NAMI NJ Webinar Series: Stress & Anxiety in Youth with Autism and Developmental Disabilities

Summary

This NAMI New Jersey webinar features Dr. Lynch, a child psychologist with extensive experience working with children with autism and developmental disabilities. The session delves into stress and anxiety disorders prevalent in this demographic, particularly highlighting challenges exacerbated by the COVID-19 pandemic. Dr. Lynch explores the concept of diagnostic overshadowing, detailing how mental health and developmental disabilities co-exist, often leading to anxiety. The webinar offers insights into cognitive and social factors, sensory sensitivities, and strategies to manage these stressors. It underscores the importance of personalized care and adapting communication techniques to better support children. Practical advice for caregivers, along with strategies to facilitate smoother transitions back to normalcy post-pandemic, are shared.

Highlights

• Dr. Lynch emphasizes understanding diagnostic overshadowing and co-existing mental health disorders with developmental disabilities. 🧩
• Caregivers are encouraged to maintain routines and slowly introduce changes to minimize anxiety. 🔄
• Strategies such as visual support and personalized coping plans are key to managing sensory and social challenges. 👀
• The importance of fostering an inclusive environment to help children with developmental disabilities thrive socially is highlighted. 🌈
• Practical tips include using relaxation techniques and ensuring virtual healthcare options are utilized. 💻

Key Takeaways

• Anxiety and stress commonly accompany autism and developmental disabilities in children, demanding nuanced understanding and management. 🧠
• COVID-19 has intensified anxiety challenges, making routine and transition management pivotal. 🚦
• Sensory sensitivities are significant in causing distress, thus requiring environments that minimize unpleasant stimuli. 🔉
• Social skills development focused on structured, small-group interactions can enhance socialization in children with developmental disabilities. 👥
• Language and communication adjustments using visual aids can greatly help children express needs and reduce anxiety. 🔡

Overview

In this compelling webinar, Dr. Lynch draws from years of experience to provide a deep dive into stress and anxiety issues faced by youth with autism and developmental disabilities. He stresses the significance of addressing underlying anxiety rather than just managing surface-level behaviors, encouraging caregivers to understand the root causes of distress.

As the world battles the pandemic, Dr. Lynch shares how COVID-19 exacerbates existing challenges, increasing the necessity for structured routines and well-planned transitions. He provides insightful perspectives on how to deal with changes in family and educational settings, ensuring children remain as comfortable and supported as possible.

Social and sensory demands present unique challenges, and Dr. Lynch offers accessible strategies involving visual aids and simplifying communication. These tools can crucially reduce anxiety by helping children navigate complex social interactions and overwhelming sensory environments, fostering a more inclusive and supportive atmosphere for growth.

Chapters

• 00:00 - 00:30: Introduction This chapter introduces a webinar hosted by the South Asian mental health program of NAMI New Jersey. The focus of the webinar is on addressing stress and anxiety disorders in youth with autism and developmental disabilities, with considerations of the impacts of COVID-19. Dr. Lynch, a child psychologist, is the featured speaker for the event, thanks to an introduction from Subha Polysetti.
• 00:30 - 01:00: Speaker Introduction The chapter titled 'Speaker Introduction' begins with Subha being invited by Bina to introduce the speaker. Subha expresses gratitude and proceeds to introduce Dr. Lynch, who has been working with Subha's child for eight years. Dr. Lynch has played a significant role in addressing various challenges faced by the child, including anxiety and stress, due to being on the spectrum and having developmental delays.
• 01:00 - 01:30: Dr. Lynch's Background The chapter titled "Dr. Lynch's Background" explores the professional journey and accomplishments of Dr. Lynch. He is currently the director of the Pediatric Behavior Medicine Department at Gordep Children's Hospital in Morristown, where he founded the Aspirations Life Management Program. With over 20 years of experience in child care, including five years of service in Ireland, Dr. Lynch also facilitated a social skills group that the narrator's son participated in years ago, highlighting his dedication to developmental support for children.
• 01:30 - 03:00: Dr. Lynch on Anxiety Management Dr. Lynch is a recognized author in the field of anxiety management and autism, having penned two significant books, including the award-winning "Totally Chill." In his talk, Dr. Lynch addresses the prevalent issue of stress and anxiety disorders, particularly among individuals with developmental disabilities. His discussion spans various age groups, including children, teens, and young adults, emphasizing the widespread nature of these challenges.
• 03:00 - 05:00: Mental Illness and Developmental Disabilities The chapter discusses the intersection of mental illness and developmental disabilities, focusing on childhood psychology. A child psychologist from Gorham Children's Hospital in Morristown shares insights into their work with developmental disabilities, particularly in anxiety management for children with autism and related issues. They emphasize that anxiety often underlies behavioral difficulties in children, suggesting a need to address anxiety rather than just the behavior itself.
• 05:00 - 06:00: Prevalence of Mental Illness in Developmental Disabilities The chapter focuses on addressing anxiety in individuals with developmental disabilities as a preventive measure to avoid distress and behavioral challenges. It acknowledges the universal anxiety experienced during the pandemic and emphasizes that children with developmental disabilities and their families are equally affected.
• 06:00 - 10:00: Factors Contributing to Anxiety in Developmental Disabilities This chapter explores the various factors that contribute to anxiety in children with developmental disabilities, particularly in the context of the COVID-19 pandemic. It highlights the additional challenges faced by these children and their families. The chapter begins by taking a broader view of why anxiety and stress are prevalent in this group before discussing potential strategies to address these issues.
• 10:00 - 13:00: Cognitive Factors and Anxiety Traditionally, mental illness and developmental disabilities were seen as mutually exclusive, influenced by the concept of diagnostic overshadowing. This meant that if an individual had one diagnosis, it was believed they could not have another. Specifically, symptoms in people with developmental disabilities were considered inherent to the disability itself, preventing the consideration of concurrent mental health issues.
