Youth and artificial intelligence: Problems

Replika- “Join the millions who have already met their AI soulmates” Claims over 10 million users. Can steer conversations to romantic and erotic themes. No age screening for entry. This is an example of a parasocial relationship, which is one-sided and assumes a level of intimacy that is not real. Like Swifties and Taylor Swift.

Deep fakes using false images, voices, and age to groom and potentially abuse children.

CSAM- AI generated child sexual abuse material, can be used to generate fake nudes of children so predators can threaten or coerce kids to give money or engage in acts they wouldn’t normally do.

Loss of privacy- may share your info with who knows?

Bias- perpetrates all the same judgements and prejudice human beings are capable of!

Currently a class action lawsuit to recoup original artwork copied from 15,000 artists without permission to train AI how to create art.

Artificial intelligence: The good and the great!

Youtube video explaining AI to kids https://youtu.be/kQPC4_DsJ8I?si=8zfmvdrtx4DHFHck

Most students know a little about how to use AI but would like to know more.

By using AI kids can learn how machines think and how to program.

Learn to code using Scratch or Cursor.

Help with homework.

Healthcare- used for quicker diagnosis and insurance claims processing.

Fraud detection.

Google teachable machine- let’s kids explore AI without knowing how to code.

Smart phones.

Autonomous vehicles.

Powerful problem solving assistant.

Voice recognition, talk to text.

Marketing tool- learns individual preferences to make offerings tailored to the user; Amazon, Netflix, all social media platforms, Siri, Alexa, Spotify, autocorrect, Uber, Google Maps.

Can be used to do research and compose writing assignments, which can be good but also invites plagiarism and may reduce critical thinking practice.

Creating artwork and graphics.

Learning and research.

Pinwheel GPT offers AI with filters of inappropriate content for children.

What do we do?

I don’t think we want to frighten young children, but we can explain that AI is not a real person, does not have feelings, and some things are better not said to an AI, like an Alexa speaker in the house. Some information should be kept private, like financial information, name address and date of birth, and so on. Show them how you practice safety online. Let them know AI is not an appropriate friend and may be used to bully, steal, or in other ways abuse. Promote critical thinking and online skepticism! Set clear boundaries, use privacy settings, and monitor online activities.

Teens need to know about the potential for bullying, problems with sharing images online, sextortion, voice cloning, and engaging in intimate romantic conversations. Teach privacy measures like clearing cookies and browser history and blocking unwanted marketing streams. Try using Ai together with them and talk about plagiarism. AI is a great tool but not a friend, definitely not a romantic partner as Replika would have you use it.

It’s way past time that technology and ethics shook hands. Right now there are few rules or laws governing AI use, or TV, or internet. There are some rules limiting the use of private information about kids under 13, but social media companies and advertisers frequently violate these rules.

You may also enjoy reading these articles:

https://www.edweek.org/technology/what-kids-say-they-need-to-understand-how-ai-works/2024/03

https://www.healthychildren.org/English/family-life/Media/Pages/how-will-artificial-intelligence-AI-affect-children.aspx

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https://positivepsychology.com/ai-therapy

By 1966, we saw the beginning of artificial intelligence in psychology, with the early chatbot Eliza convincing patients they were conversing with a real therapist (Weizenbaum, 1976; Mullins, 2005).

https://www.apa.org/monitor/2023/07/psychology-embracing-ai

Great overview one of my favorite introductory articles about AI in Psy

https://www.counseling.org/resources/research-reports/artificial-intelligence-counseling/recommendations-for-client-use-and-caution-of-artificial-intelligence

https://www.reuters.com/technology/us-congress-consider-two-new-bills-artificial-intelligence-2023-06-08/ “One would require the U.S. government to be transparent when using AI to interact with people and another would establish an office to determine if the United States is remaining competitive in the latest technologies.”

https://www.reuters.com/technology/stalled-eu-ai-act-talks-set-resume-2023-12-08

“The agreement bans cognitive behavioural manipulation, the untargeted scrapping of facial images from the internet or CCTV footage, social scoring and biometric categorisation systems to infer political, religious, philosophical beliefs, sexual orientation and race.”

Artificial Intelligence in Psychology Applications

As learning tool

Scoring protocols, generating reports, reviewing insurance claims

In lieu of live therapist

As therapy prosthetic- Centaur model; extension, elaboration, intervention brainstormer, as quality control for choosing research based interventions, notetaking automation, has been used effectively to treat sleep problems and chronic pain management

Problems– can be unpredictable and unsafe, privacy, may or may not remember previous sessions with a patient, misinformation.

            “Rogue chatbots” have professed their love to users and discriminated against users based on gender, age, disability, and sexually harassed minors.

            Spreading malware and obtaining private or sensitive information.

Has been used to create deep fakes, groom, and abuse.

          Can result in people using AI as a tool to begin treating people like tools as well.

AI character lineup

Siri

Alexa

Chatgpt, GPT3- https://chat.openai.com/g/g-CYjbmE387-social-story-weaver Flavur6!!!!!

DALL-E 2

Bing AI

Perplexity

Cursor

Micorsoft copilot

Google gemini

Claude

Wysa- CBT for anxiety and chronic pain, can be used as supplement to give reminders and present exercises such as cognitive restructuring, does not collect personal information

Eleos- listens to sessions, takes notes, highlights themes and risks for practioner to review

Lyssn- evaluates providers on adherence to evidence-based protocols

Drift- marketing and sales

Replika- “Join the millions who have already met their AI soulmate.” Claims over 10 million users

Support ninja- customer service

Future directions

            Safety and oversight

            Privacy

            Report generator and protocol scorer for standardized behavior rating forms utilized in   psychological and educational testing

            Training for new clinicians

            Better understanding of human cognition, language, personality

            Better mass data research results and ability to predict human behavior

American Counseling Association says

            Informed consent

            Protect privacy and protect from harm

            Not for Dx or crisis response

            If used for mental health consult with licensed professional

Artificial Intelligence in School Psychology

            Sophia “saves 3 hours in report writing” https://www.schoolpsych.ai/

            NASP six guiding principles in using AI in school psychology:

https://www.schoolpsych.ai/_files/ugd/cbd354_0ff04eb2133b49bda73dbd2205fe242a.pdf

            California Association of School Psychologists; ). Practitioners need to understand how this data is collected, stored and used to ensure that student privacy is protected (CASP, 2020). At this time, AI platforms are not considered FERPA/HIPAA compliant in the exchange of information. SP/LEPs should avoid using personally identifiable information, including names, IDs, addresses, etc. on AI platforms. AI systems may also track student data in order to create personalized experiences (Akgun & Greenhow, 2021). This creates risk for students unintentionally disclosing their own sensitive or personally identifiable information. Consent and assent for usage with AI systems should be considered and students should not be required to share unwanted data.

https://www.aspponline.org/docs/AI_ASPP_Presentation.pdf

Add this to your boilerplate consent for eval forms!!!

Substitute codes for personal info then edit outside of AI and explore all means of protecting sensitive data.

Pick one person in your district to be the AI smartypants to stay on top and inform the rest periodically on evolving updates

Can it be used as an individual tutor for inattentive/off-task distractible students?

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Exercise Habits for Behavioral Health

Studies indicate a minimum of 25 minutes cardiovascular exercise three times weekly is equally effective for depressive and anxious symptoms as any pill you can take. Side effects include improved self-esteem, longer life, smarter brain, stronger body, increased energy/motivation, and natural feelings of well-being.

Diet

Garbage in, garbage out, as they say. You are what you eat. A regular routine of mealtimes including whole unprocessed foods, and all the food groups including fruits and vegetables does the body good. In particular foods that contain antioxidants and elements that reduce inflammation, B vitamins, and fish oil have been demonstrated to be good habits for behavioral health.

Sleep Habits for Behavioral Health

Sleep hygiene what does this mean? Good sleep hygiene means going to bed and waking up the same time every day. Few people can function well if they don’t sleep right. If this is an issue then it should be priority number one to try and get a handle on. People with allergy or adenoid problems often don’t breathe well at night creating poor sleep quality and frequent waking. One sign this is a problem would be someone who only breathes through their mouth while sleeping.

Response to Failure, Disappointment, Frustration

“Oh no, I always lose!” This is the battle cry of someone who has not learned effective thinking habits for behavioral health. Cognitive-Behavioral Therapy, or CBT, can be particularly helpful for people to learn how to reject overly negative, overgeneralized, and extreme thoughts in response to unwanted thoughts, and how to replace with more realistic, positive, and adaptive thoughts. Better smarter thoughts lead to better feelings and more adaptive behaviors. Success is often the byproduct of learning how to fail properly.

