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Depression represents a significant mental health concern for children and adolescents. It is often associated with significant impairment in other areas of their lives as well including disruption in academic achievement, peer relationships, family functioning, and sense of self.

There are multiple contributing factors to adolescent depression that include, but are not limited to, genetic contributors, family discord, deficits in problem solving, social and coping skills, difficulty with emotional regulation, and environmental stressors.

Child and adolescent depression are frequently unrecognized because they accompany difficulties in other areas. More often, adults attend to poor grades, skipping school, increased arguments with parents, oppositional behavior, and anxiety that frequently accompany depression.

What to look for in your child or adolescent:

There are some differences in the presentation of depression in children, adolescents, and adults. In children and adolescents, irritability is more common than sad mood. As adolescents approach adulthood, the presence of a sad mood becomes more evident. When looking at children and adolescents, adolescents are more likely to show excessive sleep, hopelessness, lack of enjoyment in activities, sluggishness, and fewer physical complaints (i.e., stomachaches, headaches, etc.) than are children. Suicidal ideation is also rare in childhood and increases markedly during adolescence.

When you notice these traits in your child, it is important to seek professional help.

In the area of depression, prevention goes a long way. In taking preventative steps, you prepare your child with the tools to more effectively connect with others and regulate their own mood and environment. With treatment recovery rates are high.

Treatment often includes individual therapy to address skill building (social skills, coping skills, emotional regulation skills, and conflict resolution), family therapy to improve communication and parent-child relationship, and group therapy to enhance feelings of connectedness and self-esteem.

The next school year is underway, and you may have some concerns about your child’s academic performance.

Now is the best time to consider getting a jump start on understanding how to help your child succeed in this school year.

Attention Deficit Hyperactivity Disorder (AD/HD) and Learning Disabilities (LD) can greatly interfere with your child’s ability to do well in school. Not only does this mean that their grades could suffer but it may also leave them feeling uninterested in school and create problems with their teachers. In some cases, your child may be labeled as lazy or unintelligent, and the problem is left unresolved.

Despite public knowledge about AD/HD and LD, many parents are often unaware that their child has a disorder which is easily remedied with the accommodations at school and psychological treatment. Psychological testing for AD/HD and LD is an effective way to learn more about the problems a child faces when it comes to interacting and engaging in their learning environment.

Symptoms of AD/HD include: failure to sustain attention within certain areas of functioning such as school or work; difficulty following instructions; trouble maintaining attention during play or other activities; being forgetful or disorganized; and a general reluctance to engage in activities involving mental effort. In order for someone to be diagnosed with AD/HD these characteristics need to be apparent in more than one setting such as when doing homework, in the classroom, or while participating in afterschool activities.

Characteristics of Learning Disorders are separated into four categories: Reading Disorders, Math Disorders, Disorders in Written Expression, and Learning Disorder Not Otherwise Specified (LDNOS). Each scale is measured by comparing the individual’s proficiency in the specific area to the average of children within their chronological age, intelligence, and age-appropriate education. A diagnosis of LDNOS indicates a difficulty in all three areas of schooling, each may be to a different degree of significance.

Timing is crucial when planning an intervention to assure your child’s success. Having your child tested and/or treated early in the school year can prevent him or her from falling behind. As appropriate, medication and counseling services are readily available for your child. Family involvement is also crucial for success because the better you understand your child’s disorder, the better you can advocate for, support and encourage them in their efforts at school and when doing homework.

Treatment for AD/HD and LD not only improves one’s academic career, but it can also prevent future behavioral and/or social problems. Children with AD/HD and LD often have difficulties in daily interactions with peers due to frustration, low self-esteem, and feeling misunderstood or “stupid.”

A psychologist can work on helping them improve their social skills, organizational skills, develop more confidence, and learn how to seek out attention and help from adults in a positive manner. Our child psychologists can help you understand your child’s needs and how to best help them be successful in school.
are readily available for your child. Family involvement is also crucial for success because the better you understand your child’s disorder, the better you can advocate for them at school and support and encourage them in their efforts at school and when doing homework.

Treatment for AD/HD and LD not only improves one’s academic career, but can also prevent future behavioral and/or social problems. Children with AD/HD and LD often have difficulties in daily interactions with peers due to frustration, low self-esteem, and feeling misunderstood or “stupid.” A psychologist can work on helping them improve their social skills, organizational skills, develop more confidence, and learn how to seek out attention and help from adults in a positive manner.

Educating your children about sex can be one of the most challenging and awkward steps of parenting. However, research shows engaging children about these issues instead of putting them off may help prevent premature sexual activity, teen pregnancy, and sexually transmitted diseases. As a parent, it may be difficult for you to decide on the right time to talk to your children about sex, and many parents wait until they are confronted by their son or daughter about these issues. As you may feel uncomfortable or unsure about what to say to your children, here are some tips to help with your discussion.