• 15:00 - 18:00: Sensory Sensitivities and Anxiety The chapter discusses how mental illnesses were historically overlooked in individuals with developmental disabilities, often attributing symptoms of mental health issues like psychosis and anxiety to the existing disability. This perspective has changed over time, recognizing that conditions such as anxiety and depression can co-occur with disorders like autism, and should be treated as separate, addressable issues.
• 19:00 - 23:00: Social Demands and Anxiety The chapter titled 'Social Demands and Anxiety' delves into the prevalence of mental illness among individuals with developmental disabilities. It highlights a significant finding that these individuals experience mental illness at a higher rate than the general population, underlining the urgent need to address this issue. The chapter references a prominent study which observed that nearly 40 percent of children with intellectual disabilities met the criteria for at least one mental illness, underscoring the gravity of this concern.
• 24:00 - 27:00: Language Demands and Anxiety The chapter titled 'Language Demands and Anxiety' reviews various studies on anxiety disorders in children, particularly those with autism. It highlights that disruptive behavior disorders, including ADHD and anxiety disorders, are prevalent health disorders. A middle study found that nearly 40% of children and adolescents with autism meet the criteria for at least one anxiety disorder. Further research following these children into adulthood revealed that over half still met the criteria for a current anxiety disorder.
• 28:00 - 31:00: Task Frustration and Anxiety This chapter explores the prevalence of psychiatric and anxiety disorders among individuals with developmental disabilities. It highlights that while anxiety is particularly common, other mental health issues such as depression and psychosis are also prevalent. The chapter sets the stage to delve into the reasons why anxiety is so prominent in this demographic.
• 31:00 - 46:00: COVID-19 Pandemic and Its Impact The chapter "COVID-19 Pandemic and Its Impact" discusses the additional stress and anxiety experienced by children with developmental disabilities during the pandemic. It highlights that these children, similar to their peers, can be affected by academic pressure and family issues. The pandemic has exacerbated these stresses, introducing new challenges specific to their developmental needs.
• 46:00 - 53:00: Strategies for Addressing Anxiety The chapter titled 'Strategies for Addressing Anxiety' emphasizes the importance of identifying the multiple factors contributing to anxiety, particularly in children, as a precursor to finding effective solutions. It likens this process to diagnosing issues in a car, where one must first identify the problem before making any changes.
• 53:00 - 59:30: Q&A Session The chapter titled 'Q&A Session' discusses the source of sound and its importance in finding effective solutions to auditory processing issues. It reviews cognitive factors influencing these issues, particularly in children with intellectual disabilities or autism. The key point is that these children often process information differently, focusing on details rather than the whole picture. This understanding is crucial in addressing developmental disabilities.
• 59:30 - 60:00: Conclusion and Resources This chapter highlights the strengths of individuals with detailed-oriented skills, particularly their remarkable attention to detail and memory. However, it also acknowledges challenges they face when required to adopt a broader perspective. This includes experiencing stress and anxiety when unexpected changes occur or when dealing with transitions. The chapter aims to provide insights into balancing these strengths and challenges, illustrated by an example from the author's own office experiences.

NAMI NJ Webinar Series: Stress & Anxiety in Youth with Autism and Developmental Disabilities Transcription

• 00:00 - 00:30 development manager and program coordinator for samaj south asian mental health program of nami new jersey today's topic is stress and anxiety disorders in youth with autism and developmental disabilities support for kovid19 and beyond we are honored to have dr lynch a child psychologist with us on this webinar dr lynch was introduced to us through subha polysetti one of samaj's passionate and dedicated
• 00:30 - 01:00 volunteer leaders thank you subha i would like to invite subha to give us a brief introduction thank you bina good morning everyone i just want to take a minute to introduce our speaker today dr lynch has worked with my child for the last eight years who is on the spectrum and also has developmental delays he has helped my son with a variety of challenges including anxiety and stress which
• 01:00 - 01:30 have often been related to his developmental delays my son also participated in the social skills group run by dr lynch at goreb years ago dr lynch is currently the director of the pediatric behavior medicine department at girdep children's hospital in morristown where he developed the aspirations life management program dr lynch has over 20 years of experience in working with children including five years in ireland
• 01:30 - 02:00 he has written two books on the topic of anxiety management and autism including the award-winning totally chill today dr lynch will be exploring the high incidence of stress and anxiety disorders in people with developmental disabilities across the age range including in children teens and young adults thank you dr lynch for taking the time to come speak with us today thank you so much great thank you so
• 02:00 - 02:30 much for the kind introduction really appreciate it welcome everybody so i am a child psychologist and i work out of um gorham children's hospital in morristown and i do have a special interest in working with developmental disabilities and a particular interest in anxiety management for kids with autism and related concerns because very often i see that when um parents come to me with a child who has behavioral difficulties very often anxiety is at the core of those challenges so rather than addressing the behavior
• 02:30 - 03:00 through a system of consequences what i prefer to do is address the anxiety so that way we're preventing the distress and we're preventing the behavioral challenges from occurring in the first place now speaking of anxiety i certainly have to acknowledge the anxiety that we're all speaking with regard to the current pandemic we're all feeling it in children with developmental disabilities and their families are not immune from this
• 03:00 - 03:30 anxiety and stress in fact there are some additional challenges for kids with developmental disabilities in their families as regards the covet 19 pandemic so i definitely want to address that but i thought it would be useful to first step back and get the broad view of why anxiety and stress tends to occur so often in children with developmental disabilities and what we can do to address that
• 03:30 - 04:00 okay so not that long ago uh mental illness and developmental disabilities were often thought of as being mutually exclusive and this is partly due to a concept known as diagnostic overshadowing so with diagnostic overshadowing if you have one diagnosis it precludes a diagnosis of something else so in terms of developmental disabilities the thinking was is that any behavior any emotional symptom was part and parcel of the developmental
• 04:00 - 04:30 disability they didn't think about mental illness as being co-morbid to the developmental disability yes also occurring along with it so someone for example with an intellectual disability presented with psychotic symptoms that would be dismissed as part of their intellectual disability um if someone with autism presented with symptoms of anxiety or depression that would be dismissed as part of their abroatism okay but over time it was
• 04:30 - 05:00 discovered that not only can persons with developmental disabilities have mental illness in fact it occurs at a higher rate than the population at large so it's a real pressing issue that needs to be addressed just take a look at some prevalent studies here the top study looked at children with intellectual disability and found that close to 40 percent met the criteria for at least one mental