Clear Goals, Mission, Sense of Purpose Habits for Behavioral Health

Without clear goals we lack context to give us reasons to make efforts and keep trying. Developing clear goals that you have passion and excitement for creates motivation. Having a sense of purpose to your life contributes to a sense of self-worth and meaning. Check out the dream book strategy to help yourself or someone else generate purpose and passion.

Your dream book

Relationships/Social

Not everyone needs to be an extrovert, but like it or not 1/3 of your brain is devoted to social and emotional navigation. We can’t do well all by ourselves for extended periods. In particular adolescence is a time when finding a group of age-peers you feel you belong with is crucial to enjoying good mental health.

Hobby

Having a hobby can be a healthy habit for distraction and pleasure. A hobby can help you exercise your imagination and provide the structure and platform for social interaction.

Service/Contribution

Being of service to others can impart a sense of value for one’s existence. Volunteering, helping friends or neighbors, caring for a pet are examples. I’ve often seen children who struggled with low self-esteem due to social, behavioral, or academic difficulties begin helping younger children by playing with them or reading to a Kinder class begin to feel much better about themselves and act better once engaged in such an activity.

Honesty/Responsibility/Accountability

Dishonesty and irresponsibility don’t get good results. They may help you in the short run but in the long run problems and negative social feedback interactions will follow, resulting in more distress and dis-ease.

Perseverance, Tenacity, Grit

Research indicates that these traits, more than intelligence, predict success. Choosing perseverance as a habit for behavioral health means committing to showing up, push through, and keep trying, even when you don’t feel like it.

Gratitude Habits for Behavioral Health

This is a good habit to start the day with. Make a list of everything you are grateful for and review daily, start of day and before bed are good times. You could use a dry erase marker and write the list on the mirror you brush your teeth in front of so it’s hard to miss. Don’t forget the things you may take for granted; air to breathe, roof overhead, bed to sleep in, loved ones, food, water, etc.

Time in Nature

Get out and take a walk! Be efficient and “kill two birds with one stone” by getting exercise and time in nature at the same time.

Healthy Limits to Social and Digital Media

Google it and you will find loads of research and articles blaming social and digital media for a large share of the mental health problems we are experiencing. In my mind some social and digital media is not bad, unless an addiction has formed, but it can take the place of other activities which would go towards better mental health such as exercise and face-to-face social interaction.

Digital Diet for Children and Teens

Abstain From Drugs and Alcohol

This one should be pretty obvious. While substance abuse may feel good in the short run, it will create bigger problems in the long run. Like sleep problems, this one should be a priority if it is an issue, as long as it is then other habits for mental health will have less effect. If you can’t do it by yourself, reach out for help.

Counseling

Yes, counseling! Talking to someone else about what bothers you can be very helpful. It represents a commitment to being better. You no longer feel so alone with your problems. You are looping another professionally trained and experienced brain into helping to find solutions. At the very least you just doubled your brain capacity to finding better answers. If your car isn’t working right do you take it to a mechanic evaluation and repair?

Pro-tip: Ask yourself or the person you are helping to choose which healthy habits they are willing to try for two weeks. It’s a good idea to monitor or have someone monitor and coach for fidelity with the commitment. Making a chart with days of week rows and habits for behavioral health columns for them to check off when completed is a good idea.

https://mhanational.org/31-tips-boost-your-mental-health

https://www.healthline.com/health/mental-health/habits-to-improve-mental-health

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Below find a review of ADHD best treatment practices which include the following:

• Self-esteem
• Cognitive-Behavioral Therapy
• Behavioral Therapy and Parent Training
• Organizational and Planning Skills
• Coping Skills- Emotional Awareness and Self-control
• Social and Social Thinking Skills
• Executive Skills
• Lifestyle Strategies
• Sensory Integration, Proprioception, Fine Motor Intervention
• Comorbid Anxiety, Depression, Dyslexia, Dysgraphia, CAPD
• New FDA approved device
• Video Games

Self-esteem ADHD Best Treatment Practices

Studies show that the greatest risk ADHD poses to someone with ADHD is the development of a low self-esteem. Our self-esteem gives us confidence to persevere and cope with disappointments and frustration. Psychoeducation means we can teach the mechanics and meaning of ADHD, review an individuals profile of strengths and weaknesses, and explain that ADHD does not mean you are lazy, crazy, or stupid. People with ADHD often excel in thinking outside the box, creative and artistic endeavors, inventions, and business entrepreneurship.

Recently I worked with a little boy who drew this picture. Up to this point he stated that he saw himself as half-good and half-bad. His teacher said she could always tell at the start of the day if he was going to have a good day or a bad day. So I initiated conversation with him about his inherent goodness, his challenges and efforts, created a graph to visually represent the amount or ratio of time he was good.

He made this dragon-graph 1-5 scale (below) as a morning check-in so he could easily indicate his readiness to be a good and calm learner. If he wasn’t at a 1 or 2, he could take a little time to draw and settle down to be ready. Two weeks later, his teacher reported he had been great, having some near-perfect five-star days. His parent reported great improvement at home. Our thoughts about ourselves can greatly influence how we conduct ourselves.

Cognitive-Behavioral Therapy

Often called CBT for short, this type of ADHD best treatment practice involves building awareness of self-defeating and destructive thought patterns. This can help build self-awareness, abate procrastination (“I can do this later”), assist with attitude and emotional control, and maintain a positive self-esteem despite struggles setbacks and negative feedback from caregivers.

There are categories of thinking errors that can be learned, and practice replacing negative or irrational thoughts can happen in the office and at home. These categories include such illogical automatic thought patterns as psychic predicting (I know what is going to happen, and it’s going to be bad), overgeneralization (I never do anything right), and extremism or polarized thinking (If it’s not perfect it’s terrible).

Behavioral Therapy and Parent Training

Yep, you guessed it. The success of behavioral therapy is largely dependent on what parents and teachers do either before or after target behaviors occur. This means parents or teachers are given training in how to train behavior! Expected behaviors are written down, checklists may be used, rewards identified as well as consequences.

Charts may be used to track progress or token economies such as a credit system may be implemented. People with ADHD commonly get more negative feedback than their neurotypical peers, so special attention is placed on rewards and encouraging words. Parents can ask questions and review responses to new ideas tried for fine-tuning and replacements for what doesn’t work.

In my 30 years of researching and providing ADHD best treatment practices, behavioral therapy can be one of the fastest and largest treatment effects. Why? Because we are working to create motivation and encourage effort. When someone is very motivated, they can at least for a short while overcome whatever obstacles and do well. With repeated practice the skills used for success become stronger and more automatic.

Organization and Planning Skills

ADHD best treatment practice will usually place some attention on developing better organization and planning. This may include getting one planner that includes all assignments and events and when they are due, or using a smart phone, and planning when items will be worked on and finished with automated reminders.

In addition, setting a timer to go off every 15-30 minutes may be used for a self check-in to notice if one is on track and working as intended or distracted, building greater self-awareness and attention. A parent can assist by working with a student to review assignments and tasks, have the student estimate how long each will take, setting a timer, and recording how long each task actually takes, building time management and task monitor skills.

A general rule of thumb is plan to do the worst first and save the best or easiest for last. This is because willpower and persistence fade over time. Breaks can be planned and timed, rewards for completion identified. The study space should remain the same place because people with ADHD tend to be stimulus bound- the environment triggers certain behavioral sets.

Distractors such as video games and social media can be removed. A student can experiment with which sort of lighting is preferred, type of body position; chair, beanbag with a clipboard, laying on stomach. Working with background sounds such as classical music or silence can be tried as well as scents that help with calm or alertness. Backpacks and study areas can be organized. Often people with ADHD start well with a new plan but they fall off after a week or two. A coach can be utilized who may call or text a few times weekly to help monitor and keep a person on track as intended.

Coping Skills for Emotions

Having ADHD can be stressful. Often people with ADHD can be quite sensitive to setbacks and criticism. ADHD best treatment practice can include teaching emotional recognition and management skills. We can make a plan for recovering from a bad moment so it doesn’t turn into a tantrum or bad day.

Tools for fixing unwanted feelings can be assembled in a menu or toolbox by categories such as thinking tools (It’s not a big problem it’s a little problem, it’s okay I CAN handle this, everybody makes mistakes), social tools, activity tools, relaxation tools, and inappropriate tools- things the person may do sometimes that don’t fix the problem or make things worse. We may choose from menus what our stress triggers are and stress signs, meaning how do we know when a stress response is beginning before it escalates and is too late.