Preschool

Before jumping to the pre-teen and teen years, let’s start from the beginning, since even young children may ask about sex-related topics, such as body parts, pregnancy, etc. There are many sources of information which can influence your child’s understanding of sex such as television, movies, music, and peers. For this reason, parents should provide their children with age appropriate answers to their questions starting at an early age; importantly, this helps distinguish you as someone they can turn to about these types of questions.

• Young children have a tendency to be curious about their own bodies. Take this time, perhaps during bath time, to help them understand the different parts of their anatomy. Don’t be afraid to say “penis” or “vagina” to prevent negative associations with their bodies. It is important that you express which parts of their bodies are private and which are okay to show in public.
• A child’s curiosity may lead to masturbatory behavior, even in a public setting. While this behavior is normal for children, parents should express to their child that this is not acceptable in public; the message and tone is not that the behavior is wrong but rather it is private.
• Communicate to your children that their genitalia should not be exposed to others, nor should anyone other than a physician, nurse, or parent be allowed to touch their private areas. Talk to them about “good touch” and “bad touch”, letting them know if they ever feel bad about touch they should tell their parent or a trusted adult. While the vast majority of interest in bodies is perfectly normal, parents should be aware that a child’s overenthusiastic interest in sexuality could be linked to sexual abuse. Consulting with a pediatrician or psychologist can be helpful if you have such concerns.
• When preschool children see someone pregnant, it may prompt them to ask how pregnancy occurs. Like all questions at this age, the trick is answering honestly but in a way they can understand, and realizing they don’t need full information yet and probably won’t even notice you’ve left out the details. For example, one answer to this question would be: When a man and a woman are grownups there is a special grown up hug they can do that make babies.

Take a minute to listen to the content of questions, as some questions seemingly about sex may not be at all. In one family, a preschool child made a group of adults quiet quickly when she asked upon meeting her aunt’s new husband for the first time if they slept together. The aunt cautiously replied, “Yes”, to which the child said happily, “Oh good!” When the aunt asked why that was good, the child explained, “Now I know who he is. Like mom and dad sleep together, grandma and grandpa sleep together…” The child knows nothing of sex, but a couple sleeping together tells her something about the relationship, that it is close and special.

Elementary School

Elementary school brings about another series of questions which children may ask their parents concerning sex. Children may ask more about the connection between sex and having babies and sex and love. Around the pre-teen age, children’s bodies begin to develop, which can be very confusing. Here are some tips to help you better communicate with your child.

• There is quite a difference in this group when we look for example from first grade to fifth and sixth grade. With younger children, continue the advice from above in the preschool section, i.e., answer questions honestly but only with as much detail as the child seems to be pulling for.
• You may find yourself answering questions earlier than you had imagined because an older child at school informs a group of younger children about the birds and the bees! Stay calm and listen at first; see how much your child has been told before you start your answer. Often the child’s biggest concern is that an older child is making fun of them and perhaps trying to get them to believe something that isn’t true, or similarly showing the child is a “baby” because he or she doesn’t know the facts of life. Whatever your child has been told about sex that is true, confirm as true, and correct any misconceptions the child has been given.
• An ounce of prevention is worth a pound of cure. In the pre-teen years (perhaps ages 11-12), if your child is asking questions about having sex, you may want to take this time to begin to discuss contraception and STDs. Express your concern for their well-being and need to protect and respect their bodies and others.
• Some children may begin to experience puberty as pre-teens. Both males and females should be knowledgeable of menstruation, male and female genitalia responses, and breast development in order to better understand the changes occurring in their own bodies as well as others. Particularly with girls, as it can be scary if they begin menstruation not knowing it is going to occur, so most experts would say girls should know about this by age 11 or 12 at the latest.

Junior High School/High School

Junior high school and high school children go through the most difficult sexual pressures. Now is the time when parents are able to bond with their child through open communication about sexual relationships. Being the one to answer all of those confusing and embarrassing questions is perhaps one of the most important roles parents can play during this phase of their child’s life.

