Shy bladder or fear of the splash? Toilet training isn’t always a quick dash.

7 Top Toileting Tips for kids with Autism

Toilet training is a milestone majority of children complete from the ages of 18 months to 3 and 1/2 years. Children indicate readiness through taking an interest in the process, imitating others and holding on to get to the toilet. However these signs of willingness aren’t always apparent in children with autism spectrum disorder, with some children taking longer to learn these skills. 

There are other factors that may make it tricky for your little one with ASD to master toilet training, these include: 

  • Ability to recognise internal signs of needing to go to the toilet 
  • Trying something unfamiliar or new, out of their routine 
  • Sensory sensitivities around nappies, underpants, the toilet and bathroom, the feeling of going to the toilet
  • Anxiety about transitioning to the bathroom, toilet and different bathrooms or toilets
  • Issues around toileting such as constipation

Top Tips:

  1. Make sure it is the right time and season for both you and your toddler. Ensure you both are well and have addressed any medical issues e.g., constipation, and are committed.
  2. Prepare yourself! Buy/organise all the right equipment you need e.g., step stool, lots of underwear and replacement clothes, rewards, timers, toys, etc.
  3. Making visuals or prompts to help you and your child understand the process and sequence (or using videos, social stories or physical prompts).
  4. Support sensory sensitivities e.g., colour of walls, calming activity beforehand, toilet seat texture.
  5. Use a highly motivating reward immediately after a desired behaviour in the toileting sequence is completed (changing if need be and phasing out once achievement is met).
  6. Make toileting part of a routine – use toilet timing (set times when they are most likely to go, e.g., when they get up, before or after a meal).
  7. Accidents are expected and toddlers can help with changing and cleaning up, then start the process again!

Resources:

Raising Children website:

https://raisingchildren.net.au/autism/health-wellbeing/toileting-hygiene/toilet-training-autism

AMAZE website:

https://www.amaze.org.au/wp-content/uploads/2019/08/Amaze-Information-Sheet-Toilet-training-for-autistic-children.pdf

By Kim McGregor – Senior Psychologist

Kim McGregor is a registered Psychologist with a Master’s degree in Educational & Developmental Psychology. She has worked extensively with infants, children and their families in not for profit, early childhood, specialised school and government multidisciplinary settings providing assessment, diagnosis and treatment for their developmental, cognitive, social, emotional and learning needs.

Her goal is to always work from a person centred and family focused partnership with parents providing clear communication, empathy and support throughout the journey of understanding and helping their child.

Death and dying… How to talk about the loss of a loved one with your child.

By Olivia Smith – Psychologist

As much as we might hope that our child will be spared from having to deal with the death of someone they know, sadly this is not always the case. Adults can allow their own discomfort in discussing such a difficult topic create confusion and possibly even fear for children. Ideally, we should try and help children to understand death before they encounter it.

So, what is the best way to approach these discussions? 

  • Be clear and to the point, e.g., “I’m sorry to tell you that Grandma has died”. Avoid euphemisms such as ‘we lost her’, ‘she’s gone to sleep’, ‘she passed away’ or ‘she has gone to heaven’, as this can lead to misunderstandings. 
  • Try to be as honest as possible – avoid trying to ‘protect’ children, they are astute at picking up when something is wrong but may be confused by lack of information.
  • Assure them it was nobody’s fault, as children can sometimes blame themselves. 
  • Depending on the age of the child, you might need to explain what being dead means, e.g., that person’s heart stopped beating, they stopped breathing and their brain shut down; they can no longer move, talk, or think. Sometimes a good way to discuss this can be if you happen upon a dead insect at home. 
  • Do not be alarmed if younger children start acting out scenarios about death in their play- this is very normal and a way of processing what has happened. 
  • Be open to talking about the fact no-one lives for forever, and most people die when they are old. Explain that a smaller number of people may die before they’re old, and this can seem unfair. It may be due to illness or an accident.
  • Children are often curious about what happens after we die. How you respond to this depends on your own cultural and spiritual beliefs. You might also discuss that others may have different beliefs, and that is okay. 
  • Normalise any emotional response your child might have – even if they do not seem to have one at all. 
  • Don’t feel like you must hide your own sadness from your child; instead explain you are sad because you loved the person a lot. 
  • Try to answer any questions they might have or discuss them later if needed. 
  • Give your child a choice about attending the funeral. Take the time to explain to them what to expect, including whether the individual is being buried or cremated, what others may do, and what the body will look like (in the case of an open casket). You might organise another adult to be with them during the ceremony and have materials on hand for them to take a break if needed.  
  • Talk about ways your child might like to remember the person, e.g., creating a special place in the garden, making a box of memories, writing a letter to them, or sharing memories. 

