Featured Article

Asperger’s Disorder is the term for a specific type of pervasive developmental disorder which is characterized by problems in development of social skills and behavior. In the past, many children with Asperger’s Disorder were diagnosed as having autism, another of the pervasive developmental disorders. While autism and Asperger’s have certain similarities, there are also important differences. For this reason children suspected of having these conditions require careful evaluation.

In general, a child with Asperger’s Disorder functions at a higher level than the typical child with autism. For example, many children with Asperger’s Disorder have normal intelligence. While most children with autism fail to develop language or have language delays, children with Asperger’s Disorder are usually using words by the age of two, although their speech patterns may be somewhat odd.

Most children with Asperger’s Disorder have difficulty interacting with their peers. They tend to be loners and may display eccentric behaviors. A child with Asperger’s, for example, may spend hours each day preoccupied with counting cars passing on the street or watching only the weather channel on television. Coordination difficulties are also common with this disorder. These children often have special educational needs.

Although the cause of Asperger’s Disorder is not yet known, current research suggests that a tendency toward the condition may run in families. Children with Asperger’s Disorder are also at risk for other psychiatric problems including depression, attention deficit disorder, schizophrenia, and obsessive-compulsive disorder.

Child and adolescent psychiatrists have the training and expertise to evaluate pervasive developmental disorders like autism and Asperger’s Disorder. They can also work with families to design appropriate and effective treatment programs. Currently, the most effective treatment involves a combination of psychotherapy, special education, behavior modification, and support for families. Some children with Asperger’s Disorder will also benefit from medication.

The outcome for children with Asperger’s Disorder is generally more promising than for those with autism. Due to their higher level of intellectual functioning, many of these children successfully finish school and attend college. Although problems with social interaction and awareness persist, they can also develop lasting relationships with family and friends.

These facts have been brought to you by  the American Academy of Child and Adolescent Psychiatry. For free resources information for families who have children with Asperger’s Disorder, please visit www.myaspergerschild.com.

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 or 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
• Often questioning rules
• 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
• Spiteful attitude and revenge seeking

The symptoms are usually seen in multiple settings, but may be more noticeable at home or at school. One to sixteen percent of all school-age children and adolescents 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, psychological and social 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 hyperactivity 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 Management Training Programs to help parents and others manage the child’s behavior, Individual Psychotherapy to develop more effective anger management, Family Psychotherapy to improve communication and mutual understanding, Cognitive Problem-Solving Skills Training and Therapies to assist with problem solving and decrease negativity, or Social Skills Training to increase flexibility and improve social skills and frustration tolerance with peers.

Medication may be helpful in controlling some of the more distressing symptoms of ODD as well as the symptoms related to coexistent conditions such as ADHD, anxiety and mood disorders.

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-out 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 healthy life choices such as exercise and relaxation. Use respite care and other breaks 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 or qualified mental health professional that can diagnose and treat ODD and any coexisting psychiatric condition.

For help with handling a child with Oppositional Defiant Disorder contact:

Oppositional Defiant Disorder Resource Center

Phone: 202.966.7300  / Web: www.aacap.org

This resource center offers a definition of the disorder, answers to       frequently asked questions, and information on getting help.

Anxiety is part of life. it’s a natural byproduct of having a brain that is capable of such high-wire acts as considering the future. A little anxiety is good, even necessary, and a great motivator to get us to plan well and perform.

Yet too much anxiety can be disabling. For millions of people, worry disrupts everyday life, restricting it or even overshadowing it entirely. An estimated 15 percent of Americans suffer from one anxiety disorder or another. These include generalized anxiety, specific phobias, obsessive-compulsive disorder or flat-out panic attacks. As a group, anxiety disorders constitute the most common disorder.

How do you know whether you are worrying too much? When anxiety moves beyond an occasional wave of apprehension to become a constant and dominating force in your life, you need to take steps to curb anxiety.

Sometimes anxiety explodes in a panic attack, marked by a general feeling of terror. A person engulfed in a panic attack usually experiences a racing or pounding heart, sometimes even pain or heaviness in the chest. Breathing becomes difficult. The body trembles and hands turn clammy. The person may notice tingling in their hands and feet, sometimes in their arms and legs. They may start to feel light-headed.

Victims feel out of control. Many feel like they are going crazy. Panic attacks are so frightening that sufferers wonder whether they will survive the episode.

At least 5 percent of tAmerican adults experience panic attacks. Often, the attacks come out of the blue, for no apparent reason. Or they can come on when a person is coping with extreme stress. Either way, panic attacks can last for several minutes.

Other forms of anxiety are less dramatic but more widespread.

For some, other people are the cause of anxiety. Social anxiety creates the feeling that you are being watched and judged by others, even if rationally you know that this is not the case. In its milder forms, social anxiety can create extreme self-consciousness in the presence of others; but in its severe form it can be debilitating, leading sufferers to avoid soical situations altogether.

Another common form of worry is generalized anxiety disorder. Sufferers are filled with questions – negative ones – and dwell on endless “what ifs.” They feel trapped in cycles of anxiety and worry.

General anxiety doesn’t typically lead to panic attacks, but it can still be incapacitating. The endless worry saps energy, destroys interest in life and prompts frequent mood swings.

It’s possible that some people are born with a temperament that inclines them to anxiety. Regardless of how anxiety develops, it’s possible to control it.

Even though you may have tried relaxation or stress management, anxiety may still be interering with your work or personal life. At this point you should get a consultation from a helth professional.

Treatment is tailored to the specific concerns that preoccupy each person. Nevertheless, there are some treatment techniques that are widely applied. Persons who are experts at treating anxiety often use a combination of approaches:

Cognitive Therapy

Focuses on creating an understanding of the thought patterns that bring on worry. It helps anxiety sufferers separate unrealistic from reallistic thoughts.

Behavior Therapy

Focuses on taming anxiety through control of specific ways the body overreacts to worry. One common approach is to teach controlled breathing and the relaxing of muscles that contrict with worry. Both techniques lower heart rate and blood pressure.

Relaxation Training

Through a mixture of cognitive and behavior techniques, helps avert high anxiety. One approach is to think of a relaxing scene when anxiety levels start to rise.

Desensitization

Those who suffer from phobias and obsessive-compulsive disorder are gradually and safely exposed to whatever is the source of their anxiety, until, over time, tolerance is built.

Medication

Antidepressant and antianxiety medications are most effective in combination with psychotherapy.

This month’s Featured Article was found in Psychology Today. For more information about how to handle anxiety disorders, you may want to seek some form of counseling. If you are not already connected with a psychologist in your area, you can learn more about what counseling options are available through your employer. Contact your company’s Employee Assistance Program (EAP) or Human Resources Department. You can also use the Psychology Today therapist finder to locate a psychologist near you by visiting www.psychologytoday.com