More Questions & Answers

Information on issues affecting families.  See me for further literature.
  1. DEALING WITH THE ANGRY CHILD
  2. HELPING CHILDREN COPE WITH DEATH
  3. STEALING
  4. SOCIAL ANXIETY AND SHYNESS
  5. IMPROVING CHILDREN'S SOCIAL SKILLS
  6. LOSS OF A LOVED ONE
  7. MOVING
  8. CHILD SEXUAL ABUSE
  9. OPPOSITIONAL DEFIANT DISORDER (ODD)
  10. Los Ninos que no Pueden Prestar Atencion (ADHD) No. 6
  11. CHILDREN WHO CAN'T PAY ATTENTION
  12. ANXIETY AND FEAR
  13. SAFETY INFORMATION FROM THE CHILD ABUSE PREVENTION CENTER
  14. CYBER-BULLYING
  15. HELPING CHILDREN UNDERSTAND CANCER
  16. TALKING TO YOUR KIDS ABOUT YOUR DIAGNOSIS
  17. SIBLING RIVALRY-Can't We All Just Get Along?!
  18. MAKING BEHAVIOR CHARTS WORK
  19. TEN TIPS FOR FAMILIES IN TOUGH TIMES
  20. 5 THINGS YOU SHOULD NEVER SAY TO A PARENT whose CHILD HAS AUTISM



DEALING WITH THE ANGRY CHILD

Handling children's anger can be puzzling, draining, and distressing for 
adults. In fact, one of the major problems in dealing with anger in children 
is the angry feelings that are often stirred up in us. It has been said that 
we as parents need to remind ourselves that we were not always taught how to 
deal with anger as a fact of life during our own childhood. Our goal is not 
to repress or destroy angry feelings in children--or in 
ourselves--but rather to accept the feelings and to help channel and direct 
them to constructive ends. 

Parents and teachers must allow children to feel all their feelings. Adult 
skills can then be directed toward showing children acceptable ways of 
expressing their feelings. Strong feelings cannot be denied, and angry 
outbursts should not always be viewed as a sign of serious problems; they 
should be recognized and treated with respect. 

To respond effectively to overly aggressive behavior in children we need to 
have some ideas about what may have triggered an outburst. Anger may be a 
defense to avoid painful feelings; it may be associated with failure, low 
self-esteem, and feelings of isolation; or it may be related to anxiety 
about situations over which the child has no control. 

Angry defiance may also be associated with feelings of dependency, and anger 
may be associated with sadness and depression. In childhood, anger and 
sadness are very close to one another, and it is important to remember that 
much of what an adult experiences as sadness is expressed by a child as 
anger. 

IMPORTANT POINTS ABOUT ANGER TO CONSIDER 
�	We should distinguish between anger and aggression. Anger is a 
temporary emotional state caused by frustration; aggression is often an 
attempt to hurt a person or to destroy property. 
�	Anger and aggression do not have to be dirty words.  In looking at 
aggressive behavior in children, we must be careful to distinguish between 
behavior that indicates emotional problems and behavior that is normal. 
�	In dealing with angry children, our actions should be motivated by 
the need to protect and to reach, not by a desire to punish. Parents and 
teachers should show a child that they accept his or her feelings, while 
suggesting other ways to express the feelings. An adult might say, for 
example, "Let me tell you what some children would do in a situation like 
this..." It is not enough to tell children what behaviors we find 
unacceptable. We must teach them acceptable ways of coping. Also, ways must 
be found to communicate what we expect of them. Contrary to popular opinion, 
punishment is not the most effective way to communicate to children what we 
expect of them. 

RESPONDING TO THE ANGRY CHILD
Some suggestions for dealing with the angry child include:
~~CATCH THE CHILD BEING GOOD. Tell the child what behaviors please you. -
Respond to positive efforts and reinforce good behavior. An observing and 
sensitive parent will find countless opportunities during the day to make 
such comments as "I like the way you come in for dinner without being 
reminded"; "I appreciate your hanging up your clothes even though you were 
in a hurry to get out to play"; "You were really patient while I was on the 
phone"; "I'm glad you shared your snack with your sister"; "I like the way 
you're able to think of others"; and "Thank you for telling the truth about 
what really happened." 
~~DELIBERATELY IGNORE INAPPROPRIATE BEHAVIOR THAT CAN BE TOLERATED. This 
doesn't mean that you should ignore the child, just the behavior.  
The "ignoring" has to be planned and consistent. Even though this behavior 
may be tolerated, the child must recognize that it is inappropriate. 
~~PROVIDE PHYSICAL OUTLETS and other alternatives. It is important for 
children to have opportunities for physical exercise and movement, both at 
home and at school. 
~~MANIPULATE THE SURROUNDINGS. Aggressive behavior can be encouraged by 
placing children in tough, tempting situations. We should try to plan the 
surroundings so that certain things are less apt to happen. Stop a "problem" 
activity and substitute, temporarily, a more desirable one. Sometimes rules 
and regulations, as well as physical space, may be too confining. 
~~USE CLOSENESS AND TOUCHING. Move physically closer to the child to curb 
his or her angry impulse. Young children are often calmed by having an adult 
come close by and express interest in the child's activities. Children 
naturally try to involve adults in what they are doing, and the adult is 
often annoyed at being bothered. Very young children (and children who are 
emotionally deprived) seem to need much more adult involvement in their 
interests. A child about to use a toy or tool in a destructive way is 
sometimes easily stopped by an adult who expresses interest in having it 
shown to him. An outburst from an older child struggling with a difficult 
reading selection can be prevented by a caring adult who moves near the 
child to say, "Show me which words are giving you trouble." 
~~BE READY TO SHOW AFFECTION. Sometimes all that is needed for any angry 
child to regain control is a sudden hug or other impulsive show of 
affection. Children with serious emotional problems, however, may have 
trouble accepting affection. 
~~EASE TENSION THROUGH HUMOR. Kidding the child out of a temper tantrum or 
outburst offers the child an opportunity to "save face." However, it is 
important to distinguish between face-saving humor and sarcasm, teasing, or 
ridicule. 
~~APPEAL DIRECTLY TO THE CHILD. Tell him or her how you feel and ask for 
consideration. For example, a parent or a teacher may gain a child's 
cooperation by saying, "I know that noise you're making doesn't usually 
bother me, but today I've got a headache, so could you find something else 
you'd enjoy doing?" 
~~EXPLAIN SITUATIONS. Help the child understand the cause of a stressed 
situation. We often fail to realize how easily young children can begin to 
react properly once they understand the cause of their frustration. 
~~USE PHYSICAL RESTRAINT. Occasionally a child may lose control so 
completely that he has to be physically restrained or removed from the scene 
to prevent him from hurting himself or others. This may also "save face" for 
the child. Physical restraint or removal from the scene should not be viewed 
by the child as punishment but as a means of saying, "You can't do that." In 
such situations, an adult cannot afford to lose his or her temper and 
unfriendly remarks by other children should not be tolerated. 
~~ENCOURAGE children to see their STRENGTHS as well as their weaknesses. 
Help them to see that they can reach their goals. 
~~USE PROMISES AND REWARDS. Promises of future pleasure can be used both to 
start and to stop behavior. This approach should not be compared with 
bribery. We must know what the child likes--what brings him pleasure--and we 
must deliver on our promises. 
~~SAY "NO!" Limits should be clearly explained and enforced. Children should 
be free to function within those limits. 
~~TELL THE CHILD YOU ACCEPT HIS OR HER ANGRY FEELINGS but offer other 
suggestions for expressing them. Teach children to put their angry feelings 
into words, rather than fists. 
~~BUILD A POSITIVE SELF IMAGE. Encourage children to see themselves as 
valued and valuable people. 
~~USE PUNISHMENT CAUTIOUSLY. There is a fine line between punishment that is 
hostile toward a child and punishment that is educational. 
~~MODEL APPROPRIATE BEHAVIOR. Parents and teachers should be aware of the 
powerful influence of their actions on a child's or group's behavior. 
~~TEACH CHILDREN TO EXPRESS THEMSELVES VERBALLY. Talking helps a child have 
control and thus reduces acting out behavior. Encourage the child to say, 
for example, "I don't like your taking my pencil. I don't feel like sharing 
just now." 

THE ROLE OF DISCIPLINE
Good discipline includes creating an atmosphere of quiet firmness, clarity, 
and conscientiousness, while using reasoning. Bad discipline involves 
punishment which is unduly harsh and inappropriate, and it is often 
associated with verbal ridicule and attacks on the child's integrity.
 
One of the most important goals we strive for as parents is to help 
children develop respect for themselves and others. While arriving at this 
goal takes years of patient practice, it is a vital process in which 
parents, teachers, and all caring adults can play a crucial and exciting 
role. In order to accomplish this, we must see children as worthy human 
beings and be sincere in dealing with them. 
________________________________________
Adapted from "The Aggressive Child" by Luleen S. Anderson, PhD.

Helpful Books 
A Volcano in My Tummy : Helping Children to Handle Anger : 
A Resource Book for Parents, Caregivers and Teachers
When Kids Are Mad, Not Bad : 
A Guide to Recognizing and Handling Your Child's Anger
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HELPING CHILDREN COPE WITH DEATH

              TALKING TO CHILDREN ABOUT DEATH

Living with Death

Death is a reality that children, like all of us, can learn to live with. 
Even before the death of a close family member occurs, parents can begin to 
introduce the idea of death as a part of everyday life. The nightly news, a 
trip past the cemetery, or a dead plant or bird may spark conversation about 
death. 

Start early, be honest and encourage children to talk about their feelings 
regarding death. Periodic conversations about death are important since 
understanding death is a gradual process. Children will take in the 
information as they are ready and increase their understanding as they 
develop. 

Children feel the loss of loved ones just as intensely as adults do, 
although this grief is often expressed in different ways: through play, art 
or even acting out. Children will cope with grief according to the stressors 
created by their relationship to the person (or animal) who has died. 
________________________________________
Ages and Stages

Newborn to 3 Years
Even the youngest of children sense when their family routine is disrupted 
and those around them experience emotional upset. However, infants and 
toddlers have little understanding of death. 

Child's reaction: 
Changes in sleeping, eating and mood.

HOW TO HELP: 
�	Keep routines and physical setting as familiar as possible. 
�	Provide constant nurturing. If parent is too distraught, seek a 
caring adult substitute. 

Ages 3 - 6 Years
Typically, a child will not understand that death is permanent. The child 
may think of it as temporary or magically reversible, or may even appear to 
be unaffected. Fears that dead people may be cold or hungry in the grave are 
common. 

Child's reaction: 
May have frightening dreams, repeat questions about death, revert to earlier 
behaviors. Children may play out the events surrounding the death. Children 
this age will take words literally. Since children have limited experiences, 
they make sense of the world by connecting events that don't relate. For 
example: Aunt Sally died from a headache. Daddy says he has a headache. 
Maybe he will die, too.

HOW TO HELP: 
�	Look into the child's eyes and touch the child gently when 
discussing a death. 
�	Shorten time away from the child. Be sure he knows where you are and 
how to reach you. 
�	Avoid words such as sleeping, resting, loss, passed away, taking a 
long trip. 
�	Talk about what it means to be dead in concrete terms such as 
someone doesn't breathe, eat, go to the bathroom or grow. 
�	Repeat simple, honest explanations as often as the child asks. 
�	Reassure the child of his own safety and your plan for continued 
presence. Share that most people die when they are older. 
�	Allow expressions of feelings such as drawing pictures, reading and 
telling stories about death or the loved one, or reenacting the funeral 
service. 

Ages 6 - 9 Years
A child this age may view death as something that comes and takes people 
away or can be caught like a cold. Some children may still think the dead 
person will return. Guilt may make a child feel responsible for the death 
through her own wishful thinking (I wish he would die!), harsh words (You'll 
be the death of me yet.) or not doing something (I didn't help Grandpa mow 
the lawn. Now he died.). Fears related to death may arise. 

Child's reaction: 
The child may feel distressed, confused and sad or show no signs at all. 
Fear of abandonment by other family members is common. Often these children 
are obsessed with the causes of death, as well as the physical processes to 
the body after death.