• Parents should work together to educate their children. Children may be curious about the changes the other gender experiences. It can be helpful to get both a mother’s and a father’s perspective on sex and sexual development.
• Assure them that the physiological changes they are going through are completely normal. All of his or her peers are experiencing the same insecurities, difficulties and curiosity they feel. There is no need to feel they are unusual or weird.
• Teen pregnancy is becoming more common each year, but few children know how devastating this can be for their futures, particularly girls. Encourage your child to use contraception if they are going to engage in sexual activity but to also be aware that using them does not guarantee they will prevent getting pregnant. Alert them to which ones only protect against pregnancy and which prevent both pregnancy and STDs. Suggesting abstinence as an alternative to sex is also recommended. Let your child know sex has emotional aspects that can be complicated and are better handled as an adult. The overall message is that sex has practical and emotional consequences and for your child to delay sexual activity and particularly intercourse until older.
• Keep the lines of communication open. As a parent, it can be difficult to remain calm when you find out your child has done something of which you do not approve. Overreacting can sometimes cause more harm than good. If you yell at your child for one sexually related issue, they are less likely to come to you when they may have a more serious one. Address them with a cool-tempered, but genuinely concerned attitude to motivate change without turning them away.
• Let your child know how you feel about sex. Knowing how a mature adult views sex can create a healthy role model for them to follow. They will then be better able to assimilate your beliefs and knowledge into their own personal views; however do not be surprised if they do not share your perspectives.
• Parents should alert their children to stressful situations in which they may feel pressured to engage in sexual activity. It is crucial that parents prepare their child to say “no”. Encourage them to develop an assertive language regarding saying “no” to intercourse and other sexual activity.
• Parents should discuss with their child strategies for handling their feelings of sexual desire. If you are going to be encouraging them to say no to sex then it is helpful to discuss openly situations in which this will be difficult. Do not shame the child or make his or her sexual desire seem bad or wrong; conversely, let your child know desire is normal and that thinking in advance about how to choose not to engage in sex even in the face of desire helps one be prepared for the moment.
• Let your children know that in a secure, mature relationship sex is a wonderful, bonding, and fun part of intimacy! If you make sex sound all bad, i.e., pregnancy, disease, a “bad” reputation, etc., they may tune you out completely. Instead, explain that when they are older sex will be a wonderful part of their relationships, and you just want to encourage them to wait and bring sex into their lives at the time when they are best prepared to handle all of the complicated aspects of it.

References
https://www.medem.com/?q=medlib/article/ZZZ6JP71NUC
https://parentingteens.about.com/od/teensexuality/a/teen_sex_talk.htm
https://www.valuesparenting.com/talktokids.php

Written by: Christina Rodriguez of Triangle Total Tutoring

How many fulltime jobs does a parent have? Career. Household. Children. These are each a fulltime job. You may feel that a disproportionate amount of time and energy are required by school demands. You’re not alone! Most families experience tremendous stress due to school work. Helping your children manage their academic responsibilities is one of the most time consuming components of child rearing. But your child’s academic success can increase her self esteem exponentially and reduce the family’s stress level dramatically.

Today’s young adult navigates a competitive environment that is more intense than ever. As a parent you want to help your child do well in school to prepare him for college and the future. Unfortunately, academic pressures can wreak havoc on the present by taking a toll on family life and zapping vitality and exuberance from your teen or even pre-teen.

Although modern day academic pressures are unique and greater than ever, some of the best study tips have been around for a long time. Combined with a few new tools at our disposal today, you can help your child maximize his success and also his sense of accomplishment and well-being.

You can help your child harness his energy for positive results, thus helping him achieve his potential and breaking the cycle of stress and worry.

Procrastination. Often, a young person hardly taps the extent of his potential because he doesn’t get started on his assignments early enough, or she squanders her time and energy by procrastinating. This can lead to feeling overwhelmed, which propagates the cycle. If she can just get started, she’ll build momentum and a desire to carry through what she’s already begun. Set boundaries and help your child to structure her time.

1. Allot a specific time each day for focused schoolwork, and be clear to your student that he is expected to be on-task.
2. Provide a quiet space to do homework. Eliminate distracting electronic gadgets for a set period of study time. (No phone zone.)
3. Make sure your child gets enough sleep. Enforce a bedtime if necessary. If your child is a zombie at school, the whole day is practically worthless. Even if he wants to stay up late to finish an assignment, the cost in sleep is too great.
4. If your child resists putting aside time and space each day to focus on schoolwork, don‘t be afraid to bring in a third party, such as a tutor who can jump-start study sessions and guide your student to work efficiently and develop effective study skills.
5. Rewards can be motivating; keep rewards timely and simple when used. As a last resort, consequences also work for some children who otherwise refuse to do homework or study.

The right attitude. You can model a positive mentality for your child. Rather than agreeing with her that she’ll never use math (or chemistry, or whatever it may be), point out the benefits she is deriving: the strong writing skills she’s developing; the ability to think critically; the ability to focus; the building of “brain muscle”. Just as it takes work and practice to develop a good backhand or jump shot, the same is true of mental skills that will last a lifetime.

1. Continually reinforce the importance of education.
2. Focus on school work — make it a priority.
3. Encourage your student to discuss his difficulties with the teacher, and attend “extra help” sessions after school.
4. Emphasize consistency. One bad grade will not ruin a semester. Good study habits will pay off over time.

Watch for warning signs. Nip problems in the bud — do not let things reach a crisis point. Intervene at the first signs of trouble. Nowadays you can monitor your student’s progress and academic standing via class and school web pages. Emailing with the teacher can also provide insights as to how best assist your child. Though he may view it as somewhat intrusive, internet tools are available to you for a reason. Don’t neglect to know if your child is floundering. He may assure you that he’s “got things under control” but he may not be able to “handle things” as well as he thinks. Get him the support he needs.

