Karen Chesnutt, Ph.D

Month: November 2016

IQ Tests

November 29, 2016 / / 0 Comments

Those dreaded words, “It’s a test!” Even after being out of school for many years, the idea of a test still makes us nervous.  So, if it has been suggested that your child needs to have an IQ test done, here are some things that you need to know.

What are they?

There are all kinds of IQ tests.  Each type has some strength in terms of what they measure and some weaknesses. Often, a psychologist will ask you to outline your concerns and then will pick the test that will best answer your questions.  In a separate blog, I will review a number of these tests to give you an idea of what each one is like.

The tests themselves are made up of sub-tests.  What psychological researchers and test developers have done is to identify each kind of “cognitive” skill (meaning thinking skill).  Then they have analyzed school success and determined the most important cognitive skill that is related to good school performance. Then, they try to find tasks for those cognitive skills and include them in the battery. Parents often ask me specifically how each task relates to schoolwork, and the truth is that it is a statistical relationship. IQ tests don’t test reading or math, for example. Sometimes, parents are confused by this and don’t realize that the tests are developed to predict overall school success. For example, an IQ Test could be used to predict how well a student will do overall in high school.

On some of the IQ tests, we can look at some patterns in the sub-test scores and answer some other questions about how your child learns.  Some of them can help us identify if your child is a verbal learner or a visual learner.  On some, we can measure how efficiently your child works on specific kinds of tasks.  Some of the newer tests have included more sections on reasoning.

The sub-tests that are included are designed to give us information about how successful your child is likely to be in school.  Remember, they do not measure life success.  This is a common misconception.

What information can we get from them?

IQ tests help us get a general idea of what our expectations should be about school performance.   Other factors may be involved, but IQ test data can help us make good academic choices for our children.

Students with ADD sometimes have a specific pattern of sub-test scores that helps make that diagnosis.  IQ tests can identify some specific types of learning disabilities.

What can’t an IQ test do?

It can’t diagnose reading disabilities, dyslexia or math disabilities.  Other tests, in addition to an IQ test, are needed.  It can’t diagnose autism or autism spectrum disorders.  It can’t diagnose emotional difficulties such as depression or anxiety.

So, if your child needs an IQ test, no worries!!

  • Most of the time, children think they are playing “games.” It is far less stressful than the tests you remember.
  • The results should help you plan for your child. They provide a road map for school services, not a “life sentence” of any sort.  I advise parents to use this data only for what it was designed to do—to plan for school.

DON’T FORGET!

      IQ tests can’t predict life success.  IQ data must never be used to judge a child’s value.  Even though in popular use, it is implied that high IQs are better or more valuable, that just is not true.  Your child’s worth should never be linked to a number!

“I Think My Child is Gifted”

November 24, 2016 / / 0 Comments

Many parents come to me with their young children who have shown a pattern of precocious development. These young people have reached milestones at a younger age than expected. Many have huge vocabularies and seem to understand concepts that are far above their age level.

Parents want to know if they should schedule some testing for their children, to determine if they are truly superior in intelligence. There are some things that you may want to consider before moving ahead with testing.

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We do have intelligence tests that start at about 2 ½ years of age.  We usually use the Stanford Binet Intelligence Battery (SBIB) or the Weschler Preschool and Primary Scales of Intelligence (WPPSI).  For school age children, we use the Weschler Intelligence Scale for Children (WISC).  (In a separate blog, I will discuss more details about each of these).  The result of this kind of testing will be a number that is labeled “IQ.” These numbers are often misused. Some parents look at the results and think that this number represents a firm intelligence level, one that will persist as the child gets older. That is not true. Some of the early tests tend to overestimate IQ and there can be a great change in these scores over time.  A child who scores in the superior range at 4 years of age is likely to score in the average range at 9.  The opposite can also be true. Be careful in interpreting IQ scores in young children.