Olivia is an Educational and Developmental Psychologist who has worked in a range of settings, including schools, universities, the not-for-profit sector and private practice. She has substantial experience working with children, adolescents and their families, including completion of neurodevelopmental and learning assessments.

Olivia strives to build warm and collaborative relationships with children, adolescents, parents and other professionals involved in a child’s life.

So your child is moving on to High school…Managing the transition

Before you know it your primary school aged child will be thinking and talking about going to secondary school.

Transitioning from primary to secondary school is a major life event for your child and your family. It is also an exciting time, full of prospects; growing up, becoming a teenager, facing new challenges, and changing friendships.

However, some children may view this new adventure with reservation and anxiety around changes to curriculum subjects, old and new friendship groups and expectations from teaching staff and others. 

The following suggestions aim to assist with a supportive and smooth transition:

  1. Discuss and involve your child in all aspects of looking at and picking the school to transition to including:
    • the type of school (public, religious, private or home schooling)
    • size of the school 
    • curriculum and other subjects/activities offered 
    • school proximity to home and travel time
    • school culture and expectations
    • friends attending or others known to the family 
    • student support and well being
  2. Encourage open discussions with your child about their thoughts and feelings in regards to the transition and monitor any behaviour changes.
  3. Visit and practise going to the school (e.g. build familiarity with school routes and surrounding areas).
  4. Increase your child’s independence skills (e.g. dressing and personal care, looking after belongings, understanding timetables and review the layout of the school for easy transition between classes). 
  5. Integrate and consolidate home routines with school routines (e.g. morning, afternoon and night time routines).
  6. Connect with other families attending the school.
  7. Understand where to go and who to go for for support or help in the school.
  8. Provide your child with resources (e.g. books, websites or other information about growing up and transitioning to secondary school).

The Victorian Government has provided the following website to assist families with the transition to secondary school:

https://www.vic.gov.au/moving-primary-secondary-school-information-parents-and-carers

Written by Senior Psychologist Kim McGregor

Kim McGregor is a registered Psychologist with a Master’s degree in Educational & Developmental Psychology. She has worked extensively with infants, children and their families in not for profit, early childhood, specialised school and government multidisciplinary settings providing assessment, diagnosis and treatment for their developmental, cognitive, social, emotional and learning needs.

Her goal is to always work from a person centred and family focused partnership with parents providing clear communication, empathy and support throughout the journey of understanding and helping their child.

Sibling rivalry… Already?

How to prepare your child for the arrival a new sibling

Written by Judy McKay

For many children the birth of a sibling can be met with mixed emotions and is a time marked by many changes. Preparing your child at a developmentally appropriate level can help to alleviate feelings of anxiety and assist in helping your child adapt to some of the new changes.

Suggested children’s books you can read together:

  • The Most Terrible of All – Moun Thi Van  (Explores sibling rivalry through the concept of monsters).
  • Mia Moves Out – Miranda Paul (Explores the concept of having to share with a new sibling). 
  • Hello in There – Jo Witek (A story of a sister who can’t wait to meet their new sibling).