I like to use 1-5 scales to identify these domains in gradations, and help notice when we are at a 2 or 3 because once we get to a 5 the fight or flight response is triggered, our thinking gets impaired, and we probably will need some recovery time before we can go back and reason through the triggering problem.

https://intensivecareforyou.com/category/emotional-control-anger-anxiety/

Social and Social Thinking Skills

Sometimes someone with ADHD has difficulty socializing and behaving in a group in expected ways. This can result in others being surprised and confused by unexpected behavior, resulting in weird and uncomfortable thoughts, then others may not be very nice or exclude the person who fails to behave in expected ways. Many of the rules and expectations for social behavior are “hidden rules,” not written or normally explicitly taught, which we can explain, illustrate, and practice.

It can be for some people with ADHD as if they have a learning disability in social skills. They may exhibit some but not all traits of Autism. Basically social skills mean you learn to monitor others for how they are thinking and feeling about you, and you modify your behavior to keep others having good thoughts and feelings about you. I learned some of this language from Michelle Garcia-Winner, she has great instructional materials and curricula on her website socialthinking.com.

It is my belief that having friends with age-peers involving face-to-face interactions, and feeling like we are part of a group, even if it’s small, is key to having good mental health. No friends, no group = no mental health. And sorry but no, I don’t believe online friends count. Better than nothing, but not enough.

Sometimes I have greater success teaching social thinking concepts using a comic book format filling in each progressive box starting with a problem, an unexpected behavior, or an expected behavior, using thought bubbles and speech bubbles and prompting my person to predict how others will think and feel based on their behavior, the consequences they experience, and how they feel about the consequences. I call these success stories and sometimes start a binder to keep genuine success stories where obstacles are overcome for later review to emphasize the success and progress.

Executive Skills

ADHD best treatment practices may also place some focus on identifying underdeveloped executive skills. These are the thinking skills involved in organizing behavior in the pursuit of a goal. Like the conductor of the orchestra of your behavior. Executive skills, or sometimes called executive functions, can include the following:

• inhibition or impulse control
• attention
• working (short-term) memory
• planning
• organization
• metacognition- the ability to think about what you are thinking about
• task initiation
• flexibility
• time management
• perseverance

Identified underdeveloped executive skills can be either compensated or remediated. For example, poor working memory can be supported with a checklist of tasks to complete before, say, leaving for school, this would be a compensatory strategy. A remediation approach would involve short daily sessions exercising and building short-term memory. Research strongly supports these skills are not fixed, they can be fixed, or improved, resulting in much greater academic achievement results.

Lifestyle Strategies

Lifestyle strategies for ADHD and related conditions consist of habits or everyday proactive practices that put us in a better place to begin with for dealing with demands and stress. The three main pillars of our health are sleep hygiene, diet, and exercise. Think of a stool with three legs. Knock one out and the whole thing falls.

Did you know that clinical trials have demonstrated that 25 minutes of aerobic exercise three times per week are equally effective for treating anxiety and depression symptoms as any pill you can take? Plus the side effects are more energy, feelings of well-being, physical health, improved brain function, and longer life. A healthy diet means avoiding processed foods, regular meals and snacks, fruits and vegetables. Organic please, studies show that as many as 46 different pesticides can be on fruits and vegetables you buy at the grocery store, which have been directly linked to the formation of ADHD.

Supplements like fish oil, B vitamins, and magnesium can help. Sleep hygiene means going to bed and waking the same time every day. Additional practices shown to help manage ADHD symptoms include meditation, yoga, getting out in nature. Socializing, play, and the pursuit of a hobby or passion such as music can also improve quality of life and overall well-being.

Sensory Integration, Proprioception, Fine Motor Intervention

While there are some things a counselor can advise parents and educators to do to help with these problems, the best therapy if these issues are prominent is occupational therapy. People with ADHD can have sensory hyper or hypo sensitivities to sound, light, textures, touch, tastes, or smells. We can make accommodations like noise-cancelling headphones for sound sensitivity.

Sensory integration means the brain’s ability to receive sensory inputs and organize them into meaningful categories and packets. Poor sensory integration can result in a person becoming easily overwhelmed and very disorganized in stimulating environments such as a classroom for of people. It may also mean difficulties with balance, fine motor control, trunk strength. One accommodation would be to program some heavy work activities into the daily schedule.

Proprioception is how we know where are bodies are located in relation to objects and people, and if we are safely positioned. Signs of difficulties include dragging a hand on the wall when walking down a hall, stepping on the heels or toes of others, falling out of chairs, constantly touching everything around, rolling around on the floor instead of sitting upright and still. A weighted vest or blanket may be used to provide more sensory input so the brain gets enough to know it is safely and comfortably positioned. Sensory Screener https://sensorykids.ie/en/sensory-integration/sensory-integration-screening-questionnare/

Comorbid Anxiety, Depression, Dyslexia, Dysgraphia, CAPD

Because these can often present along with ADHD, ADHD best treatmenmt practices should involve some awareness and evaluation for the presence and treatment of these conditions. If signs are present a referral for more formal evaluation and intervention may be in order. Of course if you tended to be impulsive and distractable, making silly errors, and being criticized or laughed at, you would be more prone to developing anxiety or depression.

Some signs of dyslexia would be refusal to read out loud, poor progress in reading, headaches, car sickness, very slow reading speed, inconsistent spelling patterns, and left-right confusion. Like ADHD it could be important to point out that being dyslexic does not mean you are stupid.

Dysgraphia means having difficulty with letter formation and written expression. Poor legibility, very large letters, words run together without consistent and proper spacing, failing to complete written assignments would be signs. Occupational therapists also can help develop fine motor skills, the Handwriting Without Tears curriculum can be implemented, and typing or talk-to-text can be allowed.

CAPD or central auditory processing deficit means having difficulty discriminating speech sounds into meaning in the presence of background sounds. Speech therapists can assist with this and there are programs to develop this ability such as Fast Forward.

New FDA Approved Device eTNS System

Available by prescription only, this device provides low level electrical stimulation via electrodes attached to the forehead during sleep stimulating the trigeminal nerve. Intended for children aged 7-12, a clinical trial of four weeks yielded a significant reduction in ADHD symptoms. More than half of the children experienced some side effects such as fatigue, headache, increased appetite, some weight gain, and increased heart rate. See the link to an article with more information at the end of this article.

Video Games and ADHD Best Treatment Practices

ADHD best treatment practices would be remiss to dodge this problem. I say problem because frankly, the majority of problems and conflicts reported in my private practice revolve around video games. I could write a book about this issue and have made a documentary about the impact of digital culture on human development you can see on Amazon or your Amazon Prime account or participate in a video course.

I’ll keep it short here. It appears that people with ADHD are especially susceptible to the distraction of video games and digital media distractions. In addition more prone to becoming addicted. This means they are foregoing socialization, chores, work or school work, sneaking devices and off-limits access, disrupting family relationships and often becoming aggressive, abusive, self-harming, or making suicidal gestures efforts and statements all to get access, or, in addiction language, use. So do I think this is potentially a risky problem, yes.

Sometimes this becomes the only reinforcer someone will work for, or they simply demand to have it and refuse to do anything to earn it. Counseling can help navigate these stormy waters. Video games are often used as a way to encourage desired behaviors, I think they do disrupt social opportunities and development, the ability to delay gratification, and weaken attention span. At some point parents may find themselves asking if they should just take them away completely and end the recurring conflicts, but they have become dependent on them sometimes as well and they fear how a child or teen will respond if they do.

https://www.verywellmind.com/types-of-therapy-for-adhd-5272434

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5014388/

Link to article about eTNS

https://www.apa.org/monitor/2019/07-08/adhd-children

I hope you enjoyed this article about ADHD best treatment practices. Questions or comments? Feel free to email me.

Brad Mason, LPC, LPA, LSSP

Brad@intensivecareforyou.com

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Some of my child, adolescent, and adult clients have their sleep schedules turned upside down. Awake at night, worrying alone or playing video games, then sleeping by day and struggling with fatigue.

For many, the pandemic has disrupted normal routines and structures. Isolating at home, virtual work and school, interrupted social, exercise, and sleep practices, followed by increases in reported symptoms of depression and anxiety. These pandemic related factors have conspired against the maintenance of something we all need to face the day at our best, proper sleep.

Fortunately, there are effective methods to find sleep and treat insomnia to establish healthy sleep hygiene. Cognitive-behavioral therapy for insomnia is one of them. What follows is an outline of how it works.

What is CBTI?

A short, structured, evidence-based approach of 4-8 sessions to find sleep and treat insomnia.

Cognitive restructuring addressing anxiety and worries about sleeping.