Don’t be reluctant to enlist outside help; a good tutor. When it comes to schoolwork, parent-child encounters can be fraught with tension, making for a potentially explosive situation. By partnering with a tutor who can work with your child, you can remove family dynamics from the equation and avoid a lot of stress. Seek out a tutor who can really connect to your child. A tutor should have expertise in their given field and strong communication skills. Look for a tutor who will build a rapport with your child. Your student will appreciate having someone outside of his family who he can count on to provide academic support and positive encouragement. Make sure to receive periodic feedback and updates from your tutor.

An experienced tutor knows how to get the most productivity out of a study session. She should be able to keep the session moving by asking and answering questions, giving drills to enhance skill mastery, and explaining concepts. She should be able to present a topic in a manner that reinforces the method the teacher is using in class, or alternatively, be able to present the material from another angle, thus finding the method that is more suitable to your child’s style of learning.

In addition, a tutor should be patient and work at the student’s pace, but also guide her get her work done in a timely manner. The tutor will keep the ball rolling, both throughout a study session and throughout the semester/ school year.

Achieve balance. Today, more often than not, family tranquility is affected by how well things are going in the classroom. You can help your child harness his energy for positive results, thus helping him achieve his potential and breaking the cycle of stress and worry.

As your child grows up, you want to encourage him to develop independence and to take ownership of his responsibilities. However, it is not yet time to relinquish parental support and oversight. You can help your child stay on track by putting in place some structure and routines that will help her use time well and circumvent procrastination.

Utilize today’s technology to help your child stay on top of his academic responsibilities. You or a tutor can help manage your child’s academic affairs by staying on top of due dates and upcoming tests and quizzes via the class webpage, and such using that information to pass on reminders to your child.

Though he may fight you initially, your child will appreciate it when he’s able to truly enjoy his free time knowing he’s completed his academic objectives for the day or week. A more positive and less stressed-out outlook will help him be motivated. Improved study habits will result in better grades, and in turn a happier family.

For more information contact: Christina Rodriguez, Triangle Total Tutoring, (919) 961-3365, [email protected]. Specializing in SAT Preparation, Calculus, Pre-Calculus, Trigonometry, Geometry, Algebra I & Algebra II, Pre-Algebra, and Middle-School Math.

A note from Dr. Lepage…
CELEBRATE SUCCESSES!

When a child comes home with a D or F, often those poor grades get more attention than the good grades, since they are an area of concern. That attention can span from the “I’m disappointed in you” conversation and being grounded when the poor grade is a result of a child not doing their schoolwork or not studying, to a fairly pleasant conversation about putting in place a study plan, hiring a tutor, or developing some sort of an action plan when the poor grade has occurred after a child tried their best. In both scenarios, often times the conversation about the poor grade overshadows the successes on the report card. Remembering to make an equally big deal – maybe even more of a big deal – about a child’s accomplishments is a great way to build pride in his or her strengths and build overall self-esteem. I suggest when a child comes home with a mixed report card, celebrate successes first. Say something like, “You did a terrific job in ‘xx’ subjects! I am so proud of you! I see you didn’t do as well in ‘xx’ but we can talk about that after we celebrate your accomplishments. Tonight (or this weekend) we are going to celebrate your successes!” Then develop a celebration plan with your child, and refrain from mentioning the poor grade during that celebration. A day or two after celebrating your child’s success, address the poor grade. The point is not to ignore the poor grade, but rather to make sure the good grades don‘t get lost in the shuffle, so your child experiences a balanced reaction to their grades that focuses equally on the positive. So remember, when report card time comes around, celebrate!

When to get help: Sometimes a poor grade can be addressed by parent intervention at home in the form of study help and study organization, and/or rewards and consequences. Sometimes a tutor can turn things around by teaching effective studying and test-taking skills, and by helping the child understand the material. Other times a psychologist is needed for testing or therapy, as some poor grades result from a learning disorder, AD/HD, test taking anxiety, social stress at school, or even family stress at home. Testing can determine the presence of LD or AD/HD as well as anxiety, depression or any mental health condition that could impact academic performance. LD and AD/HD can be overlooked when a child has done well in school previously; however, children on the mild end of the spectrum of these disorders sometimes do well in lower grades and then struggle when the difficulty of the material increases. Testing provides diagnostic clarity so interventions can be targeted and effective; even when the result is that there is no disorder, that is highly valuable information as parents then know the interventions need to be study / tutoring / rewards / consequences based. When stress of some kind is causing a child to do poorly, a psychologist can provide therapy to address the problem. For example, teaching stress-reduction and focusing techniques for test taking, improving social skills, or decreasing anxiety or depression. Research has shown anxiety and depression can reduce academic performance, and therapy to address these can both improve academics and provide the child with emotional relief so they feel better. Please feel free to call any doctor at Lepage Associates should you have questions about your child’s academic performance.

IS EARLY ENTRY TO KINDERGARTEN RIGHT FOR MY CHILD?

When parents call to ask about early entry to kindergarten, I often hear, “I know everyone thinks their child is brilliant, but my child really is advanced.” … And they are generally correct! They have noticed their child recognized letters and numbers early, perhaps even started reading some, seems to take in information and retain it, and has a strong curiosity around academic-type learning. If you have noticed these things in your child and are trying to decide whether early entry to kindergarten is right for your child, there are several things to consider.

