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Parent and Child Psychological Services PLLC 
941.357.4090 (Office)/ 727.304.3619 (Fax)
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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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    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. ​

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Parent and Child Psychological Services PLLC 
info@childtherapysrq.com
941.357.4090 (Office)
727.304.3619 (Fax)                                                                                                                                                               
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