• 05:00 - 05:30 health disorder the highest were disruptive behavior disorders such as adhd and anxiety disorders the study in the middle reviewed research that looked at anxiety in children and adolescents with autism and they found that close to 40 percent met the criteria for at least one anxiety disorder and then the study on the bottom followed children with autism into adulthood and they found that over half met the criteria for a current
• 05:30 - 06:00 psychiatric disorder and anxiety disorders were the most common but there were other disorders as well including depression in psychosis so as we can see mental illness certainly can occur in developmental disabilities and anxiety tends to be one of the the higher categories um that occur in this population so why is that so it's important to
• 06:00 - 06:30 understand that anything that can cause anybody anxiety can cause a child with a developmental disability anxiety so just like any other kid children with developmental disabilities can have stress due to academics they can feel stressed due to family strain and they certainly feel the stress that we're all feeling in regards to the current pandemic but i find that there are some factors that relate to having a developmental disability that tend to
• 06:30 - 07:00 ramp up anxiety or tend to contribute to it and bear in mind that there's often more than one factor at play at any given time it's really important to to do a little bit of detective work and to identify what factors are contributing to the anxiety that we see in our kids because that's going to lead us to the most effective solutions it's a little bit like having a a car that's making a sound you don't just go in and start changing parts you figure out
• 07:00 - 07:30 where's the sound coming from and that will then lead you towards the the most effective solution so let's review some of these first there are cognitive factors so whether you're talking about intellectual disability and or autism the brain processes information a bit differently than other children one really important difference to to consider is that kids with developmental disabilities tend to process the world by details
• 07:30 - 08:00 rather than by context so they can have wonderful attention to detail wonderful memory for detail and this is a great strength but when they need to step back and see the big picture sometimes there's some challenges with that and that can create stress and anxiety when there are changes that are unexpected and it can create stress and anxiety when there's difficulty dealing with transition so let me give you an example from my own office so
• 08:00 - 08:30 in my office here you see that there's there's a portrait there of a beach i have a couple of chairs behind me i have my my computer here and i have a little figurine here of of a bird okay if a kid doesn't have a developmental disability and they've been seeing me for a while for a while and they come to my office and this bird is missing they may notice it but it's not going to be a real big deal if i have a child coming in with a developmental disability and this is missing they could really be
• 08:30 - 09:00 thrown off by that first of all they're going to immediately spot that and you can see that they're going to ask with anxiety in their voice you know what happened what happened to the bird statue it's because when they come to see me they're not just seeing me they're seeing me the guy that wears his glasses sometimes on his head sometimes down the guy with the the beach scene in his uh hanging on the wall with the computer and the two chairs and that bird statue for a child with a
• 09:00 - 09:30 developmental disability all those details hang together so when one detail is missing it throws them off completely okay and related to that are challenges that our kids tend to have with changes so change is going from one task or situation to another so what our kids need to do is because they process the world by details when you ask them to go let's say from
• 09:30 - 10:00 one classroom to another they have to carry all of those details with it and they have to make the adjustments to a whole new set of details so if you try to get your child to do that quickly if or if they're not prepared to make that transition that's when anxiety is going to be ramped up and certainly we know and i'm sure you you know that during times of transition that's when we see a lot of behavioral challenges it's because they're processing the change and if
• 10:00 - 10:30 it's going too quickly for them they get overwhelmed and that leads to those challenges there's also general inflexibility in our kids which can sometimes create the stress and challenges the brain likes order in in the developmental disabilities the world often seems unpredictable because of their of their challenges so they want to make up for this unpredictability by imposing rules in order and expectation
• 10:30 - 11:00 that's why a lot of the kids that i work with become the the rules police so we'll point out to other kids when they're breaking the rules and this doesn't do them any favor socially they'll point out to their teachers when when something is eaten minutely inaccurate they point out to me all the time when i say something that that isn't 100 inaccurate and sometimes this can even get them in trouble with law enforcement because if they detect something that they say is not
• 11:00 - 11:30 going by the book they just kind of have to point it out no matter who it is okay so that can create anxiety which again can create some social challenges for our kids related to the to the above is a preference for routines so if our kids um get into a routine and that has to be broken in some way that can create a lot of stress and anxiety so as you can imagine change transition inflexibility routine
• 11:30 - 12:00 all of these things have been thrown into this array with regard to the current pandemic so we've had to cope with massive changes to routine and now as we enter the next phase of our response to the pandemic we're going to have to deal with changes yet again so again this can create challenges for all of us but additional challenges for kids with developmental issues so what can we do about this well first of all you want to minimize abrupt or multiple changes to
• 12:00 - 12:30 the extent that you can i know currently we don't have a lot of control over it but as much as you can you don't want to run your home or your classroom like a boot camp but you want to avoid too many changes within the same time period we want to ease our children into transitions you want to provide them with reminders or visually supported schedules i do want to add one caveat here you want to be careful with the notion of time time is an abstract concept that a lot of children have difficulty understanding so if you say you know 10 minutes we're
• 12:30 - 13:00 leaving that may not mean that much particularly when it comes to um situations like video games where you tell your child get off this video game in 10 minutes but 10 minutes rolls around and guess what they're about to reach a new level or or unlock some new character and it's going to be very very difficult to get them off that game may be difficult anyway but it can be particularly challenging if you just rely on time so you want to rely more on the sequence of events than say
• 13:00 - 13:30 for example when you're done with this game when you unlock that character when you get to the next chapter whatever it is then we move on to the next thing okay we also want to prevent routines from forming in the first place i had consulted in ireland with a preschool and we had tricycles in the in the play area and they were different colors so if a student chose we'll say the blue tricycle the next day
• 13:30 - 14:00 we would encourage them and lead them towards the red bicycle or the yellow bicycle because what would happen if they chose the blue tricycle day one and then day two they also chose the blue vice tricycle and then the third day that's it that's all it can take to to to have a child lock in into a routine and once that routine routine is there it's very difficult to dislodge it so you want to mix things up a little