Activities to do as a family:

  • Mark in the calendar important pregnancy milestones
  • Look at baby photos as a family
  • Work on an art project for the new baby’s room or a gift for their arrival
  • Involve your children in creating a list of possible baby names
  • Go shopping as a family for baby toys or clothes – have your children pick out something special for the baby.

Raising Children Network Articles: 

New baby: helping toddlers & preschoolers | Raising Children Network

New baby: helping children & teens adjust | Raising Children Network

Take Home Message

  1. Adjusting to the new dynamic may take time. Where possible, maintain a sense of routine and predictability during the transition period.
  2. It’s important to validate their feelings in response to their sibling.
  3. Prepare your child for you needing to focus on the new baby initially but reassure you are still there for them. 
  4. Involve your child in the process and decision making where possible and appropriate. 

Judy is a registered psychologist with a Master’s degree in Educational and Developmental Psychology. She has experience working with young people, their families and extended support networks across educational, clinical and community-based settings. Judy enjoys working creatively and flexibly with children and adolescents to explore their difficult emotions and experiences.

R U OK? No Qualifications Needed…

Each year, R U OK Day rolls around so quickly – surprising us here at NCCD! It typically results in a last minute scramble to make sure we are involved in sharing the important message of the initiative. This year, we want to provide you with the tools you need to feel confident checking in with someone who might just be doing it tough at the moment.

While R U OK Day becomes more prominent in the community each year, you might want to know more about its origins and what the initiative is all about. You can learn more here in this short video.

This year the message is about just opening up the conversation with someone who you think might be struggling, and remembering the “no qualifications needed” theme – you don’t need to be a mental health expert; you don’t to provide need answers – the important step is to simply ask the question before listening, encouraging action and finally checking in:

You can start up a conversation by asking “are you okay?” of course, but some other conversation starters could be:

  • “how are you going?”
  • “how have you been?
  • “I’ve noticed something might be going on with you?”
two women sitting on a couch chatting
Photo by Cliff Booth on Pexels.com

Once you’ve asked, let the person talk to you while you patiently allow them the space.

Encourage the person to take action like calling a helpline, seeing a psychologist or connecting with their GP.

Lastly, check in with the person once they’ve had time to process and take some action.

There’s more info here on the RU OK website. We encourage you to ask the question – it can save a life.

If this topic has raised feelings which are distressing for you, please contact Lifeline on 13 11 14.

Amanda Abel Founding Director

Be aware, What’s your child hiding there?

Recognising Eating Disorders

In my recent post to acknowledge Body Image and Eating Disorders Awareness Week, I introduced you to the concepts of body image and eating disorders, as well as what proactive steps you can take as parents to help prevent the development of an eating disorder in your child. 

Unfortunately, despite our best efforts, eating disorders can and do occur. By nature, eating disorders are secretive and can be difficult to pick up on until your child is incredibly unwell. 

Signs to be on the lookout for:

  • Your child is engaging in dieting and/or sudden exclusion of food groups (including suddenly becoming vegetarian or vegan or developing a self-diagnosed ‘intolerance’). 
  • Finding evidence of bingeing (e.g., food disappearing from the fridge or pantry, empty wrappers in the bin/bedroom, etc.) 
  • Frequent bathroom visits during and after meals. 
  • Engaging in excessive or compulsive exercise (e.g., pushing themselves to exercise when sick or injured; feeling an obligation to exercise with little pleasure obtained). 
  • Avoiding social situations (especially related to eating, such as meals out or dinner with the family). 
  • Sudden interest in food preparation and planning (e.g., cooking, looking at recipes etc., although they may not consume the food themselves). 
  • Changes in how they dress (typically baggy/loose fitting clothing, even in warm weather). 
  • Denying they are hungry or eating very slowly. 
  • A distorted body image. 
  • Appearing highly anxious, moody, or irritable. 
  • Rapid weight change.
  • Fatigue, including difficulties with concentration. 
  • Dizziness or fainting. 
  • Cold sensitivity. 
  • Changes to their menstrual cycle (including periods stopping completely). 