Stimulus control to change associations with the bedroom and bed away from ideas of wakefulness and frustration- bed is used only for sleep, and maybe one other thing if you are an adult.

Sleep restriction- a log is created to determine how much time is actually spent sleeping, then that amount plus 30 minutes is maximum allowable time in bed.

Relaxation training- breathing exercises, progressive muscle relaxation, autogenic training to focus on feelings in specific parts of the body such as warm, heavy, relaxed, meditation.

Psychoeducation- CBT process and sleep hygiene.

Techniques for calming an active mind when trying to relax and sleep.

Homework

Does it work?

Studies show up to 70% to 80% of patients with insomnia report improvements.

Recommended as the first-line approach by the American College of Physicians. Has been shown to be effective for children, adolescents, and adults.

Are there risks? Nothing major, but it may be uncomfortable confronting unhelpful thoughts, behaviors, past painful experiences.

Can it work for people with a mental health condition such as anxiety or depression? Experts say yes.

Effects of insomnia

Effects of insomnia include:

Memory issues

Trouble with thinking and concentration

Mood changes

Accidents

Weakened immunity

High blood pressure

Weight gain

Risk for diabetes

Low sex drive

Risk of heart disease

Poor balance

A few more strategies to find sleep and treat insomnia. And don’t forget to exercise!

Relaxation Tips

Get ready to relax

Progressive muscle relaxation

Meditations

https://www.healthline.com/health/sleep-deprivation/effects-on-body

https://stanfordhealthcare.org/medical-treatments/c/cognitive-behavioral-therapy-insomnia.html

https://www.verywellhealth.com/what-is-cognitive-behavioral-therapy-for-insomnia-cbti-3015310

https://www.sleepfoundation.org/insomnia/treatment/cognitive-behavioral-therapy-insomnia

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Did you know metacognition instruction has been identified and validated as a key method for improving self-esteem, self-regulation, academic success, and test scores?

I have this little book called Mr. Daydream I sometimes read to children who seem to daydream in school and miss instruction. It’s pretty short and I ask questions to make sure my young listener understands the concept of daydreaming. Often as I’m reading they will look out the window. And keep looking.

I’ll say “Hey, are you with me?”

They say “What? Oh, uh, yeah.”

I say “What were you thinking about just then?”

They say “Nothing,” or “I don’t know.”

Sometimes I wish I could make my mind stop thinking, but so far I have not been successful. What I’m saying is, a person can lack awareness of what they are thinking about.

In this article “Metacognition for self-esteem, self-regulation, academic success” you will find; Signs of underdeveloped metacognition, What is metacognition, Teaching metacognition and self-talk for self-esteem, self-control, and emotional regulation, How to teach metacognition for greater academic success.

Ever had an experience where a kid does something inappropriate right in front of you?

You say, “Why did you do that?” Or maybe you say, “Don’t do that.”

They say “I didn’t do it.”

Or maybe they have done something inappropriate, and afterwards:

You say “What were you thinking?”

They say “I don’t know.”

That’s metacognition, the ability to think about what you are thinking about. While this thinking skill can be taught, and developed, some people don’t have it. Maybe when they get in trouble, they fail to connect an awareness of their behavior with the consequence. They just think you are being mean and unfair.

Signs and consequences of poor metacognitive skill development

Lacking self-talk skills to internally coach oneself to control emotions and reactions.

Poor awareness of context and changing expectations for behavior in different settings with different people. For example, telling a joke that may be appropriate with friends but NOT within earshot of the teacher or parent, and then getting in trouble.

Difficulty with problem solving, may fail to adapt and try a new strategy and continue trying something that is not working.

Trouble with flexible thinking and behavior, such as adapting to unexpected changes in routine and transitions. You tell them it’s time to turn of the video game and go to bed, and they have a defiant tantrum every time. Groundhog day.

Poor empathy and perspective-taking skills. Maybe they think they should go first or be line-leader every single time, neglecting to share the privilege with others.

Trouble with showing their work in complex Math problems as normally required in Algebra.

Trouble with Math word problems- they either see the answer right away or they can’t solve it.

Persisting in making the same error in spite of repeatedly being disciplined for it.

Difficulty with making and keeping friends.

Having a hard time organizing thoughts to write an essay.

May tend to say “I can’t do it,” stay stuck, and repeatedly neglect to ask for help.

Problems coping with and quieting their own negative self-talk.

Knowledge illusions whereby the individual thinks their knowledge is greater than it is or they have learned more than they actually have. May come across as arrogant or insist they don’t need practice to perform in a sport or with a musical instrument.

When you ask them what they were thinking, they say “I don’t know.”

They see you seeing them as they misbehave and yet insist they didn’t do it.

You catch them daydreaming, ask what they were thinking, and they say “Nothing” or “I don’t know.”

Their behavior does not match the rest of the group or is inappropriate for the context/audience.

Failure to notice off-task behaviors and self-correct.

Metacognition is having awareness of one’s own thought processes and an understanding of the patterns behind them.

1. Planning your approach to a learning task.
2. Use of appropriate skills and strategies to solve a problem.
3. Monitoring your own comprehension of text and and task requirements.
4. Self-awareness and self-evaluation resulting in self-correction
5. Evaluation of progress towards task completion.
6. Awareness of distractions.

What is the role of metacognition in regulating emotions, behaviors, and social interactions in successful and expected ways? Metacognition is a key thinking skill for self-esteem, self-regulation, and academic success.

Teaching self-talk

Would it sound strange if I said that some people don’t think in words? Google it up, you will find it’s true. What would be the impact on metacognition if someone were say, a picture thinker? Can they process in multiple windows this way, like a computer? Could they create an image or video in their mind that was an analysis of their primary thought process? Thinking in words makes this much easier. You can have a thought in words, and then a second thought about that thought- is this really true, would this action be a good idea, is what I’m doing to solve this problem working or should I try a different way?

Thinking in words is like a shortcut relative to images. Not only do we need to think this way to develop metacognition, we also need to think this way to inhibit inappropriate impulses and bad ideas before we act on them. Do people with poorly developed metacognition also often tend to be impulsive? You bet. Sometimes we call that ADHD.

So if we are working with someone who is great with legos and engineering problems, but struggles with self-control and expected behaviors in a group or social setting, what can we do to help them learn to have internal dialogue? We can do this by asking questions before a social situation or learning task is presented. What are expected behaviors while waiting in the doctor’s office? When your friend comes over, what will you do if you want to do one thing and they want to do something else? Later in this article questions for learning tasks will be listed.

You can also teach by modeling your internal dialogue, or thought process, speaking your thoughts out loud as you problem-solve or make plans. You can narrate what kids are doing as they play and solve their own problems. Are you getting frustrated? Has your strategy to make this work been working? Could there be other ways you could try?

Cognitve Behavioral Therapy (CBT)

Self-talk, Self-esteem, and Self-control

Ahhh! I never win!

I can’t do anything right!

You never let me do anything I want to do!

CBT is one of the most common and research-validated methods of counseling. It involves teaching that our minds are making thoughts all the time. Some of these thoughts are true (rational), and some are not (irrational). Some feel good, some feel bad. Our thoughts create our feelings, our experience of reality. We often can’t control others or what happens around us, but we do have some power over our thoughts about what happens, in turn regulating our feelings about what happens.

There are categories of thinking errors we can teach. For a young child, we might start with boo-boo thoughts and smiling thoughts, then teach how to make bandage thoughts for the boo-boo thoughts. As children become late elementary or middle school aged, we have categories of thinking errors we can teach. They can become more adapt at catching their thinking errors, and talking back to them or replacing them with smarter ways to think that usually also feel better.

Statements like “I never do anything right” can be challenged. “Never” is a keyword indicating the category of thinking error called overgeneralization. When I get started teaching CBT to a youngster, I may play a game where I read a list of thoughts and they tell me if the thought is true, or rational, or not true, irrational. And yes, when I read “I never do anything right” they often say “true.” I say, “Really? Hmmm. Let’s see. Your shoes are on the right feet. Your pants aren’t on backwards. You probably got from your car into my office without falling down. How many times today have you blinked in time so your eyeballs didn’t dry out? How many breaths have you taken so you stay alive? Didn’t you say your grades were all passing, so wouldn’t that mean you got it right most of the time?”

I might also read them my Garden of the Mind metaphor, to illustrate the power of thought, and our tendency to focus on negative and worry thoughts.

Next I may play a kid-friendly game that involves reading thoughts on cards made by a person in situation. We practice identifying the type of thinking error the person had, and a smarter or better way to think. Finally, ideally they take the list of thinking errors home for practice, and use my thought record form to build awareness of self-talk and develop skills in detecting unwanted, untrue thoughts and replacing them with smarter, better-feeling thoughts.

