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Self Care for Parents of Struggling Children

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Self Care for Parents of Struggling Children

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Parenting is hard work, and parenting a child with mental health issues is exponentially harder. You're almost certainly putting in more effort than any other mom or dad you know, yet your kid may still be at risk, struggling, or making less progress than her peers. This raises a crucial question: How can you keep going without becoming exhausted?

Avoiding parent burnout requires real effort. Experts note it includes consistent self-care, establishing a strong support network for yourself, and having a trustworthy therapeutic team for your child. Another piece of the puzzle is learning to tap into one of the most powerful motivators on earth: your love for your child. Here are 12 ideas for how to do that.

Write down her good qualities, even if they haven't been visible lately. Find ways to talk about these to your partner, your friends and your child. "This morning I ran across that poem you wrote about ______, and it reminded me how creative you are. I've always admired that about you." (If your child mutters she is no longer like that, you can counter with a smile and something like, "Oh, deep down it's still there. Right now you're depressed, and no one is their best self when they are sick.")

Telling a humorous family incident or recounting a tale of your own foibles can help everyone feel connected. Silly baby stories, grade school antics, and memories of times you embarrassed yourself are great ways to get started laughing ... and remembering that good times do happen. Remembering more recent moments of happiness or enjoyment helps, too.

When using words is difficult, we can often still get through with gestures. Think back to what "said love" to her when she was little, or what used to soothe him when he was upset. Arriving at your teen's bedroom door with a gentle, "Hey, I thought maybe you'd like this" and a favorite treat can remind you both that you care, even if the offer is declined.

The look of surprise on a troubled child's face when he is greeted with joy instead of concern is a startling reminder of the importance of the need to express our affection in words and affect. A cheerful, "Oh, I was just thinking of you!" can shift both your heart and his to a better place.

Patience and perseverance blossom when we see parallels between our own emotional landscape and that of our children. When you're feeling overwhelmed, it's eye-opening to consider that this may be how your son feels all day, every day. A spike in your own anxiety or a wave of feeling helpless can provide you with powerful insight into what's going on when your daughter gets panicky.

Sometimes we retreat from difficulty without realizing it. If your child craves contact and you've pulled back physically, add "Touch him three times daily" to your to-do list. A quick back rub when he's hunched over homework, or a gentle hand on his shoulder while you're asking a question can help you stay connected.

It may help to remind yourself that not-knowing how to make things better doesn't mean you're inadequate - it simply means you haven't figured it out yet. Read up on your child's diagnosis, and be utterly frank with your child's therapist about your need to learn better ways to handle your child's outbursts or irritability or anxiety attacks. Tackling this as a learning-curve problem alleviates a great deal of insecurity, and makes it easier to connect with the love you have for your child.

Set aside time to face your feelings over what your child's illness has done to him, to you, and to family life. Give yourself permission to grieve what you have lost. You are not a bad parent for resenting how your child's irritability or outbursts impact you; it's possible to love your child and hate the effects of his illness at the same time. The key is to find healthy ways to process what you feel.

Write down one positive thing that happened every day, even if you have to hunt for the distant glimmer of light. You'll be surprised how much better you feel when you take time to do this. Go a step further and let your child know what you've observed, applauding her effort or catching her doing something good.

Sometimes a child's actions trigger old memories or reactions we thought we'd outgrown. It's unfortunate that when our offspring push our buttons, the buttons still belong to us - and we need to take responsibility for them. When we overreact to a situation, it may be a clue that it's time to work through longstanding issues for our own sake as well as for the sake of our kids.

Though mental illness isn't optional, the added burden of secrecy is. Opening up about what you're going through is likely to increase your emotional bandwidth significantly, giving you a much-needed infusion of energy. Confide in trusted friends, or find a support group for parents facing similar challenges (locally or on social media) to decrease your sense of isolation.

Depressed, anxious, and impulsive kids say and do many hurtful things. Even though you are the target, this is usually more about their pain than about you. Take a few deep breaths and remind yourself that some portion of the venom is the illness talking. Then repeat silently to yourself, "My love is deeper than your pain," and respond to your child as calmly as you can.

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Preventing Parent Burnout - Child Mind Institute

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Parenting is hard work, and parenting a child with mental health issues is exponentially harder. How can you keep going without becoming exhausted? A support network is key, but so is tapping emotional resources, especially your love for your child.

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Many parents understand the importance of healthy eating habits and staying active for their child's physical health. Now, with rates of mental health issues in children on the rise, more and more parents are realizing the value of supporting and nurturing their child's mental health as part of their overall health and wellness.

And while kids' mental health may be misunderstood as only a concern for children diagnosed with or seemingly at risk for a mental health disorder, one psychologist at Children's Health℠ encourages a different perspective.

Nicholas J. Westers, Psy.D., ABPP, a Children's Health clinical psychologist and Associate Professor at UT Southwestern, explains, "Good mental health is really about creating, encouraging and using everyday healthy habits - like sharing and acknowledging feelings, correcting unhealthy and unhelpful thinking, showing empathy and building resiliency."

Dr. Westers shares his advice on how all parents can teach kids about mental health and support their children on a journey to better mental health.

What is mental health?

Mental health is our emotional, psychological and social well-being, according to the U.S Department of Health and Human Services. Our mental health can affect how think, feel and behave and influence daily activities such as relationships, academic performance and physical health.

How many children have a mental health disorder?

The Centers for Disease Control and Prevention (CDC) estimates that up to 1 in 5 children in the U.S. experience a mental, behavioral or developmental health disorder. The most common disorders among children include:

How can parents affect children's mental health?

Parents play an important part in supporting and encouraging a child's good mental health habits. Mental health disorders do run in families, so if you suffer from anxiety, your child may be more likely to have an anxiety disorder, too. However, that is not always the case because environment also matters.

"What's most important is good modeling and instilling healthy habits so kids can face adversity later in life," says Dr. Westers.

How can you improve children's mental health?

Parents can nurture a child's mental health by building a close relationship with them, providing structure and boundaries, fostering independence, encouraging social connections, teaching healthy habits and modeling positive behavior.

Dr. Westers breaks down eight ways to help improve children's mental health:

1. Be intentional and attuned

Parents can nurture their child's mental health by paying close attention to their child's verbal and nonverbal cues. This helps identify when your child needs support or when they need someone to talk with.

When parents are attuned to their child - meaning they are consciously aware of their child's nonverbal physical and emotional needs and respond empathically to meet those needs - children develop a secure foundation from which their mental health can flourish. Children can sense if their parents are interested in them and if their parents approve or disapprove of them. Provide a secure base in which your child can safely experience their feelings, even before they can identify and verbally articulate them. Children learn best when they feel safe, so teaching them how to identify their feelings will go further if they are safe to express those very feelings.

2. Balance closeness and compliance

A good relationship with parents is one of the strongest protective factors against mental health disorders. Look for everyday opportunities to lead with empathy and foster closeness. This can help create a healthy relationship - one that makes it easier for your child to come to you when they face a problem.

