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Anxiety and Children by rachel funnell, LMFT

2/14/2019

What is Anxiety?:
The definition of anxiety is: a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome. Anxiety is there to keep us from danger. It is a built-in self-protection mechanism that every human has.There is nothing wrong with experiencing the feeling of anxiety; it is how we react to those feelings that can lead to harm or unhealthy behaviors.

What does anxiety look like in children?
These are some examples but anxiety can present in many, many other ways.

Clinging/separation anxiety
tantrums
crying
hypervigilance
avoidance of people/places or things (which can often look like refusing to go/do what is expected)
regression (bedwetting, thumb sucking, baby-talk)
tics, or unusual kinetic movements
increased sensory seeking behaviors
shutting down
rapid talk/increased inquisitiveness, or reassurance seeking
selective mutism
lack of concentration/inattentiveness
increased somatic complaints
agitation
restlessness
difficulties with transitions
sleep disruptions

What is a protective level of anxiety and what is a problematic level?
The anxiety is considered to be a problem when it affects the child’s daily functioning. There will be many times throughout a child’s life that anxiety will increase due to life events and this is not to be a concern unless it becomes chronic. Some diagnoses require at least 4 weeks of ongoing symptoms and others at least 6 months.

Causes of anxiety

Trauma: disasters, accidents, abuse etc but also medical procedures, community violence, death of a loved one-person or pet, a move, witnessing violence
Learned behaviors: children pick up cues from the adults in their lives and learn how to manage their feelings by modeling what they see
Genetic predisposition; including sensory sensitivities

When do you know that your child needs professional help?
When the anxiety is affecting the daily functioning of the child and/or the family for a few weeks and is not the result of a situation that one would expect anxiety to increase. In addition, if the heightened anxiety continues after the situation has resolved, professional attention may be warranted.

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Identifying Attention Deficit Hyperactivity Disorder (ADHD) in Young Children by kirsten ellingsen, ph.d.

2/2/2019

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Attention Deficit Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed behavioral disorders in childhood. Rates have been increasing over the past few decades and there are different reasons suggested for this increase, including better screening for ADHD. According to the DSM-5, the childhood rate of ADHD in the United States is estimated at five percent. Community population samples and parent report of children in some studies have found higher estimates (up to 11%).

ADHD can profoundly affect children’s educational performance, wellbeing, and social interactions (American Academy of Pediatrics, 2011). Common referral concerns for ADHD include exhibiting behaviors such as high activity level, impulsivity, and poor attention. Accurate diagnosis, particularly when children are young, requires informed clinical judgment, the use of multiple assessment measures (often through formal neuropsychological evaluations), and information about how a child is functioning across different settings over time. Children can be diagnosed as young as 4 years of age (although most children are not diagnosed with ADHD until age 7). While symptoms may be observed in early childhood, accurate diagnosis is incredibly difficult – because many of the “problem behaviors” associated with ADHD fall in the range of typical or age-expected behavior for young children.

Early signs of possible ADHD that have been identified include:

Acts before thinking
Changes activities frequently
Has a short attention span
Fails to focus and follow directions
Distracts easily
Has difficulty staying on task (Fewell & Deutscher, 2002, p27)

According to Dr. Mark Mahone, early signs of ADHD risk for preschool children include:

Dislikes or avoids activities that require paying attention for more than a few minutes

Loses interest and moves on to another activity after engaging in an activity quickly
Talks more and makes more noise compared to same age peers
Climbs on things even when told not to
Not able to hop on one foot by age 4
Almost restless
Fearlessness results in getting into dangerous situations
Warms up too fast to strangers
Aggressive to peers and preschool expulsion
Injures him or herself by running or moving fast even when told not to do so

(http://www.kennedykrieger.org/overview/news/it-adhd-or-typical-toddler-behavior-ten-early-signs-adhd-risk-preschool-age-children)

