.

It's a basic and obvious fact that babies need unconditional love and attention. However, actually providing this can be extremely difficult with just one baby. For parents with multiple babies who may have developmental problems, it's a massive struggle without additional support from family, friends, medical doctors, developmental specialists, and other outside help.

I've written often on this blog about how crucial the relationship is between a parent and child, right from the start. It is the very foundation of a child's healthy social and emotional development. Through this critical first relationship with mother, babies become kids who can communicate appropriately, manage their feelings, play well with other children, and empathize with others.

It is hard enough to develop and nurture but one relationship with a single newborn infant, not to mention an additional seven who may also experience developmental delays due to their prematurity. For even the most amazing mom, eight is just too much.

Thursday, January 29, 2009

From Babies to Big Kids

As a child therapist, I get lots of questions from parents that start with, "Is it normal if my child is...?" There are so many developmental milestones to pay attention to and young children are changing so rapidly, it can be confusing to know where your child should be!

These days, there are lots of ways for parents to get information about their young child's development.

Parents don't have to necessarily wait until their child's next appointment with the pediatrician or see a child therapist to have their questions about development answered. There are books galore and internet resources available.

One of the newest and best of these comes from Zero to Three in Washington, D.C. They have created From Babies to Big Kids, an email newsletter parents can subscribe to which outlines where their child should be developmentally.

It's so easy! Just enter your name, email address, and the age of your child (you can enter up to three) and you will get a monthly From Babies to Big Kids newsletter tailored to your child.

This and other tools on Zero to Three's website can provide a lot of very helpful information for parents which can be further fleshed out by a pediatrician, child therapist, teacher, or other early childhood professional.

Saturday, January 24, 2009

The K5: Great for Kids and Parents

One of the best things about what I do is getting to know all kinds of people -- from parents and teachers to school administrators and occupational therapists. They are constantly giving me good information and support.

One of the latest helpful resources I’ve learned about from a second grade teacher is The K5 ( If you guessed that it’s for parents with kids Kinder through 5th grade who are looking for some tips and guidance, you are absolutely right!

Here, you’ll find advice on everything from how to help your child get ready for school on time to tips about finishing homework.

You can even ask their school psychologist, J. David Carr, questions! Here’s a taste of the clear and solid guidance you get from him and folks at The K5:

Friday, January 23, 2009

A Willingness to Nurture

"For as much as government can do and must do, it is ultimately the faith and determination of the American people upon which this nation relies. It is the kindness to take in a stranger when the levees break..but also a parent's willingness to nurture a child, that finally decides our fate." --44th President Barack Obama, January 20, 2009

What an amazing and exciting week this was!

I hope that many parents, grandparents, teachers, and others who care for our youngest children were able to witness the inauguration and the ushering in of an era of hope and change.

When I attended the Zero to Three conference here in Los Angeles in December, there was a lot of conjecture about President-Elect Obama's true commitment to young children and families. And, there was a lot of discussion about our feelings of hope that his administration could help to increase awareness and resources spent on this critical period of a child's life.

After all, the first three years are when the bulk of brain development happens; it is the time when children make the fastest and most dramatic gains.

As I listened to President Obama's speech on Wednesday morning, I of course honed in on the small part of it directed at parents.

Parents, teachers, daycare providers, you are key to implementing the positive changes that we seek as a nation. You are the ones who instill in our littlest ones the belief that they are loved and valued. That they can become an Ironman, Superman, or the President of the United States.

This is a task that each one of us can help with, even if we don't have our own kids. As we move through the world, we can be the adults who model good behavior, who do what is right even if it is hard. We can be grownups who are willing to listen to others' opinions and show kindness to people who are different from ourselves.

Let us move forward with hope in our hearts and as our new President puts it, the willingness to nurture our children.

Friday, January 9, 2009

A Belated New Year's Message

Happy New Year!

After a period of life transitions, the blog is back!

Now that the holidays are behind us, it's a good time to make a list of what we would like to achieve in the year ahead. For parents, some of these things may be general, like "Be a better mom or dad." Or, more specific, such as "Read one story to my child every night before bed."

As for me, I want to continue to help moms, dads, and anyone else taking care of our youngest children to be the best caregivers they can be.

For this blog, this means that I will be including more information on child development and parenting issues, guidance, links to resources, and answering any questions that you may have.

So please stay tuned!

Happy New Year!