For example, when your child throws a fit in the middle of a restaurant, your first reaction might be to settle them quickly, so they start behaving. While it's important for children to learn how to be good citizens, it's also important to show empathy in the moment. Instead of telling your child to be quiet, consider if there is another factor at play. Is she hungry? Did he not take a nap today? Did they have a bad day at school?

This applies to older children and teenagers all the more. They are more likely to comply with parental requests when they feel loved by and close to their parents.

"Consider if you've deposited enough emotional closeness into your 'relationship bank account' so that a request for compliance does not bankrupt your relationship," encourages Dr. Westers. "If your teen is about to move out, perhaps your long-term relationship with them is more important than getting them to rigidly obey certain arbitrary rules, such as those five extra minutes on their computer or video game."

3. Allow your child to experience distress and failure

Understandably, parents often want to swoop in and stop children from experiencing heartache or failure. However, those distressing experiences are key to building a child's mental health. "Failure builds resilience and encourages growth, understanding and even empathy," explains Dr. Westers.

As long as your child is safe, consider standing on the sidelines and being ready to support and encourage them when they need it most - instead of fixing a problem as soon as it happens.

4. Let children be bored

No playdates this week or next? No problem. Boredom, Dr. Westers says, is when creativity takes root. It's when children learn how to manage conflict with friends and siblings, how to problem solve, manage time, engage their imagination, develop self-control and be independent. These are all key traits in building resiliency and supporting your child's mental health. Keeping your child busy with scheduled activities may keep them from complaining of boredom, but it may also keep them from cultivating these skills. Don't feel pressured to fill every hour of your child's day with activity.

5. Provide structure

It's easier to deal with failures and struggles in life when we know that some boundaries and routines are in place. That includes boundaries at bedtime, limits on electronics, rules for playtime and expectations on how we treat others and ourselves. It is okay to allow for flexibility, but placing boundaries and structure communicates to your child that you love them and are invested in their well-being.

6. Encourage connections

Social health is a key part of our mental health. We are wired for connection. Building relationships allow us to learn how to be a better friend and learn critical social skills, such as reading and responding to nonverbal cues.

Dr. Westers suggests that for every hour of online connections, kids may need 30 minutes of face-to-face connections. That means balancing online video games with sending children outdoors to play with friends in the neighborhood.

7. Model good behavior

One of the most important ways parents can nurture their child's mental health is to model healthy behavior. That includes being open about your feelings - without oversharing details. It also means showing how you bounce back from a mistake.

"Parents mess up. Kids mess up. We hurt people we love," Dr. Westers says. "We have to recognize that and communicate our remorse. When our children see that it's okay to mess up, they learn not to dwell on past mistakes. They can become more resilient and move on to better and brighter memories."

8. Make healthy choices

Our physical health plays a critical role in our mental health. Our mind and body are intricately connected, and healthy eating, exercise and adequate sleep have all been shown to protect against mental health disorders and improve mood.

Parents should continue to encourage and model healthy choices that benefit physical, emotional and mental health, including:

Your child's mental health is a vital part of their overall wellness. Learn how you can help them build resilience and strong emotional habits.

Learn more

Children's Health provides comprehensive services to support children's and teens' mental health. Learn more about our Pediatric Psychiatry and Psychology Programs.

You can also access emotional care and support from the comfort of your home with Virtual Visit Behavioral Health. With a behavioral health care appointment, you can speak to a board-certified psychiatrist or licensed therapist using video technology. Learn more about Virtual Visit Behavioral Health.

Sign Up

Stay current on the health insights that make a difference to your children. Sign up for the Children's Health newsletter and have more tips sent directly to your inbox.

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How to Nurture Your Child's Mental Health - Children's Health

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Many parents understand the importance of healthy eating habits and staying active for their child's physical health. Now, with rates of mental health issues in children on the rise, more and more parents are realizing the value of supporting and nurturing their child's mental health as part of their overall health and wellness.

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Talking with Caregivers About Mental Health

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Talking with Caregivers About Mental Health

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A little preparation can set the stage for a more open and productive conversation with parents. They may be noticing the same troubling signs in their teen at home, or you may have a perspective that is new to parents. Either way, your goal should be to come from a place of caring and concern, and keep the focus on working together to connect the family with the best possible resources to help the student.

The following information is adapted from "Effective Communication with Parents," a guide developed by the Center for the Advancement of Mental Health Practices in Schools.
Three Important "Dont's"
#1: Don't wait for a problem to start a relationship.
If the first time you introduce yourself to a student's parents is when you meet to discuss a mental health concern, your challenge, and the resistance you may meet, are that much greater. Instead, make an attempt to call or meet the parents of each student in your class early in the semester. Let them know that you are looking forward to partnering with them to help their child succeed. If possible, try to call parents occasionally to share positive feedback about their children as well. If and when a concern arises, you'll be glad you did.

#2: Don't go it alone.
As soon as you notice a potential mental health issue with one of your students, your first call should be to your school's guidance counselor or staff mental health professional. He or she is trained to help everyone involved - you, the student and the parents. In partnership, you can determine the best strategy for sharing your concerns with the parents, identifying resources and next steps.

#3: Don't assume the worst.
Discussing a concern with a student's parents doesn't always set up an adversarial relationship. Most parents will be grateful for the candid fact-based information you can share, and many will be relieved to have their own concerns validated.

The right time and place

Each situation is unique. Together, you and your school's mental health professional can determine how best to reach out to parents. Here are some tips for connecting through printed newsletters, on the phone, and in person:

Newsletters or written communications:

Send messages home in the parents' native language, and written at an appropriate reading level. If you know of parents who cannot read, consider sending audiotaped messages, or asking the student to read the communication aloud to the family.

Try to make newsletters visually appealing and limited to one page; much longer will discourage reading.

Phone calls:

Aim for the number of positive phone calls you make to outnumber the negative calls. Even when the purpose of the call is to share a concern, also share positive statements. Again, take steps to avoid connecting only when there is a problem.

Invite the parent to share their concerns.

Ask permission to share your concerns, allow time for them to respond to your concerns, and to offer solutions.

Use active listening by repeating back in your own words what you think the parent is saying and then ask for confirmation that you heard it correctly.

Parent-teacher conferences and other face-to-face meetings:

Here too, balance positive and negative statements.

Make a list of at least 10 positive things about the child, along with no more than four areas of concern that you would like to address together.

Begin by sharing some of the positive things about the student, then ask permission to share your concerns.

Don't try and accomplish everything in a 15 minute conference. If you can, schedule more time or a follow-up conversation.

More tips for productive parent-teacher conversations

You might find some of the suggestions below helpful for making the most of your conversations with parents:

1. Express empathy. Ask permission to share what you have observed about their student in the classroom that concerns you, and then ask what they have observed at home, and what strategies they might have tried in the past to address their concerns. Use open-ended questions and reflective listening (repeating back what you hear them saying in your own words) to help show that you understand. Express understanding related to their frustration or worries.

2. Help parents see the difference between where the student is now and where he/she wants to be. You may need to help them compare the consequences of change versus maintaining the status quo.

3. Avoid arguing. You're not seeking to prove a point or to be right. Instead, you are trying help the parent/guardian understand your concern and see the pros and cons of change.