HOW TO HELP: 
�	Be a good listener. Correct any confusing ideas the child may have. 
�	Provide play opportunities and routine. 
�	Reassure the child the death was not her fault. 
�	Provide opportunities to open discussion with a quiet child by 
reading stories related to death. 
�	A child who chooses not to talk about the death may be comfortable 
writing or drawing her thoughts in a journal.
 
Ages 9 - 12 Years
Preteens have a better understanding of the permanence of death. Some 
children in this age range may appear to be unaffected by death on the 
surface. They may see death as a punishment for bad deeds. 

Child's reaction: 
Anger directed at a variety of people -- self, parents, others, the person 
who died, siblings. Guilt and grief stem from the anger as do feelings of 
responsibility.

HOW TO HELP:
�	Assure him that the person didn't die because he was "bad." 
�	Talk about the ways in which things are different and how they are 
the same. 
�	Reassure the child he did not cause the death. 

SHOULD YOUNG CHILDREN GO TO THE FUNERAL HOME?
Yes they can, if they are interested in and prepared for what they will see, 
who will be there, how people may be feeling and what they will be doing. 
For young children, be specific in your descriptions of what the 
surroundings will look like. For example, describe the casket and clothes 
and that the body will be lying still, not able to breathe or talk. Answer 
questions and encourage the child to go with you. Bring along someone to 
care for the child if you are distraught or the child needs to leave.  
If you or your child is uncomfortable with children present at the funeral 
home, children can leave notes or pictures to be placed in the coffin. 

Going to the funeral home:
�	Provides structure for early grieving. 
�	Helps bring a sense of closure. 
�	Provides a place to vent emotions and receive support from family 
and friends. 
�	Includes the child so she doesn't feel angry or left out. 
________________________________________
SHOULD YOUNG CHILDREN ATTEND THE FUNERAL OR MEMORIAL SERVICE?

Yes, funerals and memorial services provide needed rituals. But children of 
any age should not be forced to participate. Other rituals that may be 
helpful include remembering the loved one's birthday and reviewing photos 
and keepsakes to be reminded of the loved one.

Although children of varying ages have differences, there are common threads.
�	Share information at the child's level of understanding. Find out 
what the child understands. Don't assume what is known. 
�	Talk about and accept feelings. 
�	Share rituals. 
�	Be available for ongoing discussions since mourning is a process. 
Admit that you do not have all the answers. 
�	Share information in doses the child can handle, small bits at a 
time. Let the child know it is OK to be angry, OK to be mad. 
�	Allow the child or teen to be silent about this issue. 
________________________________________
Books Dealing with Death

Preschool
Nana Upstairs, Nana Downstairs by Tomie De Paola. Young Tommie learns what 
it is like to be young and old, very old, and finally to die by visiting his 
grandmother and great-grandmother. G.P. Putnam's Sons, New York, 1973 

The Tenth Good Thing About Barney by Judith Viorst. A young boy learns to 
deal with the death of his cat by remembering all the good things about him. 
Antheneum, New York, 1971 


6-9 Years
Badger's Parting Gifts by Susan Varley. Badger's friends are sad when he 
dies, but they treasure the legacies he left them. Mulberry Books, 1984
 
Saying Goodbye to Daddy by Judith Vigna. Frightened, angry and lonely after 
her father is killed in a car accident, Clare is helped through the grieving 
process by her mother and grandmother. Albert Whitman, 1991 


9-12 Years
Grover by Vera and Bill Cleaver. Grover attempts to deal with the death of 
his mother and the changes her death has made in his life. J.B. Lippincott 
Co., 1970 

A Taste of Blackberries by Doris B. Smith. A story told from the child's 
perspective about a young boy who loses his friend, including the two boys' 
relationship, the accident and the ambulance, the rituals involved from the 
visitation to the graveside service, and how the young boy begins to make 
sense of the death and learns to go on with his life. Rinehart and Winston, 
1983 

Adult
How Do We Tell Children? by Dan Schaefer and Christine Lyons. Designed for 
adults to help children better understand and cope when someone dies. 
Newmarket Press, 1988 revised 

Good Answers to Tough Questions by Joy Berry. Answers to tough questions 
children may have about death. Children's Press 
________________________________________
Adapted from Helen Danielson, Child Development Specialist and Kim Bushaw, 
Parent Line Program Specialist, NDSU
________________________________________
April 1995 (Reviewed and reprinted April 1996) 
________________________________________
Back to Top


STEALING

Stealing is the taking of things or being in possession of things that 
belong to someone else without their permission. Stealing is a common 
behavior in young children. Almost all children take things that don't 
belong 
to them at one time or another. Stealing, however, is a behavior that can be 
quite upsetting to parents. Many parents who have caught their children 
stealing worry that their children are on the road to becoming hardened 
criminals. These parents should be relieved to know that the vast majority 
of 
children who occasionally steal grow up to be law abiding citizens. While 
stealing is often considered a normal or common behavior in young children, 
it must still be addressed and corrected. Here are some things that parents 
can do to prevent and deal with stealing behaviors in their children. 


Pre-Schoolers

Stealing is a common, normal behavior in pre-school-aged children. Under the 
age of six, most children have difficulty understanding the concept of 
private property. They have difficulty understanding that they don't have 
rights to property that belongs to someone else. This is because children at 
this age are generally self-centered. They feel that they can take what they 
want, and often don't understand that this might be wrong. Because most pre-
school aged children do not yet understand that stealing is wrong, it is 
usually not a good idea for parents to punish them for stealing. Instead, 
this is an excellent time for parents to begin teaching their children about 
ownership and the concept that stealing is wrong. 


School-Aged Children

By the time children are about the age of six, they are beginning to better 
understand the concept of ownership. They are also beginning to understand 
that stealing is wrong. Once children begin to show an understanding of 
these concepts, parents should begin setting limits on stealing behaviors, 
and providing punishment when such behavior occurs.


Why Children Steal

Children take things that do not belong to them for many different reasons. 
These reasons can differ from child to child, or any one child can steal for 
a number of different reasons.

*Parents may knowingly or unknowingly reinforce stealing behavior. Parents 
who do not punish their children when they take things that do not belong to 
them may be reinforcing the behavior. 

*Modeling. Children learn by watching their parents. Parents who take things 
that do not belong to them, for example, parents who take supplies from the 
office for use at home, may be teaching their children that in some 
instances stealing is all right. 

*Some children have no money of their own to buy what they want. Children 
who don't have their own money to spend may steal what they want.

*To make themselves look good in front of peers. Some children begin 
stealing because their peers are doing it and they want to be accepted by a 
certain peer group.

*A sign of behavioral/emotional problems. Some children may steal as a 
symptom of some underlying problem.


Prevention

There are many things that parents can do to prevent the onset of stealing 
behavior in their children.

*Discuss and explain why stealing is wrong. Parents should make sure that 
their children know why stealing is wrong. Parents can point out that 
stealing means taking something that rightfully belongs to someone else.

*Teach ownership. While children are very young it is a good idea for 
parents to begin teaching their children what ownership means. Parents can 
explain that people have a right to their own property, and that it is wrong 
to take something that belongs to someone else. Parents can use examples, 
such as, "How would you feel if someone wanted your favorite stuffed animal 
and just decided to take it?" Parents can also use examples that occur in 
everyday life, such as by explaining to children how one pays for things at 
the store and borrows books from the library, by pointing out things in the 
home that belong to different people, what gifts are, etc.

*Teach appropriate ways of getting what one wants. Parents should teach 
their children how to get what they want without stealing. For example, 
parents can suggest that children ask for things they want, save up their 
money to buy the things they want, etc.

*Model appropriate behavior. Parents should set a good example for their 
children by asking before they borrow things, by not taking things that 
don't belong to them, and by being open and honest.

*Develop a close, open relationship with children. Parents should make every 
effort to communicate effectively with their children. Children who are 
close to their parents are much more likely to take on their beliefs and 
values than children who don't have a close relationship with their parents. 

*Praise and reward honest behavior. Parents should make every attempt to 
praise their children for being honest. The more parents praise their 
children's honesty, the more likely they will continue to be honest in the 
future.


Intervention

There are many things that parents can do to address stealing after it has 
occurred.

*Remain calm. When parents discover that their child has stolen something it 
is very important that they don't overreact. Parents should keep in mind 
that all children take things that don't belong to them at one time or 
another. Parents who become overly upset may instill feelings of guilt and 
shame in their child, which can affect self-esteem. Parents should try to 
remain calm instead, and should deal with stealing behaviors in as matter-of-
fact a manner as possible.

*Confront quickly. Just as it's important for parents not to overreact, it 
is also important that parents don't underreact. When parents find out that 
their child is stealing, they should confront and deal with the stealing 
immediately. The longer stealing is allowed to continue uncorrected, the 
more difficult it is to correct later on.

*Apply consequences. Parents should decide what the specific consequences 
are for stealing, and apply them every time stealing occurs. Parents should 
inform their children of these consequences before they are used. 
Consistency is very important. Here are some suggestions:

*Correct the behavior. Correcting means making some kind of restitution. For 
example, if a child takes a candy bar from a store, correcting would involve 
requiring the child to return to the store and return the candy bar (if it 
isn't half-eaten), or if the candy bar can't be returned, paying for the 
candy bar. If the child has no money to pay for what he or she has taken, 
parents can loan the child the money and then subtract it from an allowance, 
or require that the child do chores around the house to earn the money to 
pay for it. It might also be a good idea for parents to require that the 
child apologize to the person from whom the item was stolen. Sometimes this 
is very difficult for children, so parents may not want force the issue if 
their child is unable to make an apology. It is, however, very important 
that 
the child go along on the trip to make the return. It is very important that 
the child assume responsibility for correcting the misbehavior.

*Apply natural consequences. After correcting the behavior, consequences 
should be applied. Having to do extra chores around the house to earn the 
money to pay for a stolen item is an example of a natural consequence. 
Another example is not allowing the child who stole the candy bar to have 
sweets for a certain period of time.

*Label the behavior. It is very important that parents call the behavior 
exactly what it is. For example, parents shouldn't call taking (without 
permission) what doesn't belong to one's self as "borrowing." Children who 
are able to understand the concept of ownership should be told that they 
are "stealing" when they take something that does not belong to them.

*Provide adequate supervision. Parents should make sure that they know what 
their children are up to. Children who are not monitored closely by their 
parents tend to be more likely to steal and to engage in other problem 
behaviors. 

*Understand why the behavior occurred. Different children steal for 
different reasons. Because of this, it is important for parents to try to 
find out why their children steal. Asking a child why he or she has stolen 
something will probably not give parents the answers they need. They may 
need 
to look at what's going on in the child's life, what personal problems the 
child may be having, etc. Once parents find out why, corrective measures can 
be taken to eliminate or minimize the behavior. For example, parents could 
set up an allowance/chore system for a child who stole because he has no 
spending money of his own.

*Don't interrogate children or force them to self-incriminate. Parents 
should not force their children to admit to stealing. Children often lie to 
protect themselves. If parents aren't pretty sure that their child has 
stolen 
something, they probably should not apply consequences. Instead, they should 
let their child know that they are skeptical, and express hope that their 
child will be honest with them.

*Help children find ways of earning their own money. Parents should make 
sure that their children have some sort of regular income. If children have 
money of their own to spend as they wish, they will be more likely to buy 
what they want instead of stealing it. Children can earn money by doing 
chores around the house, etc.

*Don't shame children for stealing. Parents should try not to make their 
children feel guilty for stealing. They should also try not to call their 
children names, for example a thief or a liar. Such tactics can be very 
damaging to children's self-esteem. Instead, parents should let their 
children know that they are disappointed in their children's behavior, but 
this does not mean that they are bad people. They should then apply 
consequences and treat the situation matter-of-factly.