Characteristics of ADHD - Predominantly Inattentive Presentation

Fails to give close attention to details or makes careless mistakes
Has difficulty sustaining attention
Does not appear to listen
Struggles to follow through on instructions
Has difficulty with organization
Avoids or dislikes tasks requiring sustained mental effort
Loses things
Is easily distracted
Is forgetful in daily activities

Characteristics of ADHD - Predominantly Hyperactive/Impulsive Presentation

Fidgets with hands or feet or squirms in chair
Has difficulty remaining seated
Runs about or climbs excessively in children; extreme restlessness in adults
Difficulty engaging in activities quietly
Acts as if driven by a motor; adults will often feel internally as if they were driven by a motor
Talks excessively
Blurts out answers before questions have been completed
Difficulty waiting or taking turns
Interrupts or intrudes upon others

(See more at: http://www.chadd.org/Understanding-ADHD/Parents-Caregivers-of-Children-with-ADHD/Symptoms-and-Causes/Symptoms-and-Diagnostic-Criteria.aspx#sthash.fz8ZbS23.dpuf)

Impulsivity, inattention, high activity levels and distractibility are all commonly observed in young children. Problems with self-control or hyperactivity occur with many preschool children and are expected -to a degree. Therefore, it is important to consult with a knowledgeable and informed professional who can help differentiate between developmentally appropriate (or age appropriate) behaviors and when behaviors fall outside of the expected range. Problematic behaviors need to be more frequent, severe, and persistent compared to same age peers. It is also the combination of these behaviors and how they affect functioning in different environments that might suggest a possible underlying disability. If you have concerns about your child’s behavior or questions about ADHD talk with your pediatrician, a psychologist, or a neuropsychologist.

Resources:

Preschoolers and ADHD (National Research Center on ADHD) https://chadd.org/wp-content/uploads/2018/05/preschoolers.pdf

Is it ADHD or Typical Toddler Behavior? Ten Early Signs of ADHD Risk in Preschool Children:
http://www.kennedykrieger.org/overview/news/it-adhd-or-typical-toddler-behavior-ten-early-signs-adhd-risk-preschool-age-children

ADHD: https://kidshealth.org/en/parents/adhd.html

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The Importance of Free Time and Play for Children by tara motzenbecker, ms, ncsp

1/25/2019

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The American Academy of Pediatrics advocates for the protection of
children’s unstructured playtime because of its numerous benefits, including
the development of foundational motor skills that may have lifelong benefits
for the prevention of obesity, hypertension, and type 2 diabetes. Play is also one of the principal ways in which children develop understanding, explore conflict, and rehearse emotional and social skills. A child's language is play. Unfortunately, in the world we live in, well-intentioned parents often feel pressure to sign children up for multiple structured enrichment activities such as music lessons, tutoring, etc. When you combine these structured activities with all of the structured time spent in school and then out of school doing homework, the children have hardly any free time left. Yet it is during their free time that children learn how to take risks, how to solve boredom, how to connect socially, and how to problem solve with others.

For example, picture a brother and a sister who are home and decide to play “lava”. They have to agree on certain rules for jumping over the lava (aka the floor). They have to negotiate, and they use their creativity to make up the world that is in their shared imagination. A younger sibling may let the older sibling take charge, but eventually the younger child will want to add in an extra rule and have to stand up to the older sibling. These siblings have learned negotiation, creativity, compromise, navigating risk, and how to summon courage. Children need to develop these skills as children, or we are setting them up to be teenagers and adults that feel anxious when they have to make decisions or engage in anything risky.

So the next time your child says, “I’m bored!”, you can pat yourself on the back, resist the urge to alleviate the boredom, walk away and know that this is going to be an important time in your child’s development.

Remember, birds fly. Fish swim. Children play.

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Snowballing Debt by rachel funnell, lmft

1/18/2019

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Debt is a major source of stress for most people, so figuring out a way to get out of the debt quickly is ideal. One quick way to get out of debt is to use the snowballing method. This method allows a person to start small with very focused intensity on one debt at a time until all the debt is paid off.