4. Roll with resistance rather than meeting it head on. It's common and understandable for parents to resist acknowledging a mental health problem, or to feel that somehow they are being "blamed" for the situation. They do not necessarily have to agree with you.

5. Acknowledge the positive attempts they and the student have made so far. Your optimism can reduce the discomfort that parents may feel.

6. Communicate respect. Act as a compassionate and knowledgeable consultant, while respecting the family's freedom of choice and self-direction.

7. Respect cultural differences. Remember that different cultures have different norms regarding personal space, touching, eye contact, etc.

Preparing for parental resistance or denial

It's not uncommon for family members to deny the existence of a mental health or behavioral problem. If during your conversation a parent/guardian grows defensive or rejects your concern, continue to rely on these conversational tools.* And remember: the way you behave and respond plays a big role in diffusing or aggravating that resistance.

1. Shake hands to welcome them (if culturally appropriate).

2. Sit face-to-face (if culturally appropriate).

3. Ask permission to share your concerns with the family.

4. Establish time limits and the issues to be covered early.

5. Speak gently, calmly and confidently.

6. Stress the positive, and be gentle with the negative.

7. Use open-ended questions and reflective listening.

8. Listen with empathy and respect, which also requires reflective listening.

9. Welcome constructive criticism and ideas.

10. Remember that you and the parent are allies.

11. Focus on problems, not personalities.

12. Share feedback - if you have objective data about the concern (grades, attendance, etc.), share it.

13. Affirm, reinforce and compliment - frequently acknowledge the positives in both the student and the parents.

14. Discuss a plan - transition from discussing the concern to providing options and negotiating a plan for addressing it.

15. Provide information and resources - visit the Resources section of this website for ideas.

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A little preparation can set the stage for a more open and productive conversation with parents. They may be noticing the same troubling signs in their teen at home, or you may have a perspective that is new to parents.

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Talking with your teen about mental health

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Talking with your teen about mental health

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Activities, events and fun things to do in L.A. with kids. L.A. Parent is your resource for kids activities in L.A. as well as articles and resources on special needs, summer activities and positive parenting.

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What Are Anxiety Disorders?

Anxiety disorders cause extreme fear and worry, and changes in a child's behavior, sleep, eating, or mood.

What Are the Kinds of Anxiety Disorders?

Different anxiety disorders can affect kids and teens. They include:

generalized anxiety disorder

separation anxiety disorder

social anxiety disorder

panic disorder

selective mutism

specific phobias

Generalized anxiety disorder (GAD). GAD causes kids to worry almost every day - and over lots of things. Kids with GAD worry over things that most kids worry about, like homework, tests, or making mistakes.

But with GAD, kids worry more, and more often, about these things. Kids with GAD also worry over things parents might not expect would cause worry. For example, they might worry about recess, lunchtime, birthday parties, playtime with friends, or riding the school bus. Kids with GAD may also worry about war, weather, or the future. Or about loved ones, safety, illness, or getting hurt.

Having GAD can make it hard for kids to focus in school. Because with GAD, there is almost always a worry on a kid's mind. GAD makes it hard for kids to relax and have fun, eat well, or fall asleep at night. They may miss many days of school because worry makes them feel sick, afraid, or tired.

Some kids with GAD keep worries to themselves. Others talk about their worries with a parent or teacher. They might ask over and over whether something they worry about will happen. But it's hard for them to feel OK, no matter what a parent says.

Separation anxiety disorder (SAD). It's normal for babies and very young kids to feel anxious the first times they are apart from their parent. But soon they get used to being with a grandparent, babysitter, or teacher. And they start to feel at home at daycare or school.

But when kids don't outgrow the fear of being apart from a parent, it's called separation anxiety disorder. Even as they get older, kids with SAD feel very anxious about being away from their parent or away from home. They may miss many days of school. They may say they feel too sick or upset to go. They may cling to a parent, cry, or refuse to go to school, sleepovers, playdates, or other activities without their parent. At home, they may have trouble falling asleep or sleeping alone. They may avoid being in a room at home if their parent isn't close by.

Social phobia (social anxiety disorder). With social phobia, kids to feel too afraid of what others will think or say. They are always afraid they might do or say something embarrassing. They worry they might sound or look weird. They don't like to be the center of attention. They don't want others to notice them, so they might avoid raising their hand in class. If they get called on in class, they may freeze or panic and can't answer. With social phobia, a class presentation or a group activity with classmates can cause extreme fear.

Social phobia can cause kids and teens to avoid school or friends. They may feel sick or tired before or during school. They may complain of other body sensations that go with anxiety too. For example, they may feel their heart racing or feel short of breath. They may feel jumpy and feel they can't sit still. They may feel their face get hot or blush. They may feel shaky or lightheaded.

Panic disorder. These sudden anxiety attacks can cause overwhelming physicals symptoms, such as feeling shaky or jittery, trembling, a racing heart rate, and shortness of breath. Panic attacks can happen any time. They're more common in teens than kids.

Selective mutism. This extreme form of social phobia causes kids to be so afraid they don't talk. Kids and teens who have it can talk. And they do talk at home or with their closest people. But they refuse to talk at all at school, with friends, or in other places where they have this fear.

Specific phobias. It's normal for young kids to feel scared of the dark, monsters, big animals, or loud noises like thunder or fireworks. Most of the time, when kids feel afraid, adults can help them feel safe and calm again. But a phobia is a more intense, more extreme, and longer lasting fear of a specific thing. With a phobia, a child dreads the thing they fear and tries to avoid it. If they are near what they fear, they feel terrified and are hard to comfort.

With a specific phobia, kids may have an extreme fear of things like animals, spiders, needles or shots, blood, throwing up, thunderstorms, people in costumes, or the dark. A phobia causes kids to avoid going places where they think they might see the thing they fear. For example, a kid with a phobia of dogs may not go to a friend's house, to a park, or to a party because dogs might be there.

What Are the Signs & Symptoms of Anxiety?

A parent or teacher may see signs that a child or teen is anxious. For example, a kid might cling, miss school, or cry. They might act scared or upset, or refuse to talk or do things. Kids and teens with anxiety also feel symptoms that others can't see. It can make them feel afraid, worried, or nervous.

It can affect their body too. They might feel shaky, jittery, or short of breath. They may feel "butterflies" in their stomach, a hot face, clammy hands, dry mouth, or a racing heart.

These symptoms of anxiety are the result of the "fight or flight" response. This is the body's normal response to danger. It triggers the release of natural chemicals in the body. These chemicals prepare us to deal with a real danger. They affect heart rate, breathing, muscles, nerves, and digestion. This response is meant to protect us from danger. But with anxiety disorders, the "fight or flight" response is overactive. It happens even when there is no real danger.

What Causes Anxiety Disorders?

Several things play a role in causing the overactive "fight or flight" that happens with anxiety disorders. They include:

Genetics. A child who has a family member with an anxiety disorder is more likely to have one too. Kids may inherit genes that make them prone to anxiety.

Brain chemistry. Genes help direct the way brain chemicals (called neurotransmitters) work. If specific brain chemicals are in short supply, or not working well, it can cause anxiety.

Life situations. Things that happen in a child's life can be stressful and difficult to cope with. Loss, serious illness, death of a loved one, violence, or abuse can lead some kids to become anxious.