*Seek professional help for persistent problems. If stealing becomes a 
chronic or significant problem, parents should contact a mental health 
professional for assistance. 

http://www.parenting-ed.org/
 

Written by Kristen Zolten, M.A. and Nicholas Long, PhD, Department of 
Pediatrics, University of Arkansas for Medical Sciences
Back to Top


SOCIAL ANXIETY AND SHYNESS

 Helping Shy Kids get the Most Out of Their School Experience

by Amy L. Krain, Ph.D. and Snigdha Rathor, M.A.

All teachers have had shy students in their classroom. These children are 
the ones who keep to themselves and quietly complete their work, often 
hiding 
from the attention of the teacher or their classmates. However, some of 
these children are not just shy or quiet but may have social anxiety 
disorder. For these students, simply going to school everyday and 
interacting 
with other children and adults makes them feel extremely anxious. They are 
excessively shy, have an intense fear of social and performance situations, 
and are concerned about humiliation or embarrassment. Anxiety may be 
excessive enough that anticipation of a social event may provoke a panic 
attack or cause intense distress. 

HOW DO TEACHERS KNOW IF A STUDENT IS SUFFERING FROM SOCIAL ANXIETY?

At times it is difficult to determine when social anxiety is excessive. A 
good guide to follow is to answer the four D's�disproportion, disruption, 
distress, and duration. 

�	Disproportion�Is the stress unrealistic for the situation? Children 
with social anxiety disorder may feel as nervous talking to a single person 
as others feel when giving a speech to a room of 100 people. 
�	Disruption�Is the distress interfering with daily functioning in 
social activities, family relationships, or in academic performance? Some 
socially anxious children would rather fail a test than ask the teacher a 
question or for help. 
�	Distress�Does the child or adolescent feel a burden or extreme worry 
throughout the entire activity? A socially anxious child may feel so nervous 
that he cannot even enjoy his own birthday party. 
�	Duration�Does the anxiety persist throughout the activities? 
Multiple activities? Does the child worry before activities? Understanding 
how long the anxiety lasts can help determine the severity of anxiety. 

WHAT SPECIFIC BEHAVIORS SHOULD TEACHERS/PARENTS LOOK FOR IN THE CLASSROOM?

Teachers can make important observations that can help to identify a child 
who is suffering from social anxiety. Signs such as making inconspicuous 
seating choices, avoiding eye contact with teachers and peers, remaining on 
the side during play or activities, or refusal to eat in the school 
cafeteria may indicate anxiety. Unfortunately, some signs of anxiety may be 
confused with low functioning, oppositionality, laziness, and being 
distracted or uninterested. It is important to observe the child in several 
situations to make the appropriate distinction.

In order to alleviate their anxiety, most children with social anxiety try 
to actively avoid anxiety-producing situations. While this seems like an 
effective strategy (for the student), it often makes the situation worse. 
For example, Jeff, a socially anxious child, refuses to go to the blackboard 
when called to work out a math problem. As a result, the teacher insists 
that 
he complete the problem and tells him that the whole class will wait until 
he 
has done so. This exchange draws more attention to Jeff, which is likely to 
cause an increase in his anxiety since this is exactly what he is trying to 
avoid. Other attempts at avoidance may include speaking very softly and/or 
quickly when called on. 

It is important to realize that teachers and parents can play a role in 
unwittingly fostering this avoidance. Jeff's teacher might see that he is 
very uncomfortable when answering questions in class and may stop calling on 
him to help alleviate his anxiety. As a consequence, his teacher might also 
lower his/her academic expectations or exclude him from small group work and 
partnerships. His parents may also rescue him in situations that cause 
discomfort (i.e. provide notes so that he does not have to attend gym class 
or allow him to leave school if he feels too anxious). If Jeff is allowed to 
avoid these situations, he will never learn to cope with them directly and 
his anxiety will only increase, not diminish over time. Therefore, it is 
important to encourage participation, not avoidance, by using some of the 
tips listed below. 

WHAT CAN BE DONE TO HELP STUDENTS WITH SOCIAL ANXIETY?

There are three components that can be targeted to decrease the social 
anxiety a child experiences. 
1.	Situation/Environment�What situations cause anxiety? Can the 
situation be changed to reduce anxiety so that the student can participate? 
2.	Cognitions�What is so scary about the situation? Sometimes children 
or adolescents have "thinking traps" where they jump to conclusions, 
disqualify the positive, or catastrophize the situation. It is important to 
discuss these ideas and help children to understand exactly why they are 
worried. 
3.	Behavior�How does the child's behavior affect the situation? For 
example, if the child is avoiding a situation, does that result in future 
isolation which can cause a negative self-image? 
Teachers should try to make these children feel safe and secure in the 
classroom. It is important to celebrate tiny achievements with positive 
reinforcements, show understanding when there are "bad" moments, and try to 
show that one uncomfortable moment or choice will not equate to being 
a "bad" kid. 

WHEN IS IT TIME TO SEEK OUTSIDE PROFESSIONAL HELP?

Sometimes simply understanding the child's anxiety is not enough to decrease 
the worry. When anxiety reaches a level of disorder severity or the child or 
adolescent has complex symptoms or suicidal thoughts or intentions it is 
important to contact a mental health professional.
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IMPROVING CHILDREN'S SOCIAL SKILLS

        HOW PARENTS CAN FACILITATE SOCIAL SUCCESS FOR THEIR CHILDREN

As children grow, their relationships with their peers become increasingly 
influential in their lives. Children's friendships not only provide a 
foundation for later adult relationships, they also buffer children from 
stress and lessen the risk of later emotional and behavioral problems. When 
children are socially successful, their friendships are a source of well 
being, pride, and identity. Yet some have difficulty getting along with 
others because of shyness, conflict, teasing, or other challenges. Parents 
can do a great deal to facilitate the social success of their children by 
recognizing barriers and providing appropriate guidance and support.

COMMON BARRIERS TO HEALTHY SOCIAL DEVELOPMENT

Social anxiety is a common obstacle to social success. Many children 
experience shyness at some point, usually during class presentations, school 
plays, or dances. Although shyness is usually temporary, some children are 
troubled by more significant fears of embarrassment or rejection. This 
anxiety may cause them to be quiet and withdrawn in social interactions, or 
in more serious cases, to avoid these encounters altogether. In some 
children and teens, this social anxiety may eventually lead to depression, 
hopelessness, and a loss of interest in social encounters.

Other children may struggle socially because of disruptive, impulsive, or 
aggressive behaviors. Some children have difficulty making or keeping 
friends due to overly exuberant, hyperactive tendencies. These children may 
interrupt conversations, have difficulty waiting their turn, or intrude on 
others' play. They may also become frustrated easily and have a hard time 
calming themselves down, resulting in tantrums or aggression. Besides 
creating trouble for parents and teachers, these objectionable social 
behaviors may make children unpopular with peers.

HOW TO ENCOURAGE SOCIAL SUCCESS:

Parents play an important role in the social lives of their children, both 
directly and indirectly. This eventually becomes a supporting role, with 
children taking center stage and parents quietly providing the necessary 
elements--rides to the mall, brownies at a sleepover, or consolation after a 
negative experience. The following are some general guidelines for 
encouraging social success:

~ Use parent-child and sibling relationships. Research has shown that warm, 
trusting family relationships lay the groundwork for healthy social 
development in children. Use the ups and downs of family interactions to 
teach important social lessons.
~Practice what you preach. Model positive social skills by sharing how you 
handle arguments, hurt feelings, and misunderstandings as they occur. 
Children look to their parents' behavior to help them understand new or 
confusing situations.
~ Get to know your child's friends. Offering to facilitate social encounters 
for your child or teen can provide natural opportunities to get to know his 
or her friends. You don't need to overstay your welcome--moments in the car, 
in a restaurant, or at an amusement park can really add up.
~ Listen first, talk later. Listen to your child's complaints about his or 
her peers with genuine interest, and resist giving advice before your child 
feels understood. Knowing how to handle teasing or rejection doesn't 
necessarily make children feel better. Being heard and understood just might.
~ Praise, praise, praise. Go out of your way to praise your child's 
treatment of others. Statements like, "I love the way you kept calm when your sister 
was yelling at you," or, "It was nice how you invited Jake to the movie," 
actively reinforce your child's respect and caring for others.
~Explore a variety of social settings. Trouble connecting with schoolmates 
is often due to a mismatch of personalities or interests. Introducing your 
child to new and varied social circles like team sports, clubs, or youth 
groups may provide for a better social fit.

HOW TO ENCOURAGE YOUR SHY OR EMOTIONALLY SENSITIVE CHILD:

- Share your own experiences. Children are often amazed to hear that their 
parents were once teased, left out, or lonely. Tell your child how you have 
handled shyness or other social difficulties--both in childhood and in the 
present.
- Ask about your child's fears. Anxious children often harbor questionable 
ideas about how others perceive them or how friendships are "supposed to 
be." Find out what these beliefs are and encourage your child to challenge 
them in their daily social encounters.
- Push a little harder. Parents often desire to protect their children and 
keep them comfortable. However, taking this approach with shy children may 
actually help them avoid important social experiences. Gently encourage your 
child to face his or her social fears.
- Empathize. Although you should avoid feeding into your child's anxiety or 
shyness, take care not to criticize these emotions. You will be better able 
to encourage social risk taking if you are empathic and supportive.

HOW TO FOSTER SOCIAL SUCCESS IN YOUR HYPERACTIVE, IMPULSIVE OR DISRUPTIVE 
CHILD:

- Encourage creative, constructive activities. Avoid toys and games that 
encourage aggressive play, such as wrestling, toy guns or swords, or play 
fighting. These activities are not always problematic, but children with 
impulse control issues can carry things too far or have a hard time calming 
down.
- Closely monitor high-risk situations. Be aware of situations that have led 
to aggressive, angry, or unsafe behaviors in the past. Be ready to step in 
before things get out of hand.
- Praise preemptively. Frequently praise your child for asking first, for 
keeping hands to self, or for taking turns before disruptive behavior occurs.
- Be clear about playtime rules. Create and consider posting a set of rules 
regarding behaviors like hitting, threatening, and following directions. 
Review these rules together before playdates or parties, and be sure your 
child understands the consequences for breaking them. Form a discipline 
strategy that you can use consistently, both at home and in public.

SUMMARY
Children's social lives are complex and varied and there are many ways to 
be successful socially. Some children feelmost comfortable with one or two 
close friends, whereas others prefer to be part of a large social network. 
Most children eventually find their niche and are able to achieve their 
social goals. With the right mixture of empathy and involvement, parents can 
aid greatly in this process.

Written by Timothy Verduin, Ph.D. of the NYU Child Study Center. 
NYU CHILD STUDY CENTER
THE PARENT LETTER         VOLUME 5, ISSUE 7 MARCH 2007


For further information, guidelines, and practical suggestions on child 
mental health and parenting issues, please visit the NYU Child Study 
Center's website, AboutOurKids.org.
Giving Children Back Their Childhood
NYU Child Study Center
577 First Avenue New York, NY 10016
(212) 263-6622
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LOSS OF A LOVED ONE

LEARNING TO LIVE THROUGH LOSS: HELPING CHILDREN UNDERSTAND DEATH
Carolyn S. Wilken, Ph.D. ,Joyce Powell Kansas State University 

Perhaps a child you know is facing the death of a loved one. Adults often 
fear that children are too fragile to face the reality of death. Actually, 
most children are emotionally strong and want to know about death. The truth 
helps them understand what is real, and what is imaginary. Just like adults, 
children need to be able to feel pain, mourn, and grow.

This fact sheet will help you understand how children view death and how you 
can help a child cope with the death of a loved one. 

HOW PRESCHOOL CHILDREN PERCEIVE DEATH
Very young children understand facts best. They think in specific, concrete 
terms. When death is explained as "sleep" or "a long trip" they may expect 
the deceased to wake up, or return.

Very young children see death as reversible, as it is often shown in 
cartoons. They may ask, "When will Bobby come back?" You may need to explain 
again and again, "Bobby is dead. That means he won't ever live with us 
again. But we will always remember him."

They may not realize that death will happen to everyone and every living 
thing. They may need to ask again and again, "Do girls die? Do doggies die?"

Young children need to ask questions about the death again and again. They 
need to learn the facts about the death and to make certain the facts have 
not changed.