1. Cognitive (academic) readiness. This is the area most parents first consider, i.e., will my child be able to understand the academic material being covered and keep up with the rest of the students in learning. There are numerous checklists on a variety of websites to help you determine if your child might be cognitively ready. One helpful hint we give parents is to purchase some academic „activity books‟ and see how your child does. You might start with a pre-school book and then move on to a kindergarten book. These are available in stores such as Learning Express and large bookstores, and you may also find some at Target or Wal-Mart. If your child breezes through the pre-school activity book and can even do some pages of the kindergarten book that is a good sign.

Ultimately you will need official psychoeducational testing to determine where your child falls cognitively/academically compared to his or her peers, as the school will require this testing to consider your child for early entry. This testing is not provided by the school. It must be done privately by a licensed psychologist, and include test versions approved by your school district. Any psychologist who does such testing should be able to tell you what those tests are. Your child will be given an IQ test and an achievement test and generally must score in the 98th percentile or above on the IQ test and at the 98th percentile or above in math or reading on the achievement test. Parents often ask what the difference is between IQ and achievement testing; the difference can best be summarized as innate abilities versus achievement in learned material. The IQ test assesses for abilities such as verbal and non-verbal abilities and the speed at which the child can process information. Achievement testing assesses math and reading skills relative to others the child’s same age.

2. Developmental readiness. Chronological age is not the best predictor of success in kindergarten, hence the focus on kindergarten „readiness‟ and not just chronological age. Developmental readiness has three major components: emotional, social, and behavioral.

Is your child emotionally mature for his or her age? Does he or she have good emotion regulation when upset or angry? Can your child be away from mom and dad for several hours at a time without getting upset? Is your child able to share and take turns? Do interactions between your child and other children generally go well? Can your child sit still and pay attention for 15-20 minutes at a time? (FYI, TV and video games don’t count.) How self-sufficient is your child? Can he or she tie shoes and get a jacket on and off? How well behaved is your child in general? Does your child still tantrum when not getting his or her way, or can your child generally be redirected and/or motivated by rewards and consequences?

On pediatrics.about.com, the following is reported: “According to the U.S. Department of Education’s National Center for Education Statistics, traditional signs of readiness to start kindergarten include being able to: communicate about things he or she needs and wants, share and take turns, be curious and enthusiastic about trying new activities, pay attention and sit still, use a pencil and paint brushes, count as high as 20, and recognize the letters of the alphabet. Other traditional signs of readiness are that a child can follow one to three step instructions, behave well in the classroom, and can get along well with peers. It is important to note that in the Fast Response Survey System (FRSS) Kindergarten Teacher Survey on Student Readiness, teachers reported that the most important signs of school readiness are being able to communicate needs and wants and being curious and enthusiastic about trying new activities. Counting and recognizing letters and even sitting still were reported to be less important signs.”

3. Physical readiness. Probably the least recognized area of readiness, there are some physical skills related to success in kindergarten. Research has found motor skills important in a child’s early learning, with fine motor skills needed to learn to write, and interestingly, gross motor skills found to be related to learning to read. Fine motor skills such as holding a pencil properly (pencil grip) to complete school work and cutting with scissors to keep up with class projects are important. Gross motor skills such as balance, coordination with running and jumping, and catching and throwing impact how a child fits in on the playground.

Where do you go from here? This is not intended to be an exhaustive list of the cognitive, developmental (emotional/social/behavioral) and physical factors you should consider, but rather to get you thinking in the right direction about questions you should ask yourself about your child. Ultimately parents know their children best; can you picture your child in the kindergarten setting doing well?

If your child has demonstrated above average academic abilities, it is important to nurture those abilities, and to keep your child from boredom. Academically advanced children who are under-stimulated can become bored which can lead to unhappiness, a disinterest in academics, and even behavioral acting out. Thus if your child appears to be a candidate for early entry, we strongly encourage you to have your child tested so he or she can enter kindergarten if ready and enjoy the benefits of being in the environment most appropriate for their abilities.

In North Carolina the public school cutoff date for kindergarten entry is that your child must be five-years-old by August 31st of the current school year. If your child’s birthday falls close to this date and/or you believe your child is ready for kindergarten in all domains described above, you should consider kindergarten readiness testing. To allow gifted children to enter kindergarten early, in 1997 the NC General Assembly passed legislation allowing a child who has reached his/her 4th birthday by April 16th of the current school year to enter kindergarten if he/she demonstrates an extraordinary level of academic ability and maturity. Thus kindergarten readiness testing can be done anytime from April 16th forward. The test report becomes the foundation of your child’s application package for early entry, to which you will also likely be required to add letters of recommendation and samples of your child’s work. You can turn this application package in to the school no later than 30 days after the fall semester starts, however, since that would mean your child has missed the first month+ of kindergarten waiting that long is not recommended. We suggest you try to get your child’s application package in by August 1st at the latest, and earlier is better, so turning it in to the school in May, June or July is better than waiting until August.

