How are your children affected by traumatic events in the media?

Events reported in the media can very traumatic for all of us. And the impact of trauma on children can be particularly devastating to their development. Left untreated, all but the mildest of childhood trauma can have an impact on the child.

Trauma is defined as an “event outside normal human experience”. These events are generally emotionally painful and distressing, and overwhelm a person’s ability to cope, The person’s response involves intense fear, helplessness, or horror.

American Academy of Child and Adolescent Psychiatry identifies 2 types of trauma: One-episode Trauma, and Repeated Trauma. One-episode trauma is the result of a specific “event”.

Repeated trauma can include situations of chronic traumatic stress such as repeated neglect, abuse and maltreatment, including physical violence, sexual abuse, repeated verbal abuse and poor early childhood care.

Substance Abuse and Mental Health Services Administration reports
• More than 60% of youth age 17 and younger have been exposed to crime, violence and abuse either directly or indirectly.
• Young children exposed to 5 or more significant adversities in the first 3 years of childhood face a 76 percent likelihood of having one or more delays in their cognitive, language, or emotional development.
• As the number of traumatic events experienced during childhood increases, the risk for the following health problems in adulthood increases: depression; alcoholism; drug abuse; suicide attempts; heart and liver diseases; pregnancy problems; high stress; uncontrollable anger; and family, financial, and job problems.

According to the Attachment & Trauma Network Inc, parenting a traumatized child is very challenging and requires a more focused, trained approach than parenting emotionally healthy children. Traumatized children frequently show signs of emotional delay, often acting much younger than their chronological age. Behaviors can range from being withdrawn and non-responsive to aggressive and violent. Responses to typical parenting techniques, such as time out or removal of privileges are often surprising, and parents’ frustration to the child’s opposition can inadvertently cause the behaviors to escalate.

In a 2006 report on Trauma Informed Care, the National Association for State Mental Health Program Directors indicates long term effects of trauma on a child vary, depending upon many factors:
• Characteristics of the child- age, past trauma experiences
• Characteristics of the trauma-type of trauma, severity, chronicity
• Post-trauma factors: early intervention, social support & symptom resolution

Early intervention in childhood psychic trauma is important. Families that offer support, understanding, and a sense of safety as close to the time of the traumatic event as possible can effectively limit the effects of trauma on a child. Munther Barakat, PsyD, a licensed clinical psychologist who works with children, provides tips for parents on dealing with trauma.  It is also a good idea to consult a child and adolescent psychiatrist or other mental health professional for evaluation and treatment.

If your child, or a child you know has experienced trauma, contact Aurora Psychiatric Hospital at 877-666-7223 or visit our web site at Aurora Psychiatric Hospital.

For more information on trauma visit these resources:

Is your child ready for the new school year?

Back to school sales are being promoted already in just about every retail store. Is it really time to start planning for the new school year?

Kradwell School offers these tips for making a smooth transition from summer vacation to new school year.

One of the best ideas is to keep a child’s mind sharp when not in school. Use the summer to read, access a local library, engage in a science project at home or visit a museum for a fun history lesson.

Similarly, kids who don’t write during the summer have to relearn to write (and spell) when school starts. Practice handwriting and spelling. Correct the spelling and ask for neat handwriting Here are a few ideas:

  • Have them write a few sentences about what they’ve done that day or week.
  • Write letters to friends or relatives
  • Encourage kids to write thank you notes
  • Teach your child how to write and send an email message
  • Create a family newsletter or blog
  • Suggest your child keep a journal

Before your child starts kindergarten, it would be GREAT if they could write their name correctly, know their numbers to 20, say the alphabet (and letter sounds), and know basic shapes and colors.

Find out about your child’s school.  Whether your child is returning to the same school or starting at a new one, it’s always a good idea to be aware of any changes at the school. Is there a new principal? What’s going on with the curriculum?

As most school districts start in September, schools tend to be open a month before. You can call the school directly and speak with an administrator or visit the school for information.

Whether you attend an “open house” or schedule a one-on-one conference, you should meet with your child’s teachers. By talking with your child’s teachers and/or going to the Department of Education Web site for your state, you can also find out key benchmarks on the academic calendar, such as which tests are administered and when. The teacher may also be able to provide you with a copy of a lesson plan or syllabus that gives you an idea of what will be taught in class.

You should also tour of the building-be aware of all the facilities your child may come into contact with. And don’t forget the guidance counselor. That person will be another key ally for you and your child. Guidance counselors have access to all of your child’s academic records. They also have knowledge of programs to help your child in and out of school. They’re also trained to provide basic counseling services to your child if he is having problems in school.

 Get your child into the back-to-school routine. During the summer, staying up late and sleeping in are the norm. But as the start of school draws near, children need to get back into a routine.