Young children are likely to believe their thoughts or feelings have power 
over others. A child who was angry at his mother before her death may 
believe he is responsible for the death.

HOW GRADE SCHOOL CHILDREN PERCEIVE DEATH
Children of this age know that death is permanent and that everything dies. 
They often are very curious about physical details.

These children need physical, tangible ways to experience and express grief. 
Rituals such as visitations, funerals, and memorial services are very 
important.

Children accept their parents' religious beliefs. A belief in life after 
death generally comforts children if that concept has been part of their 
religious beliefs before the death.

Boys tend to have more difficulty talking about death and showing their 
feelings.

TELLING A CHILD THAT SOMEONE HAS DIED
1. Someone emotionally close to the child should be the one to "break the 
news.";

2. Choose a location where you will not be disturbed.

3. Stay with the known facts. If you don't know the facts, find out before 
telling the child about the death.

4. Be concrete - avoid misleading terms like ";He's asleep".

5. Avoid phrases like "All wounds heal in time"  and "Everything will be all".  The child cannot 
comprehend such statements. Say,"This must feel frightening (or confusing)"

6. Simply be with the child. Allow the child to ask questions and answer as 
clearly and factually as possible. If you don't know, say so.

7. Be quiet and wait. Sometimes it takes a while for children to understand 
what has happened. The child also may need time to react to the news.

Because of young children's misconceptions of death, you may need to stress 
that:

- The person or the doctors could not prevent the death.
- The person loved the child.
- The person was not angry at the child.
- The person will never come back.
- The child will be loved. Someone will take care of the child.
- Feelings are all right: sadness, anger, and crying are ok.
- There's nothing wrong with playing and having fun.

You can gently reassure children with these concepts even if they have not 
asked questions about them. Children may not be able to verbalize some of 
their concerns right away or may feel too embarrassed to ask you.

ONE WAY TO EXPLAIN DEATH TO CHILDREN
"When someone dies, that means their body is no longer working. The heart 
stops beating, they no longer need to eat or sleep, and they no longer feel 
any pain. They don't need their body any longer. That means we will never 
see them again as we could before." (From Children and Death, by Danai 
Papadatou and Costas Papadatos.)

COMMON SIGNS OF MOURNING IN CHILDREN
When they learn of the death of a loved one, children have many of the same 
physical and emotional responses as adults, but children mourn their loss in 
different ways. Adults need to be aware of these signs of mourning in order 
to accurately meet the children's needs. When children's mourning behaviors 
are wrongly perceived as misbehavior, the children's hurt and confusion may 
deepen.

Anxiety
Children may lose their sense of security and fear another death or loss. 
Young children may become clinging or demanding.

Vivid memories
Real or fantasized images related to the death can intrude on other 
thoughts. Memories can show up as dreams or nightmares.

Sleep difficulty
This is very common. If "sleep" is used to describe death, the child may 
fear sleeping. Children who cannot mourn the death during the day may have 
more dreams and nightmares about it.

Sadness and longing
Some children cry. Some don't. Some are sad for a long time; some aren't. 
Some children try to hide their sadness to protect their parents. Children 
may long for the loved one, become preoccupied with memories, or may carry 
an object that reminds them of the deceased. For a while, this can help the 
child deal with the pain.

Anger and acting out
Children may become very angry at death, God, or adults in general. Or they 
may be angry at themselves, and somehow feel responsible for the death.

Guilt
Some children believe they are responsible for the death. Some may feel 
guilty because of a thought or deed. Feelings like, "It was my fault" or "I 
must have been bad" may cause lingering guilt. The child needs to talk about 
these feelings and needs your help to understand that they are not true.

School problems
The child may learn more slowly than usual due to difficulties in 
concentrating, memories, sadness, and grief.

Physical complaints
Common complaints include headaches, stomach aches, and may even include 
symptoms similar to those of the deceased.

SHOULD CHILDREN ATTEND THE MEMORIAL SERVICE?
Children need rituals. Participating in the funeral or memorial service 
helps make the death seem more real and encourages the healing that comes 
from mourning. Children may feel angry or left out if they are not allowed 
to participate. Of course, no child should be forced to participate if he or 
she does not want to.

HELPING CHILDREN ATTEND SERVICES
1. Prepare the child for the experience: what the room looks like where the 
body will be viewed, what the casket looks like, how the deceased is lying, 
and that the skin looks different than usual and is cold because the body 
isn't working anymore. Explain how adults at the funeral may behave; crying 
or even laughing while reminiscing.

2. If the child wishes, help him approach the casket. Viewing the body helps 
the child understand what death is and that their loved one is, in fact, 
dead. Few children later regret viewing the body; many regret not doing so. 
Most focus on the familiar features of their loved one. Plan the child's 
first viewing to be in private with a supportive adult. The child's age and 
maturity are critical factors to consider.

3. School age children can help make some of the decisions about the service 
for a family member. For example, they may want to choose a song or the 
burial clothes.

4. Suggest specific ways for children to express their feelings. They might 
choose to place something in the casket, write a letter, or draw a picture. 
Young children may want to touch the deceased or look under the closed part 
of the casket to know that the legs are actually there. Older children may 
value time alone to talk to the deceased. Be responsive and supportive of 
what the child wants to do. Do not force them to engage in any un-
comfortable activity.

5. The support of a trusted adult is important. A parent who has lost a 
spouse, child, or parent may not be able to provide this support. The parent 
will need to participate in the event and mourn. The child may need another 
caring adult who can comfort, answer questions, and leave the room with the 
child if necessary.

6. Encourage the child to talk, draw, or play to release emotions after the 
service. Patiently correct any misunderstandings about death or the service.

AS YOU ALL BEGIN TO HEAL
Photos and mementos are especially important for children who may 
fear "forgetting" the person or what the person looked like. Children 
especially appreciate having a photo of the loved one in a non-breakable 
frame that they can carry wherever they wish. The child may wish to hold on 
to memories by continuing traditions that involved the loved one and 
remembering birthdays and other important dates. These things can help the 
child remember the love and caring the deceased felt for him.

DOES MY CHILD NEED PROFESSIONAL HELP?
Any kind of extreme behavior is a red flag signaling a need for professional 
counseling: suicide threats, serious destructive acts toward property, 
people, or animals, frequent panic attacks, or substance abuse. Other 
changes include an inability or unwillingness to socialize, continued denial 
of the death, feeling responsible for the death, or a long-lasting decline 
in school performance.

Children may need special help if they had a difficult relationship with the 
person before the death, if there was confusion or misinformation 
surrounding the death or if verification of the death was delayed.

Books are an excellent tool to help children become aware of and talk about 
their feelings concerning the death of a loved one. As you read to the 
child, ask questions. "How is the character feeling?" "Is it true the person 
died because the child was angry?" The responses often will give you clues 
about how the child thinks and feels, allowing you the opportunity to 
correct misunderstandings and suggesting what kind of emotional support to 
give. Children identify with the characters in books. Learning that the 
characters have feelings similar to theirs helps the healing process.

BOOKS ABOUT DEATH FOR PRESCHOOL CHILDREN
When Grandpa Died by Margaret Stevens
A little girl learns about death from her grandfather. When he dies, she 
learns about mourning and how to go on living.

Badger's Parting Gifts by Susan Varley
Badger's friends are sad when he dies, but they treasure the legacies he 
left them.

Nonna by Jennifer Bartoli
A family learns that life continues even after Nonna (grandmother) dies. 
They find positive ways to remember her.

The Accident by Carol Carrick
After his dog is hit by a truck and killed, Christopher must deal with his 
feelings of depression and anger.

The Happy Funeral by Eve Bunting
A Chinese-American girl participates in her grandfather's funeral.

The Memory Box by Mary Bahr
When Gramps realizes he has Alzheimer's disease, he starts a memory box with 
his grandson to keep memories of all the times they have shared.

BOOKS ABOUT DEATH FOR GRADE SCHOOL CHILDREN
Early readers will enjoy reading the above titles for themselves. For ages 8 
to 10, try these titles:

Grover by Vera and Bill Cleaver
Ten-year-old Grover attempts to deal with the changes his mother's death 
made in his life in some serious and some funny ways. (Fiction)

The Remembering Box by Eth Clifford
Nine year old Joshua's weekly visits to his beloved grandmother on the 
Jewish Sabbath give him an understanding of love, family, and tradition 
which helps him accept her death. (Fiction)

My Daddy Died and It's All God's Fault by Sue Holden
Young Chris tells his story - his feelings of sadness, anger, false guilt, 
and confusion - to help other young people know they are not alone. (Fiction)

How It Feels When A Parent Dies by Jill Krementz
Eighteen young people (ages 7 to 16) describe their feelings when a parent 
died and how they learned to go on in life. (Non-fiction)

Losing Someone You Love: When a Brother or Sister Dies by Elizabeth Richter
Sixteen young people (ages 10 to 24) describe the fears, sorrow, and other 
emotions they experienced when a brother or sister died. (Non-fiction)
Back to Top


MOVING

WHEN FAMILIES MOVE: Helping Children Adjust
by Robin F. Goodman, Ph.D.; updated by Anita Gurian

INTRODUCTION: Why and How
Moving to a new community can be an exciting but sometimes difficult event 
for a child and a family, depending on the across the country. For many 
moving is a positive experience, as it brings the opportunity to develop new 
friendships, pursue new interests, increase social confidence, and learn 
important lessons about adapting to change. If parents are positive about 
the move, children will have an easier time adjusting. Following is a guide 
for managing the different issues facing parents and children when they move.

AGE MATTERS
A child's age and general personality affect how the child will deal with 
moving. Some children adapt easily to new situations; others may need more 
time to make a gradual adjustment. 
�	Children in kindergarten or first grade may be vulnerable because 
they are in the process of separating from their parents and adjusting to 
new authority figures and social relationships. They may temporarily regress 
to behaviors typical of an earlier stage and become more dependent on their 
parents.
�	School-age children are likely to be concerned about fitting in with 
new peers and dealing with different academic demands. Their general 
personality and social style may influence their ease in adjustment. They 
may also be better able to tolerate the new kid jitters if a sibling will be 
at the same school.
�	Some children will actually thrive in the new environment depending 
on the circumstances of the move, an accepting peer group, and a supportive 
mentoring adult network. 

THE MOVING PROCESS
Three phases of the move�before, during, and after�and three environments�
educational, social, and family�should be considered.

BEFORE THE MOVE
�	Timing the move is important. Parents should carefully consider 
their options when faced with the decision to move. Certain moves may be 
inevitable or impossible to predict. But when circumstances allow for 
flexibility, it is often better to postpone or avoid a move at certain 
transitional times, such as immediately following a divorce. Some people 
find 
that moving mid year enables children to take the second part of the school 
year to adjust, while others find that starting fresh in the fall when 
change 
typically happens is easier. 
�	Talk about the decision. Explain the reason for the move in language 
appropriate to the child's age. If the move is for the better, explain how 
it will affect the children for the better. If the move will mean difficult 
changes, parents must be honest about things that will and will not change. 
For older children, include them, if possible, in any decision making. 
Although children may not have veto power about the move, allow them control 
over certain areas of their life such as the color of their new bedroom or 
the choice of after-school activities. 
�	Of course, whenever possible, children should visit the new home and 
town before the move. If this is not possible, obtaining a video or having 
friends or a real estate agent send pictures via the Internet will help 
children visualize their new home, make the decision real, and help them 
plan the living arrangements. 
�	Older children may enjoy using the Internet to research their new 
home. Map Quest and visitor's bureau information sites can get them 
involved, interested, and looking forward to self-designed adventures. 
�	Be prepared for difficult reactions and be careful not to succumb to 
bribes or threats. Children are often naturally upset and angry about a 
move. Parents should not sugar coat or minimize their reactions, nor should 
they avoid a child's negativity. Some leniency may creep in�extra time spent 
on the computer or watching TV�however, it is important to set limits on 
behavior and acting out, but it is also important to accept their sadness.
�	For children with special needs, parents should plan ahead for 
referrals and resources. Maintaining consistent services and proactively 
setting up systems for children with educational, medical, or mental health 
needs can ease the transition, help maintain progress, and deal with 
problems resulting from the move. Current tutors, teachers, mental health 
and 
medical professionals should be consulted and asked for recommendations and 
help in obtaining services in the new location.
 