Children show great variability in their developmental patterns. Some children show a pattern of growing very quickly at first, and then leveling off.  Other children show the opposite pattern, starting slowly but then showing spurts of development as they grow up. So, if you test your child at one point, can you count on that information to make predictions about the future?  No, you can’t. You don’t have any information about your child’s future development pattern.

The other consideration relates to brain development. There are many skills that we cannot measure until the brain itself matures. For example, if you want to get an estimate of your son or daughter’s reasoning, you will need to wait until adolescence to have that type of skill tested.

So, are there times that testing can be helpful?  Yes. Here are some general rules of thumb about when to get testing.

  • One time that testing is warranted is when you are trying to design a behavior program for your child. The test results will tell you what is happening NOW, and that is what you need to know so you can tailor the program to your child.
  • I like to test the younger children if they come to me for treatment of anxiety. Children who seem to be bright often can perceive things intellectually that they can’t deal with emotionally. The test results can help determine if this is what is happening and this helps me in my treatment of their anxiety.
  • Sometimes, testing is required to access particular academic-type programs.

What should parents do? I would suggest not pursuing testing unless it has some current application, especially if your child is young. Many parents are hopeful that their child will be found to be gifted. It is far more important that parents focus on providing for their children’s emotional, social and also intellectual needs as they are now. In that way, you can be sure you are meeting all your child’s needs.

The Dogsled Theory of Self-Confidence

November 22, 2016 / / 0 Comments

That is not a misprint or an exaggeration! Helping your child develop a healthy self -confidence has a great deal to do with dog-sledding. One of the most grueling races in dog-sledding is the Iditarod, a race across the tundra that is almost 1200 miles long. I wanted to know how the dogs were trained to run that race and in the process I learned something about self-confidence.

We live in a time where people believe that just giving praise or positive reinforcement (whether really deserved or not) will help children develop healthy self-confidence.  This is the source of the “participation trophy” idea. It doesn’t work. Hollow praise does not build self-confidence or self worth.

The training for the puppies includes having them try to get over a log, over and over again. Then they had to walk out of the river, over uneven ground and they did this over and over. I asked the reason why because none of this seemed to relate to the dogsled race.

The trainer told me something very important. He said that he wanted his dogs to believe that there was nothing they could not get through, nothing they could not face. That is what is real self-confidence. It’s not a reward for just showing up. It is the confidence that comes from experience. From trying over and over again and sometimes failing. Then, from getting up and doing it again until you are emotionally strong enough to face what life has in store for you. That is self-confidence.

Development of self-confidence in this way is particularly important for boys.  They cannot achieve it in any other way.

What should a parent do?  You need to make sure your son has life experiences that allow him to:

  • Try himself against circumstances without your rescuing. You can think about these like logs that he needs to overcome
  • Overcome daily challenges without your help.

I had an opportunity to ride on a dogsled with a driver who had competed in the Iditarod.  He told me that as a result of that experience, he had learned to handle his life the same way. He learned to believe that he could handle circumstances, and also learned to take them one at a time. One log at a time. He learned not to be overwhelmed by many problems, but to tackle one at a time, just like he did on the trail. He learned not to worry about what was not happening, just to focus on overcoming one obstacle at a time.

Self-confidence is a result of experience, of trying things, of failing and then succeeding.

What to Do When the Break Up Happens

November 17, 2016 / / 0 Comments

Inevitably, relationships end, even for teens or young adults with developmental disabilities. We need to help them cope with this part of life as well. Often, parents are so relieved that they don’t think to help their child cope with the flood of emotions that occur.

What should a parent do?  There are two steps that need to be taken. Your first step is to “normalize” the situation. That means to help your child understand that everyone who has a relationship has a breakup at some point in  life. I have my patients talk about what siblings or friends have gone through. This validates their experience.  Then, you want to help your child identify his/her feelings.  There are a jumble of emotions that need a word to label them.  You child may feel angry, hurt, betrayed, humiliated and maybe even demeaned. Often there is a sense of not being good enough or not being worthwhile. It is important to get some verbal labels on these feelings. Then you can reassure your child that these feelings, though valid, will get better, but not necessarily quickly.  That is true for everyone.