Learned behaviors. Growing up in a family where others are fearful or anxious also can "teach" a child to be afraid too.

How Are Anxiety Disorders Diagnosed?

Anxiety disorders can be diagnosed by a trained therapist. They talk with you and your child, ask questions, and listen carefully. They'll ask how and when the child's anxiety and fears happen most. That helps them diagnose the specific anxiety disorder the child has.

A child or teen with symptoms of anxiety should also have a regular health checkup. This helps make sure no other health problem is causing the symptoms.

How Are Anxiety Disorders Treated?

Most often, anxiety disorders are treated with cognitive behavioral therapy (CBT). This is a type of talk therapy that helps families, kids, and teens learn to manage worry, fear, and anxiety.

CBT teaches kids that what they think and do affects how they feel. In CBT, kids learn that when they avoid what they fear, the fear stays strong. They learn that when they face a fear, the fear gets weak and goes away.

In CBT:

Parents learn how to best respond when a child is anxious. They learn how to help kids face fears.

Kids learn coping skills so they can face fear and worry less.

The therapist helps kids practice, and gives support and praise as they try. Over time, kids learn to face fears and feel better. They learn to get used to situations they're afraid of. They feel proud of what they've learned. And without so many worries, they can focus on other things - like school, activities, and fun. Sometimes, medicines are also used to help treat anxiety.

How Can I Help My Child?

If your child has an anxiety disorder, here are some ways you can help:

Find a trained therapist and take your child to all the therapy appointments.

Talk often with the therapist, and ask how you can best help your child.

Help your child face fears. Ask the therapist how you can help your child practice at home. Praise your child for efforts to cope with fears and worry.

Help kids talk about feelings. Listen, and let them know you understand, love, and accept them. A caring relationship with you helps your child build inner strengths.

Encourage your child to take small steps forward. Don't let your child give up or avoid what they're afraid of. Help them take small positive steps forward.

Be patient. It takes a while for therapy to work and for kids to feel better.

Helping Your Child Manage Anxiety

Feeling nervous, worried, or uneasy at times is a normal part of growing up. You can help prevent anxiety from becoming a bigger problem by learning how to help your child feel more in control and ways to cope with stress.

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Anxiety disorders cause extreme fear and worry, and changes in a child's behavior, sleep, eating, or mood. Different anxiety disorders can affect kids and teens. They include: generalized anxiety disorder separation anxiety disorder social anxiety disorder panic disorder selective mutism specific phobias Generalized anxiety disorder (GAD).

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Teacher Toolkit - Classroom Mental Health

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Teacher Toolkit - Classroom Mental Health

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Mood Disorders

As a teacher, you're in a unique position to identify the signs early and help your students navigate their way to better mental health.

How to talk to a student

Wondering what to say when a student shares personal mental health concerns with you? This section will help you get started.

Your Community Resources

Check out this database of mental health resources located in your community.

Search Database

Working with families

This section will help you work with your school's staff to make the right connection with families so you can partner to find solutions.

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As a teacher, you're in a unique position to identify the signs early and help your students navigate their way to better mental health. Wondering what to say when a student shares personal mental health concerns with you? This section will help you get started.

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Mindfulness Exercises for Kids in the Classroom - Waterford.org

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Use these 51 mindfulness activities to help children recognize and manage their thoughts, emotions, and actions—all important SEL skills.

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51 Mindfulness Exercises for Kids in the Classroom

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Classroom Practices to Support Mental Health

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Classroom Practices to Support Mental Health

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Easy-to-implement, evidence-based mental health practices for elementary classrooms

Explore by skill category

Or, view all practices and use filters to find what you need

The practices align with Ontario's curriculum and are designed to help educators model and teach social-emotional skills and create and sustain mentally healthy classrooms.

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Everyday Mental Health Classroom Resource - Help students learn to take care of their mental health through simple, everyday classroom practices.

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Self-awareness is the ability to be aware of one's inner life-one's emotions, thoughts, behaviors, values, goals, strengths, challenges, attitudes, mindsets- and how these elements impact our decisions.

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Empowering Students and Educators with Mindfulness and Self-Care Training that is Simple, Sustainable, and Impactful.

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When teachers recognize a student’s depression and intervene with flexible supports, that student can feel—and learn—better.

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Centers for Disease Control and Prevention

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Children with attention-deficit/hyperactivity disorder (ADHD) experience more obstacles in their path to success than the average student. The symptoms of ADHD, such as inability to pay attention, difficulty sitting still, and difficulty controlling impulses, can make it hard for children with this diagnosis to do well in school.

To meet the needs of children with ADHD, schools may offer

ADHD treatments, such as behavioral classroom management or organizational training;

Special education services; or

Accommodations to lessen the effect of ADHD on their learning.

Classroom Treatment Strategies for ADHD Students

There are some school-based management strategies shown to be effective for ADHD students: behavioral classroom management and organizational training.

The behavioral classroom management approach encourages a student's positive behaviors in the classroom, through a reward systems or a daily report card, and discourages their negative behaviors. This teacher-led approach has been shown to influence student behavior in a constructive manner, increasing academic engagement. Although tested mostly in elementary schools, behavioral classroom management has been shown to work students of all ages.

Organizational training teaches children time management, planning skills, and ways to keep school materials organized in order to optimize student learning and reduce distractions. This management strategy has been tested with children and adolescents.

These two management strategies require trained staff-including teachers, counselors, or school psychologists-follow a specific plan to teach and support positive behavior.

The American Academy of Pediatrics (AAP) recommends that the school environment, program, or placement is a part of any ADHD treatment plan. AAP also recommends teacher-administered behavior therapy as a treatment for school-aged children with ADHD. You can talk to your child's healthcare provider and teachers about working together to support your child.

Special Education Services and Accommodations

Most children with ADHD receive some school services, such as special education services and accommodations. There are two laws that govern special services and accommodations for children with disabilities:

The Individuals with Disabilities Education Act (IDEA)

Section 504 of the Rehabilitation Act of 1973

The support a child with ADHD receives at school will depend on if they meet the eligibility requirements for one of two federal plans funded by IDEA and Section 504: an individualized education program (IEP) or a 504 Plan.

What are the main differences between the two Plans?

IEPs provide individualized special education services to meet the unique needs of the child.

A 504 Plan provides services and changes to the learning environment to meet the needs of the child as adequately as other students.
Learn more about IEP and 504 Plans [PDF - 2.75 MB]
Accommodations

IEP and 504 Plans can offer accommodations for students to help them manage their ADHD, including:

Extra time on tests;

Instruction and assignments tailored to the child;

Positive reinforcement and feedback;

Using technology to assist with tasks;

Allowing breaks or time to move around;

Changes to the environment to limit distraction; and

Extra help with staying organized.

There is limited information about which types of accommodations are effective for children with ADHD. However, there is evidence that setting clear expectations, providing immediate positive feedback, and communicating daily with parents through a daily report card can help.

What Teachers Can Do To Help

For teachers, helping children manage their ADHD symptoms can present a challenge. Most children with ADHD are not enrolled in special education classes, but do need extra assistance on a daily basis. The National Resource Center on ADHD provides information for teachers from experts on how to help students with ADHD.