DURING THE MOVING PROCESS 
	It can be tempting to literally "clean house" when moving. But this 
should be done gingerly with respect to children's possessions. Discarding 
old toys or unused items may be warranted at the time of a move, but the 
loss of material things may overwhelm some children. Better to help them 
sort 
out the bulk of their things once they've moved in when they can feel more 
in 
control of their new environment. 
�	For young children and toddlers, put their furniture on the moving 
van last so that it is first to unload. This will help orient them quickly 
to the new surroundings. 
�	Have children of all ages pack a bag of essential, favorite, "can't 
live without" things to keep with them at all times.

AFTER THE MOVE
After the move�it's time to attend to school, social and family life 
�	Scheduling some trips away from the new home may actually help 
establish the new base. It becomes the place to "come home to" and enhances 
the sense of familiar place that is needed. 
�	Have children invite friends from their old hometown for a visit. 
This can help the child make decisions about what is new and fun and give 
the child a chance to "show off" the new place. It also helps the child get 
an oft-needed dose of validation from old buddies. 
�	Access religious and community organizations. They can provide a 
ready structure of activities, contacts, and resources for the whole family. 
If the family was involved with similar groups before, participating in such 
activities in the new location can increase feelings of familiarity. 
�	Encourage children to become involved in a sports team. Teams 
provide a ready-made group of peers on a regular basis. It becomes easier 
for 
a child to then say 'hi' and to avoid feeling like a stranger in the 
lunchroom. Parents can invite the team over for ice cream or pizza to help 
the child build new relationships. In this way parents can get to know 
parents of new peers.
�	A school club or group is another activity to be encouraged for 
children. Not only does this provide the benefit of a ready group of peers 
with a similar interests; it offers an adult contact for the child and for 
the parent as well. Most parents and children can find some type of 
organized, existing activity that will meet a child's needs; a child who is 
mechanical may do well on the technical crew of the drama club. It may be 
important to think beyond the traditional orchestra, soccer team, and chess 
club. 
�	Parents should also access their own network to gain information 
about the local culture for themselves and their children. 
�	Parents should not be surprised if their child shows improvement 
outside of home before having a changed attitude with the family. It is 
important to be in contact with the school and other areas in which children 
are involved to monitor their progress in making the transition. Children 
who are still sullen or angry at the parents about the move at home may in 
fact be making a good transition in school and showing signs of acceptance 
and integration. It is also vital to be aware of how children are adjusting 
so that parents or other adults can intervene to help a child if necessary. 
�	The Internet is a mixed blessing for children in such situations. E-
mail to far away friends helps a child stay connected to a support system 
and provides an outlet for talking about the new home and experiences. But, 
when a child spends long periods of time chatting with friends "back home" 
it 
can decrease the motivation to become involved with the new community and 
interfere with the adjustment to new friends. 
�	Be patient, some children will dive in, develop a support network of 
friends, and become involved with school and activities without missing a 
beat. Other kids may need more time and help to feel acclimated and at ease. 
Providing them with new experiences in new places will help them in the 
future when they make decisions for themselves about where to live. 
When parents are sensitive to the impact of moving on their children, they 
can make moving a positive experience, enhancing children's emotional 
growth, adaptability, self-confidence and social skills. 
________________________________________
POSTED 08/21/02; UPDATED 08/24/08
Back to Top


CHILD SEXUAL ABUSE

Facts for Families
Child Sexual Abuse
No. 9; Updated July 2004

Child sexual abuse has been reported up to 80,000 times a year, but the 
number of unreported instances is far greater, because the children are 
afraid to tell anyone what has happened, and the legal procedure for 
validating an episode is difficult. The problem should be identified, the 
abuse stopped, and the child should receive professional help. The long-term 
emotional and psychological damage of sexual abuse can be devastating to the 
child.

Child sexual abuse can take place within the family, by a parent, step-
parent, sibling or other relative; or outside the home, for example, by a 
friend, neighbor, child care person, teacher, or stranger. When sexual abuse 
has occurred, a child can develop a variety of distressing feelings, 
thoughts and behaviors.

No child is psychologically prepared to cope with repeated sexual 
stimulation. Even a two or three year old, who cannot know the sexual 
activity is wrong, will develop problems resulting from the inability to 
cope with the overstimulation.

The child of five or older who knows and cares for the abuser becomes 
trapped between affection or loyalty for the person, and the sense that the 
sexual activities are terribly wrong. If the child tries to break away from 
the sexual relationship, the abuser may threaten the child with violence or 
loss of love. When sexual abuse occurs within the family, the child may fear 
the anger, jealousy or shame of other family members, or be afraid the 
family will break up if the secret is told.

A child who is the victim of prolonged sexual abuse usually develops low 
self-esteem, a feeling of worthlessness and an abnormal or distorted view of 
sex. The child may become withdrawn and mistrustful of adults, and can 
become suicidal.

Some children who have been sexually abused have difficulty relating to 
others except on sexual terms. Some sexually abused children become child 
abusers or prostitutes, or have other serious problems when they reach 
adulthood.

Often there are no obvious physical signs of child sexual abuse. Some signs 
can only be detected on physical exam by a physician.

Sexually abused children may develop the following: 
�	unusual interest in or avoidance of all things of a sexual nature 
�	sleep problems or nightmares 
�	depression or withdrawal from friends or family 
�	seductiveness 
�	statements that their bodies are dirty or damaged, or fear that 
there is something wrong with them in the genital area 
�	refusal to go to school 
�	delinquency/conduct problems 
�	secretiveness 
�	aspects of sexual molestation in drawings, games, fantasies 
�	unusual aggressiveness, or 
�	suicidal behavior 

Child sexual abusers can make the child extremely fearful of telling, and 
only when a special effort has helped the child to feel safe, can the child 
talk freely. If a child says that he or she has been molested, parents 
should try to remain calm and reassure the child that what happened was not 
their fault. Parents should seek a medical examination and psychiatric 
consultation. The School Social Worker can help with this process.

Parents can prevent or lessen the chance of sexual abuse by: 

�	Telling children that if someone tries to touch your body and do 
things that make you feel funny, say NO to that person and tell me right 
away 
�	Teaching children that respect does not mean blind obedience to 
adults and to authority, for example, don't tell children to, Always do 
everything the teacher or baby-sitter tells you to do 
�	Encouraging professional prevention programs in the local school 
system 

Sexually abused children and their families need immediate professional 
evaluation and treatment. Child and adolescent psychiatrists and other 
mental health professionals can help abused children regain a sense of self-
esteem, cope with feelings of guilt about the abuse, and begin the process 
of overcoming the trauma. Such treatment can help reduce the risk that the 
child will develop serious problems as an adult.

More safety information can be found below.
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OPPOSITIONAL DEFIANT DISORDER (ODD)

Facts for Families--Children With Oppositional Defiant Disorder

No. 72; Updated December 1999

All children are oppositional from time to time, particularly when tired, 
hungry, stressed or upset. They may argue, talk back, disobey, and defy 
parents, teachers, and other adults.   Oppositional behavior is often a 
normal part of development for two to three year olds and early 
adolescents.  
However, openly uncooperative and hostile behavior becomes a serious concern 
when it is so frequent and consistent that it stands out when compared with 
other children of the same age and developmental level and when it affects 
the child's social, family, and academic life.

In children with Oppositional Defiant Disorder (ODD), there is an ongoing 
pattern of uncooperative, defiant, and hostile behavior toward authority 
figures that seriously interferes with the youngster's day to day 
functioning.  Symptoms of ODD may include:

-frequent temper tantrums 
-excessive arguing with adults 
-active defiance and refusal to comply with adult requests and rules 
-deliberate attempts to annoy or upset people 
-blaming others for his or her mistakes or misbehavior 
-often being touchy or easily annoyed by others 
-frequent anger and resentment 
-mean and hateful talking when upset 
-seeking revenge 

The symptoms are usually seen in multiple settings, but may be more 
noticeable at home or at school.  Five to fifteen percent of all school‑age 
children have ODD.  The causes of ODD are unknown, but many parents report 
that their child with ODD was more rigid and demanding than the child's 
siblings from an early age.  Biological and environmental factors may have a 
role. 
 

A child presenting with ODD symptoms should have a comprehensive 
evaluation.  
It is important to look for other disorders which may be present; such as, 
attention‑deficit hyperactive disorder (ADHD), learning disabilities, mood 
disorders (depression, bipolar disorder) and anxiety disorders. It may be 
difficult to improve the symptoms of ODD without treating the coexisting 
disorder. Some children with ODD may go on to develop conduct disorder.

Treatment of ODD may include: 
~Parent Training Programs to help manage the 
child's behavior, 
~Individual Psychotherapy to develop more effective anger 
management, 
~Family Psychotherapy to improve communication, 
~Cognitive‑Behavioral Therapy to assist problem solving and decrease 
negativity, and 
~Social Skills Training to increase flexibility and improve 
frustration tolerance with peers.  A child with ODD can be very difficult 
for parents. These parents need support and understanding.  Parents can help 
their child with ODD in the following ways: 

-Always build on the positives, give the child praise and positive 
reinforcement when he shows flexibility or cooperation. 

-Take a time‑out or break if you are about to make the conflict with your 
child worse, not better.  This is good modeling for your child.  Support 
your child if he decides to take a time‑out to prevent overreacting. 

-Pick your battles.  Since the child with ODD has trouble avoiding power 
struggles, prioritize the things you want your child to do.  If you give 
your child a time‑out in his room for misbehavior, don't add time for 
arguing. Say "your time will start when you go to your room." 

-Set up reasonable, age appropriate limits with consequences that can be 
enforced consistently. 

-Maintain interests other than your child with ODD, so that managing your 
child doesn't take all your time and energy.  Try to work with and obtain 
support from the other adults (teachers, coaches, and spouse) dealing with 
your child.  

-Manage your own stress with exercise and relaxation. Use respite care as 
needed. 

Many children with ODD will respond to the positive parenting techniques.  
Parents may ask their pediatrician or family physician to refer them to a 
child and adolescent psychiatrist, who can diagnose and treat ODD and any 
coexisting psychiatric condition. 

For additional information see other Facts for Families or call the School 
Social Worker.
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Los Ninos que no Pueden Prestar Atencion (ADHD) No. 6

Los Ninos que no Pueden Prestar Atencion (ADHD) No. 6

No. 6 (Revisado 7/04)

Los padres se preocupan mucho cuando reciben una carta de la escuela 
diciendo 
que el ni�o no le presta atenci�n a la maestra o que se porta mal en la 
clase. Una posible causa para este tipo de comportamiento es el Trastorno 
Hiperactivo de D�ficit de Atenci�n (ADHD).

Aun cuando el ni�o con ADHD quiere ser un buen estudiante, su comportamiento 
impulsivo y su incapacidad para prestar atenci�n en clase con frecuencia 
interfiere y le causa problemas. Los maestros, los padres y los amigos saben 
que el ni�o se est� portando mal o que es diferente, pero no saben 
exactamente qu� es lo que est� mal.

Cualquier ni�o puede no prestar atenci�n, distraerse con facilidad, actuar 
de 
manera impulsiva o ser hiperactivo a veces, pero el ni�o con ADHD muestra 
estos s�ntomas y este comportamiento con mayor frecuencia y severidad que 
los 
otros ni�os de su misma edad o nivel de desarrollo. El ADHD ocurre en 3-5% 
de 
los ni�os de edad escolar. El ADHD tiene que comenzar antes de los siete 
a�os 
de edad y puede continuar hasta que el ni�o llega a ser adulto. El ADHD 
ocurre en familias, con alrededor de un 25% de los padres biol�gicos 
habiendo 
tenido esta condici�n m�dica.