The second step is to talk about the ways to handle the situation. What are the kinds of behaviors that one follows after breaking up. Here are a few suggestions:

  • Your son/daughter should try to avoid contact the ex.
  • The rule is that when they see each other, “Hello” is fine, but then nothing else.
  • Help your son/daughter contain his/her anger. Accusations and outbursts don’t help anything.  Blame is not helpful either.
  • You can help by modulating your own emotions. Being negative about the ex is not going to help your son/daughter feel better. I think it is far more helpful to respond that this is part of life and that even though you were glad that he/she had a relationship, this is a frequent outcome. And, you are confident that he/she can get through it.
  • Then, after you have dealt with the emotions, teach your child the art of distraction. Make a list of the things he/she likes to do and then suggest that using these can help minimize the emotions. For example, you might want to watch your favorite video or use one of your video games to distract you from these feelings.

Even though these are difficult experiences to go through, they can help your son/daughter learn valuable life lessons.

“Mom, Dad, I’ve Got a Girl/Boyfriend!”

November 15, 2016 / / 0 Comments

These are words that provoke panic in parents of children with special needs. As these young people develop into late adolescence, parents and teachers confront the problem of relationships within this group. We do know that even though there may be some cognitive and social delays in these students, their emotional development is similar to their non-handicapped peers. They want to be like everyone else, like the people they see on TV. They don’t want to be alone. They want to be valued by someone of the opposite sex. Same sex relationships offer unique challenges to special needs children and I will address that in a future blog post.

Unfortunately, our response to these relationships is often to deny or to try to prevent them. The results are often disastrous. When left to their own devices, these students end up putting themselves at risk, experimenting with sexual behavior.  Some become obsessed with the opposite sex or with engaging in sexual behavior, often inappropriately.  They might be punished, lectured, isolated, or shamed.

In my practice, I like to take a different approach. I like to teach them about the issue of relationships, to help them understand but also to give them some rules to follow. Since these teens have compromised understanding, I like to give them rules. They don’t have to figure anything out, they don’t have to interpret anything, they don’t have to make judgments.  They just have to follow the rule.  It is much simpler and clearer for them.  I also emphasize that if they don’t follow the rules, they clearly are not ready for a relationship.  I also point out that skipping steps is grounds for adults to intervene.

For example, I tell them that there are stages for each relationship. So if a teen is in Stage 1, they have identified someone that they are interested in and the person has indicated interest as well.  The purpose is to get to know someone and to have shared experiences. The rule at this stage is “No sexual behavior.”  You are only at Stage 1.  You are supposed to talk on the phone, go places together but nothing else.

Stage 2 means you have gotten to know this person and you have done many things together.  You have gone to Homecoming or have gone to the movies. You have had a chance to talk regularly on the phone. You know this person.  I often ask my patients to tell me about their boyfriend/girlfriend. If they can’t describe this person’s interests or likes, they stay in Stage 1.  If they have learned some things about this person, they can move to stage 2.  They are now ready to physically indicate that they are “together.”  They do this by holding hands, sitting close to each other, kissing etc., but that is all.  That is the rule. I also like to point out that there are many other ways that we show affection for someone. We may do special, thoughtful things for them, give them gifts, take their needs into account.  Learning these things is important before moving to Stage 3.

Stage 3 is for much more serious relationships. My general rule of thumb is that they have to have been together in Stages 1 and 2 for at least a year.  I tell them that this is the most difficult stage, because they now need to take each other’s needs into account. I like to work individually with the teens to review important issues such as boundaries.  This is a place where I think parents need to be involved in outlining acceptable behavior.  Family rules should apply to these teens just as they do with non-handicapped teens. When parents outline the rules they are comfortable with, the guidance needs to be clear and concrete.