I’ve scheduled testing. How do I prepare my child? What do I tell my child? What will the experience be like for my child? These are all common questions parents ask, so we will address them here.

Over-preparation is not recommended. Drilling your child on reading and math can be stressful to a 4-year-old. What you want is for your child to enter kindergarten early if he or she is naturally ready for the experience, not for your child to be pushed hard toward that as a goal. You can do some general preparation in ways that are fun for your child, such as number and word games, activity books, reading to and with your child, etc. Preparation that is important is to be sure your child is well rested the night before the testing and eats a healthy breakfast. You should also bring snacks in case your child gets hungry during testing. It generally only takes about two hours, still, hunger is distracting so it is best to be prepared. We will schedule your child sometime in the morning; children (and adults) fatigue in the afternoon so that is not an ideal time to achieve the best scores. We provide breaks for children as needed so they can do their best.

Do not tell your child he or she is going to take a very important test to determine getting into school early. That creates pressure which is stressful, and stress can negatively impact test scores. Also the standardized instructions given to your child at testing include prompts to motivate them to do their best, so you do not need to worry in advance that you need to provide that prompt. Tell your child he or she will be going to play some fun games for a couple of hours, games such as number games, word games, puzzles and blocks, etc. If asked if it will be hard, the answer is, “No, it will be fun.” This is true; the tests are designed as a series of subtests that children generally experience as short, fun games or activities.

Thus children generally experience the testing as enjoyable. Many children ask at the end when they can come back and “play” again.

Our Kindergarten readiness page also has LINKS TO NORTH CAROLINA PUBLIC SCHOOLS INFORMATION ON EARLY ENTRY TO KINDERGARTEN.
https://lepageassociates.com/kindergarten-readiness/#links
From there you can link directly to the early entry to kindergarten guidelines for Durham County, Orange County, Wake County, Person County, Chatham County, Caswell County, Harnett County, Franklin County, Lee County, Alamance County, Granville County, and Johnston County. If you don‟t see your NC county in this list check anyway because we are always adding counties as we get their information.

We often think of eating disorders/disordered eating as an adolescent or adult problem, but they can occur in young children, too, and the health complications can be quite harmful. Studies have shown the age at which children have been concerned about their body size and body image has been declining. Also, children of any age may overeat in our society of fast and processed food, and children of any age may use eating as emotional comfort or as a means to exert control. Thus even elementary school children can need help with disordered eating. The following symptoms are associated with food restriction (which can result in malnourishment and affect healthy development), or over-eating and binge-eating. Physical symptoms include weight loss, weight gain and obesity, intolerance to hot or cold temperatures, dehydration, amenorrhea (irregular or absent menstruation), lanugo (fine layer of hair-like “peach fuzz”- growing over arms, chest, face, and back in order to insulate the body), electrolyte imbalance, calluses on hands, dizziness, fatigue, sore throat, tooth decay, mouth ulcers, and tension headaches. Chronic emotional distress, lower self-esteem, anhedonia (loss of pleasure in activities), anxiety, and peer victimization are common psychological factors that both underweight and overweight children and adolescents often experience.

Potential difficulties that require early intervention:

1. Eating habits tend to be secretive as they are associated with guilt and shame.
2. Lack of resources (i.e. time, money) to obtain nutritious foods.
3. In comparison to adults, children and adolescents are not as likely to view their eating behaviors as problematic; they are also less aware of the short and long term health effects of disordered eating/eating disorders.
4. Children and adolescents are less likely to ask for help because they view their behaviors as either necessary or even helpful.
5. With regards to food restriction, adults may think that the child or adolescent is merely going through a passing stage and believe it is best not to intervene.
6. Adults are not sure how to intervene and are often criticized or treated with hostility by their child if they do try to intervene.

What to look for:

1. Restricted food intake.
2. Eating excessive amounts of food past the point of fullness (either following a period of restriction or following a period of normal eating).
3. Secretive eating.
4. Engaging in food rituals (i.e. taking an excessively long time to eat food because time is spent cutting up food into tiny pieces, rearranging the food on the plate, hoarding foods, chewing food but then spitting it out).
5. Cooking for others and not eating the food.
6. Excessive time spent reading cook books and dieting tips.
7. Increased irritability, sadness, or distress around mealtimes.
8. Drenching foods in fat free/low calorie condiments (i.e. mustard, vinegar).
9. Frequent weighing of oneself.
10. Excessive exercise.
11. Wearing extremely tight fitting clothes to show off body or wearing extremely baggy clothes to hide body.
12. Going to the bathroom after most meals.
13. Increasingly isolated behaviors.
14. Denial of hunger despite severe food restriction.
15. Expressions of guilt or shame after eating.

What you can do: The earlier the intervention, the greater likelihood of establishing healthy and adaptive eating habits.