Un ni�o con ADHD con frecuencia muestra algunas de las siguientes 
caracter�sticas:

dificultad para prestar atenci�n 
falta de atenci�n hacia los detalles y comete errores por ser descuidado 
se distrae f�cilmente 
pierde los materiales escolares y se olvida de entregar la asignaci�n 
tiene dificultad para terminar los trabajos escolares y las asignaciones 
dificultad para escuchar 
dificultad para llevar a cabo �rdenes m�ltiples de los adultos 
deja escapar las contestaciones cuando no se le pregunta 
impaciencia 
es inquieto o se agita 
deja su asiento y corre o trepa de manera excesiva 
parece que siempre tiene que estar haciendo algo 
habla demasiado y tiene dificultad para jugar tranquilo 
interrumpe o se entromete en lo de otros 
Al ni�o que presenta los s�ntomas del ADHD debe de hac�rsele una evaluaci�n 
comprensiva. Los padres deben de pedirle a su pediatra o m�dico de familia 
que los refiera a un siquiatra de ni�os y adolescentes, quien puede 
diagnosticar y tartar esta condici�n m�dica. Un ni�o con ADHD puede tener 
otros des�rdenes siqui�tricos tales como un desorden del comportamiento, 
desorden de ansiedad, desorden depresivo, o desorden bipolar. Estos ni�os 
pueden tambi�n tener deficiencias para el aprendizaje.

Sin el tratamiento adecuado, el ni�o se atrasa en sus estudios y puede 
perder 
sus amistades. El ni�o experimenta m�s fracasos que �xitos y es criticado 
por 
los maestros y familiares que no reconocen su problema de salud.

Las investigaciones demuestran claramente que los medicamentos pueden ayudar 
a mejorar la atenci�n, enfoque, comportamiento dirigido hacia metas y 
destrezas de organizaci�n. Los medicamentos de mayor ayuda incluyen los 
estimulantes (varias preparaciones de metilfenidato y anfetamina), y el no-
estimulante atomoxetina. Otros medicamentos, tales como la guanfacina, la 
clonidina y algunos antidepresivos pueden tambi�n ayudar.

Otros enfoques del tratamiento pueden incluir una terapia cognoscitiva de 
comportamiento, entrenamiento en las destrezas sociales, entrenamiento a los 
padres y modificaciones en el programa educativo del ni�o. La terapia de 
comportamiento puede ayudar al ni�o a controlar su agresividad, a modular su 
comportamiento social y a que sea m�s productivo. La terapia cognoscitiva 
puede ayudar al ni�o a crear autoestima, a reducir los pensamientos 
negativos 
y a mejorar las destrezas para resolver problemas. Los padres pueden 
aprender 
a manejar sus destrezas, tal como el dar instrucciones paso por paso en vez 
de pedirle varias cosas a la misma vez. Las modificaciones en la educaci�n 
pueden ser dirigidas hacia los s�ntomas de ADHD a la vez que hacia las 
incapacidades de aprendizaje coexistentes.

Un ni�o que ha sido diagnosticado con ADHD y tratado de forma apropiada 
puede 
tener una vida productiva y exitosa.
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CHILDREN WHO CAN'T PAY ATTENTION

Children Who Can't Pay Attention/ADHD--FACTS FOR FAMILIES        
                                         No. 6; Updated July 2004

Parents are distressed when they receive a note from school saying that 
their 
child won't listen to the teacher or causes trouble in class. One possible 
reason for this kind of behavior is Attention Deficit/Hyperactivity Disorder 
(ADHD).

Even though the child with ADHD often wants to be a good student, the 
impulsive behavior and difficulty paying attention in class frequently 
interferes and causes problems. Teachers, parents, and friends know that the 
child is misbehaving or different but they may not be able to tell exactly 
what is wrong.

Any child may show inattention, distractibility, impulsivity, or 
hyperactivity at times, but the child with ADHD shows these symptoms and 
behaviors more frequently and severely than other children of the same age 
or 
developmental level. ADHD occurs in 3-5% of school age children. ADHD must 
begin before the age of seven and it can continue into adulthood. ADHD runs 
in families with about 25% of biological parents also having this medical 
condition.

A child with ADHD often shows some of the following: 

trouble paying attention 
inattention to details and makes careless mistakes 
easily distracted 
loses school supplies, forgets to turn in homework 
trouble finishing class work and homework 
trouble listening 
trouble following multiple adult commands 
blurts out answers 
impatience 
fidgets or squirms 
leaves seat and runs about or climbs excessively 
seems "on the go" 
talks too much and has difficulty playing quietly 
interrupts or intrudes on others
 
A child presenting with ADHD symptoms should have a comprehensive 
evaluation. 
Parents should ask their pediatrician or family physician to refer them to a 
child and adolescent psychiatrist or a pediatric neurologist, who can 
diagnose and treat this medical condition. A child with ADHD may also have 
other pyschiatric disorderss. These children may also have learning 
disabilities. 

Without proper treatment, the child may fall behind in schoolwork, and 
friendships may suffer. The child experiences more failure than success and 
is criticized by teachers and family who do not recognize a health problem.

Research clearly demonstrates that medication can help improve attention, 
focus, goal directed behavior, and organizational skills. Medications most 
likely to be helpful include the stimulants (various methylphenidate and 
amphetamine preparations) and the non-stimulant, atomoxetine. Other 
medications such as guanfacine, clonidine, and some antidepressants may also 
be helpful.

Other treatment approaches may include cognitive-behavioral therapy, social 
skills training, parent education, and modifications to the child�s 
education 
program. Behavioral therapy can help a child control aggression, modulate 
social behavior, and be more productive. Cognitive therapy can help a child 
build self-esteem, reduce negative thoughts, and improve problem-solving 
skills. Parents can learn management skills such as issuing instructions one-
step at a time rather than issuing multiple requests at once. Education 
modifications can address ADHD symptoms along with any coexisting learning 
disabilities.

A child who is diagnosed with ADHD and treated appropriately can have a 
productive and successful life.
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ANXIETY AND FEAR

How Families Can Help Children Cope with Fear and Anxiety

Whether tragic events touch your family personally or are brought into your 
home via newspapers and television, you can help children cope with the 
anxiety that violence, death, and disasters can cause.
Listening and talking to children about their concerns can reassure them 
that they will be safe. Start by encouraging them to discuss how they have 
been affected by what is happening around them. Even young children may have 
specific questions about tragedies. Children react to stress at their own 
developmental level.
The Caring for Every Child's Mental Health Campaign offers these pointers 
for parents and other caregivers:

�	Encourage children to ask questions. Listen to what they say. 
Provide comfort and assurance that address their specific fears. It's okay 
to admit you can't answer all of their questions. 

�	Talk on their level. Communicate with your children in a way they 
can understand. Don't get too technical or complicated. 

�	Find out what frightens them. Encourage your children to talk about 
fears they may have. They may worry that someone will harm them at school or 
that someone will try to hurt you. 

�	Focus on the positive. Reinforce the fact that most people are kind 
and caring. Remind your child of the heroic actions taken by ordinary people 
to help victims of tragedy. 

�	Pay attention. Your children's play and drawings may give you a 
glimpse into their questions or concerns. Ask them to tell you what is going 
on in the game or the picture. It's an opportunity to clarify any 
misconceptions, answer questions, and give reassurance. 

�	Develop a plan. Establish a family emergency plan for the future, 
such as a meeting place where everyone should gather if something unexpected 
happens in your family or neighborhood. It can help you and your children 
feel safer. 

If you are concerned about your child's anxiety consult your physician.  If 
you are concerned about how anxiety may be affecting your child at school, 
contact the School Social Worker.
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SAFETY INFORMATION FROM THE CHILD ABUSE PREVENTION CENTER

�	As many as one in seven boys and one in four girls will be sexually 
abused before the age of 18.

�	Remind children never to get into a car or go anywhere with a 
stranger.

�	Develop code words for caregivers other than mom and dad, and remind 
your children never to tell anyone that code.  Explain to your child that 
only adults responsible for them will know this code word, and to never go 
anywhere with anyone they don�t know unless they know the code word.

�	80% of perpetrators are known by the child and / or the parents.

�	Be alert about your child�s activities.  Watch for any changes in 
their behavior.  Talk with children about any close relationships they form 
with other adults.  Parents may first become aware of their child�s sexual 
abuse when they notice changes in their child�s behavior.

�	Let your children know that their bodies belong to them.  Teach your 
children to know the difference between a �good� touch and a �bad� touch.

�	We usually teach our children that they must always obey adults, so 
we need to let them know that they should not obey an adult who is touching 
them in a �bad� way.

�	Never force a child to sit on someone�s lap, or hug or kiss anyone.  
Doing so will let your child know that it is okay to say no to an adult if 
the adult is making them uncomfortable.

�	When talking with your child, use language he/she will understand.  
You don�t need to nor should you discuss frightening details.  You want your 
child to be alert, but not afraid of all adults.

�	Most importantly, your children need to know that they can talk to 
you at any time about anything.  Having good communication with your child 
is the key.  A child that feels comfortable discussing his/her problems with 
you is more likely to report abuse.

�	For more information, visit the Child Abuse Prevention Center 
website at:  www.child-abuse-prevention.org

�	Contact the School Social Worker with any questions or concerns.
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CYBER-BULLYING

Bullying is a problem in all schools and much is being done to reduce the 
incidence of children hurting other children in order to feel more 
powerful.  Websites such as www.pacerkidsagainstbullying.org are helping 
parents, teachers and most of all students learn how to cope with bullying.  

Cyber-bullying is another increasingly present type of bullying. Some 
children will "click to inflict" pain to others. To keep your children safe 
remember these tips:
�	Keep the computer in a central location so that you know what your 
chilren are doing online.
�	Use the parental controls feature on your computer to block out 
unwanted sites and email.
�	Check the �history� of your child�s websurfing to see what sites 
they have been visiting and who they have been communicating with.
�	Ask your child to tell you of any emails or messages that make them 
uncomfortable.

Below are some common Email, Text and Instant Messaging (IM) abbreviations 
used online:

A/S/L		Age/Sex/Location
LMAO		Laughing my A�off
MoS		Mother over shoulder
BFF		Best Friends Forever
MYOB	        Mind your own business
DIKY		Do I know you?
F2F		Face to face
PG11		Parents here watch your language
IHU		I hate you
PAL		Parents are listening
URH		Your are a ho
PAW             Parents are watching
PIR             Parent in room
LMIRL           Let's meet in real life
420             Marijuana
143 or 459      I love you
FOAF            Friend of a friend
C-P             Sleepy
WYRN            What's your real name?
NALOPKT         Not a lot of people know that

Contact your School Social Worker or child's teacher if you feel your child 
is a bully or is being bullied either online or at school.  Working 
together we can help to stop this menace.
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HELPING CHILDREN UNDERSTAND CANCER

Helping Children Understand Cancer 
adapted from �Cancer Care Briefs�

When someone has cancer, it affects the entire family, particularly 
children. Cancer is a complicated disease to understand, even for adults. 
There are many types of cancers and no easy way to describe them in simple 
terms. But if you, your child, or someone in your family has cancer, 
discussing it with your children may be the most important thing you can do.

In addition to the information provided in this publication, you can also 
refer to �Resources for Cancer & Parenthood� for additional resources that 
may be helpful. You can obtain a copy through the Cancer Resource Center at 
(415) 885-3693 

Protecting Children Can Make Things Worse
When cancer strikes a family, children sense that something is wrong, even 
if they don�t know what it is.
Talking it over with them, in words they can understand, is always better 
than hiding it. If you keep things from them, children think that things are 
worse than they really are.

For example, it is not uncommon for young children to think their actions 
somehow caused a parent or sibling to get cancer. It is important to not 
only communicate with your children, but to listen to them, and make sure 
they understand what is happening. No matter what their age, there are ways 
to communicate with children about cancer, treatment, and, if necessary, 
life and death.

How to Tell Children That You or Someone in Your Family Has Cancer
When a child�s life is touched by cancer, it can cause a great deal of 
emotional trauma � mostly because any kind of serious illness is scary to a 
child. Fortunately, as a parent, you can help your child overcome many of 
his or her fears by simply explaining the situation in a calm, reassuring 
way.