What should a parent do when confronted with this situation?

  • Begin by teaching your son/daughter the stages in relationships. This is not clear in the media or in the other teens your child comes in contact with, so they will need to be taught.
  • Ask your school to develop a similar system so that it can be reinforced in school.
  • Even though this is a difficult topic, you can help your teen to develop healthy relationships that enrich his/her life.

The NFL is Paying Attention, Are You?

November 10, 2016 / / 0 Comments

For a long time, I have been concerned with the impact of concussions and mild head injuries on children. Most of the time, parents and even the children themselves minimize the possible outcomes. They often forget even to mention these events to me when they come in for an evaluation.

An article in Yahoo News titled “After concussion, kids’ quality of life may dip for months” by Kathryn Doyle is important in beginning the discussion of how these mild concussions can impact school functioning and life functioning. Parents have not had a great deal of information to help them when their child has a concussion. The authors looked at 2,000 children who had suffered an acute concussion and then followed them as they recovered.  Some recovered quickly. Others had symptoms that persisted beyond 3 months. Two findings seem most significant to me.

  • First, all students with head injuries showed evidence of academic difficulty after their injury regardless of how quickly they recovered. So, even if your child seemed to recover quickly, his or her school-work may show evidence of difficulty up to three months later.
  • Second, they also measured quality of life issues. They found the same pattern in that children with concussions had a decline in their quality of life for at least 3 months.

The article makes some recommendations for treatment that are important, even though more work is needed. They recommend slowly returning children to their regular routine. They also note that more research is needed on this important to devise treatment strategies for this group of children.

https://www.yahoo.com/news/concussion-kids-quality-life-may-dip-months-175224913–spt.html

Why Are So Many of Our Children Anxious?

November 8, 2016 / / 0 Comments

That’s the question my sister recently asked me.  Teens in high school now have soaring rates of anxiety.  College students now also have highly anxious and this is increasing regularly.  The question is, “Why?”

There are several reasons, and it is easy if we look at the “greatest generation” (people born between 1910-1925) for comparison.

  • People in the “greatest generation” had things they believed in. My father believed in the US Government.  He is a true “patriot” in that he believed in the fact that we were the “good guys.”   Subsequent revelations have indicated that that is not exactly true.
  • People believed in the free market system. My father worked for the same company for his whole career.  He believed that they produced the best product, had the worker’s interests at heart and that they would do “right” by the country.  Unfortunately, none of that is true.
  • People believed in the church. Recent revelations have shown that the church could not be trusted as well.
  • People believed in heroes.   My father believed that Joe Paterno and Penn State were heroes.  Unfortunately, that proved not to be true.  Sports figures?  Movie Stars?  Politicians?  There are many others we can name, but we can’t name too many people who we truly regard as heroes.  Instead, this generation has Homer Simpson and the disgraced adults in the public eye.
  • People believed that regulators would keep us safe.  Then there was Flint, and many other examples.

So the problem for children and teens becomes, who can we trust?  Who is running our world?  Some have turned to each other and found bullying emails instead.

So, are you worried yet?  You can see how our young people don’t feel that they have any security in their life.  It is the role of parents, teachers and other adults to provide safety nets for our young people.  They will need to develop their own emotional strength to deal with a very complicated world.

Addiction

November 3, 2016 / / 0 Comments

In the August 13, 2016 Buffalo News, I read about Chris Maloney, a young man in his twenties who had worked to overcome his addiction to opioids.  His family supported him during that time, encouraging him to do everything possible to defeat the disease of addiction.

When he was able to be drug free, they felt that he was on his way to a successful life.  He began to pursue some of his interests, moved to a new location and entered an education program to begin his career.  He and his parents were encouraged by his progress.

Overcoming addiction and developing emotional strength are not the same.