• 14:00 - 14:30 bit so it's this kind of delicate balance to balance between having structure in our kids lives and yet also mixing it up enough so that they get used to some variety and certainly when our kids do handle change well we want to highlight that sensory sensitivities is a real big one for a lot of our guys sensory regulation difficulties are common in developmental disabilities the brain may not effectively filter out or or organize sensations this can lead to
• 14:30 - 15:00 hyposensitivity where the child doesn't feel enough of a sensation or hypersensitivity when the input comes flooding through and it's experienced as harsh or even painful so certainly this can impact the traditional five senses uh noise touch sight smell and taste so with noise it could be general noise or specific noises with touch you could be being touched it
• 15:00 - 15:30 could be crowds the feeling of shirt tags bothers a lot of our kids with sight things like fluorescent lighting are very challenging for our kids and with smell it could be general smells are very specific ones and taste challenges can lead to or contribute to um narrow eating habits but our kids have other sensory systems too and these can be impacted such as the vestibular system of the system of balance a lot of our kids experience pain
• 15:30 - 16:00 differently and even things like body temperature can be thrown off from a sensory standpoint and that can contribute to anxiety which then leads to behavioral challenges um and in general our kids tend to have a narrow sensory comfort zone so they can be very easily overstimulated or under-stimulated so if there's not enough going on that can create challenges too and that's what we're finding during this pandemic is that a lot of kids are being challenged because there's not enough
• 16:00 - 16:30 stimulation happening and so as we return uh to our next as we go into our next phase of recovery and as kids start to return to activities as they start to return to school we're going to have to remind our kids how to cope with sensory stimulation because they they've been in a situation now where there's been a relatively low level of sensory input we're going to have to be prepared as a
• 16:30 - 17:00 re-enter challenging sensory uh situations the other thing we want to watch out for or some of the sensory challenges of returning um to our next phase of recovery a lot of our kids have challenges with which we're on the mask so we have to be careful about that and figure out what material is going to work for our kids some of our kids may get the temperature checks and that is going to be challenging so we want to make sure that our kids are prepared for that and that the people do the temperature checks
• 17:00 - 17:30 are aware of what sensitivities our children may have okay so you want to minimize unpleasant stimulation to the extent that you can you want to use environmental strategies whenever you can so if it's something you can change pretty easily do it so if you're if you have a student for example that sits next to a hallway and they are distracted and thrown off by kids walking back and forth
• 17:30 - 18:00 along the hallway move them or if you could have them leave class early so that they can void a crowded hallway then do that so um if they can wear uh headphones and block out sound without it uh affecting their functioning do that okay environmental strategies or things like sound absorbing tiles the use of natural lighting all of these things can make a really big difference in the comfort level of our children you want to come up with a coping plan so if you're going into a situation that you
• 18:00 - 18:30 know is going to be challenging so for example let's say once we we get back to going to events like weddings um that you want to prepare so what i'll do with my kids is we'll look up the venue online and we'll see where they can go if things become challenging and i'll work with the parents on coming up with a plan for that and in general you want to be aware of you can keep your child in that comfortable sensory zone so that they're not being under stimulated or overstimulated
• 18:30 - 19:00 okay i did talk a little bit about some of the ways that we would support sensory issues during the current pandemic social demands so kids with developmental challenges often struggle in uh social situations but it's important to understand that her kids want to be social they want to socialize but there's challenges with social situations that sometimes make it difficult for them so for example the language demands
• 19:00 - 19:30 processing language when you think about it most social situations there's a number of kids there's a lot of language going back and forth and our kids may struggle with that so for example i had a teenager i was working with and he was invited to hang out with five other kids i was thrilled when he told me this but then he says to me i can't do it how can i have five conversations i don't have five mouths so he wanted to do it but he was
• 19:30 - 20:00 overwhelmed by the thought of navigating all of that language there are also sensory factors in social situations as i just discussed when you think about it uh social situations for kids we're talking about birthday parties we're talking about dances there's a lot of noise going on there's a lot of crowds going on and this could be challenging for our kids and there's also some of the challenges that our kids have with developing
• 20:00 - 20:30 social skills so things like turn taking starting conversation being able to read body language some of our kids need assistance with that and they may learn to master some of those skills but as they get older social situations start to change and they become more complicated and social rules become more complicated and more nuanced so our kids continue to need support even as they master basic
• 20:30 - 21:00 um social uh situations trying to keep up with social demands can be challenging especially when you're not quite sure what it is that you're not quite getting and that's what a lot of my kids convey to me like i just don't know why i don't know why i'm not clicking with other kids and it's some of these these social nuances that they're not quite getting so during the current pandemic some of the challenges have been interacting online um so a lot of our kids have difficulty anyway with navigating social situations
• 21:00 - 21:30 and doing online interactions can be challenging so um knowing when and how to jump in for example if you're doing um some kind of online chat with your friends can be particularly challenging okay some strategies for social situations so you want to set up situations that are likely to foster success not failure you don't want to throw your kid into something
• 21:30 - 22:00 just for the sake of it so sometimes i'll have parents tell me oh well he doesn't really like to do teen sports but we throw him into it because we thought it'd be good for him i would really advise you to be careful about that not that kids with developmental disabilities can't do well in team sports they think they certainly can't but you want to think about your particular child and what works for him or her in general our kids do well um with social situations um that are small small in number one
• 22:00 - 22:30 two three other kids that are pretty structured and that are based around those around their strengths so what i've been heartened by lately over the last few years is that yes the team sports are there and they're great for it for the kids that like that but now we're seeing things like lego clubs gaming clubs robotics and this is great for a lot of our kids because it's small it's structured and it's based around a lot a lot of what their strengths are
• 22:30 - 23:00 too okay we want to work on social skills to build up to build on confidence and i and we want to work on generalization that's really important you can teach your child a social skill but it's important that he or she knows when and how to apply that so be specific give concrete examples and we want to foster a tolerant atmosphere for our kids we want to encourage kids who don't have disabilities to understand our kids and to accept some of them that some of
• 23:00 - 23:30 their behaviors may be different than what they're used to but it doesn't make them a bad child and that they have a lot to offer okay so during the pandemic what you want to do for example you want to practice some of those online interactions so if your kid uses zoom for example practice that with your kid log on so that they can get used to the technical aspect and if you do set up some online interactions start with one or two peers first so they can