How does this method work?
In short, you’ll pay off your debts from smallest to largest. First, you will need to get organized by creating a spreadsheet or document where you can list all of your debt from smallest to largest. Then you begin to make minimum payments on every debt except the smallest one. You are going to put every extra dollar you have towards that smallest debt until it’s paid off. Once that debt is paid off you will take the money you were putting to the first debt and start to apply it to the minimum payment of the next smallest debt. This allows you to be putting more money towards the second debt while continuing to make minimum payments on the other debts. Once the second debt is paid off, you take all that money and apply it to the next debt. You continue to do this until all your debt is paid off.

Why does this method work?
There has been a lot of research on the snowballing debt method and it all says that it’s the most efficient and effective way to manage debt. The reason this method works so well is due to seeing results so quickly. You will begin to feel good when you start to pay off each debt and actually see a lot of progress on the debt that you’re focused on. When you start to pay off each debt, it will give you motivation to continue with this method until all your debt is gone. This motivation will also help you make wiser choices regarding what you are spending your money on. You will begin to eat out less or not buy things that you really don’t need at that moment.

How to make this method even more effective?
If you are looking to make this method even more effective, then create a budget for all your debt and expenses. By creating a budget, you will be able to keep track of where all your money is going and even find areas in which you could reduce spending and add the extra money to your debt. The best way to stick to your budget is to reduce the frequency of using debit or credit cards and just use cash to pay for everything. By using cash, you are more likely to pay attention to how much you are spending because it’s tangible. When we swipe a credit card or debit card we are too removed from it to make better decisions on our purchases. Take out a certain amount of cash each month that will go to all of your living expenses. Then create an envelope for each of the expenses and put the designated amount of cash in it. You will then take the money from the envelope when needed and it will help you stick to your budget. While sticking to a budget can be hard, using cash will set you up for success.

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Happy New Year! resolution tips by dr. kirsten ellingsen

1/4/2019

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For many the start of a new year is a time to reflect and set resolutions. It presents an opportunity to assess both achievements and disappointments from the past year, to cultivate gratitude, and to set goals for change. It might bring a sense of hope and excitement for new possibilities, as well as a time to grieve from loss or unmet needs and reconcile expectations about what you thought would occur and your present reality.

While making lifestyle changes to improve general health is a positive endeavor (and can happen any time), there might be pressure to set unattainable resolutions this time of year.

If you want to set goals for change in the new year:

Make a plan.
Keep it simple.
Be specific.

Identify one or two behaviors in a general area (e.g., run twice a week for 30 minutes vs exercise more, turn off the TV and computer at 8:00pm vs spend less time on electronics). Be realistic. Change takes time and effort. (And research now finds that habits take between 18-254 days to form (averaging 66 days not 21 as previously thought) h ttps://onlinelibrary.wiley.com/doi/abs/10.1002/ejsp.674.

Also, consider resolutions that relate to promoting family health and strengthening family relationships. This effort can start with reducing family stress. The article “Managing Stress for a Healthy Family” offers the following five suggestions to help: (https://www.apa.org/helpcenter/managing-stress.aspx)

Evaluate your lifestyle. Model healthy behaviors for children
Talk about it. Initiate conversations and provide opportunities for your children to talk about their feelings. Ask how they are doing.
Create a healthy environment. Create a clear and relaxing physical environment
Focus on yourself. Make sure you are eating well and getting enough physical activity and sleep
Change one habit at a time. Focus on changing one behavior at a time to reduce feeling overwhelmed and increase success

Get everyone involved in setting family goals. Making positive lifestyle change is easier with support. Involving your children and partner can help. Focus the discussion on positive changes and point out achievements from the past year. The Gottman Institute offers the following suggestions as “resolutions that are easier kept as a family” 1) go to bed at the same time 2) unplug devices 3) eat meals together 4) create reading time 5) exercise as a family 6) work toward a financial goal 7) switch out soda and 8) go meatless one day a week. (See https://www.gottman.com/blog/make-new-years-resolutions-family-affair/) Make your new years resolutions a family affair).