1. Work together as a family by trying to approach the problem with a team effort.
2. Don’t blame yourself or your child; disordered eating and eating disorders have many causes and parents are often paralyzed by fears that they “did something to cause the problem.”
3. Take care of yourself and reflect on your own values, beliefs, views regarding food and body image.
4. If necessary, create a treatment team (child, parents, therapist, dietician, personal trainer, etc.).
5. Try not to label foods as “bad” or “good” and encourage your child to try a variety of foods that can “fuel” his or her body.
6. If your child either over exercises in isolation or is resistant to all exercise, take a group approach. Encourage your child to participate in exercise activities with others (i.e. a family hike, joining a team sport, etc.).

Dr. Tina Lepage Answers Questions from Carolina Parent magazine on
CHILDREN AND BODY IMAGE: HOW PARENTS MATTER

(1) Given today’s powerful and omnipresent cultural and media stereotypes about bodies and beauty, do you think parents have any control over how children and adolescents feel about their bodies? Please explain.

Actually, parents have a lot of control over how children and adolescents feel about everything, their bodies included. For example, studies have found that the messages that parents give to their child have more influence on the child’s thoughts and behaviors than messages they get from peers. So parents can help combat unhealthy media and cultural messages about body image by providing healthy messages within the home.

(2) In what ways do a parent’s body image “issues” affect and/or determine those of his or her children? Is it more common for children to have the same or different body image issues as their parents?

In terms of overall self-image, on an internal level children see themselves as half mom and half dad. Thus if mom or dad has a poor body image, the child is at risk for having concerns about his or her own body, and for having low self-esteem around this issue. More specifically, children identify closely with the same sex parent in terms of their vision of what it means to be a man/boy or woman/girl. Since girls are more vulnerable to body image issues (due to societal pressures), and girls take their primary cues from their mom’s attitude about body image stuff, it is especially important for moms to reflect in their words and actions a healthy attitude about their bodies. Conversely, if mom and dad have a positive and healthy body image, the child is more likely to feel good about his or her own body, even in the face of cultural and media images that hold up unrealistic and sometimes even unhealthy body images. However, even with the best body images within the home, parents do need to also provide information to counteract the media and culture.

(3) What are the keys to establishing/nurturing a child’s healthy body image? How early should parents start? Is this a planned process or does it just happen?

There is both some planning and “it just happens” around nurturing a positive body image for your child. The “it just happens” part is what I spoke of above, wherein the parents’ body images have an effect on the child’s developing sense of self. In terms of when to start, it is never too early to nurture a positive body image (and positive self-image overall), though the key is to not have a high focus on the body and instead chose things that flow naturally into conversation. Here are some hints: (1) refrain from making negative comments about people’s bodies in general, and instead focus on the positive and on compliments versus tearing people down, (2) focus on health versus body size, for example, talk about healthy eating versus dieting and exercising for heart and body health versus to lose weight, (3) institute healthy eating and exercise into your family routine, (4) talk about looking healthy versus looking skinny, thin or fat, and (5) compliment your child regularly.

(4) Thinking specifically about ages 10-14, what are the major body image issues and how can parents best support a healthy attitude?

By this age of 10-14, children are very aware of the societal pressure to be thin and attractive, and this includes both boys and girls. The major body image issue for girls is thinness, which can be very difficult to deal with at this age as puberty sets in. This is also an issue for boys, and though there is less pressure to be “rail thin”, there is still pressure to be thin in general and to be “good looking”. The second major issue is more a broad area of the pressure to be attractive, which goes beyond the issue of thinness to things like nose size, acne, wearing clothes that are “in”, etc. Parents can support a healthy attitude by (1) having a healthy body image themselves, (2) having a healthy family lifestyle, (3) regularly providing information to counteract what the children see in the media, and (4) teaching the importance of character, personality, and accomplishments over external looks (for example, focusing more on compliments and positive feedback around positive character behaviors, such as helping a friend, doing one’s chores, trying one’s best at school, etc., and accomplishments, such as learning to ride a bike, or doing well in school, etc.).

Want To Get the Perfect Gift For Your Partner or Child?
Match It To Their Love Language!

Oh, how I love thee, but how should I show you the ways? Christmas is fast approaching and you may feel pressured to choose a gift your partner or child will like. One of the love hot topics that we’ve seen when working with couples is partners feeling at a loss about how to demonstrate their love in a meaningful way to their partner. For example, have you ever gone out of your way to cook a special meal for your partner and been less than impressed with their appreciation (or lack thereof)? Or maybe you tell your partner you love him or her frequently but they still seem unsure of your feelings for them?

According to Gary Chapman, author of The Five Love Languages, this is because we often show our partners how we feel about them in our own “love language” and not theirs. Growing up, we learned to show love in ways our families did. For example, some families are very verbally expressive with compliments and others are physically touchy-feely giving hugs and kisses frequently. Just as some families speak French and others speak Spanish, we learn to express our love in a language we have learned. So when two people come together who were raised speaking different “languages”, they find, in order to effectively communicate love, it’s time to learn a second language! So if you feel your partner hasn’t quite gotten the message of how much you love them, read on to figure out other languages you can use.