• 23:30 - 24:00 get used to that and then you broaden out as they get used as they get used to it okay language demands language processes and challenges are common to developmental disabilities some kids struggle with the basics of communication uh such as expressive language this is expressing yourself receptive language which is understanding what others are telling you i'm not being able to communicate your basic wants and needs causes frustration
• 24:00 - 24:30 in and of itself but it has a magnifying effect because if our kids get anxious they may have difficulty conveying that to others so that the anxiety can ramp up even further but even kids who can communicate their basic wants and needs may struggle with other aspects of communication such as pragmatic communication which is using language effectively in social situations or uh non-literal forms of language such stuff like similes and metaphors
• 24:30 - 25:00 so trying to keep up with with the language demands of social situations as i as i said earlier can lead to confusion which can lead to to to anxiety and during the pandemic the use of this technology has really compounded our our children's language uh difficulties so when there's lag when the screen freezes when we're thrown off and have to sign back on that's frustrating for all of us but it really throws our
• 25:00 - 25:30 throws our kids throws our kids off so some strategies for language demands you definitely want to make sure to use visual supports so even though a child may be able to read just a little bit of a visual cue can really go a long way towards helping them to understand a situation visually based schedule use pictures to remind your kid of what expectations they have you can use photographs if you're getting ready for a new situation so they have an idea of what to expect
• 25:30 - 26:00 clear communication is really important you want to watch the pace of your language especially when we really need our kids to understand something you want to watch out for overly abstract language and you want to focus on key words when you really want to get your point across you don't want to talk to your kid like a robot all day long but when there are times when you really need to get your point across break it down into its simplest components make sure your kid
• 26:00 - 26:30 understands what you said before delivering the next instruction and you want to give means for expressing frustration or anxiety it could be a word it could be a short phrase it could be pointing out a picture you want to make sure that your child has some way to tell us when they're distressed so that we can then help them to to cope and during this this pandemic we want to if we as we're using these technologies we want to make sure that our kid has an opportunity to practice and if
• 26:30 - 27:00 they also know what they can do if for example there's lag if the screen freezes let's teach our kids this ahead of time so that they're prepared for it when it does uh happen okay and there's task frustration too our kids kids with developmental disabilities are wonderful and they know a lot they're they they're intelligent in so many ways but they sometimes have challenges with conveying what they know
• 27:00 - 27:30 okay and that gap between knowing something and being able to show it really creates a lot of frustration for our kids which also contributes to their anxiety so there are some common areas that our kids tend to have some struggles with certainly motor skills for a lot of our kids i find a lot of our kids particularly struggle with fine motor skills especially motor skills that require the coordination of left and right so things like tying shoes and using scissors
• 27:30 - 28:00 and and riding a bicycle our kids also struggle with executive function skills the executive function is like the manager part of our brain so um again our kids can have great memory for details but the executive function kind of helps to put it all together and it helps us with attending it helps us with organizing and planning skills our kids also may struggle with some abstract thinking skills um so especially skills that are
• 28:00 - 28:30 involved social emotional concepts and non-literal tasks like poetry and opinion pieces our kids can give us facts all day long so for example if you ask them to memorize facts about the civil war they may be fantastic at that but if you told them okay your assignment is to describe what it would have been like to have been a soldier during the american civil war they may struggle with that because well they would they may say well how do i know i'm not that person so that abstract thinking can be a
• 28:30 - 29:00 struggle for our kids there's a couple of other key academic areas that tend to be uh challenging for our kids one of them is reading comprehension so our kids sometimes learn to read fluently sometimes at an early age but it's understanding what they're reading can sometimes be a challenge and i can sometimes lag behind but the one area that i really find that where a lot of our kids struggle with is writing and that's because writing writing really involves all the skills that that i mentioned above there's a motor component
• 29:00 - 29:30 there's an executive function component because you have to organize your thoughts and very often writing requires us to think abstractly and to put ourselves in the mind of the reader and our kids sometimes struggle with that um so writing is one of those areas where a lot of our kids tend to struggle all right so what can we do about this certainly we want to give our kids the means to express when they're frustrating i always say remediate accommodate or celebrate remediation means that we
• 29:30 - 30:00 build up weaknesses accommodate means that we work around it and celebrate means that we use a child's strengths um to to to bring out the best to him we want to consider the timing of tasks many of our kids do better early in the morning uh sometimes you may want to um alternate tasks so they give them a challenging test and an easy and a challenging task and we want to present tasks challenging tasks on a graduated uh basis always praising for persistence
• 30:00 - 30:30 and and effort the key to learning for any of us is to find that sweet spot between being challenged but not but not being overwhelmed we really need to be acutely aware of this when we're working with a child with a developmental issue during the pandemic what i found is that a lot of our kids are really missing one-to-one support um it's and i think what's really important is that the one-to-one support whether we're talking about an aide or learning uh support teacher
• 30:30 - 31:00 yes it helps in terms of instruction but i find that a lot of our kids just miss having that person there as a mental anchor and so we need to work around that during the pandemics so i encourage families and schools to work together to come up with a plan so that our kid makes sure that they get some one-to-one time even a little can go a long way but they need that they need that they need that one-to-one support still even if it's virtually
• 31:00 - 31:30 okay so uh some of the challenges of the the current pandemic the interesting thing about this pandemic is this is something that's impacted the entire world every single person on the face of the planet against that planet has been impacted by this and our kids are no exception so our kids have all of these challenges and you do as well as family members so there's anxiety and fear over the health of the virus
• 31:30 - 32:00 this is kind of morphed over time from what it is to what's going to happen as we re-enter certain phases of society there's the massive adjustment and changes in routines and this is all changing again again as we as we enter the next phase uh maintaining academic progress and motivation has been challenging even for a student for kids that were really really good students
• 32:00 - 32:30 um and i must say that all of our kids have done wonderfully i'm so proud of all of our kids for for getting through this school year but even the most motivated student that's really starting to tire of this um and i noticed that the last weeks of school were really challenging for for our kids to maintain that motivation there's the coping with the confines of of quarantine which is challenging again for all of us i don't care how how big your house is it's very small at the moment and i know