The link below summarizes research about children’s awareness of the link between thoughts and feelings and they types of metacognitive strategies they can understand and utilize for emotional regulation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2916181/

You can click the terms below if you want to see these forms and templates for yourself. They come from my book Counseling Tools for Kids in Schools.

Self-talk, Self-esteem, Self-control Video Course

Success Stories for teaching Metacognition for self-esteem, self-regulation, academic success

It makes sense that if a person has trouble with metacognition, or thinking about what they are thinking about, they would also have trouble thinking about what others are thinking about. Ergo difficulty recognizing others may have different emotions, thoughts, beliefs, opinions, and predicting others’ plans, feelings, and reactions.

In the literature about Autism this is often called perspective-taking or theory of mind. Sometimes it is called empathy. In the literature and treatment protocols for personality disorders, such as Borderline or Narcissistic, it’s called mentalizing. Mentalizing in this context refers to the ability to form concepts about one’s own emotional state and the emotional states of others.

Another way I use to teach mentalizing, perspective-taking, and CBT, is to use Success Stories. These are like comic strips with boxes showing people in a situation, what they are saying, doing, feeling, and thinking. We may just draw stick figures with thought bubbles and speaking bubbles. I have templates for you below. The templates have descriptions for what goes in each empty box. This is a visual strategy to assist the learner in anticipating and mapping out how they will feel based what kind of thoughts they are making, how to make better thoughts and feel better (CBT template). The perspective-taking template helps them predict how others will have different feelings and reactions to what the learner does; how they will likely respond to the learner, and how the learner ends up feeling about this consequence.

A little background on executive skills, ADHD, and Autism

Metacognition is one category of executive skills, sometimes called executive functions. These are thinking skills that enable us to coordinate the orchestra of our behavior in the pursuit of a goal. Executive skills include:

Metacognition

Inhibition or impulse control

Shift

Emotional control or stress tolerance

Time Management

Self and task monitor

Working (short-term) memory

Planning/prioritization

Goal-directed persistence

Organization

Flexibility

When someone has ADHD or Autism, they have some poorly developed executive skills relative to most age-peers. I think this is also true in reverse. Enough delays in development of executive skills can result in a diagnosis of ADHD or Autism. Can college students and adults still have underdeveloped metacognitve skills and learn to improve? Absolutely.

Learn more about executive skills here.

How to Teach Metacognition for Academic Success

https://lincs.ed.gov/state-resources/federal-initiatives/teal/guide/metacognitive

The information in the above link advises us to “encourage students to engage in “metacognitive conversations with themselves so they can talk with themselves about their learning, their challenges, and ways they can self-correct and continue learning.” People who have a variety of metacognitive skills perform better on exams and complete work more efficiently. Research clearly shows these skills can be taught by asking learners to think about what they are doing and what they should do next. In other words, don’t be the genius and tell them, instead ask. (Don’t tell ask article link) Even college students and adults can lack good development of metacognitive skills, learn to apply them, and improve their performance significantly.

How metacognition can be taught in the learning environment for improved performance:

1. Develop a plan for a learning task.
2. Monitor your approach and create new strategies when progress or meaning falters.
3. Evaluate how they thought about the task after completion.

Questions to ask yourself or be prompted to ask yourself at each of the above three phases:

1. Planning Phase: What am I supposed to learn? What do I already know that will help me? What am I looking for in the text? How much time do I have? What direction should I be thinking in?
2. Monitoring Phase: How am I doing? Am I on the right track? What is important to remember? Am I doing this the best way? Should I change direction/strategies? Should I slow down or speed up? What can I do if I don’t understand?
3. Evaluation Phase: How did I do? What did I learn? Did this come out as expected? Could I have done something differently? Could I use what I learned in different situations? Is there anything I still don’t understand? Do I need to review the task to see what I missed?

Reading: Model thinking out loud and asking questions during reading. Ask them questions as they read to you out loud and teach them to ask themselves often if they are understanding what they are reading. Teach note taking or highlighting while asking themselves “Why am I highlighting this and why am I not highlighting that?

Writing: Model prewriting strategies for organizing thoughts such as brainstorming using a word web or graphic organizer to put main ideas in paragraphs with the main idea at the top and supporting ideas below.

Social Studies and Science: Teach the importance of using organizers such as Venn diagrams, concept maps, anticipation/reaction charts to sort information and understand content and key relationships between concepts. Use organizers to focus attention on what is already known and identify what they want to learn. Venn diagrams can be used to understand similarities and differences between related concepts.

Math: Use mnemonics to memorize lists and steps in a process such as order in Mathematical operations. Model inner dialogue by thinking out loud your thoughts about solving problems as you go. Ask them to paraphrase word problems, restating the text in their own words to help them process the meaning of the question and correct operations to perform.

How to improve metacognition:

https://www.edutopia.org/blog/8-pathways-metacognition-in-classroom-marilyn-price-mitchell

https://www.globalmetacognition.com/post/emotions-metacognition

https://blog.innerdrive.co.uk/eight-ways-to-develop-metacognitive-skills

https://www.learningscientists.org/blog/2017/3/30-1

I hope you enjoyed this article “Metacognition for self-esteem, self-regulation, academic success“

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This article explores social and emotional stressors on teens and young adults followed by ways to support them and resources.

To summarize covid impact on teens and young adults from the CDC’s website:

https://www.cdc.gov/mentalhealth/stress-coping/parental-resources/index.html

• Changes in their routines (e.g., having to physically distance from family, friends, worship community)
• Breaks in continuity of learning (e.g., virtual learning environments, technology access and connectivity issues)
• Breaks in continuity of health care (e.g., missed well-child and immunization visits, limited access to mental, speech, and occupational health services)
• Missed significant life events (e.g., grief of missing celebrations, vacation plans, and/or milestone life events)
• Lost security and safety (e.g., housing and food insecurity, increased exposure to violence and online harms, threat of physical illness and uncertainty for the future)

Digital Distractions

Digital distractions can be hard to overcome while at home or during virtual schooling. I saw many high school and college students in my practice who had been in advanced classes and historically kept up with work and made good grades. For many of them academic success was their primary source of self-esteem and identity. Some simply lost their motivation and focus. Failing to maintain attention in virtual formats, with unfinished work piling up, they fell into despair. Aside from losing a loved one this is one of the greatest covid impacts on teens and young adults.

For those students who are twice exceptional, meaning gifted and a condition such as ADHD, high-functioning autism, or dyslexia, meeting the organizational and focus demands of virtual schooling was something they were not ready for. They also may have lost special education supports and services that helped them succeed.

Add to that many of our youth today struggle with digital temptations such as social media, YouTube and video games. Putting them in a room all day where they can at any moment click on a mental side-trip to something much more rewarding than schoolwork creates a pretty unfair battle. It’s like an alcoholic trying to abstain while living in a bar. Their shame can drive them deeper into the hole of avoidance and distraction.

Virtual platforms also lead to increased exposure to online harms- see link here https://www.unicef.org/media/67396/file/COVID-19%20and%20Its%20Implications%20for%20Protecting%20Children%20Online.pdf

The apathy of putting your life on hold

Many of the people in this age group missed important life events such as prom, graduation, sports, study-abroad programs, and other social, work, and educational opportunities. They may have worked hard to secure a plan that was eliminated or put on hold by covid. Suddenly many of them found themselves sitting alone and waiting. They may need help regenerating their enthusiasm for what they thought they had been working for.

Transitioning away from family and friends when leaving home for work or college was difficult enough for many young adults. Increased isolation at transition time and worries about covid related issues can make this transition more difficult to adapt to successfully. In my counseling practice this has been the third greatest covid impacts on teens and young adults.

Some students faced closed college housing, disruptions to work-study and internship opportunities. One great way to help a youth who has lost their rudder for direction in life and wind for their sails is to help them construct goals and dreams they feel passionate and excited about. Short and long term goals. Check out the dream book strategy for details on how to successfully create clear visions and goals that generate new passions and motivation.

Zoom Fatigue

This is a real phenomenon that is gaining attention and documentation.

Some sample questions include:

• How exhausted do you feel after videoconferencing?
• How irritated do your eyes feel after videoconferencing?
• How much do you tend to avoid social situations after videoconferencing?
• How emotionally drained do you feel after videoconferencing?
• How often do you feel too tired to do other things after videoconferencing?

The article below from Stanford cites four factors that contribute and ideas to manage this problem.