(For recommendations on helping children identify and set their OWN goals see https://www.parents.com/holiday/new-years/resolution/8-ways-to-help-kids-make-new-years-resolutions/).

Finally aim for gradual, ongoing change that is sustainable. Think about what would work for you and your family. Don’t give up if you have a set back- life is full of unexpected challenges and some days are just hard. Getting back on track and working toward the goals you set for yourself or as a family is a great model for your children of resilience and perseverance.

Happy 2019!

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“I can’t believe that my child lied to me….” By Amanda Hanson, Psy.D.

12/16/2018

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As children began to develop increased verbal and cognitive skills to navigate the world, they also begin to understand consequences, outcomes, reality, and fantasy. With this increased skill set, children often implement these skills in a variety of ways, including dishonesty and lying. Parents and caregivers commonly report concerns and frustration for when their child is dishonest with them, even about small things, as they are making efforts to teach their child about right and wrong. When the lying continues, parents and caregivers become frustrated and unknowingly engage in a pattern of behavior that can reinforce rather than detract from this common childhood behavior. If parents and caregivers are able to understand the common reasons why children lie, as well as develop positive communication and response skills, they will likely be able to prevent this issue from becoming a larger issue in the future.

Most often it is important to understand that young children are likely to use lies or dishonesty as a naïve approach to the world, as they lack sophistication cognitively and are still learning to process and organize information. Lying in young children is quite common, and does not necessarily mean that the child will grow up to be deceitful, but will rather outgrow the tendency to lie as more maturation continues. In understanding reasons as to why young children lie, the most common motivations are to avoid consequences or to not disappoint adults with their actions. The use of escape or avoidance of consequences is likely the most common reason for lying, as the child is learning at a higher level that behaviors have consequences, that can be negative in nature. As they begin to be taught morals and lessons of right from wrong, the potential for lying increases.

In order to effectively manage an interaction in which a parent or caregiver becomes aware their child is lying, the use of positive communication strategies should be utilized rather then emotional reactions. It is important for the parents and caregivers to practice going to “SLO CAMP,” when approaching the child in this situation

S- Separate the child from the behavior. Assisting the child in understanding that you may disapprove of their behavior, but you do not love them any less. Avoid using labels about your child, such as calling them a “liar” or “dishonest.” Speak to the behavior as being dishonest, not generalizing these terms to the child.
L- Lead by modeling and example. Attempt to avoid using lies, even little white lies when engaging in your life. Children are big proponents of using learned and observed behaviors, so if you use lies, your child is likely to model them, as it demonstrates that lying is “okay”
O- Opportunity. Use the lying behavior as a chance to understand why the child lied. Exploring reasons as to why the child lied to you and cannot be honest is an important piece of information. By validating feelings, and identifying that you understand that the child lied due to fear can be helpful in increasing opening the lines of communication and improving the child’s confidence in you in the future.
C- Remain Calm. Parents and caregivers typical first reaction is to become upset and frustrated when the child lies. The child is likely lying in order to avoid consequence and upsetting you, so when you approach in an emotional way, it is reinforcing as to why the child wants to avoid being honest. You are still able to express your feelings about the child’s behaviors, do so in a calm and goal-oriented way.
A- Avoid setting the child up to lie. Some parents will often ask their child questions that they already know the answer to in order catch the child in position to make choice between truth and lie. When the parents or caregivers already know the answer, the tone of voice and approach is likely setting up the child to wants to avoid any further involvement, thus increasing the chances of lying. Use questions that allow the child to provide answers and focus on problem solving rather than punishment and shaming.
M- Mistakes are teaching moments. Using poor choices to help make better choices is the process of learning. Using a problem solving approach is going to be a more effective way in managing your child’s behaviors that become angry and frustrated. In that teachable moment, use active problem solving skills to help your child process their choices, and identify better ways to handle the situation next time.
P-Praise! When you child does admit a negative behavior or a poor choice, to you acknowledge and praise their honesty. While it does not take away from the negative action that has occurred, identifying the positive aspect to their approach is a good way to boost this decision for the future.