• 32:30 - 33:00 in my in my own house that um no matter where i want to go there's either a family member there or my dog is there and and so over time that that's creating stress for all of us that just being confined and there's the missing or modified milestones so kids that have had to either miss or heavily modify their graduation or their birthdays this this is certainly creating distress
• 33:00 - 33:30 and frustration for us but if there's one characteristic characteristic of this pandemic that's really contributing to our anxiety it's insurgency so from the very beginning this pandemic has been defined by uncertainty what is the virus is it coming to america will it spread how quickly will spread and then there's been so much conflicting information out there with regard to what we should do or what we shouldn't do and that's continuing as we enter the next phase
• 33:30 - 34:00 of our response to it uh what works and what doesn't work so those are challenges that we all have to contend with but there's additional challenges for kids with developmental issues and their families first of all many kids with developmental issues have comorbid health issues and this can really ramp up the anxiety over whether or not you may have an underlying condition there's the challenges of online learning that i had mentioned earlier that can really compound frustration there's the impact of not having that
• 34:00 - 34:30 face-to-face learning support that i mentioned earlier there's the difficulties about uh navigating online social interactions that i talked about and there's the challenges of online healthcare televisions have been great um but they can pose some challenges there's the technology technological challenges and our communication with our healthcare providers may not be as long as we want them to be but use telehealth okay i want to encourage you to
• 34:30 - 35:00 to do that all right so um addressing fear and anxiety so you want to answer your child's questions about pandemic about the virus honestly but you want to make sure that you provide them with an information that at a level that they can process uh particularly with kids with developmental issues you want to watch out because they have that rigid thinking that i had talked about a little bit earlier and this can be challenging for our kids because if you think about it we told them you can't go outside you can't be around
• 35:00 - 35:30 other people and now we're telling them well now it's safe to go outside and now it's safe to be near other people although we still want to encourage six six feet distance so that's really challenging for our kids because it's like well you told us this on the one hand and now you're telling us something something else so you want to make sure that we talk to them about relative risk and convey that as well as we can that things are changing and as things change our behavior can
• 35:30 - 36:00 change and we can still be safe okay um and we can use visual supports to do that use concrete examples whenever you can but no matter what you do no matter how you need to explain this to your kids always make sure you pivot to what we're doing to keep them safe and that whatever we're doing is to keep them safe okay we want to watch out for for media exposure you don't want you don't want to avoid it entirely but you want to monitor it
• 36:00 - 36:30 remember that um our kids no longer get news from from uh watching the six o'clock news it's everywhere it's in social media even in their video games they have chat functions where they're learning about uh the virus and the pandemic we want to make sure we understand what they know so that we can clarify it but you also want to you know want to watch how much of it we watch i had a kid told me he's about 16 years old and he said it's something he said it
• 36:30 - 37:00 was so what he said was just so wise i asked him you know are you watching the news about this because i want to see how that was impacting him and this was in march when things were really kind of heavy and he said i watch enough of the news to stay informed but not so much that i panic and i thought that was a great lesson for all of us you want to learn and practice relaxation skills i'm going to talk about that in a minute and you just can't be good all good all distractions so things when stress is building up do
• 37:00 - 37:30 something that that's pleasurable do something that gets you out of your own head we need to encourage your kids to do the same okay so routines we want to maintain routines to the extent that we can as our routines change as we enter the next phase we want to make sure that our kids are prepared for that as much as possible visual schedules work great using cues so that if you if you can designate a certain area of your house or apartment as a learning area that's
• 37:30 - 38:00 fantastic so it's great to have routine but we also want to make sure that we balance that with variety as well and speaking of that we want to learn new things i know some families have been redecorating rearranging things they've been having family nights celebrating holidays i mean this is great i think by now most of us have gone through our bag of tricks when it comes to this luckily uh certainly um in in new jersey where we're able to to do more as restrictions are lifting
• 38:00 - 38:30 and the seasons change we're able to do different types of things which is great now everybody has their own comfort level and everybody has their own risk tolerance and you all have your own risk factors some of you may have people with underlying conditions in your home and and we do need to be careful but what i'm advising all families to do is whatever level you're at whatever you can challenge yourself to re-enter do it in a way that that you feel is
• 38:30 - 39:00 safe but start to do that as soon as you can so for example if you don't feel comfortable with walking in a park then get go for a drive in your car if you don't feel comfortable sitting in a restaurant as we're able to do that then order order take out do something different do something new so that our kids see that we are slowly getting back all right so um there are mental uh health concerns i've talked about a lot of these already
• 39:00 - 39:30 so decreased social interaction decreased novelty um all of these things can contribute to mental health and in in the other side of that is that we have all these challenges to our mental health and yet there's fewer ways to um to address it so for example you know we can't go to to the gym at least not yet um extracurricular activities have been changed so the things that would normally be stress relievers for us we either can't do it or we can't do it in a way um that is as satisfying for us
• 39:30 - 40:00 this is changing but this it's still the situation where we're not able to do these to the extent that that perhaps we need to so we're concerned about about new or exasperated disorders like anxiety depression mental health care has been been interrupted and there could be pent up mental health needs with the pandemic so we want to make sure that we maintain mental health we want to watch our kids for for signs of distress and remember with kids in general uh and particularly with kids with
• 40:00 - 40:30 developmental issues they may not say it but they may show their distress through behavior so watch out for that watch out for things like irritability sleeping change sleeping problems changes in appetite crying and so forth we want our kids to learn and apply relaxation and coping skills and as i mentioned earlier we want to find that delicate balance between structure and variety for our kids and use virtual mental health care mental health professionals quickly
• 40:30 - 41:00 adapted to this crisis in terms of going virtually and luckily it is something that that can be done it's not ideal not for me but but but it's it's it's the next best substitute and so please i encourage you to use virtual mental health care until we're able to go back to office visits all right and relaxation skills so i teach kids with developmental issues relaxation skills i find that not only can they use it but i find that they really embrace it