Here are some tips for classroom success.

Communication

Give frequent feedback and attention to positive behavior;

Be sensitive to the influence of ADHD on emotions, such as self-esteem issues or difficulty regulating feelings;

Provide extra warnings before transitions and changes in routines; and

Understand that children with ADHD may become deeply absorbed in activities that interest them (hyper-focus) and may need extra assistance shifting their attention.

Assignments and Tasks

Make assignments clear-check with the student to see if they understand what they need to do;

Provide choices to show mastery (for example, let the student choose among written essay, oral report, online quiz, or hands-on project;

Make sure assignments are not long and repetitive. Shorter assignments that provide a little challenge without being too hard may work well;

Allow breaks-for children with ADHD, paying attention takes extra effort and can be very tiring;

Allow time to move and exercise;

Minimize distractions in the classroom; and

Use organizational tools, such as a homework folder, to limit the number of things the child has to track.

Develop a Plan That Fits the Child

Observe and talk with the student about what helps or distracts them (for example, fidget tools, limiting eye contact when listening, background music, or moving while learning can be beneficial or distracting depending on the child);

Communicate with parents on a regular basis; and

Involve the school counselor or psychologist.

Close collaboration between the school, parents, and healthcare providers will help ensure the child gets the right support.

Parent Education and Support

CDC funds the National Resource Center on ADHD (NRC), a program of Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD). The NRC provides resources, information, and advice for parents on how to help their child. Learn more about their services.

How to best advocate for your child

Understand your child's diagnosis, how it impacts their education, and what can be done at home to help.

Understand your child's IEP. If you have questions, don't be afraid to ask.

Speak with your child's teacher.

When possible, obtain written documentation from teachers, administrators, or other professionals working with your child.

Know your rights.

Play an active role in preparing your child's IEP or 504 Plan.

Keep careful records, including written documentation, communication between home and school, progress reports, and evaluations.

Try to maintain a good working relationship with the school while being a strong advocate for your child.

Communicate any concerns you may have about your child's progress or IEP or 504 Plan.

Encourage your child every day, and work with your child to create a system to help with homework and other school projects.

What every parent should know

More Information

Reference

1. Evans S, Owens J, Bunford N. Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. Journal of Clinical Child & Adolescent Psychology 2014;43(4):527-551 [Read overview]

2. DuPaul GJ, Chronis-Tuscano A, Danielson ML, Visser SN. Predictors of receipt of school services in a national sample of youth with ADHD. Journal of Attention Disorders Published online December 10, 2018. [Read summary]

3. Harrison JR, Bunford N, Evans SW, Owens JS. Educational accommodations for students with behavioral challenges: A systematic review of the literature. Review of Educational Research 2013;83(4):551-97.

4. Moore DA, Russell AE, Matthews J, Ford TJ, Rogers M, Ukoumunne OC, et al. School-based interventions for attention-deficit/hyperactivity disorder: A systematic review with multiple synthesis methods. Review of Education. Published online October 18, 2018.

5. https://chadd.org/for-parents/individuals-with-disabilities-education-act/

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To meet the needs of children with ADHD, schools may offer ADHD treatments, special education services, or accommodations to lessen the effect of ADHD on their learning.

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Guide

Attention-deficit hyperactivity disorder, or ADHD, is a condition that makes it unusually difficult for children to concentrate, sit still, follow directions and control impulsive behavior.

Attention-deficit hyperactivity disorder, or ADHD, is a condition that makes it unusually difficult for children to concentrate, sit still, follow directions and control impulsive behavior. This guide focuses on what educators need to know about teaching kids with ADHD: how it affects children in the classroom - girls as well as boys - and how we teachers can help kids with the disorder succeed in school.

Many children with ADHD show signs of the attention disorder before they reach school age. But it's in school, when they are having trouble meeting expectations for kids in their grade, that most are referred for diagnosis.

That's why it's important that educators be well-informed about the attention deficit hyperactivity disorder - able to recognize children who might be struggling with ADHD, but also aware that the symptoms and behaviors associated with ADHD may also have other possible explanations.

There are three kinds of behavior involved in ADHD: inattention, hyperactivity and impulsivity. Of course all young children occasionally have trouble paying attention to teachers and parents, staying in their seats and waiting their turn. Kids should only be diagnosed with ADHD if their behavior is much more extreme in these areas than other kids their age.

These symptoms of ADHD are divided into two groups - inattentive and hyperactive-impulsive. Some children exhibit mostly inattentive behaviors, and others, predominantly hyperactive-impulsive. But the majority of those with ADHD have a combination of both, which can make it very difficult for them to function well in school.

Here are behaviors signs of ADHD you might observe in school in those two categories.

Inattentive Symptoms of ADHD:

Makes careless mistakes in schoolwork, overlooks details

Is easily distracted or sidetracked

Has difficulty following instructions

Doesn't seem to be listening when spoken to directly

Has trouble organizing tasks and possessions

Often fails to finish work in school or chores in the classroom

Often avoids or resists tasks that require sustained mental effort, including doing homework

Often loses homework assignments, books, jackets, backpacks, sports equipment

Hyperactive or Impulsive Symptoms of ADHD:

Often fidgets or squirms

Has trouble staying in his seat

Runs and climbs where it's inappropriate

Has trouble playing quietly

Is extremely impatient, can't wait for his turn

Always seems to be "on the go" or "driven by a motor"

Talks excessively

Blurts out answers before a question is completed

Interrupts or intrudes on others' conversations, activities, possessions

ADHD Behavior and Serious Impairment

It's important to keep in mind that not every high-energy or impulsive child has ADHD. Children are diagnosed with ADHD only if they demonstrate these symptoms so often that they are causing real difficulty in at least two settings - i.e., at school and at home. And the pattern that's causing them serious impairment must persist for at least six months.

The Difference Between ADD and ADHD

ADD, or attention-deficit disorder, is an older term for the disorder we now call ADHD, or attention-deficit hyperactivity disorder. It was called ADD up until 1987, when the word "hyperactivity" was added. Some people still use the old term, ADD, out of habit, or because it's a more familiar term than ADHD. Some use it to refer to kids with ADHD who aren't hyperactive.

Why Age Is Crucial in ADHD Diagnosis

Within any given classroom, there is an age range of students that spans almost a year, and a year can make a big difference in a child's ability to self-regulate. That's why it's important when teaching kids with ADHD and when considering a child's behavior, to compare it to other children the same age - not to the range of kids in his class or grade.

Two studies in the last few years concluded that kids who are youngest in their class are disproportionately diagnosed with ADHD. A Michigan study found that kindergarteners who are the youngest in their grade are 60 percent more likely to be diagnosed with ADHD than the oldest in their grade. And it doesn't affect just kindergarteners: a North Carolina study found that in fifth and eighth grade, the youngest children were almost twice as likely as the oldest to be prescribed medication for ADHD.

Why Are Some Kids With ADHD Prone to Disruptive Behavior?

Defiance and emotional outbursts are not themselves symptoms of ADHD, but kids with ADHD are at higher risk for developing these behaviors. Some kids who have ADHD tend to become frustrated and overwhelmed by demands placed on them that they cannot consistently fulfill, because of inherent deficits in paying attention, reining in impulses and controlling their activity level.