About three weeks before school starts, have your child go to bed 15 minutes earlier at night and get up 15 minutes earlier in the morning. When school is two weeks away, have your child go to bed 30 minutes earlier at night and get up thirty minutes earlier in the morning. When your child is about to start school in a week, have him go to bed an hour earlier at night and get up an hour earlier in the morning.

Kradwell School is dedicated to serving the needs of students in 5th through 12th grade who have experienced overwhelming difficulties in traditional educational environments.

By developing a bedtime routine, your child will be less resistant to the early morning wake-up calls to get ready for school. In addition, you can prepare the evening before for morning routines surrounding starting school each year.

Select clothing, including shoes and socks, and have them laid out. Hair accessories, backpacks zipped and ready, lunches made or at least decisions about what will be in the lunch, and determining weather-appropriate attire helps to minimize morning madness. Having a set place for backpacks minimizes lost homework or missing items in the harried morning routine.

Make sure your child gets enough sleep. Sleep experts from the National Sleep Foundation say that kids need their rest to perform well at school. Follow their practical tips for setting your kids’ back-to-school sleep clocks at least two weeks before the school year begins.Pre-school and school-age children should receive 10-11 hours of sleep each night. Establish those bedtime requirements, and then stick to it.

Organize your family’s time. As appointments and daily schedules for the year form, take note of them and write them down. Use a large calendar to keep track of schedules and events or place a weekly schedule for each person on the refrigerator or other prominent place in your home. Make a habit of checking it twice a day – in the morning and at night. Teach this habit to all of your family members.

Buy and organize school supplies.  Depending on your child’s grade level (K0-12), the type of supplies needed will vary. Some schools send a list out a couple of weeks before the school year. If no such list is provided, many stores provide free school supply lists for their customers. They’re pretty concise and arranged by grade level. Be prepared to have to go out and purchase something else the night of the first day of school. There is always one teacher who requires a certain supply but doesn’t let their students know until the first day of school.

Set goals and expectations. The start of the school year is a wonderful time to re-examine school performance – both academically and extra curricular activities. Remember to set doable goals and try not to over stress your teenager. Be sure to set the time for homework-establish a learning schedule, including parameters for homework.

Setting aside a designated period of time after school or in the early evening that is to be used only for schoolwork is a strategy that has been proven effective for many students. There are several factors that can influence the decision about which time is best. Some children, for example, may complete homework more successfully by beginning immediately after school, leaving the rest of the late afternoon and evening for other activities. Others may need time to “wind down” after being in school all day before they’re relaxed and focused enough to complete homework successfully.

Emphasize the positive. Kids pick up on your attitude. If you complain about shopping for back-to-school clothes and supplies, they’ll pick up on it. If you speak negatively about your child’s teacher, they will start the year thinking negatively about him or her. Instead, identify what excites your child and focus on that. Talk to each other about the school year coming up and reaffirm with your child that you are there to help whenever help is needed-be sure to tell your child this and don’t assume they already know. It is easier to handle stress from outside sources – like school – when you know someone is on your side.

Don’t wear them out! Kids who are signed up for five different summer camps, tutoring, piano lessons, and ballet will never get the ‘break’ that comes with summer break! Give them downtime. Let them play. Let them sit around and say ‘I’m bored’ every once in a while. This advice should also be applied year-round. Limit our kids to 1-2 extracurricular activities at a time during the school year. As they get older, maybe they’ll show that they can handle more or less than that. Let your child know that school is their main priority and biggest responsibility.

Kradwell School is a private, nontraditional, nonsectarian fifth through twelfth grade Program. Kradwell School is dedicated to providing a child-centered, flexible, educational environment that meets the diverse academic, emotional and social needs of students.

Fall enrollment is now underway (2012-2013).Contact Leslie Newman 414-395-8125 or mail leslie.newman@aurora.org to arrange a visit to Kradwell School.  Openings are available in both the middle and high school programs. For more details about Kradwell School, enrollment information and a video tour of Kradwell school, visit www.kradwell.org.

Extreme heat, medication can combine to create extreme health risks

The mercury’s rising across the country, and with the rising temperature comes increased risk of a potentially fatal illness: heat stroke.

The Milwaukee County Medical Examiner’s Office released reports Monday which show five deaths last week could be heat related. Heat-related deaths were also reported in La Crosse, Lone Rock and Janesville, and the death of an Onalaska man is also being investigated as possibly related to the heat.

But, did you know that mental illness and some medications used to treat mental illnesses actually increase the risk for heat stroke? Recently, the Substance Abuse and Mental Health Services Administration blogged this warning, and in this 2006 press release, the National Alliance on Mental Illness appealed to the news media and other authorities to publicize heightened risks of heat exhaustion and heat stroke for people with mental illnesses who take psychiatric medications.