If you are able to stop, and take yourself to “SLO CAMP,” when faced with lying in young children, they are likely to begin to alter their behaviors with time. Remind yourself that behavior change is a process, and this behavior will not go away overnight. However, by implementing positive skills, the relationship with your child will begin to improve. If the lying continues to become a chronic issue and is being met with limited results, seek out professional assistance and guidance.

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Can you catch OCD? Explaining PANS/PANDAS by Kirsten m. Ellingsen, ph.d.

12/6/2018

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A child suddenly begins to show obsessive and compulsive behaviors and have serious separation anxiety with intense mood swings. His parents noticed that these problems started quickly and unexpectedly-seemingly overnight. Their child’s behavior has changed dramatically and he is no longer functioning well at home and school.

I recently had a neighbor in the medical field ask if PANDAS was real. It is understandable why this syndrome is confusing… and why it might be distressing for parents. There is uncertainty about the cause and there is variability in the presentation of symptoms. The idea that a child could suddenly develop significant obsessions and compulsions or a serious tic disorder after having strep throat is definitely concerning. The prevalence is not known. The connection to strep is unclear. Best practice in treatment requires both medical and psychological interventions. The diagnosis is not based on a definitive blood or “lab test”, but on the clinical presentation of symptoms. A diagnosis requires a physical exam and assessment of a child’s medical and psychiatric history to understand how and when symptoms started and what else might be going on to contribute to these behaviors or concerns.

What is it? PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) is a subtype of PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). PANDAS typically affects children who are 3-12 years of age. There is an acute, or sudden, onset of distressing symptoms and a significant change in a child’s behaviors during or after an episode of strep or scarlet fever (but this might be weeks after). Children suddenly exhibit new or significantly increased obsessive and compulsive behaviors or tics. They also usually have other serious behavioral symptoms. Separation anxiety, restricted eating, aggression, intense mood changes, depression, sleep disturbances, frequent urination, ADHD symptoms (hyperactivity and impulsive behavior) and academic decline are common additional problems that might also co-occur.

OCD typically has a gradual progression, but with PANDAS the behaviors appear suddenly. If symptoms are present before strep, they are significantly and dramatically worse after. The PANDAS Network estimates that one in 200 children may have PANDAS/PANS, but the exact number is not known. It is important to consider that strep is common during childhood (some estimates are that children in elementary school have a strep infection 2-3 times a year), but the actual incidence of PANDAS is rare. Of children who are diagnosed with OCD, it is thought that up to 10% have PANDAS. Accurate diagnosis requires a comprehensive evaluation with an experienced physician. Again, other diseases need to be ruled out after a physical exam, medical tests, and psychiatric history.

What is the Treatment? In July 2017, the PANS Research Consortium published comprehensive treatment guidelines (https://www.liebertpub.com/doi/10.1089/cap.2017.0042).
A child will need medical, psychological, and school based support. If PANDAS is suspected a throat culture is taken and antibiotics are administered. Often this results in a noticeable decrease in OCD symptoms. Treatment recommendations also involve participation in research-supported therapy to help address the immediate distress from obsessions and compulsions, anxiety, or mood changes. Cognitive Behavioral Therapy, including Exposure and Response Prevention (ERP) and parent support are recommended best practice. School support is often needed for both behavioral and academic challenges (such as the frequently observed decline in motor skills / handwriting).

For more information about PANS/PANDAS see the websites and fact sheets in the links below. If your child has OCD or a tic disorder and had a sudden onset of significant and distressing symptoms please talk with your physician or use the links below to find an expert in the field. If you need help navigating this process or want therapeutic support please contact our office.