Making transitions from one activity to another can be particularly difficult for kids with ADHD in the classroom, especially when they involve stopping some activity they find more stimulating than what comes next. Clinicians call it an inability to "attention switch," and it can result in children disrupting the class or acting out.

Other Causes for Behaviors That Look Like ADHD

A child who can't seem to sit still, who blurts out answers in class without raising his hand, who doesn't finish his homework, who seems to be daydreaming when the teacher gives instructions - these actions are associated with ADHD behavior, but they can also be a result of other factors, from anxiety to trauma to just being younger than most of the kids in the class, and hence a little less mature.

That's why it's important for teachers and parents both to be aware of other things that could be influencing a child's behavior.

Inattention: A child who is inattentive could be distracted by a worrisome or painful situation at home, or because she's being bullied on the playground, and recess is coming up. If a child with OCD doesn't know the answer to the question, it looks like he wasn't paying attention, but it's really because he was distracted by obsessions. When a child seems to be looking everywhere but at the pages of the book she is supposed to be reading, another possible cause is that she has a learning disorder.

Hyperactivity: If a child is fidgeting when she's supposed to be reading, she could have sensory issues that are making her uncomfortable, or a learning issue that is causing her great frustration. And if she bolts from her chair, it could be because she is ashamed that she doesn't seem to be able to do what the other kids can do, and intent on covering that fact up.

Impulsivity: Anxiety is another condition, often hidden, that can cause kids to be unable to follow rules or wait their turn, or to lash out when they are upset.

Gender Differences in ADHD: How are Girls Different From Boys?

The stereotype of ADHD is boys disrupting the classroom by jumping up from their seats, getting in other kids' business or blurting out answers without raising their hands. But girls get ADHD too, and they tend to be diagnosed much later because their symptoms are more subtle.

More of them have only the inattentive symptoms of ADHD, and they get written off as dreamy or ditzy.

If they have the hyperactive-impulsive symptoms they are more likely to be seen as pushy, hyper-talkative or overemotional.

Impulsive girls may have trouble being socially appropriate and struggle to make and keep friends.

They often work so hard to compensate for their weaknesses that they are able to hide their challenges.

The growing awareness, as they get older, that they have to work much harder than their peers without ADHD is very damaging to their self-esteem.

Girls who are chronically hard on themselves about their mistakes may be struggling with thoughts that they're stupid or broken.

What Are Executive Functions?

Executive functions are the self-regulating skills that we all use to accomplish tasks,
from getting dressed to doing homework. They include:

Planning

Organizing time and materials

Making decisions

Shifting from one situation to another

Controlling emotions

Learning from past mistakes

Most kids with ADHD have deficits in some executive functions, though not all children with executive function issues have ADHD.

How Can Teachers Help Kids With ADHD?

Children with ADHD in the classroom who have trouble complying with rules and completing tasks can benefit from a daily report card system that sets positive behavioral goals and rewards to reinforce the behavior when they meet those goals.

The desired behaviors might be for the child to remain seated, to finish schoolwork, to raise his hand before speaking. The child receives points for successfully meeting goals, and his parents receive a daily behavior report card, enabling them to further to reinforce positive behavior in school with praise and prizes earned.

This system allows teachers to focus on what the child is doing well - rather than what he isn't doing well. It can bolster his self-esteem and help him feel positive about school.

Commonly Used Medications for ADHD

Many children with ADHD are prescribed stimulant medication to help reduce their symptoms. There are two main classes of stimulant ADHD medications:

Methylphenidate-based medications: Ritalin, Methylin, Concerta, Metadate, Daytrana Patch, Ritalin LA

Dextroamphetamine-based medications: Adderall, Vyvanse, Dexedrine, Focalin

There are also many different release formulas for stimulant medications, which make them effective for different periods of time:

Immediate-release formulas are effective for about four to six hours.

Extended-release formulas last as long as nine to twelve hours.

Children taking immediate-release formulas are often given medication in the middle of the school day by a school nurse. The goal is to maintain an effective dose during the school day but have the ADHD medication out of the child's system by bedtime, to facilitate sleep.

This guide was last reviewed or updated on February 23, 2023.

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Attention-deficit hyperactivity disorder, or ADHD, is a condition that makes it unusually difficult for children to concentrate, sit still, follow directions and control impulsive behavior.

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For Professionals | School Based Behavioral Health (SBBH) | University of Pittsburgh

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Professionals working in school-based behavioral health will find many resources on this page. Students and the faculty members in the University of Pittsburgh’s School-based Behavioral Health Specialization have developed professional development resources including slide presentations and accompan…

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The LEADERS PROJECT!

Here you will find biographies of pioneers and leaders in the field of children and behavioral health. In learning about schools and behavioral health, it is important to be aware of the origin of the evidenced-based interventions, data collection practices, models, and policy efforts. These are the people who inspire us to continue advocating for children with behavioral and mental health disorders. We encourage you to browse and meet these great leaders and pioneers who have spent their life's work advocating for those who are unable to advocate for themselves.

Stories for Children

Available now on SBBH: stories for children! These stories were designed as developmentally appropriate, child-friendly approaches to explain behavioral interventions. A caregiver information guide appears in the back of the book. This guide will explain the intervention in parent-friendly language.

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School Based Behavioral Health (SBBH) | University of Pittsburgh

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Here you will find biographies of pioneers and leaders in the field of children and behavioral health. In learning about schools and behavioral health, it is important to be aware of the origin of the evidenced-based interventions, data collection practices, models, and policy efforts.

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Ready, Set, Go, Review: Screening for Behavioral Health Risk in Schools

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The National Center for School Mental Health (NCSMH) leads innovation in comprehensive school mental health systems designing and evaluating cutting-edge programs, practices and policies to advance high impact outcomes for youth, families, educators and communities.

Through the HRSA-funded School Health Services National Quality Initiative, we developed the School Health Assessment and Performance Evaluation system, or the SHAPE system. Register for SHAPE as an individual, school, district, or state to improve your school mental health systems for free. SHAPE users have access to a screening & assessment library, resource center, school mental health quality assessment, and more. Learn more on our NCSMH SHAPE page.

In our resources on this site, you can navigate through descriptions and resource samples across the 8 domains of the school mental health quality assessment that align with the national Mental Health Technology Transfer Center Curriculum:

Foundations of School Mental Health

Teaming

Needs Assessment and Resource Mapping

Mental Health Screening

Mental Health Promotion for All (Tier 1)

Early Intervention and Treatment (Tiers 2 & 3)

Funding and Sustainability

Impact

To view our upcoming or recent webinars, visit our webinars page.

Supporting students, families, and communities impacted by bias, hate, and violence:
Key resources:

The Advancing Comprehensive School Mental Health Systems Report and Dialogue Guides Package offer collective insight and guidance to local communities and states to advance comprehensive school mental health systems.
Resources in Response to the Buffalo Supermarket Hate Crime: In response to this event, the National Child Traumatic Stress Network has developed resources to help children, families, and communities navigate what they are seeing and hearing, acknowledge their feelings, and find ways to cope together.