While it can be incredibly confronting, it is essential as a parent that you act as soon as possible. Your child’s brain and body may be experiencing starvation, meaning they are not able to make good choices for themselves.

What to do if you are concerned

  • Complete the ‘Feed Your Instinct’ questionnaire. This is a great Australian resource which produces a report you can give to your GP, as well as giving you specific strategies to support your child. 
  • Visit your GP for a double appointment (ideally one experienced in working with young people). They should be checking your child’s pulse, blood pressure and running blood tests at a minimum (not just measuring their weight). They will identify your child’s medical risk and whether they are eligible for support under a Medicare Eating Disorder Management Plan or a Mental Health Care Plan. 
  • Eating Disorders Victoria and The Butterfly Foundation both run helplines to discuss your concerns and help you identify appropriate support options. 
  • Encourage your child to speak to their school counsellor/psychologist, or another mental health professional with training in eating disorders. This may include a professional who is ‘credentialed’ in eating disorders. See https://connected.anzaed.org.au/ for more information. 

Olivia is an Educational and Developmental Psychologist who has worked in a range of settings, including schools, universities, the not-for-profit sector and private practice. She has substantial experience working with children, adolescents and their families, including completion of neurodevelopmental and learning assessments. Olivia has a special interest in eating disorders and is passionate about ensuring young people with this presentation receive appropriate and effective supports. Olivia strives to build warm and collaborative relationships with children, adolescents, parents and other professionals involved in a child’s life.

How I look and what I eat: Body image and Eating disorders

The 5th-11th of September is Body Image and Eating Disorders Awareness Week. These two topics are often misunderstood, so what better time to discuss exactly what they are? 

Body Image

Body image refers to the attitudes, beliefs, and perceptions we have of our own body. Whilst often a heightened concern during adolescence, we also carry it into adulthood. Research shows accepting and respecting our bodies (without always loving them!) is associated with higher self-esteem, self-acceptance, and an overall healthier outlook. In contrast, negative body image is associated with a higher risk of mental health issues and the pursuit of extreme methods to change one’s body. 

Eating Disorders

Eating disorders are changes in behaviour, thoughts, and attitudes towards food, eating, weight or body shape that have a detrimental impact on an individual. They affect approximately 9% of the population. Contrary to popular opinion, less than 6% of those with an eating disorder are underweight. Regardless of whether an individual is underweight or not, there can be serious, life-threatening effects; including damage to major organs, changes to the brain, reduced bone density and hormone irregularities/infertility. 

Unfortunately, in our image conscious society, we often normalise or downplay unhelpful beliefs and attitudes. An eating disorder is not a ‘lifestyle choice’ nor a ‘cry for attention’. Most importantly, dieting is not a normal part of life. Causes are complex (a combination of genetics, personality traits, life events/experiences and previous engagement in dieting behaviour). But it is important to know eating disorders are not the fault of parents or the young person. They are however something to be taken seriously, ensuring those affected receive appropriate support as soon as possible. 

What can I do?

Here are some suggestions for how families can support their children in this space: 

  • Encourage your child to view their body as a vessel that allows them to do things they enjoy. 
  • Expose your child to a range of body shapes. 
  • Encourage your child to follow their body cues, and to eat when they are hungry. 
  • Don’t put value judgements on foods; foods are not ‘good’, ‘bad’ or ‘junk’. Similarly, emphasise that what we eat does not reflect on us as a person. 
  • Eat family meals together as much as possible. 
  • Refrain from engaging in any talk regarding weight or dieting in front of your child. 
  • Support your child to be media literate- images on social media are often digitally altered and do not reflect reality. 
  • Foster positive self-esteem and encourage them to engage in activities they enjoy and feel accomplished in. 