• 41:00 - 41:30 and they really see the value of this there are strategies that focus on the body like deep breathing progressive muscle relaxation there's strategies that focus on the mind things like imagery meditation and there's activities that that combine the two um such as meditation or um excuse me yoga or tai chi and those and there are plenty of places now certainly with regard to yoga that specialize with kids and there's even
• 41:30 - 42:00 places that specialize for kids with developmental issues so you know take a look at it can really be a wonderful resource all right i do want to address relaxation for kids who have higher support needs okay before we go into to the questions here um so so your kid if your child is minimally verbal um some of those relaxation strategies may be a little bit challenging for them but it's important that we teach all kids relaxation strategies
• 42:00 - 42:30 to the extent that we can so we want to make sure that kids have a means to express anxiety i know i've mentioned this before but it's really important so if your child has a touch talker some kind of augmentative communication device please make sure that you program in words and phrases that they can use around to stress anxiety i need help i need to go to my cooking place okay apply what's comforting for your child it could be a music it could be that they have a peaceful
• 42:30 - 43:00 place that they go to be aware of that and and go to those places or or use those things when your child seems to be distressed comfort objects could be things like a favorite toy or stuffed animal they can be great for getting through challenging situations such as medical procedures and then you want to encourage your kids to use active strategies whenever possible and to the extent that you can so that they feel some sense of control and mastery over their environment even if you have to initiate it so for
• 43:00 - 43:30 example in my office here i have a rubber stick i call an oscar i don't know why but i have a kid um that sometimes he'll hit his head and he has some some intellectual challenges and whenever he does i'll say oscar and he'll nod and i'll give him the rubber snake and he then squeezes it he feels better so he participated in that process he he so he has some control so even though i had to initiate it
• 43:30 - 44:00 he had some control over what he does to cope and it's really important for all of our kids to feel some sense of control and then a really important one is care for the for the caregivers so those who care for kids with high support needs require and i'm sure you all know this regular respite and ongoing support you know when you have multiple demands it can be really draining when your resources are tapped it doesn't help anybody and it can make it really difficult for you to step back and see what you do need to
• 44:00 - 44:30 do to help manage your child's anxiety just because you're overwhelmed with pressing needs so i'm a big advocate for it i know nami is a big advocate for supporting parents who have children with developmental issues because it's good for everybody and it's the right thing to do okay just quickly so i'm going to go into q a these are my resources i have two books totally chose my complete guide to staying cool is a stress and anxiety management workbook
• 44:30 - 45:00 for kids with a with a range of develop developmental issues and then my newest book anxiety management for kids on the spectrum on autism spectrum your guide to preventing meltdowns um is for um uh parents teachers and therapists and specifically with regards to classes so these are my key takeaways we have mental health needs are common the pandemic has had a negative impact on mental health there are things we can do a team environment but our kids can learn and practice
• 45:00 - 45:30 coping strategies and with that i'd like to thank nanny for providing me with this opportunity i'd like to thank all of you for for being here and we're going to go into i believe uh questions and answers now so dr thank you very much for joining us and sharing with us this valuable information and we have lot of questions i don't know if you will able to get to all the questions but let's give it a shot so the first question is how do we work with our older children
• 45:30 - 46:00 on the spectrum not to get taken advantage of by others who lie to them steal from them and use them that's that's a really that's a really good question because first of all when people have developmental issues they do become big they do become a target of sorts and um so it is something that you need to be aware of that being said this is a really complex skill because what i've seen it i sometimes see i see two things so some of our kids
• 46:00 - 46:30 they have difficulty knowing when someone is joking with them when they're doing something because they want to connect with them they want to bond with it for example with teasing versus when they are trying to take advantage of it so i get this all the time with my kids where they don't know if they're being bullied so sometimes they may think they are when the kid is when the other children are trying to bond with them and sometimes they really are and they don't really know it so i want to teach my kids to be aware of what
• 46:30 - 47:00 kind of cues to be aware of what kind of situations do they do they want to be aware of that may indicate that there's danger here so sometimes i ask my kids for example are you friendly with this person how do you know this person okay so that's one important thing to consider then i'll then i'll have them consider what's the look on their face are they smiling with you are they um are they joking with you or do they look like they that they're they're being mean in some sort of way
• 47:00 - 47:30 and how are they with other kids around you do are they different with you when there's other kids around so these are some of the cues that i would encourage your kids to to to to to bear in mind and with kids with older kids because you know the consequences are serious at any at any age but it can be particularly serious you want to encourage them to ask questions so if they have any doubt with regard to somebody's intention make sure they know who they can go to to check it out and i'll say that to
• 47:30 - 48:00 kids listen when in doubt check it out you can always ask somebody ask somebody that you trust a trusted adult to help clarify these things for you thank you the second question is i work with children who are on the more significant end of the spectrum we are starting to work on treatments to get the students ready for health checks face masks hand washing and sanitizing etc as all these skills will be anxiety
• 48:00 - 48:30 producing for our kids i'm writing a turn of social that's what you meant will be social skills to prepare them but do you have any other strategies or techniques that you can recommend i think that's fantastic using using socially social stories with visual support is a really really good way to do it um you can write your own i've seen i don't have the resources here right
• 48:30 - 49:00 now but i've seen a number of social stories online with regard to the pandemic so i'm hoping that there's going to be social stories uh with regard to as we re return to our next phase of recovery so i think that's great but i think the more concrete you can get the better so if there's a way that you can have kids come in maybe on their own first and maybe with a with a with a care provider to go through the checks just one-to-one so there's not all that additional stimuli for them to deal with
• 49:00 - 49:30 and do some dry runs with them i think that that would particularly help i know there's logistics involved but if you can go through the situation first before school starts on a one-to-one basis that's going to make a big difference the other thing that's going to make a real big difference is make sure that anybody that's going to be to to be doing these checks whether that's the school nurses or or or staff make sure they're aware of the needs of the students and if you're a parent here and you're going to a hospital i'll make sure that people