The Need for Performance Standards in Preschools: Stealing Shamelessly from Comprehensive School Mental Health Literature by Sam Reaves, Sami Hartley, Brandy Clarke, Sharon Hoover, and Nancy Lever

Advancing Comprehensive School Mental Health Systems: A Guide for State Education Agencies with the Council of Chief State School Officers

Resources in Response to School Threats of Violence by the National Child Traumatic Stress Network

Transforming Caseload to Workload in School-Based Occupational Therapy Services, a FAQ document by the American Occupational Therapy Association

Tools for Supporting Emotional Well-being in Children and Youth by the National Academies of Sciences, Engineering, and Medicine

Advocating for Comprehensive School Mental Health (with the Family Run Executive Director Leadership Association)

Effective School-Community Partnerships to Support School Mental Health (with the National Association of School Psychologists)

Natural Disaster Resources

Restart & Recovery: Leveraging Federal COVID Relief Funding & Medicaid to Support Student & Staff Wellbeing & Connection - Opportunities for State Education Agencies (with the Healthy Schools Campaign and Council of Chief State School Officers)

School Mental Health NOW Action Alert

Social Influencers of Health and Education (with the Center for Health and Health Care in Schools)

Supporting Mental health in Schools (with the American Academy of Pediatrics)

Youth MOVE National has created a new website on school mental health advocacy!

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The National Center for School Mental Health (NCSMH) leads innovation in comprehensive school mental health systems designing and evaluating cutting-edge programs, practices and policies to advance high impact outcomes for youth, families, educators and communities. Through the HRSA-funded School Health Services National Quality Initiative, we developed the School Health Assessment and Performance Evaluation system, or the SHAPE system.

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Overview:

To watch a child grieve and not know what to do is a profoundly difficult experience for parents, teachers, and caregivers. Yet, there are guidelines for helping children develop a lifelong healthy response to loss.

In When Children Grieve, the authors offer a cutting-edge volume to free children from the false idea of "not feeling bad" and to empower them with positive, effective methods of dealing with loss.

There are many life experiences that can produce feelings of grief in a child, from the death of a relative or a divorce in the family to more everyday experiences such as moving to a new neighborhood or losing a prized possession. No matter the reason or degree of severity, if a child you love is grieving, the guidelines examined in this thoughtful book can make a difference.

Biography:

John W. James and Russell Friedman have been working with grievers for more than thirty years. They have served as consultants to thousands of bereavement professionals and provide Grief Recovery Seminars and Certification Programs throughout the United States and Canada. They are the founders of the Grief Recovery Institute®.

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Overview: To watch a child grieve and not know what to do is a profoundly difficult experience for parents, teachers, and caregivers. Yet, there are guidelines for helping children develop a lifelong healthy response to loss.

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A school-based program of mindful awareness practices (MAPs) was evaluated in a randomized control study of 64 second- and third-grade children ages 7-9 years. The program was delivered for 30 minutes, twice per week, for 8 weeks. Teachers and parents completed questionnaires assessing children's executive function immediately before and following the 8-week period. Multivariate analysis of covariance on teacher and parent reports of executive function (EF) indicated an interaction effect between baseline EF score and group status on posttest EF. That is, children in the MAPs group who were less well regulated showed greater improvement in EF compared with controls. Specifically, those children starting out with poor EF who went through the MAPs training showed gains in behavioral regulation, metacognition, and overall global executive control. These results indicate a stronger effect of MAPs on children with executive function difficulties. The finding that both teachers and parents reported changes suggests that improvements in children's behavioral regulation generalized across settings. Future work is warranted using neurocognitive tasks of executive functions, behavioral observation, and multiple classroom samples to replicate and extend these preliminary findings.

This work was supported by MARC ( http://www.marc.ucla.edu) and the authors thank the families and teachers who participated in this study, MAPs teaching assistants Yaffa Lerea and Adrienne Levin, Dr. Suzie Tortoro for her help in developing movement-related activities, and Daniel Siegel for his contributions to the research.

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Effects of Mindful Awareness Practices on Executive Functions in Elementary School Children

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A school-based program of mindful awareness practices (MAPs) was evaluated in a randomized control study of 64 second- and third-grade children ages 7-9 years. The program was delivered for 30 minutes, twice per week, for 8 weeks. Teachers and parents completed questionnaires assessing children's executive function immediately before and following the 8-week period.

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Dr. Russell A. Barkley - Dedicated to Education and Research on ADHD

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Russell A. Barkley, Ph.D. Dedicated to Education and Research on ADHD

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3 Types of School Supports to Help Students with Mental Health Conditions

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There is hope for students with mental health needs as there are several ways to secure academic and behavioral support.

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Identifying signs of mental health needs

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Identifying signs of mental health needs

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Educators are often the first to notice mental health problems in children and young adults. Here are some ways you can help your students and their families.

What Educators Should Know

You should know:

What Educators Should Look for in Student Behavior

Consult with a school counselor, nurse, or administrator and the student's parents if you observe one or more of the following behaviors:

Feeling very sad or withdrawn for more than two weeks

Seriously trying to harm oneself, or making plans to do so

Sudden overwhelming fear for no reason, sometimes with a racing heart or fast breathing

Involvement in many fights or desire to badly hurt others

Severe out-of-control behavior that can hurt oneself or others

Not eating, throwing up, or using laxatives to make oneself lose weight

Intense worries or fears that get in the way of daily activities

Extreme difficulty concentrating or staying still that puts the student in physical danger or causes problems in the classroom

Repeated use of drugs or alcohol

Severe mood swings that cause problems in relationships

Drastic changes in the student's behavior or personality

What Educators Can Do in Classrooms and Schools

You can support the mental health of all students in your classroom and school, not just individual students who may exhibit behavioral issues. Consider the following actions:

Learn more about mental health by taking a mental health awareness training

Promote social and emotional competency and build resilience

Help ensure a positive, safe school environment

Teach and reinforce positive behaviors and decision-making

Encourage helping others

Encourage good physical health

Help ensure access to school-based mental health supports

Developing Effective School Mental Health Programs

Efforts to care for the emotional well-being of children and youth can extend beyond the classroom and into the entire school. School-based mental health programs can focus on promoting mental wellness, preventing mental health problems, and providing treatment.

Effective programs:

Promote the healthy social and emotional development of all children and youth

Recognize when young people are at risk for, or are experiencing, mental health problems

Identify how to intervene early and appropriately when there are problems

Learn More about Ways to Support Your Students and Their Families

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Educators are often the first to notice mental health problems in children and young adults. Here are some ways you can help your students and their families.

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As much as parents try to shield their children from all kinds of frightening, dangerous or life-threatening events, the reality is that these things can still happen. Even when children aren't physically imperiled, they may still struggle with mental and emotional trauma, which can sometimes stay with them for the duration of their lives. Children living through the COVID-19 pandemic, for example, may experience trauma from being pulled out of school, being separated from friends or family members, and worrying about contracting the virus.

Childhood trauma is more common than most people imagine. In fact, the Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that two-thirds of all children report some kind of traumatic incident by age 16. These occurrences can lead to complicated mental health issues, but thankfully, treatment options are available to help patients of all ages deal with the lingering effects of their childhood

trauma.