The tragedy of this story, and of many like it, is that overcoming addiction and developing emotional strength are not the same. This young man had overcome his addiction but was not strong enough to move fully into his potential. Moving to a new city, facing educational challenges and dealing with the demands of everyday life overcame him. The steps were too big for him to handle. Just like we would not expect someone after major surgery to go directly into a full exercise program, we cannot expect addicted young people to face all of life’s challenges at once when they are drug free. We need to take the time to build emotional strength.  Sadly, this young man relapsed, overdosed and died. Sadder yet, is the fact that he is one of many.

After addiction, people must build emotional strength

Emotional strength is needed to overcome addiction. However, the strength to deal with daily frustrations, to face challenges, to take responsibility for one’s own life and to deal with complicated social situations is really the “heavy lifting” of living.  For some people, it is the pace or the seeming relentlessness of demands that are the most wearing and tiring. We have to build up the necessary emotional strength to face all these challenges.

It is important for us to develop support systems that have a long-term focus. Emotional strength building takes time. Public policy positions now tend to favor quick fixes and many of the programs and supports we need are not yet widely available. This is a double tragedy for families and those caught in the trap of substance abuse.

Careful goal setting is crucial

For many families, the goal is that their loved one gets “clean.” I agree that that is part of the goal. It is not enough. What our goal should be is that the person becomes able to function in life. This takes longer, many times, than the actual overcoming of addiction. Here is a list of what needs to be learned:

  1. The former user needs to learn to tolerate the stressors that led to the avoidance found in substance abuse. They need to face their own personal “demons.”
  2. They need to learn that there are no easy ways to live. Life is filled with challenges and no shortcuts.
  3. If life’s challenges were one-time events, users and ex-users would be better off. However, life is filled with ongoing challenges—rent needs to be paid each month, cars need numerous repairs. It just goes on and on. Ex-users have to be strong enough to take care of these things over and over.

If someone you know is fighting addiction

  • Remember that emotional strength is the goal.
  • It can be reached, but it takes time. There are no shortcuts.
  • It is important to remember that people can change and grow.
  • But, you cannot do it for them. Just like you cannot help them develop physical strength by going to the gym for them, you cannot help them develop emotional strength. It is their task to do.

Social Integration? Mainstreaming? Start Early!

November 1, 2016 / / 0 Comments

Do you want your special needs child to participate in our world? This is an important question for parents to consider, even if your child is still a toddler. Often, parents get overwhelmed in working to find programs, get therapy and cope at home and don’t give much thought to the future. But the foundations of future success start early in life.

Schools talk about mainstreaming for special needs children. Usually, they have children from self-contained classes join with non-handicapped peers in gym, art or music.  Just putting handicapped and non-handicapped children in the same space will NOT be successful in socially integrating these groups! It is not a matter of being together. Having them together with no preparation also gives opportunity for negative interactions.

Preparation for your child should begin very early in life, regardless of your child’s diagnosis. Here are the beginning steps:

  • Make sure your child is noticing people in the environment. When grandparents come to the house or older siblings come home from school, make sure your child looks at them and is aware of their presence.
  • Don’t let your child be self-directed. To learn social interaction, they have to be “other” directed. The best way to start is to be sure your child is parent directed at various times during the day.
  • Children need to learn to respond when spoken to. They need to learn to alert to your voice or their name. Insist that they respond the first time you speak to them.
  • Teach your child to respond to the presence of other children. Make them notice, look at and attend to other children.
  • Do not let them get into the habit of social interaction by annoyance. These are children who go from sibling to sibling (or adult to adult) and solicit attention by interfering with activities or annoying others. This is a hard habit to break and will prevent any positive social interaction.
  • Teach and insist on appropriate behavior. Integration will not work if your child’s behavior is markedly different from the other children’s.

Begin working on these steps now. I realize that this plan involves a lot of parental time.  However, without these steps, your child will not be able to function in the wider world.

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