The following are tips on how to talk to your child about a family member 
who has cancer:

� Tell them about the illness. Although cancer is complicated, there are 
appropriate ways of discussing it with children of any age. �Mommy is very 
sick, so she has to go to the hospital to get well again,� is usually enough 
for very young children; for older children, a more detailed explanation is 
better. The more they can know, the less helpless and afraid they will feel.

� Practice your explanation beforehand. It will be a great help to your 
child if you can be as calm and objective as possible when you discuss 
cancer, especially if you are the one who is ill. You should practice the 
conversation with your spouse or a friend, so that you can focus on your 
child�s fears and put aside your own for the time being.

� Avoid blame. The younger children are, the more they think the world 
revolves around them, and the more likely they are to feel responsible for a 
parent or sibling�s illness. Assure them by saying that nothing they or 
anyone else did caused the cancer.

� Explain to them that cancer is not contagious. Most children first 
experience sickness when they get a cold, measles, or some other childhood 
disease that might have been fairly contagious. It is important that you 
explain to them that cancer is not contagious. They will probably already be 
afraid that someone else in the family will get it. Assure them that this is 
not true.

� Try to balance optimism with pessimism. Telling your child that someone 
will be �all better� will only make him or her more confused and upset if it 
is not true. On the other hand, being very pessimistic can scare them 
needlessly. It is usually best to try to offer a realistic but hopeful 
assessment of the situation.

� Keep in touch with your children. If you are in the hospital for any 
extended period of time, your children may think that you don�t want to be 
at home with them. Staying in touch will help reassure them that your 
illness has nothing to do with how much you love them.

� Take your children�s feelings seriously. It is common for children to have 
many different reactions when they learn that a parent or sibling has 
cancer. These can include anger, sadness, guilt, fear, confusion, and even 
frustration. All of these responses are normal. Let them know that it is 
okay for them to have lots of different feelings and that you have many of 
them, too.

� Answer questions honestly. Discussing cancer with a child can be 
difficult, especially when there are so many questions that adults or even 
doctors cannot answer. It is best for you to be as honest as you can with 
your child, and not be afraid to say, �I don�t know� if you don�t. For 
children, the amount of information you give them is usually less important 
than making them feel comfortable with what you say.

� Help children understand treatment. Children often fear the unknown. They 
can think that a situation is worse than it really is. Explain the treatment 
process in a way that is appropriate for their age, but don�t forget, it is 
easy for a child to imagine something like chemotherapy or radiation therapy 
as bad because it can cause hair loss, nausea, and other unpleasant side 
effects.

� Prepare your children for the effects of treatment. Cancer and cancer 
treatment can often dramatically affect someone�s appearance. A physical 
change such as hair or weight loss can sometimes frighten them, or make them 
think a person has changed or is different. It is best to explain this to 
them beforehand so they are prepared. For example, you can say, �When mommy 
was sick in the hospital, she lost weight, and her hair fell out
-but don�t worry, it will grow back .She is still the same mommy on the 
inside.�

� Let children help but don�t burden them with responsibility. It is 
important to let children know that they can help their parent feel better; 
it will make them feel less helpless if you let them run an errand, fetch a 
glass of orange juice, or perform some other task that is appropriate for 
their age. But be careful not to burden them with too much. The stress of 
having someone ill in the family can be great. They will need lots of time 
to just play, relax, and be children.

� Be prepared to discuss death. This is a complicated topic, but if you or 
your family member is very ill with cancer, you should be prepared to 
discuss death with your children. Given the limitations of this information, 
it is impossible to suggest ways to discuss this with your child.  You may 
want to consult a trained counselor or clergy first. One of the most 
important things to remember is to take your child�s age into account when 
discussing death. Preschoolers, for instance, do not understand that death 
is final. School-age children tend to know that dead things don�t eat, 
breathe, or sleep and by the age of ten, children begin to understand that 
death is the end of life. There are helpful books and other resources 
available to you to help facilitate the discussion of death with children 
(refer to �Resources for End-of-Life Issues�)

Regardless of your child�s age, when discussing death, remember three things:

� Try to use very clear, specific terms. Being vague will only confuse your 
child.

� Do not use terms like �sleeping forever� or �put to sleep,� because 
children will think sleeping is like death, or be afraid that if they sleep, 
they might die.

� Finally, be patient. It will take a long time for a child to fully 
understand, and to accept, any type of loss. They certainly will not 
understand the first time you try to tell them.

Remember that when cancer strikes a family, children know something is 
wrong. Trying to protect them will only make them imagine the worst, and 
will prevent you from helping them to understand and eventually accept what 
is happening. If you need help in talking to your children, don�t be afraid 
to ask for it. As a parent, you may not always be prepared for every 
situation. Being unsure of what to say is no reason to be ashamed.

The information in this publication is designed for educational purposes 
only and is not intended to replace the advice of your physician or health 
care provider, as each patient�s circumstances are individual. We encourage 
you to discuss with your physician any questions and concerns that you may 
have.
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TALKING TO YOUR KIDS ABOUT YOUR DIAGNOSIS

Helping Children Understand Cancer:
Talking to Your Kids About Your Diagnosis
Your cancer diagnosis has a profound impact on your entire family. Not only 
do you have new information to learn and treatment decisions to make. If you 
have children, you�re probably also concerned about how much to tell them 
about what you�re going through.
 
Q.  What information do I need to give to my children in order for them to 
feel comfortable and secure?
A.  The best thing you can do for your children during this difficult time 
is to talk to them about cancer and help them with their feelings.

Here are CancerCare�s 10 tips for communicating with your children:

1. Give your children accurate, age-appropriate information about cancer.
Don�t be afraid to use the word �cancer.� Tell or show them where the cancer
is in the body. Practice your explanation beforehand so you feel more 
comfortable. Remember that if you don�t talk to your kids about cancer, they 
may invent their own explanations, which can be even more frightening than 
the facts.

2. Explain the treatment plan and how it will affect their lives. Prepare 
your childrenfor any physical changes you might go through during treatment 
(for instance, hair loss, extreme tiredness, weight loss). Let them know 
that their needs will be taken care of (for example, Dad will bring you to 
soccer practice instead of Mom).

3. Answer your children�s questions as accurately as possible. Take into 
account their age and prior experience with serious illness in the family. 
If you do not know the answer to a question, don�t panic. Say, �I don�t 
know. I will try to find out the answer and let you know.�

4. Reassure your children. Explain to them that no matter how they have been 
behaving or what they�ve been thinking, they did not do anything to cause 
the cancer. Let them know that they cannot �catch� cancer like they can 
catch a cold.

5. Let your kids know they can turn to other members of your support system, 
too. These people include your spouse or partner, relatives, friends, clergy 
person, teachers, coaches and your health care team. Tell your children that 
they can ask questions of these adults and talk to them about their feelings.

6. Let your children participate in your care. Give them age-appropriate 
tasks such as bringing you a glass of water or an extra blanket.

7. Encourage your children to express their feelings. Let them know that they
can express any feelings, even those that are uncomfortable. Let them know,
too, that it�s okay to say, �I don�t feel like talking right now.�

8. Reassure your children that they will be cared for. Tell them that even 
if you can�t always provide the care directly, their needs are important and 
will be taken care of.

9. You may have less energy, but use what you have to communicate with your 
children. Make sure you understand what your kids are asking, and make sure 
they always understand what you are saying.

10. As always, show your kids a lot of love and affection. Let them know 
that although things are different, your love for them has not changed. When 
helping your kids cope with your diagnosis, it�s almost impossible to be 
prepared for every situation. Sometimes, you may not know what to say. This 
is normal and okay. Coping with cancer may leave you feeling vulnerable, but 
remember: you are the expert on your children. Cancer can be very 
overwhelming and disruptive, but it doesn�t change the fact that you know 
your children the best. Trust your sense of how to best support your kids 
during this difficult time.

CancerCare for Kids� Can Help
CancerCare for Kids� has a staff of professional oncology social workers 
that can help your family cope with a cancer diagnosis. Our social workers 
understand children�s needs and offer support and advice to parents.
We also offer:

� Individual counseling and support groups
� Educational materials
� Practical help
� Financial help

All our services are completely free of charge and available in person, over 
the phone or online.

CancerCare�
1-800-813-HOPE (4673)
Email info@cancercare.org
Web www.cancercare.org
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SIBLING RIVALRY-Can't We All Just Get Along?!

Sibling Rivalry�-from AboutOurKids.com
by Charles Neuhoff, M. A.
Reviewed by Steven Kurtz, Ph.D.

"Dad, he's in my room and he�s using my stuff again!"
"Mom, it�s her turn to set the table and she wants me to do it!"
"He called me a stupidhead."

Do these statements sound familiar? If you have more than one child, they 
probably do because these are common examples of sibling conflict. Arguing 
and bickering among children often cause frustration and concern in parents. 
However, this behavior is a routine part of growing up in families. Only 
when bickering turns into constant arguments, fights, and the creation of 
some potentially dangerous situations, should it be considered a problem 
that should be addressed by parents. The following are some tips to help 
parents promote sibling harmony and deal effectively with sibling conflict 
when it does occur. 

Promoting sibling peace and harmony

Allow siblings to express their feelings about each other. "I hate him" 
or "I wish I had some other sister" are frequent declarations. Don't dismiss 
or suppress children's resentment or angry feelings. Parents often try to 
talk children out of their feelings by saying things like "Stop complaining 
about your brother." But anger is part of being human, and it's commonplace 
for siblings to get furious with one another from time to time. Children 
feel their parents understand them when their upset feelings are 
acknowledged. This can help them feel better and even treat another child 
better. Children need to know that although it�s okay to become angry, these 
feelings do not give them license to behave in cruel and dangerous ways.

Don't make comparisons. It is only natural for parents to notice when one 
child is more cooperative or better behaved than another, but comparing 
siblings does not encourage better behavior. Comparison intensifies jealousy 
and envy and often causes the child who was unfavorably compared to want to 
get even with the child who was praised. Instead of comparison, each child 
in the family should be given individual goals and expectations.

Equal distribution. If siblings frequently squabble over the same things, 
develop a system for equal distribution. For example, a rotation system 
could be set up in which the children take turns for such privileges as who 
decides what television program to record, who gets to choose where to go to 
eat lunch, etc.

But�treat children individually�not always equally. Some parents believe 
that the best way to avoid arguments is to strive for equality among all the 
children; for example, buying something for one child means buying something 
for the other children, or complimenting one child means complimenting all 
the children. However, it�s a mistake to think that this will avoid 
arguments and sometimes it even encourages comparisons by the children. No 
matter how hard parents try to make things equal, children are bound to find 
something that�s unfair. Instead, try to give to each child according to 
individual need. Rather than tell children that you love them equally, point 
out the special qualities that make them unique.

When and how to intervene

Don�t become involved in routine bickering or minor fighting. In situations 
when the fighting is minor and does not appear to be dangerous, try to 
pretend that you are not aware of what is happening. Whenever possible let 
siblings work out their own differences. The longer you can stay out of the 
situation, the sooner they will learn to settle their differences 
themselves. In addition, trying to figure out who started a fight is nearly 
impossible, and even if you are sure who started the fight, taking sides 
only makes things worse. If you cannot ignore the situation, leave the room 
or ask the children to take their fighting somewhere else. When the children 
see that you will not get involved, the fighting often settles down quickly. 

In the following situations, however, parents are advised to step in during 
sibling fighting: 
�	when the amount of fighting seems excessive 
�	when the same fight happens over and over without any resolution 
�	when conflict turns into real fighting in which one or both children 
may be hurt

In conflict situations, the first step is to separate the children until 
they are calm. After waiting for a cooling down period, listen to each 
child�s point of view and acknowledge their feelings. Encourage and guide 
the children to suggest at least one idea about how their conflict could 
have been avoided or resolved. Even children as young as four of five can 
suggest useful ideas. Use the opportunity to teach children some basic 
conflict resolution skills. For example, they can be taught how to use a 
timer to take turns. Furthermore, parents can teach children social skills 
by showing them the benefits of asking someone politely rather than grabbing 
or yelling. 

