Parenting a Child with Mental Health Concerns Community Education Services Blaine Munro, MSW, RMFT Sharon Halladay, MSW, RSW (Clinical) Typical Development Within the individual/child exists: Social & emotional skills (relating to others, building and maintaining relationships and managing emotions) Communication skills (two way parent to child and child to parent) Cognitive skills (learning & literacy, memory, problem solving skills) Physical Motor (gross & fine) skills Physical/neurological 1
Family Life Cycle Development Families go through stages in much the same way children go through developmental stages Family life cycle stages include: Leaving home: Single young adults The joining of families: The new couple Families with young children Families with adolescents Launching children and moving on New trend: adult children return home Families in later life Then the cycle begins again Coming Together Developmental stages and tasks Families with young children Accepting new members into the system Loss of former life style Joining in childrearing, financial and household tasks Parents increasing in maturity Child development Infant Forming attachments to primary caregivers Building trust that caregivers will meet their needs Discovering the world Preschooler Continues to discover the world, form an identity, become more independent, life skills increase, emotional awareness and regulation School age Continues to discover the world and Build mastery with complex academic tasks, relationships, finding areas of interest and aptitude, more sophisticated emotional awareness and regulation develops Adolescence Continues to discover the world Identify solidification, independence, increase in intimate relationships Disruptions to child/family development Anyone of us can experience a developmental disruption in either our individual or family life cycle stage. If the developmental disruption is not resolved then mental health concerns may become prominent and will impact all members in the family system. Most childhood mental health concerns result from developmental disruptions. 2
Personal-Social Development Creative Development Physical /Motor Development Child Communication Development Cognitive Development Red Flags: Challenges in the developmental & family life cycle Family relationships Parenting skills Family situation Child characteristics Biopsychosocial influences Early intervention yields better long term outcomes. Relationships with family members Ideally children: look for comfort from their parents/primary caregiver when they are hurt, ill, or upset show affection only to people they know well are not too clingy can accept reassurance when separated from their parent and are pleased to see their parent upon their return 3
Parenting Competencies include: reading the child s cues: facial expressions, gestures and vocalization having knowledge of appropriate developmental expectations looking at things from your child s point of view having the ability to regulate their own emotions and control their impulses Family Situation Child development disruptions and family life cycle vulnerabilities are heightened during times of stress & transition: separation/divorce conflict or violence in the home alcohol or drug abuse lack of support from friends, family, church no family recreation or family fun financial problems, illness, death, housing problem, move Child Characteristics Health/development Behavior Mood Play/Social Skills Sensitivity & Self-Control Temperament 4
Easy temperament Temperament Difficult temperament Slow to warm temperament Transactional model Attachment to primary caregiver(s) Family adversity Separation and divorce Conflict or violence in the home Substance abuse Social isolation Financial stressors Chronic illness Relationship that provides a secure base & a safe haven Atypical child characteristics Regulation of behaviour Disruptive behaviour Experience & expression of emotions Parenting skills Parents ability to manage their own frustration and emotions Understand your child s: ( Facial expressions, gestures, sounds) Offer comfort at times of distress Age appropriate expectations Eating; Sleeping, Elimination behaviour Communication problems 5
Circle of Security Indicators of concerns with attachment to a primary caregiver The child has difficulty using the caregiver as a source of security and comfort when upset, physically ill or hurt The child appears fearful, wary, or confused in presence of the attachment figure The child with insecure attachment often displays significant behavioural difficulties Challenges with regulation of behaviour Often stems from difficulties: regulating emotions; over or underreactivity to sound and touch; motor planning and visual-motor organization in development of self-regulatory capacities which underlie a variety of behavioral problems 6
Experience And Expression Of Emotion Excessive fears, separation anxiety, depressed or irritable mood with diminished interest/pleasure in activities are causes for concern Depression identified after school entry has a chronic and relapsing course Coping With Trauma Child may show a continuum of symptoms following a single event, a series of events, or chronic, enduring stress. Symptoms may include disturbances of play, nightmares, social withdrawal, temporary loss of previously acquired skills, aggression, new fears. Disruptive Behavior Aggressive and Oppositional Behavior: Developmentally inappropriate degree of aggressive, destructive and defiant behavior Early behavioral indicators Parent influences Multiple family stressors 7
Disruptive Behavior Attention Deficit Hyperactivity Disorder: Developmentally inappropriate activity level, attention, impulse control Early behavioral indicators Without intervention, symptoms persist Parent influences What s typical? Eating Behavior Feeding disorders Eating problems Parent-child interactions Sleeping Behavior When is sleep a problem? Common sleep problems falling asleep staying asleep disrupted sleep nightmares and sleep terrors 8
Elimination Behavior Difficulty developing bladder and bowel control Enuresis Encopresis or soiling Communication Problems (suggestive of Autism) Spectrum of Pervasive Developmental Disorders Core deficits Early communication indicators: no babbling by 12 months no gesturing (pointing, waving) by 12 months no single words by 16 months no 2-word spontaneous phrases by 24 months loss of language or social skills Communication Problems (suggestive of Autism) Possible signs of Autism (at 18-24 months): no pretend play not pointing to show something of interest not following someone else s eye gaze poor social responsiveness must be diagnosed by qualified health professional 9
What can be done? Strengthen family/caregiver relationships Learn skills Build your support system Adapt to the individual child Stay hopeful Strengthen family/caregiver relationships Recognize that mental health issues often result from disrupted development and/or relationships Parents role is to be bigger, stronger, kinder and wiser (Circle of Security). Look at others points of view and consider new information. Expand on family strengths Learn New Skills Understand: what is typical development behaviour management principles Repair relationships Increase tolerance and patience Increase awareness of other family members perspectives Consider what adaptations can or should be made to strengthen family functioning 10
Support Systems Professional Family physician, specialists, school, clergy, daycare Non Professional Recreation, community activities, friends, relatives, spouse Adapt to your child s unique traits /personality Consider your child s innate temperament Adjust your expectations to reflect your child s unique abilities Examine the goodness of fit between your child s temperament, developmental stage and abilities and your expectations and your temperament. Parenting Get to know and appreciate your child Early intervention goes a long way in decreasing the chances of chronic and recurring problems 11
Stay hopeful The central struggle of parenthood is to let our hopes for our children outweigh our fears. - Ellen Goodman Community Education Service To register for notification or an upcoming education session go to: www.fcrc.sacyhn.ca For general CES enquiries Email: ces@sacyhn.ca Call: 403-955-7420 12