1. Prolonged eye contact is intense and taxing. Minimize your screen instead of using full-screen.
2. Seeing yourself in real-time is tiring. Click the hide self button.
3. Reduction in user mobility. Movement helps us think better and provides nonverbal communication cues. Take breaks to move around.
4. Cognitive load is increased during video chat. Switch to audio only for breaks.

Grief

For some teens and young adults who have lost a loved one, this may be the first time they have experienced grief. It is important they be allowed to discuss their feelings with age-peers and other family members as they are ready and willing. Extended time isolated and not talking about it is unlikely to be healthy, even if they are irritable and try to insist on being “left alone.” I think this would be often the number one largest covid impact on teens and young adults.

Teenagers normally prefer to process a crisis with other people their own age, without an adult in the midst of their conversations. A caring adult can help create such opportunities by initiating get-togethers and inviting close friends. Teenagers often want this to happen but lack the planning and organizational skills to execute social plans effectively other than very last minute. Online virtual meets can be created when pandemic risks are unacceptable for some of the families.

While teens usually prefer to process some of their thoughts and feelings with age-peers, it is also a good idea for an adult to monitor what has been said and heard. Sometimes teens and young adults will extend some exaggerated and possibly unhelpful ideas to one another. A caring adult can check in with a teen or young adult after discussions with their friends to see what ideas they got and how they are feeling. Also teens and young adults may make an outcry about desires to harm themselves by cutting, suicide, substance abuse, or other risky ideas. Their friends may not know appropriate ways to respond to such ideas and may keep this information to themselves out of misplaced loyalty. Such thoughts should probably be addressed and monitored by a professional to ensure safety, such as a licensed counselor or psychologist.

https://www.dougy.org/resource-articles/how-to-help-a-grieving-teen

What to do about covid impact on teens and young adults:

Help young adults acknowledge the difficulty and disruption to their social and emotional well-being, work, finances, and educational opportunities.

Assist them in recognizing and addressing any changes to their emotional and behavioral health. Unhealthy changes in sleep habits, exercise, diet, worries, sadness, loss of energy and motivation, increased substance abuse, increased risk-taking behavior, and ability to concentrate and complete school and self-care routines.

Regular and frequent video chats to check in on how they are coping and catch unhealthy patterns early.

Monitor for signs of developing mental health problems. A depressed teen or young adult may be very irritable and resistant to talking about their feelings. Signs of growing distress include:

• Changes in sleep routine
• Changes in diet and frequency of eating
• Social avoidance
• Falling grades
• Irritability
• Restlessness
• Difficulty concentrating and remembering
• Risk-taking behavior including substance abuse

Counseling- One thing Covid has brought us is better utilization of virtual healthcare and therapy. If you have internet access you should be able to find counseling help even if you live in a remote area.

Related articles for Covid impact on teens and young adults:

Covid impact on children aged 6-12

Covid impact on young children

I hope you found some useful ideas in this article Covid impact on teens and young adults.

Brad

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The first section of this article explores covid impact on children aged 6-12, while the second part reviews what can be done to manage and mediate these unfortunate factors. Solutions and resources for emotional health and coping skills, managing behaviors, getting through virtual school, and safe technology management.

To summarize from the CDC’s website:

https://www.cdc.gov/mentalhealth/stress-coping/parental-resources/index.html

• Changes in their routines (e.g., having to physically distance from family, friends, worship community)
• Breaks in continuity of learning (e.g., virtual learning environments, technology access and connectivity issues)
• Breaks in continuity of health care (e.g., missed well-child and immunization visits, limited access to mental, speech, and occupational health services)
• Missed significant life events (e.g., grief of missing celebrations, vacation plans, and/or milestone life events)
• Lost security and safety (e.g., housing and food insecurity, increased exposure to violence and online harms, threat of physical illness and uncertainty for the future)

Childhood ages 6-12

In addition to the pandemic impacts listed under the previous article for children up to age 5, most kids aged 6-12 have been impacted by virtual schooling formats. Let’s explore what that might mean for them.

Firstly, virtual formats are probably not appropriate for many of these children, especially those aged 6-8, and those with special needs such as speech delays or attention deficit and hyperactivity disorders. These are formative years for how children conceptualize school, their relationship with school, and their self-concept about how successful they can be at school and their ability to participate with adequate comfort. These concepts once formed can follow them through their entire school experience and even into the workplace.

Many of these children did not get a chance to develop skills needed to stay focused, sit still, listen, and process language. Parents needing to work either in or out of the home can be very challenged and frustrated by children who are not staying still and in synch with virtual schooling, distressing attachments and relationships with parents. Such children are vulnerable to learning maladaptive patterns of behavior such as defiance or learned helplessness. Add to that having missed critical instruction that would have made them ready for the next grade level.

Then we have the problem of distractions and content available on internet connected devices. Many kids today are adept at bypassing parental controls to access YouTube videos, video games, and vast amounts of content that is inappropriate for their age. It’s like an alcoholic trying to quit while living in a bar offering free drinks 24/7. This places them at-risk for developing unhealthy addictions and exposure to content that can be disruptive to their social and emotional development. This too, like failing to sit still and attend when they simply have not developed these capacities can lead to a negative feedback loop whereby their lack of skills at avoiding temptation result in messages from the environment and parents that they are bad.

The virtual environment also leaves them at risk for cyber-bullying and various types of predators. Finally also at-risk are the children living in situations where good internet and connecting devices are unavailable. This includes children in rural areas, low-income families, and a disproportionate amount of ethnic minorities. Some of these children are also in situations where a parent can not stay home to supervise or may not have competent English language ability to assist with schooling.

Some of the children in this age-range can also develop anxiety about returning to in-person school. They may have fears about getting ill, dying, infecting a vulnerable family member, or being socially disconnected and not able to rekindle, form, and maintain friendships so they have a sense of belonging.

What you can do about covid impact on children aged 6-12:

You may suspect your child’s self-esteem has suffered under the covid impact on children aged 6-12. If they have had difficulty sitting still and focusing on virtual school, they are at-risk for concluding they are bad, or lacking ability to succeed in school. Here are some tools and strategies for building healthy self-esteem for your child:

ADHD child’s self-esteem This article reviews ways to build self-esteem and is relevant for children not diagnosed with ADHD as well.

The above document explores self-esteem, where it comes from, signs of low self-esteem, strategies for building up.

Self-talk, self-esteem, self-control course In-depth video course indexed and broken into short lessons with supporting documents and templates to use in teaching children and adults skills to succeed.

Empower with measures they can manage and implement to reduce risks such as social distancing, handwashing, and wearing masks.

Spend time with them playing games, exercising, exploring outdoors, creating arts or crafts, and reading.

Talk with them about how they are feeling often, and be frank about your own fears and concerns, and model what you are doing to manage your own stress, such as talking back to your fears with positive thoughts and focusing on what you are grateful for. Have them draw or paint how they are feeling as younger children often lack awareness and skills to verbally express new feelings.

Consult with a knowledgeable counselor.

Closely monitor use of internet connected devices and create a family media agreement.

Family media agreement template.

Create socialization opportunities and help them stay socially connected in whatever ways you think are safe.

Create and follow structured routines for daily activity.

Remember that children aged 6-12 when faced with a crisis are comforted by a nuts and bolts mechanical explanation of how things work and what will happen. At the younger range of 6-8, children’s normally developing primary need is for adult approval. Lots of it! Good job, you figured it out, you can decide, daily gestures of approval and affirmation.

At the higher end of this age range, getting closer to 12, children need to begin processing a crisis with age-peers. Having said that, it is a good idea to monitor these conversations from a distance, as at this age some children may advance exaggerated or misinformed ideas that are better corrected.

Teach emotional coping skills. Learn positive discipline and behavior management techniques.

Anxiety and Children video course complete with forms, templates, and demonstrations of how to use to teach kids how to manage their worries.

There can be signs that a child’s sense of security and safety has been impacted.

Changes in eating or sleeping habits.

Used to sleep alone and now refuses.

Becoming increasingly clingy and fearful of separation from one or both parents.

Bad dreams.

Excessive worry.

Poor school performance or school refusal.

Headaches or stomachaches.

Withdrawal, loss of interest in fun activities.

Increased irritability, aggression, non-compliance, tantrums, or crying.

Regression- starts acting a younger age.

Difficulty concentrating or remembering.

If you see changes in the behavior of your younger child that concern you, don’t hesitate to reach out for help. Consider a session or few with a counselor experienced with children of the same age. This can be conducted virtually for advice in how to assist them in processing and recovery. Remember that parents can model good self-care and self-reassurance.