What Is Childhood Trauma?

The National Child Traumatic Stress Network (NCTSN) defines a traumatic event as any scary, dangerous or violent event that poses a threat to the physical safety, well-being, or bodily integrity of a child. Sometimes, traumatic events may directly involve the child. Other times, the event involves the parent, guardian, or another caregiver. Threats to the physical safety of a loved one may be just as traumatic as direct threats to the child.

These experiences can trigger strong physical and emotional responses, which may persist long after the event passes. Some children develop child traumatic stress: a visceral response to childhood trauma that may affect their daily lives and emotional well-being for years or even decades after the triggering event.

Types of Childhood Trauma

A child may experience a number of potentially traumatic events, including the following:

Abuse (sexual, physical, psychological)

Life-threatening accidents or illnesses

Violence in school or the community

Bullying

Domestic violence (witnessing or experiencing)

National disasters

Acts of terror

Public health crises such as COVID-19

Loss of a loved one, especially when sudden or violent in nature

Refugee or war experiences

Neglect

Signs of Childhood Trauma

Parents, teachers, and medical providers should be alert to the signs and symptoms of childhood trauma. These signs can vary according to the age of the child.

Signs of Childhood Trauma in Preschool Children

Fear of separation from parents or guardians

Nightmares

Poor eating habits and sudden weight loss

Persistent cries or screams

Signs of Childhood Trauma in Elementary Schoolchildren

Having feelings of guilt and shame

Becoming fearful or anxious

Having sleeping problems

Having difficulty concentrating

Signs of Childhood Trauma in Middle and High School Children

Depression

Feelings of alienation

Eating disorders

Self-harming behaviors

Additional Resources on the Types and Signs of Childhood Trauma

For more information on childhood trauma and its triggers and signs, consider the following resources:

How Childhood Trauma Impacts Mental Health and Wellness

Each traumatic experience is unique, and thus childhood trauma impacts its victims in different ways. With that said, traumatic experiences can often have effects on a child that linger through adolescence and adulthood.

Developing Post-Traumatic Stress Disorder

Most children are exposed to a traumatic event at some point, and while these incidents usually result in at least momentary distress, some children return to normal functioning within a short time. In the most extreme cases, however, a traumatic event can lead to post-traumatic stress disorder (PTSD). According to the National Center for PTSD, up to 15% of girls and 6% of boys develop PTSD following a traumatic event.

PTSD is a mental health condition that can impact children in different ways. Some children find themselves replaying the traumatic incident in their minds, relieving the stress and agony. Others reenact the traumatic incident in their play. Still, others avoid any person or situation that might remind them of their trauma. Some children may also believe that they missed warning signs about the traumatic incident and therefore become hypervigilant to the point of obsession.

Children with PTSD may experience a range of symptoms, including the following:

Anger and increased aggression

Anxiety

Depression

Mistrust of others

Fear

Alienation

Low self-image

Self-harming behaviors

Other Effects of Childhood Trauma

Even children who don't exhibit the signs of PTSD can still struggle with various behavioral issues following a traumatic event. Some examples are:

Anger

Difficulty focusing or paying attention

Changes in eating habits

New fears or phobias

Increased obsession with safety

Increased focus on death and dying

Insomnia and fitful sleeping

Loss of interest in usual hobbies and activities

When left untreated, childhood trauma can have effects that last into adulthood.

According to Psychology Today, traumatic experiences "can burrow down deep into the body, contributing to chronic illness." Data from a 2019 survey showed a strong correlation between unresolved trauma and the risk of cancer.

Childhood trauma that involves sexual abuse can lead to long-term sexual dysfunction, including a higher likelihood of sexually risky behaviors.

Trauma can also lead to long-term cognitive difficulties and academic challenges. Children who have gone through trauma "may show deficits in language development and abstract reasoning skills," says the NCTSN. "Many children who have experienced complex trauma have learning difficulties that may require support in the academic environment."

Additional Resources on the Mental Health Effects of Childhood Trauma

To learn more about the link between childhood trauma and mental health and wellness, consider these resources:

Strategies for Addressing Childhood Trauma

While the effects of childhood trauma can be long-lasting, multiple strategies are available to those who've experienced trauma, allowing them to address their trauma, recover from it and live a healthy life. Mental health professionals, including psychiatric nurse practitioners, can work with their patients to identify the best recovery strategies.

Counseling

One way to deal with childhood trauma is to speak with a counselor or therapist. Those who've gone through trauma often internalize blame and guilt, potentially leading to low self-esteem. A counselor can help patients allocate blame more judiciously, develop the skill sets required for self-compassion, and learn other skills to grapple with weighty or complicated emotions.

Cognitive Behavioral Therapy

Following a traumatic episode, children sometimes develop negative behavioral or emotional responses as a way to cope with their trauma. Cognitive-behavioral therapy (CBT) is an evidence-based approach to unlearning these negative responses, training the brain to deal with trauma, stress, and grief in a healthier, more productive way.

Meditation

Mindfulness meditation may not be the best solution for everyone, but in some cases, it can provide an opportunity to increase present-moment awareness, as opposed to constantly dwelling on the past. Additionally, mindfulness meditation may increase self-compassion and also improve the individual's ability to self-regulate (that is, the ability to keep one's emotions in check).

Medication

In some cases, a psychiatric nurse practitioner or other medical professional may recommend medications to help cope with some of the effects of childhood trauma. Antianxiety medications and antidepressants may both be viable options, depending on the patient's specific symptoms.

Additional Resources on Strategies for Recovering from Childhood Trauma

To find out more about the best ways to deal with childhood trauma, take a look at the following resources:

Resources on Childhood Trauma

For children and the parents of children who've experienced traumatic events, the following resources may provide insight, support and clinical solutions:

Moving Forward from Trauma

Traumatic incidents are all too common and can have long-lasting effects on the children who experience them. The right intervention from a mental health professional, however, makes it possible not only to move forward from trauma but also to live a healthy, fulfilling life.

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Childhood Trauma: How Trauma Impacts Mental Health | Duquesne University

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As much as parents try to shield their children from all kinds of frightening, dangerous or life-threatening events, the reality is that these things can still happen. Even when children aren't physically imperiled, they may still struggle with mental and emotional trauma, which can sometimes stay with them for the duration of their lives.

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Author links open overlay panelKatie A McLaughlin, Hilary K Lambert

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Child trauma exposure and psychopathology: mechanisms of risk and resilience

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Exposure to trauma in childhood is associated with elevated risk for multiple forms of psychopathology. Here we present a biopsychosocial model outlin…

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The official Youtube channel for Dr. Gabor Maté. www.drgabormate.com

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National Institute of Mental Health (NIMH)

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Brain Activity Patterns After Trauma May Predict Long-Term Mental Health

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The way a person’s brain responds to stress following a traumatic event, such as a car accident, may help to predict their long-term mental health outcomes, according to NIMH-supported research.

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Quick Reference Guide to Common Mental Health Disorders

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Quick Reference Guide to Common Mental Health Disorders

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National Institute of Mental Health (NIMH)