In situations where one child is being teased, parents can provide 
suggestions on how he/she can handle the situation when it occurs; for 
example, ignore the teasing, kid back in a way that is humorous, simply 
agree (in a kidding way) that whatever the teaser is saying is true, tell 
the teaser that enough is enough, and ask the person in charge (parent, 
teacher, baby sitter) for help when these other ideas are not working. To 
make sure that children incorporate these skills, provide practice. Parents 
can set up and role play some provocative situations (in a playful manner), 
the child can then role play possible responses and receive feedback about 
she/he handled the situation. 

At times making a family plan can help with a conflict situation. Both 
consequences and rewards should be used. For example, children might be told 
that when there is any physical fighting, they will all have a consequence 
such as a time out, but if they can go for a morning (or entire day) without 
fighting, everyone will earn a privilege such as an extra snack, a later 
bedtime or other meaningful privilege. In a small number of families, 
sibling conflict is so severe that the help of a mental health professional 
is necessary. Consider professional consultation if: 
�	the sibling conflict is so severe that it is leading to marital 
problems 
�	there is real danger of physical harm to one or more family members 
�	the fighting is damaging to the self-esteem or psychological well-
being of one or more family members 
�	the conflict may be related to another psychiatric disorder, such as 
depression, or to drug abuse

Think long-term 

At times, sibling conflict can be very stressful and overwhelming for 
parents. However, parents should consistently remind themselves that if 
their efforts to deal with the problem are successful, they will be 
providing the children with resources that will serve them well later in 
life. As children watch parents deal with sibling conflict with equanimity 
and fairness, they are gathering valuable knowledge. They are learning how 
to get along better with each other, to share, to come face-to-face with 
jealousy, to jointly solve problems and to accept individual strengths and 
weaknesses. These experiences prepare them for important relationships in 
the future with co-workers, spouses, and even their own children. 

Related Book
Goldenthal, P. (1999). Beyond sibling rivalry: How to help your children 
become cooperative, caring and compassionate. New York: Henry Holt
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MAKING BEHAVIOR CHARTS WORK

BEHAVIOR CHARTS-- on which doing chores, behaving, and handling self-care 
tasks are rewarded with points -- can be effective ways of getting children 
to do what parents want. But often parents of children with special needs 
find that their kids don't respond to point charts; the concept is too 
abstract or the gratification too delayed. Adjusting and simplifying the 
chart idea to your child's particular needs and abilities can help. Here's 
how to do it.

Difficulty: Easy
Time Required: A little every day

Here's How:
1.	Accentuate the positive. Make the chart all about rewarding positive 
behavior, not penalizing negative. Make a big excited deal about putting 
points up or checking items off. Don't apply blame for items not checked. 
The chart is an opportunity to get extra credit for things done right. 
2.	Make success easy. Don't load up the chart with big challenging 
things you'd like your child to do. A couple of these is fine, but make sure 
there are some things he or she is already doing on a regular basis, and a 
couple of very easy things that will always earn some points or check marks. 
Add one "miscellaneous" category for rewarding random acts of good behavior. 
3.	Give variable points. If your child is not always able to do the 
items on the chart without help, then increase the number of points 
available for that task, and award them according to effort. For example, if 
your child has trouble getting dressed in the mornings, you might award 
three points if he does it himself, two if you just have to help a little, 
and one if you have to get him dressed but he cooperates. That way, you're 
able to make a positive experience out of almost any outcome. 
4.	Reward good school behavior. Ask your child's teacher to send home a 
behavior report every day; if necessary; send in an easy form that can be 
checked off quickly. Award points based on performance. Make a big deal of 
putting those on the chart, but if your child has a bad day, don't make a 
big deal of not adding them. Better luck tomorrow. 
5.	Try less abstract variations. If your child just doesn't "get" a 
chart with points or checkmarks, try putting happy faces or stickers on the 
chart for successful results. Or skip the chart and put pennies in a jar any 
time you like something your child is doing. Add beads to a string, Legos to 
a Lego tower, rubber bands to a rubber-band ball. Anything that involves 
adding on to something will work. 
6.	Review the chart every night. This gives you another opportunity to 
provide positive feedback for jobs well done. If your child responds best to 
short-term rewards, you might give something like a sticker for a minimum of 
points earned. Or use a digital camera photo to make up some fake money with 
your child's picture on it, and have a daily pay-off; cash the "money" in at 
the end of the week for bigger rewards, or let your child use it to "buy" 
things throughout the week. 
7.	Make rewards motivating. Some kids are highly motivated by an 
allowance, and for them the point pay-off at the end of the week should be 
in cash. Establish the amount in advance and put it on the chart. If money 
isn't motivating, find something that is -- a small toy? a fast-food lunch? 
GameBoy time? some special lunchbox item? pennies? a "get out of time-out 
free" card? Be creative, and look at things your child really craves, not 
things that would make sense to you. 
8.	Make rewards available. If you have a child whose spirit is willing 
but flesh is weak, make sure he or she always gets some sort of reward. The 
idea here is to be positive about successes, not negative and condemning. 
Offer a descending scale of rewards for points attained -- smaller amounts 
of money, if that's the reward, or smaller classes of motivating items. If 
your child can work with you on this, set up the rewards together and agree 
on them. Put the possibilities on the chart. 
9.	Make rewards practical. Don't offer anything you can't deliver. Big 
trips or large toys are trouble; losing them will be a negative experience 
for your child if he or she doesn't succeed in earning enough points, and 
they may be hard for you to deliver reliably. If your child is earning an 
allowance, put the money aside early in the week so you'll be sure to make 
that payday. 
10.	Fine tune the chart on a regular basis. Your child's abilities and 
your family's needs change, and the chart should change too. Do this in 
collaboration with your child if possible. Add new chores as your child's 
abilities increase, and eliminate things he or she is rarely successful at. 
Keep brainstorming new rewards and new methods of earning them. Making sure 
your child is always able to earn and excited about doing so is the true 
secret to a good behavior chart.
Tips:
1.	Coupons for desired activities, or for avoidance of un-desired ones, 
can serve as a good tangible reward for behavior-chart goals. Try pre-made 
printable coupons, or draw up some of your own.
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TEN TIPS FOR FAMILIES IN TOUGH TIMES

Tough times also bring opportunities for families to come together and value 
the things that really matter. Here are some suggestions:
1.	A strong social support network is a strong protective factor 
against stress. Make sure that contacts with friends, extended family, 
coworkers, and neighbors are maintained.
2.	Be part of a community or religious group. Encourage kids to join 
scouts or other social groups
3.	Plan to eat meals together. Family meals are a safe place where 
everyone can talk about their day, listen to each other and try out ideas. 
Encourage kids to be creative in planning meals in different places or in 
new forms � a picnic, brunch, a community dinner.
4.	Be sure that each family member gets enough exercise and sleep, 
which are good antidotes to anxious or depressed feelings.
5.	Help others by volunteering and donating time to worthy 
organizations. It is never too early�have toddlers share toys, have your 
child go with you when you bring food to a neighbor, encourage your teen to 
volunteer in an after-school program�these actions allow children to 
appreciate what they have and gives them a sense of their ability to 
contribute to the good of others.
6.	Explore fun, low cost activities. Plan trips and explore new places 
(museums, parks, concerts, etc.) in your area. Find unusual and inexpensive 
restaurants, making the point that you�re helping the economy.
7.	Establish a regular schedule for family conferences to keep everyone 
informed on how the drop in income will affect everyone�s life. Discuss, in 
age-appropriate terms:
a.	Life style changes, such as changing recreation and vacation plans 
b.	Decisions about priorities for spending money; planning a budget
8.	Involve children in helping out at home � babysitting, household 
chores.
9.	Be a model for your children on how to solve problems, how to deal 
with a crisis, how to make decisions. When they see you handle a situation 
with confidence they learn that they too can handle life's challenges.
10.	Help children focus on the positive aspects of their lives and on 
the activities over which they have control.
The good news is that kids are resilient and are generally optimistic. Help 
them develop a hopeful outlook for the future. Children who believe that 
they can take steps to make their lives better and who believe that adults 
are working to create a better world have good mental health even in 
troubling times.
Date Published: February 2, 2009, AboutOurKids.com
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5 THINGS YOU SHOULD NEVER SAY TO A PARENT whose CHILD HAS AUTISM

- By Jene Aviram 
If your child has autism then you�re a walking target for friends, relatives 
and even strangers to offer unsolicited advice. You realize they have good 
intentions but it�s still a very hurtful experience. We�ve compiled a list 
of common mistakes that people make. When talking to parents whose children 
have autism, here are five things you should never say.

1. Autism does NOT mean deaf

You�re chatting to your friend and you notice her child engaging in some 
strange behavior. You�re curious and you ask �What is he doing? Does he 
always do that?� Questions like these place a parent in a very difficult 
situation. They are also very damaging to the autistic child�s self esteem. 
The child might not look up at you but he heard what you said. A common 
misconception is that people with autism don�t comprehend the world around 
them. Nothing could be further from the truth. People with autism might not 
respond or react in typical ways. They might not have much speech but they 
do understand what�s being said. Keep in mind that many of them have acute 
hearing and can hear what you�re saying clear across a room.

2. Actions speak louder than words

You�re standing in line a busy store. The woman in front of you is 
struggling to keep her sanity intact. Her child is running off and pushing 
items off the sales racks to the ground. �What an insolent child� you think 
to yourself. �His mother should discipline him better!� Don�t jump to 
conclusions just yet. It�s very possible the child has autism. Even if 
you�re tempted, do not roll your eyes and shake your head in disdain with 
other customers. This mom faces judgment at every turn. You will make her 
day if you smile broadly at her. Then offer to keep her place in line so 
that she can redirect her child.

3. Discipline advice

You�re visiting a friend whose child has autism. Her child is painstakingly 
building a tower and he accidently knocks it over. Devastated at his 
mistake, he flies into a rage and hurls the blocks through the air. Your 
friend quiets the situation but you don�t approve of the way she handles it. 
Shocked at her son�s inappropriate outburst, you offer some well meaning 
advice and share your discipline tactics. Children with autism often don�t 
respond to conventional methods of discipline. This mom deals with more than 
you can possibly imagine and has probably tried every discipline tactic in 
the book. She�s afraid you�ll be judging her actions. A warm smile and a 
swift change of subject will do wonders for her.

4. You can leave him behind

You�re planning a trip to the amusement park. You�d love to go with your 
friend but you�re in a dilemma. Her typical kids love the amusement park but 
her child with autism seems to have a difficult time. So you come up with a 
solution. �Come with us to the amusement park� you tell her. �Your kids will 
love it. Well except for Tommy, but you can find something else for him to 
do that day.� Inviting a family to join you, except for their child with 
autism is a very crushing experience to a parent. Your intentions might be 
good but that doesn�t make the experience less devastating. Parents that 
have children with autism desperately want their kids to be accepted in the 
community. Rise above the judgments of others and invite the whole family. 
If you feel that isn�t a viable option, leave your invite for another day 
when the whole family can be included.

5. Therapy recommendations

Your grandchild has autism. You�re distraught that your children have such a 
rough road ahead of them. You�re devastated that your gorgeous grandchild is 
autistic and you want to help. Having already raised your own children 
you�ve learned a thing or two. You cringe as your daughter tells you about 
the therapy option she�s picked and the behavior management she has for her 
child. You give the gift of wisdom and let her know how she should do it 
differently. Parenting a child with autism is totally different from raising 
a normal child. You have to live it to really understand. If you want to do 
something wonderful, be supportive to the parents. Give your love, follow 
through on their decisions and stand by their side. You will become a hero 
to parents who desperately need your acceptance and support. To all the 
parents whose children have special needs, we commend and praise you! Your 
road is rocky, filled with joy and challenges. To everyone else, we stand in 
gratitude. Your love and support is immeasurable for parents and their 
special needs kids. Thank you for standing by their side. 

This article is property of and copyright � 2003-2009 Jene Aviram of Natural 
Learning Concepts. Reference of this article may only be included in your 
documentation provided that reference is made to the owner - Jene Aviram and 
a reference to this site http://www.nlconcepts.com
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