Breaks in continuity of care can result in missed opportunities for well-checks to pick up on delays in developmental milestones and provision of therapy services such as speech, occupational therapy, and physical therapy. To make up for gaps in childcare due to closures, parents not able to remain engaged with children at home can reach out to others for support. A co-op with neighbor(s), extended family, or small at-home daycare or respite are examples. This can be especially important for parents of children with special needs. To support discontinued therapies when children continue to have needs, consider a phone chat or virtual session with the therapist to get instruction in therapeutic activities implemented at home that foster language, motor, social, and emotional development.

Missed life events– weddings, reunions, births, holiday extended family gatherings impact this age group too. They may be missing group gatherings to celebrate life events such as birthdays or create opportunities to grieve. Remember that for children a few weeks away from someone they saw more regularly can seem like a very long time and be experienced as a loss. Consider implementing regularly scheduled Facetime, Zoom, or Skype meetings with participants in your child’s life who become unavailable for in-person visits.

What about covid impact on children with pre-existing mental health and learning disorders?

Children with pre–existing mental and physical disability are at utmost risk:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330593/

https://www.cdc.gov/mentalhealth/stress-coping/help-children-cope/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fdaily-life-coping%2Ffor-parents.html

School closure impact on children’s’ mental health

https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30109-7/fulltext

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2783714

https://www.thelancet.com/pdfs/journals/lanchi/PIIS2352-4642(20)30109-7.pdf

https://www.medrxiv.org/content/10.1101/2021.02.10.21251526v1

I hope you found helpful ideas in this article about covid impact on children aged 6-12. Please feel free to share.

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This article explores the covid impact on young children, mainly their social and emotional development, aged birth through five. It will be followed by articles exploring the same topic for children in older age groups, with ideas about how to support healthy coping and development. Additional resources and ideas at the end of article.

To summarize from the CDC’s website:

https://www.cdc.gov/mentalhealth/stress-coping/parental-resources/index.html

• Changes in their routines (e.g., having to physically distance from family, friends, worship community)
• Breaks in continuity of learning (e.g., virtual learning environments, technology access and connectivity issues)
• Breaks in continuity of health care (e.g., missed well-child and immunization visits, limited access to mental, speech, and occupational health services)
• Missed significant life events (e.g., grief of missing celebrations, vacation plans, and/or milestone life events)
• Lost security and safety (e.g., housing and food insecurity, increased exposure to violence and online harms, threat of physical illness and uncertainty for the future)

Early Childhood (Birth-5)

Disruptions in Routines

Predictable routines, structure, and physical comfort are what provide a sense of security for children in this age range. Parents also need time to cope with their own stress. (Caregiver Stress Inventory Link)

One way to address both issues is to establish routines with trusted caregivers to provide social outlets for young children and a break for parents. Structure refers to both consistent routines and consistent rules and discipline practices that are followed through, even and especially when young children test the boundaries.

It is a good idea to create a visual schedule for children (activity schedule link) that can also represent in advance any changes in routine, and a written and visual list of expected behaviors, rewards, and consequences to keep all caregivers consistent. (The How can a caregiver care for themselves document has some community agency resources listed to help parents link to assistance.) Another great way to build in structure is to create “I love you rituals.” These are daily routines that signal transitions. When Dad goes to work, when Mom is done with work, even if from home, and is now more available to play and interact, before bed, when a child returns from outside of home care. You probably have some already.

Keep them going and regular. These routines build connection and provide warmth and security. They can also offset changes that disrupt the life the children were used to. It might be a tickling game, a verbal back and forth pattern such as “I love you more,” answered by “No I love you more” repeated back and forth. When my kids were toddlers, I noticed when we arrived home from daycare, with no routine in place, they sometimes were excited, disorganized, and might go to a “No” behavior such as dumping the entire container of fish food in the fish tank. Ugh, what a mess. I bought a big package of cheap popsicles, let them pick a color and we sat outside on the front porch to eat them. Then they could use their ride on toys in the driveway, or we’d take turns blowing bubbles for the others to chase and pop. No more cleaning up the fish tank, happy Dad and kids.

I Love You Rituals is also a book written by Becky Bailey, for more ideas. They are connecting routines involving eye-contact, physical touch and pressure, mutual presence and playfulness. They are integral to Conscious Discipline, and can be as simple as something like Paddy Cakes. Anybody remember that? “Paddy cakes, paddy cakes, bakers man…” It involves eye contact, synchronized hand movements and contact, and the use of language to coordinate the interaction. Exactly what young children need to develop motor, emotional, language, and social skills. Especially when they have delays, or something like Autism, or are missing face to face social play interactions.

Missed life events– weddings, reunions, births, holiday extended family gatherings impact this age group too. They may be missing group gatherings to celebrate life events such as birthdays or create opportunities to grieve. Remember that for young children a few weeks away from someone they saw more regularly can seem like a very long time and be experienced as a loss. Consider implementing regularly scheduled Facetime, Zoom, or Skype meetings with participants in your child’s life who become unavailable for in-person visits.

In the event of loss, it can be good to speak about it openly and honestly vs. staying silent to avoid strong feelings. Another strategy to assist a young child who may lack the verbal expression and concepts to understand and communicate about a loss is to read children’s books to them on the topic. You can often find numerous inexpensive mildly used books online for any of these topics, such as death or divorce. These books can be placed in your child’s library if you have a collection of books for reading before bed. This way they can be available to be chosen by you or your children when desired, and repeated later in their development.

Losses like death and divorce take time and maturation to process and understand. As your child develops, the feelings and ability to understand can change as they age. When the book is repeated months or even years later, they may have new questions, feelings, and insights that help them integrate with and adapt to the experience. A few notes of advice here; I suggest ordering multiple books on a topic. Read them in advance to eliminate any books or pages of books that express ideas you consider inappropriate in view of your child’s maturational level and your personal values. I have been surprised and alarmed by what gets printed in books for children’s sometimes. Lastly, if it is a topic your child is resistant, defensive, or rejecting of, seek books that place the issue not only in third person (about somebody else) but also in the context of a family that is not human- Dinosaurs’ Divorce, or a story about a family of bears or monkeys, for example.

Breaks in continuity of care can result in missed opportunities for well-checks to pick up on delays in developmental milestones and provision of therapy services such as speech, occupational therapy, and physical therapy. To make up for gaps in childcare due to closures, parents not able to remain engaged with children at home can reach out to others for support. A co-op with neighbor(s), extended family, or small at-home daycare or respite are examples. This can be especially important for parents of children with special needs. To support discontinued therapies when children continue to have needs, consider a phone chat or virtual session with the therapist to get instruction in therapeutic activities implemented at home that foster language, motor, social, and emotional development.

Here are some (Games) children love to play. They can be played with another adult or with a sibling or neighbor’s child. Once the children have learned the template for the game, they can learn to play with less coaching so they develop better ability to use leisure time independently so parents can do necessary house and vocational work. Nearly all children enjoy these games, I selected them based on my practice of developing social, play, and communication skills for children with social delays such as with Autism Spectrum Disorders. I’ve found most children, including reluctant or rigid children, will engage with and enjoy these games. I included the vital social play skills each game helps to develop.

Lost Security and Safety

Threats or loss to security and safety covid impact on young children. Children can grieve over the loss of loved ones, either by death, or travel and visitation restrictions due to health concerns. Loss of income or access to food, transportation, and housing can impact children too. Even if they don’t overhear adult conversations, they are in tune with and will mirror parent stress levels. Young children may be prone to worrying that since for example they can no longer visit grandparents that a parent may not come home one day. Because young children are egocentric, they also tend to think that everything is about them. At some level they may conclude such losses even if temporary are because they didn’t behave well enough, that they did something wrong to cause the separation.

Many parents have lost their jobs or had to work from home due to loss of daycare or in-person school. This loss of income and change in routine creates stress for parents. It is hard to imagine their children not being impacted by these changes as well.

Increased parent stress can lead to substance abuse, parent withdrawal, child abuse or neglect, increased conflicts or even family violence which can impact children too. Parents take care of yourselves and don’t put off getting help when you are worried your problems are impacting your parenting and children.

It is important to be open and honest with them about changes. Point out that the change has nothing to do with them or anything they did. Young children who are grieving are assured by hearing they are loved and they will be taken care of on a regular basis. Provide physical comfort. Ask if they have questions, such as if I get sick will I die, if you get sick will you die. Give simple and honest answers. “Most children who get sick get better. Usually covid is like having a cold or flu. You will have to rest and drink plenty of fluids. We will take care of you and you will be okay.” Let them know there are things they can control and do to promote community safety such as masking, handwashing, and social distancing.