• 49:30 - 50:00 doing these checks are aware if your child may have some sensitivities that little bit of awareness ahead of time can really make a big difference okay the next question my child with anxiety won't open up and talk about his feelings how do i approach this okay so um you know with children not opening up there's there's a couple of things to think about one thing is simply timing i know i
• 50:00 - 50:30 all kids many kids have times when they're they're more open to talk than others i know with my own kids there's one of my children he would talk a lot on a walk i have another kid i have three children another child we would talk i would talk more um while we're driving in the car so be aware that there may be some times when it's more when your child is more open than others and and try to be aware of those times and so that you may be able to start a conversation then
• 50:30 - 51:00 and then you want to keep it open so that when you when your child does discuss something with you listen first try try to resist the temptation i know it's great uh you know as a parent myself to kind of jump in and start offering solutions but allow your child to fully express him or herself first then rephrase what you you felt your child said so that they know that they were listened to and then you can offer support and support and guidance um and then the other the third thing that i would say
• 51:00 - 51:30 is make sure that your child has the vocabulary for expressing these things and that you can have some discussions around that so they know what words to use to express themselves when i start therapy with the kid with developmental issues very often the very first thing i do is i make sure that they have a vocabulary for discussing these things so parents can do that as well okay my next question is my son's doctor has tried several medications to help with his anxiety and rumination but
• 51:30 - 52:00 nothing works why okay medication is a complicated thing and i do want to clarify that i'm not a um i'm not a physician uh um i i've certainly seen medication uh be useful for kids but there are so many factors and when you have uh developmental issues all those factors play a part so you have a grown child so that's one thing to think about you need to think about your your child's height and weight that can affect how medications are processed
• 52:00 - 52:30 many kids with developmental issues also take other medications for other things and that too can have an effect on what a medication is doing and sometimes they're taking different things so you might have a child taking medication for adhd and also taking medication for anxiety and those sometimes can counteract or interact with each other so i encourage you to think about all of these things and have an honest open discussion with your with your health care provider
• 52:30 - 53:00 over what you think is working what you think is not working take good notes um about your child's behavior so that your your health care provider has as much information as possible and and even in the the clearest and best of circumstances very often medication needs needs to be changed and managed over time my young adult daughter is extremely limited in expressive language how can i provide a means of expressing
• 53:00 - 53:30 anxiety and frustration well language is more is is certainly more than words so um the visual supports can really help a lot so i know sometimes the concern is that if we provide our kids with visual supports that we're somehow going to hamper their language development but in fact the opposite has been shown that use of visual supports like visual schedules can actually enhance our language
• 53:30 - 54:00 development so anything that you can do whether it's coming up with a board that might have several different emotions on it or several different coping strategies that your your daughter can point to and i do understand that your daughter may indeed be able to have the language to express these things but having that support can kick-start the language so if she can start off with the visuals very often that will then then then lead to more verbal expression
• 54:00 - 54:30 okay next question how do i get my 16 year old son tested to see if he has developmental disabilities well pediatrician is your first step okay so you want to make sure that you uh you talk to uh your son's uh your child's uh pediatrician because they're going to uh number one they're going to be able to offer you some some guidance uh right there and then in the
• 54:30 - 55:00 in the office visit but but number two they're going to help to facilitate the referral uh to a developmentalist uh so developmental specialists uh neurodevelopmental uh pediatricians are are really kind of the gold standard when it comes to uh assessing developmental disabilities a lot of the hospitals have developmental uh centers um so we here we have the child development in autism center and other hospitals have their
• 55:00 - 55:30 equivalent of that but they can be quite a long wait to get into to get in those initial evaluations so get the ball rolling first with your pediatrician who may be able to help smooth out that process for you but but definitely i encourage you to get a full full evaluation so that you get a real good baseline of where your child is at so that development issues are very rarely uh yes or no it's it's it's more on the lung of spectrum so
• 55:30 - 56:00 even if your child doesn't qualify for a particular category there may still be a baseline that you can get that you can then follow over time to see what areas are growing what area still needs to be addressed thank you next question why is it so difficult to find a cure for mental disability that's a really that's a really good question um there are so many factors that that go into
• 56:00 - 56:30 both developmental issues and mental health issues so there's the brain itself the the brain has developed multiple systems for for processing the world and it's built in redundancy as well and there's a reason for this so that if some of our brain functions uh for whatever reason stop working that the brain then has other functions that can jump in in in to help out the problem is that
• 56:30 - 57:00 this complicates it so much that it's it's very difficult to look at the brain and target it and say oh that's where intellectual disability is that's where anxiety is that's where depression is very often it's a combination of systems that contribute to how the brain works and so that makes cure that much more difficult also the factors that contribute certainly to mental illness are very complex so we have um social issues we have
• 57:00 - 57:30 environmental issues we have development issues so as we change over time we have the impact of things like like hormones on our development um so for all of these reasons it's a very complicated uh situation so i always say don't give up looking for cures but focus on management management's really key management is what we need to get through today and as we learn to manage things that's going to start to build up
• 57:30 - 58:00 towards towards more and more towards mastering some of some of these things thank you dr lynch thank you so much for joining us and sharing with us this valuable information it was a great webinar if anyone has any additional questions you can put them in a survey great thank you so much thank you and before we close the webinar i would like to share with our participants
• 58:00 - 58:30 our online resources and information from the nami ng website all our programs are free if you want to get involved or be a member please click on the get involved tab and choose your options click on kovid 19 information page to access all our services and resources here you will find nami new jersey online support groups local affiliate online support groups multicultural online support groups
• 58:30 - 59:00 nami signature presentations and nami new jersey webinar series here we will post today's recording along with the presentation slides feel free to reach out to nami new jersey for any support you might need thank you again for sharing this hour with us here today as a reminder it would be appreciated if you could complete the survey at the end of the webinar so that we can incorporate your feedback
• 59:00 - 59:30 for future webinars this concludes our webinar thank you all thank you dr lynch have a wonderful day everyone take care