1. Words of Affirmation: These can include compliments (“Great dinner honey!” or “I really appreciate you taking out the garbage.”), encouraging words for something your partner has set as a goal (“I bet you’d write a great book!”), kind words (this can include forgiving your partner for a wrongdoing), and humble words (this can include making requests “I’d love it if you could paint the bathroom this weekend” instead of demands “Do you ever think you’ll paint the bathroom?!?”).
2. Quality Time: Give each other your undivided attention. Go for a walk, turn off the T.V. for 20 minutes, go to dinner and look at each other and talk, or any other activity that, now that you’re thinking about it, your partner has asked you to do with him or her.
3. Receiving Gifts: Gifts can be bought, found, or made. It can be a tangible item or the gift of yourself, standing next to your partner in a time of need. According to Chapman, this is the easiest second language to learn.
4. Acts of Service: This language includes doing things your partner wants you to do. Examples include mowing the lawn, doing laundry, bathing the kids, making dinner. When any of these are done with a smile and not out of fear, guilt, or resentment, they are expressions of love.
5. Physical Touch: Examples include holding hands, kissing, embracing, massaging, and sex. It can be as simple as a quick peck out the door or sitting next to each other on the couch.

Not sure what your partner’s love language is, or that of your child? You can take a quick test online and find out instantly! Go to: The 5 Love Languages.

So when thinking of a gift for your loved one this year (and all year!), consider which one of the five love languages your partner speaks fluently. Choose an example from that category and they’re sure to hear your message loud and clear.

Have you found yourself feeling less and less fulfilled by your marriage? Have you found yourself nagging or criticizing more lately? Want to know what you can do about it?

In a time of such uncertainty in our country (When will the economy pick up? Will I lose my job? etc.), many people look to their spouses (usually the people closest to us in proximity) to explain how stressed they feel. It is not uncommon for people to report feeling less close to their spouses when they are experiencing other stress in their life, a result of mistakenly identifying their spouse’s deficiencies as the sole cause for their discomfort (when in reality, a great deal of this discomfort may be coming from others places in their life). It is often helpful, when faced with uncertainty, to focus on what you DO have control over, and what many people do not often realize is how much control they have over the satisfaction they receive in their marriage.

John Gottman, a leading researcher in couples dynamics, offers 7 principles that can help you feel more fulfilled in your marriage (from his book with Nan Silver, The Seven Principles for Making Marriage Work):

1. Enhance your “love maps”: This principle focuses on increasing how much you know about your partner. While we typically spend a lot of time in the beginning of a relationship getting to each other, the time we spend on this tends to decrease until you can’t even name your spouse’s coworkers anymore. Continuing to learn about your partner will help you feel closer. So go ahead and ask some questions! What are some goals they have? What about current stresses?
2. Nurture you fondness and admiration: What we focus on tends to expand (Ever notice the longer you stare at dirty clothes on the bedroom floor, the angrier you become?). Steer your brain toward positive aspects of your partner more often, like what a creative cook they are or their sense of adventure.
3. Turn toward your partner instead of away: Generally people are more fulfilled when they have a good dose of interaction with others. However, your partner may have learned to not turn toward you to look for interaction (possibly because you give advice when they’d rather have you listen instead). Be on the lookout for your partner’s “bids” for your attention and answer them. For example, positively acknowledge when they speak by asking a question or making a comment, despite how trivial you think it may be. See how long you can go without giving a dismissive shrug or eye roll.
4. Let your partner influence you: Gottman’s research showed marriages are less likely to end in divorce when a husband allows himself to be influenced by his wife (other research has shown married men tend to live longer, most likely for this exact reason when it relates to listening to your wife when she says it’s time to have a check-up). Bottom line, you’re not going to be very happy if all your energy goes into trying to get your partner to see things your way (aka “the right way”).
5. Solve your solvable problems: The key to doing this is by talking to your spouse as if you were having a disagreement with a guest in your home. When a guest has done something we don’t like, we politely assume there must have been a misunderstanding or acknowledge our part in the problem. The soft start-up to these conversations usually ends in much better conflict resolution then the blaming, defensiveness, and criticism that can plague disagreements with our partner. In short, be polite.
6. Overcome gridlock: Every marriage has problems that will NEVER be solved. That’s okay. What can make these problems easier is by moving from gridlock to dialogue. Have the new goal of conversations around these topics be “How can I understand why this is so important to you?” instead of “How can I make you change your mind?” How can you be respectful of the differences between the two of you?
7. Create shared meaning: What makes the two of you a couple? What are the rituals the two of you have? What values do you share? What symbols or objects have special meaning to the two of you? Answering these questions and fostering an accepting culture between the two of you can help you add to these answers and feel more connected and fulfilled in your marriage.

If you have any questions about these principles, or need help implementing them into your marriage, feel free to call us (919-572-0000) or email ([email protected]) to connect with one of our couples’ counselors.