Family and friends should always check in with loved ones living with mental illness to ensure their safety.  Disturbingly, individuals with mental illness may be particularly susceptible to heat stroke.

Certain medications, including anti-psychotics and anti-cholinergics, are known to increase the risk for heat stroke because they inhibit the body’s ability to regulate its temperature. Psychiatric medications—particularly antipsychotics, lithium and topirmate—affect the body’s ability to stay cool by causing a decrease in sweating, promoting fluid loss and dehydration, or changing how people experience heat; i.e., they may not even feel heat.

Additionally, people with mental illnesses who live in low-income housing without air conditioning are also at an increased risk for heat stroke. This combination can be dangerous; According to NAMI, during a 1999 heat wave in Cincinnati, Ohio, almost half of the 18 heat-related deaths were individuals with a mental illness. The Ohio Department of Mental Health provides this information

Heatstroke is the most severe of the heat-related illnesses, and is a medical emergency. It occurs when the body’s temperature-regulating system breaks down. The victim can’t sweat and is unable to cool himself. Internal body temperature can rise as high as 108 degrees, which can cause irreversible brain damage and death. High internal temperatures can injure almost every organ, including the liver, kidneys, lungs, heart, and muscle. It can cause permanent disability and even death.

A few facts about heat stroke:

  • It’s more likely when the outside temperature is very hot. A heat wave is defined by the National Weather Service as three or more consecutive days of temperatures at or above 90°F (32.2°C ).
  • Hyperpyrexia (core temperature greater than 105°F [40.6°C]) and central nervous system impairment causing delirium or coma are characteristic.
  • The death rate for heatstroke ranges from 10% to 75%, depending on several variables, including how promptly treatment is sought.
  • Mentally ill patients are a high-risk group. Some may not have the cognitive abilities to protect themselves; others may be taking psychotropic medications that affect heat regulation.

If you are taking one or more of the following medications or products, please be extremely cautious and avoid unnecessary or prolonged exposure to the extreme heat and high temperatures.

Antipsychotics, especially:

  • Chlorpromazine (Thorazine)
  • Thioridazine (Mellaril)
  • Mesoridazine (Serentil)
  • Clozapine (Clozaril)
  • Risperidone (Risperdal)
  • Olanzapine (Zyprexa)
  • Quetiapine (Seroquel)
  • Ziprasidone (Geodon)

Antiparkinson drugs, such as:

  • Benztropine (Cogentin)
  • Trihexyphenidyl (Artane)
  • Procyclidine (Arpicolin, Kemadrin)
  • Biperiden

Antihistamines, such as:

  • diphenhydramine (Benadryl)
  • chlorpheniramine (Chlor-Trimeton, Sinutab Sinus Allergy)

Antidepressants, especially tricyclics, such as:

  • Imipramine (Tofranil)
  • Amitriptyline (Elavil)
  • Nortriptyline (Pamelor)
  • Doxepin (Sinequan)
  • Desipramine (Norpramin)
  • Protriptyline (Vivactil)

Do:

  • Educate yourself about symptoms of heat stroke
  • Sleep in a cool place.
  • Drink extra fluids. Water is best because the body absorbs cooler solutions fast. Other fluids you can try include juice, Gatorade, and caffeine-free soda.
  • Increase salt intake if there are no medical contraindications.
  • If you take lithium, be sure to remain well-hydrated.
  • Spend time in cool places (shopping malls, movies, etc.)
  • Wear loose, light-colored, summer-weight clothing.
  • Use fans or air conditioning.
  • When feeling warm, use cool, wet compresses or sit in a tub of cool water.
  • Remain with another person.
  • Monitor loved ones and neighbors during a heat wave for signs of heat stroke

Don’t:

  • Engage in strenuous exercise in the heat.
  • Drink alcoholic beverages, coffee, and soda with caffeine (caffeine and alcohol increase water loss).
  • Spend excessive time outside in the sun.
  • Sleep or spend prolonged time in hot conditions.

Click here for more tips on preventing heat exhaustion and heat stroke.

Warning signs of heat stroke:

  • Nausea, headache, feeling poorly, weakness
  • Irritability, anxiety
  • Fast pulse, rapid breathing, dizziness
  • Hot OR dry skin, confusion, vomiting, diarrhea

The Centers For Disease Control & Prevention (CDC) provides additional information about heat stroke..

Aurora Behavioral Health Services offers complete mental health treatment options, provided by highly trained professionals in a caring, confidential manner to meet individual and family needs.  If you or someone you know needs help, contact us — online or by phone at 1-877-666-7223 — as soon as possible.