REFERENCES & RESOURCES:
https://www.nimh.nih.gov/health/publications/pandas/pandas-qa 508_01272017_154202.pdf

http://med.stanford.edu/pans.html

www.pandasnetwork.org

PANDAS Frequently Asked Questions

http://www.cmaj.ca/content/cmaj/190/3/E86.full.pdf

https://rarediseases.info.nih.gov/diseases/7312/pediatric-autoimmune-neuropsychiatric-disorders-associated-with-streptococcus-infections

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Developing a support system by Rachel funnell, lmft

11/30/2018

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Everyone needs a support system but sometimes it can be hard to identify those people. However, with the information provided, you’ll be able to identify your support system or gain some insight into how to create a more helpful support system.

Support systems are a network of people that provide you with practical or emotional support. They are people that help you when you are going through tough times, whether that be emotional or physical. Without healthy support systems, people often feel hopeless, helpless, lonely and overwhelmed. Research has shown that a support system helps an individual feel more confident in their abilities, increases use of healthier coping skills, decreases anxiety and depression and provides people with a longer and healthier life. So if there is so much benefit to having a support system, why do some people struggle with having one? There are several reasons but for some it’s the idea of admitting that you may need help. Some people believe that it shows weakness to ask for help but in reality it shows a lot of strength to admit that you can’t do it on your own. For others, it’s because they don’t know how to create a support system. Here are several ways in which to create a support system.

Who do you start with?
- You want to start with your family, friends and coworkers. These are the people that are already in your life and they already have an idea of what’s going on and how to help.
- However, not every family member, friend and coworker is going to be a good support system.
After looking at the people close to you, you can then begin to branch out into the community.
- There are several support groups and organizations that you can find just by doing a Google search or searching social media groups.
- Groups could be through churches, the city, the state or different agencies.
- Some groups are just people going through the same experiences as you and they formed their own group.
- Ask around. Ask your family, friends, coworkers, doctors, even children’s schools for any groups that maybe available.
- Don’t limit yourself to just groups that you are already apart of. Try out new groups and organizations to see if there’s any support with them.
Next, you need to look at what makes a healthy support system.
- A healthy support system is one that builds you up, encourages you, is positive, is there for you when you need them, and decreases your stress level. A support system doesn’t mean that everything in your life is better but it does mean that you are able to manage the stress better with the support of others.
- An unhealthy support system is one that is negative, isn’t there for you, brings on more stress, lies to you, doesn’t provide any help or drains you. These could be family, friends or coworkers. If so, those are the people you need to keep your distance from.
Lastly, the key to having a support system is to open up to them. If you don’t open up, then your stress level will continue. It’s hard to be vulnerable to others but if they have shown the characteristics of a healthy support system, then they will accept you and make you feel safe with them. Remember that a support system is vital to having a longer, happier life.

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Five Tips for Managing Stress Over the Holidays by tara motzenbecker, MS, NCSP

11/24/2018

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The most wonderful time of the year?? It’s maybe a little of that but also a lot of stress. Here are a few tips that can help you get through the holidays with more of the joy and less of the stress:

Be aware of what stresses you out. Awareness of our triggers is key to managing our emotions and behaviors.
Make a self-care plan to reduce your stress. Once you identify what stresses you out, do something you haven’t tried in past years to reduce it. Maybe it is asking family members to help out or maybe it’s giving yourself a day off.
Create a goal for yourself and your family. Really think about what is most important to you this holiday season. Is it making sure the kids get the best gifts? Is it making sure the family gets along? Is it about giving? Figure out what you can do to focus on one or two goals.
Ignore all of those picture perfect families you are seeing on the holiday cards and on social media. That’s all posed and planned and chances are they all had to deal with a two hour tantrum in order to snap that one perfect picture. Don’t compare yourself to anyone else and don’t feel like you need to have elaborate elf-on-the-shelf displays every morning to post on Facebook. Stay connected in real-life and focus on what is best for you and your family.
TAKE IT EASY ON YOURSELF. Be kind to yourself. That may mean throwing out a few crazy high expectations and laughing at your shortcomings. Enjoy the nice moments and let the stressful and annoying ones go.

Hopefully these tips can keep you centered throughout this stressful time of year so you can truly experience the joy with your family and loved ones.