If you would like to know more, please contact Eating Disorders Victoria (https://www.eatingdisorders.org.au/) or the Butterfly Foundation (https://butterfly.org.au/). 

Olivia is an Educational and Developmental Psychologist who has worked in a range of settings, including schools, universities, the not-for-profit sector and private practice. She has substantial experience working with children, adolescents and their families, including completion of neurodevelopmental and learning assessments. Olivia has a special interest in eating disorders and is passionate about ensuring young people with this presentation receive appropriate and effective supports. Olivia strives to build warm and collaborative relationships with children, adolescents, parents and other professionals involved in a child’s life.

Feeling the Feels – let’s start the conversation

By Associate Psychologist Laura Moresi

Across the last few decades, research has shown the importance of understanding and responding to emotions in healthy ways. Emotional intelligence is actually thought to be the best indicator of a child’s success. 

Children aren’t born with the skills to respond to and cope with their emotions, they learn through the adults around them. Even as adults we struggle with the very skills we hope to teach. So where to start?

Tips

Here are a few ideas for how to include emotions talk in your everyday life. This will support children in becoming emotionally attuned and resilient in the process. 

  • Use your child’s favourite characters from books, computer games, tv shows etc. to initiate and talk about emotions. For example, ‘Emma is frowning, it looks like she is feeling angry. When have you felt angry?’
  • Make a game of pulling different emotions faces and have your child imitate and guess the emotion. This can support social and emotional development as some children struggle with knowing what emotions look like on their own face, or on the face of others.
  • Read books that focus on different emotions with your child. Some great ones we use are; The Feelings Series by Tracey Moroney, The Colour Monster by Anna Llenas, The Red Beast by Kay Al-Ghani or The Huge Bag of Worries by Virginia Ironside.
  • Support your child to explore emotions through play. Adding an emotion focus to everyday games, e.g. drawing emotion faces or doing dances for different emotions. Also you might add emotional elements to imaginative play, e.g. caring for a baby doll as it experiences different feelings, wondering about or labelling a toy’s thoughts and feelings; “all the animals went inside without the pig, he is sad because he got left behind”. 
  • Model healthy expression of emotions to your child by labelling your own emotions or offering your own examples in an age-appropriate way, e.g. “I had to speak at a meeting today. I was so nervous I had butterflies in my stomach. Do you ever get butterflies when you’re feeling nervous?”
  • Help your child to label their own emotions and the feelings in their body, e.g. For ‘I can see you squeezing your fists, you look like you are feeling frustrated?’

The first step to learning how to respond effectively to emotions is being able to accurately identify your own emotions. Helping families to make emotion talk a regular part of their routine is an important part of supporting children’s emotional development to flourish. 

Laura Moresi has recently completed the Educational and Developmental registrar program. She is passionate about working collaboratively with families and other professionals to support children and adolescents to reach their best potential. Laura has experience working with a variety of development and mental health concerns.
Laura recognises the importance of strengthening the support systems around a young person and is passionate about working collaboratively with families, schools and other professionals to better understand and support clients throughout the therapeutic process.

Keeping it Separate…Managing separation for your children

By Associate Psychologist Olivia Smith

While it is far more common nowadays, parents still worry about the impact of their relationship breakdown on their children. As a result, some parents stay in relationships longer than they otherwise would. However, children are far more perceptive than we give them credit for. A separation which results in less conflict and a more harmonious home positively affects everyone.

That said, there are many steps parents can take to minimise the adverse effects of separation on their children. It is important to expect and normalise a range of emotional reactions, including; grief, anger, guilt, worry and feelings of rejection. Possibly, your children may even revert to an earlier developmental stage, with behaviours such as bedwetting, thumb sucking or emotional outbursts. This is completely normal and usually transitory in nature. 