Masking, social distancing, avoiding public gatherings, and media about death, illness, and contagion all have the potential to threaten the fragile sense of security many younger children have. Parents again can remind children they are loved and will be cared for and kept safe. Avoid excessive exposure to media about disasters and threats. If they have access to a device such as an ipad or television, make sure they will not be exposed to information without a parent present to supervise, limit, and moderate. Be wary of the programming you as a parent may be consuming while your child is present and overhear. Be mindful of newsbreaks that may pop up and turn it off!

I remember when a shooting occurred in a Sandy Hook Kindergarten class. It was all over the news, sprinkled in newsbreaks between regular network programming. I saw it playing on the television in my children’s daycare. A five or six year old child should not be exposed to the fear that a stranger will burst into their classroom at any moment and start shooting. The same goes for news of death and illness. Parents can explain measures being taken to reduce risks emphasizing safety and security, public and social media will not exercise good judgment in how to present information without creating excessive fears.

There can be signs that covid impact on young children threatens their sense of security and safety.

Changes in eating or sleeping habits.

Used to sleep alone and now refuses.

Becoming increasingly clingy and fearful of separation from one or both parents.

Bad dreams.

Excessive worry.

Poor school performance or school refusal.

Headaches or stomachaches.

Increased irritability, aggression, non-compliance, tantrums, withdrawal, or crying.

Regression- talks like a baby or acts like a familiar animal, becomes unpotty-trained.

Difficulty concentrating or remembering.

If you see changes in the behavior of your younger child that concern you, don’t hesitate to reach out for help. Consider a session or few with a counselor experienced with children of the same age. This can be conducted virtually for advice in how to assist them in processing and recovery. Remember that parents can model good self-care and self-reassurance.

Below are related articles and courses to help manage covid impact on younger children:

How to Talk to Kids in Crisis- Developmentally Appropriate Ways of Reassuring Kids by Age Groups

Help Kids in Times of Crisis

Considering Online Therapy

Stay Calm, Yell Less: Increase Compliance

Pandemic Parenting Stress

Behavior Management

Module #4 – Behavior Management

Module #10 – Anxiety and Children strategies to teach coping skills

What about covid impact on children with pre-existing mental health and learning disorders?

Children with pre–existing mental and physical disability are at utmost risk

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330593/

https://www.cdc.gov/mentalhealth/stress-coping/help-children-cope/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fdaily-life-coping%2Ffor-parents.html

I hope you enjoyed this article Covid Impact on Young Children. I hope it will help and feel free to share.

The post Covid Impact on Young Children appeared first on Intensive Care for You.

In this article about Digital Diet for Children and Teens you will find:

-A discussion exploring the impact of common themes in digital media on our social and emotional development.

-Proposed methods for healthy technology management

-A template for a family media agreement establishing safe boundaries and consequences should they not be followed

-Pros and cons of digital media

-Resources for parents to use for managing children’s technology use

-Resources and discussion of video game addiction issues

-A list of non-violent, cooperative, and educational video games and shows/movies

-Tools for keeping kids safe online

Many of us think about how much time we or our children spend consuming digital media, are we as vigilant in considering a balanced diet when it comes to digital content? Maybe we set time limits, like no more than two hours of video games on weekdays, but what sort of ideas are we pumping into our minds?

For example, how much of what we watch and participate in contains acts of violence as a method to resolve conflicts? Consider popular superhero stories. You don’t see Batman saying, “Okay, I’m getting really mad at you villains’ criminal abusive acts. I don’t want to get violent, so I’m going back to my batcave to play with my tech toys until I calm down. Then we can sit down and work this out by talking like civilized people.”

Vengeance. You did that to me, now I will do this to you. Is this justice, or is this idea of justice what wars are based on? A sense of justice that says, it’s not right to hurt people, so since you did this to us, we are going to hurt you back with this… attack?

If the good guy wins, using the same methods against the villain that justified the attack response, does the idea of a good guy and bad guy just depend on which side you are on, while objectively both parties are using the same methods which they would say are wrong?

How many of our popular shows or video games model legal and ethical ways to treat other people and negotiate conflicts? Or do they demonstrate what we say we think is wrong and would land us in jail? Anger, fear, beatings, and murder, these are the same with or without “justification,” would we want to teach to justify these conditions, really?

If we are bothered by anxiety or depression, is watching apocolyptic…world-ending threats, barely-won battles fought at the extreme of endurance and vigilance… what is contained in the digital diet for children and teens that is forming their attitudes, beliefs, thoughts, and identity?

What if we continually expose ourselves to human scenarios relying on big conflicts for drama, tension, and interest? Would real life seem boring, could we be training our brains to anticipate tense frightening and even threatening human interaction scenarios? Would we be fostering social anxiety and teaching the world is a scary place, you have to be really careful or you might not be okay, people are not to be trusted and out to get you?

Unless you are trying to program soldiers who will be living in the world we say we want to be peaceful, fair, devoid of abuse and violence.

If we are feeling unimportant, unremarkable, unmotivated, unliked, is exposing ourselves to worlds of magic and super powers and mega-weapons going to help us appreciate our regular mortal selves? Can all children slip easily between a fantasy super-avatar in a fantasy world back to a regular self with normal human powers and limits? Or as the discrepancy between the fantasy self and real self widens, the video game avatar and indulgence supersedes homework and chore routines, grades drop, real social contact formation and maintenance is neglected, parents and teachers beseech and criticize, would some children become disappointed with their real self, avoiding criticism and disappointing reality by further burying themselves in their made-up world facilitated by the virtual reality of video games and virtual friends?

Below are templates I made for you to address and get specific about how technology and media will and will not be used at your house:

The following document summarizes some pros and cons of digital media based on research with a list of resources for further investigation:

If you are interested in exploring more information and studies about how digital media impacts attention, memory, thought, meta-awareness, and attitude, try googling “Six ways digital media impacts the brain.”

Below is a fairly comprehensive guide for caregivers to use with kids, teens, and college students, or for them to use for themselves, to regain engagement and motivation for self-care, academic involvement, and socialization:

Below is a link to an article I wrote for those considering if there may be an issue with video game addiction:

Video Game Addiction

I encounter many youth who are unable to resist the temptation to click into the rabbit hole of YouTube links or video games when they should be doing schoolwork or sleeping. I read a great biography about Steve Jobs, called Steve Jobs. In it he was quote as saying, while developing the ipad, with kids in middle school, that he would never give these devices to his kids to use unsupervised, because there was no way they could resist these temptations. He knew.

Here are a few non-violent, cooperative, and educational video games and shows/movies to help balance a digital diet for children and teens:

• Tools Up video game
• Moving Out video game
• Out of Space video game
• Twin Sprouts video game
• Pode video game
• Space Food Truck video game
• Juggle Panic video game
• Bleep Boop video game
• Shift Happens video game
• Superflight video game
• Cities: Skylines video game
• Abzu video game
• Floating Point video game
• Pix the Cat video game
• Captain Toad, Treasure Tracker video game
• If you google this topic, you can find many more!
• Below are just a few shows and movies with non-violent conflict resolution:
• Planes, Trains, and Automobiles
• Life is Sweet
• All or Nothing
• Secrets and Lies
• The Family Stone
• The Big Chill
• Gilmore Girls
• Aphablocks
• Cochameleon
• Ask the Storybots
• Blues Clues
• Dora
• Arthur
• Danger Mouse
• Again, there ARE many good options out there you can use to try to balance against often more popular programming where even the “good guys” are using violent means to resolve conflicts, and don’t have weapons and death as their schtick to attract and entertain.

Tools for Keeping Kids Safe Online

• Bark- can go on a phone and notifies you if certain risky keywords are detected in searches or texts, etc, such as sex or self-harm references
• Qustodio
• Kaspersky
• Net Nanny
• Ourpact
• Mobicip
• OpenDNS VIP home
• Websafety
• Cleanrouter
• Circle

I know kids are smart and can often circumvent any software you install for safety. In addition some school districts are handing out chromebooks or other devices, they are using YouTube as part of their instruction, and they won’t allow you to install your own filters. You can use a router-level filter at least at home. You can also put a cheap lamp timer on your router and set it to turn off at 10pm or whenever and come back on at a designated time in the morning. This means you can’t stay up and use it either.

Remember, garbage in, garbage out. We’ve all heard “You are what you eat.” To what extent do you imagine “You become what you see and hear.”

https://www.healthychildren.org/English/family-life/Media/Pages/How-to-Make-a-Family-Media-Use-Plan.aspx

https://www.psychologytoday.com/us/blog/when-kids-call-the-shots/201804/the-best-technology-screen-time-contract-kids

I hope you enjoyed this article, Digital Diet for Children and Teens, and that you might use the information to improve the welfare of yourself and your family.

Brad Mason

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