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Is my child ready to stay home alone? by amanda hanson, psy.d.

11/16/2018

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The lives of many parents are often filled with managing work, childcare, activities, and household management. As a child begins to age, parents are eventually tasked with deciding at what point is their child old enough to stay at home alone while parents and caregivers are fulfilling other life duties and responsibilities. This decision has no clear-cut answer and is based upon numerous factors that are individualistic to the family’s presenting situations. However, there are some important points to consider when deciding as to whether to allow your child to manage themselves at home alone.
The National SAFE KIDS Campaign recommends that children are not to be left alone before the age of 12, and many will not be prepared until long after that. When considering an older sibling in caring for a younger child, experts have cautioned that older siblings are generally not ready for that responsibility of managing and supervising younger children until the age 15 or older.
If you are contemplating whether to allow your child to stay at home alone, some questions that families should explore before making an important decision may include:

Does my child feel ready to be home alone in confidence and willingness?
Does my child consistently follow the rules and guidelines of the household in order to manage the rules while being away?
Has my child been able to exercise independent judgement and appropriate problem-solving skills in the past?
Can my child handled unexpected events and stay calm to problem solve?
Have I discussed with my child different scenarios that could occur while they are home alone and explore how they would handle them?
Will my child be willing to be forthcoming in the event something occurred, and is my child generally truthful?
Can my child demonstrate and understand basic safety rules and procedures?
Will be child be able to make decisions to stay safe outside of being potentially influenced by other peers or adults?
Can my child calmly provide important information, such as the home address and phone number, in the event of an emergency?
Is my child able to physically manage safety exits, such as doors and windows?
Can my child tell time?
Have I developed a structured plan or routine with my child that clearly explains boundaries, limits, and expectations?
Is my child able to independently work on tasks, such as homework?
If there is more than one child in the home, such as siblings, can they manage to get along and solve conflicts without physically fighting or intervention from an adult?
Have I engaged in pretend situations with myself and child in the home to practice self-care skills while pretending to be “unavailable?”
Is our neighborhood safe, and are their neighbors that my child knows and I trust?

While this list is not exhaustive, it does provide some generally important questions and points to consider. Additional questions based upon your family’s needs and child’s needs should be explored.

If you decide to leave your child alone, parents and caregivers should begin with short periods of time and progressively increase time spent away, but also staying relatively close. This may include running short errands to the store, dropping off dry cleaning, or running to the post office. Assessing your child’s comfortability and ability to handle this time frame will allow parents to make adjustments accordingly.
The incorporation of safety planning is important when allowing a child to remain home alone. Such actions to take in order to increase safety are:

Posting all emergency contact numbers (I.e. doctor, hospital, fire department, police department, poison control) and a trusted friend or neighbor near the phone, or programmed in a cell phone.
Identify and show the child all fire escape plans in order to get out of the house immediately, and to vacate the home in the event that the fire alarm goes off and contact the fire department from the neighbor’s or cellphone.
Have a first-aid kit in the home, and show the child where and what is in it. Teach the child about the items and how to use them in case of an emergency.
Make sure that you are accessible. This includes having your contact number programmed into the phone, and explaining to the child where you will be, how you can be reached, and when you will return home.
Prepare a snack in advance to prevent the use of appliances being used to decrease risk of accident.
If the child arrives to an empty home, request the child contact you for a check in.
Create house rules regarding the child’s ability to:
- Leave the house
- Having friends over
- Cooking
- Answering phone or door
- Use of electronics and internet

If leaving your child alone is not appropriate for you and your family, consider alternative child care options. These may include a babysitter, after school care, or day camps. Err on the side of caution, and make an informed decision before leaving a child unattended to care for themselves.

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Parent and Child Psychological Services is a private practice serving children and families in the Sarasota, Florida area. The practice is owned and operated by Dr. Gibson, a Licensed Psychologist who is Board Certified in Clinical Child and Adolescent Psychology.

Remember, birds fly. Fish swim. Children play.

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