Aim to:

  • Create a ‘business-like’ relationship with your ex-partner. Try to communicate and collaborate about parenting in a respectful and calm manner. 
  • Introduce change gradually. Initially, try to keep other parts of children’s lives the same, (e.g., contact with grandparents, school they attend and house they live in). This also includes introducing a new partner. 
  • Be open to answering your children’s questions, including being honest about what you do and do not know yet. 
  • Support your children’s ongoing relationship with their other parent. 
  • Make others in their life aware (e.g., teachers). 
  • Maintain consistency and stability across households. 
  • Reassure your children that the separation is not their fault and does not mean either parent loves them any less. 
  • Take steps to manage your own stress
  • Both be involved in caregiving (and live close to one another where possible).

Avoid:

  • Arguing with your ex-partner in front of your children. 
  • Criticising your ex-partner in front of your children. 
  • Using your children as a ‘messenger’ to your ex-partner. 
  • Using your children as emotional support or a pseudo-partner. It is important your children are protected from adult worries and responsibilities. Seek support amongst friends, family members or a mental health professional. 

Following these guidelines provides your children with the ability to process and accept your separation. It also allows for them to maintain a positive relationship with both parents. If you would like more information please see https://www.familyrelationships.gov.au/parenting.


Busting ADHD myths

By Psychologist Judy McKay

text
“The things that make me different are the things that make me ME” – Winnie the Pooh

If you have a child with ADHD (Attention-Deficit/Hyperactivity Disorder) you might find yourself regularly having to bust ADHD myths and educate others about what ADHD actually is and is not. Below are some commonly held ADHD beliefs and the evidence for why they simply aren’t true!

“Only boys have ADHD”

Research suggests that boys are up to twice as likely than girls to be diagnosed with ADHD. Why? We think that girls with ADHD can sometimes be overlooked or misunderstood because they don’t always seem hyperactive. Instead, these children might show more of the inattentive type symptoms of ADHD (e.g., daydreaming) which are less widely identified and understood. Therefore, ADHD in girls is said to be underdiagnosed.

“ADHD is just an excuse for poor behaviour”

Children with ADHD do not have an attitude problem! They struggle to focus, plan, organise, problem solve, self-regulate and self-monitor because of the way their brain works (in particular their executive functioning part). Just like all children, they are better able to focus when doing something they enjoy or something that is new and exciting or rewarding.

“ADHD is caused by poor parenting”

ADHD is a neurological condition meaning that the child’s brain is simply wired this way. Whilst some studies show that the way a parent manages their child with ADHD can help to increase or decrease child-parent conflict ultimately, ADHD is NOT due to parenting.

“ADHD is a lifelong condition”

Most children with ADHD will continue to experience symptoms into adulthood. However, the impact that their symptoms have on their everyday functioning can reduce significantly as they get older and as they learn ways to cope and manage their ADHD.

Credit: 

https://thrivingwithadhd.com.au/adhd-myths/

https://www.understood.org/articles/en/common-myths-about-adhd

Judy is a registered psychologist with a Master’s degree in Educational and Developmental Psychology. Judy has experience working with young people, their families and extended support networks across educational, clinical and community-based settings. Judy enjoys working creatively and flexibly with children and adolescents to explore their difficult emotions and experiences. In the past, Judy has supported young people experiencing a range of neuro-developmental disorders, anxiety, trauma, social skill and emotional regulation difficulties. Judy values the individual needs of each client and attempts to incorporate their personal interests, strengths and goals throughout therapy. Judy utilises a client-centred approach to her therapy which is grounded in cognitive-behaviour therapy and other evidenced-based techniques.

Judy has a background in providing pastoral care to children and adolescents within educational settings. These experiences have enabled Judy to connect and build relationships with students of all ages, in addition to understanding the challenges typically faced by school-aged children. Judy encourages her clients to take a holistic approach to therapy and values communication with a client’s wider support network. This helps to promote positive client outcomes across all aspects of day to day life. Outside of work, Judy loves spending time at the beach or in the countryside. She further enjoys playing social sports and prioritises spending time with friends and family.