1.Meeting the Needs ofChildren and FamiliesAnxiety DisorderBy: Jocelyn (De Plata) Shah

2. http://www.flickr.com/photos/pinksherbet/3372060864There is a little girl in the center her nameis Faith. She become so anxious whenshe finds stressful situation and shestruggles with self regulation. She isseven years old and according to hermother she has been diagnosed withAnxiety Disorder but she did not specifywhat types of anxiety Faith has. 3. What is Anxiety Disorder?A generalized feeling of apprehension,fear, or tension that maybe associated withparticular object or situation or may befree-floating, not associated with anythingspecific (Wood et al. 2011).Anxiety disorder is a psychiatric conditionthat may require medical or psychologicaltreatment (CMHO).Children express their anxiety bywithdrawing from situations. 4. What can we learn about children with anxiety? http://www.youtube.com/watch?v=loR C9T8qUGk 5. Causes of Anxiety in Children Separation Anxiety Fear of Change and the Unknown Traumatic Events Family and Home-Related Stressors Environment-Related Stressors 6. Signs of Anxiety in Children fearful of puppets or large dolls. displays excessive attention seeking orjealousy with parent or main caregiver easily gets frustrated. experience recurrent headaches and/orstomach aches. short attention span. experiences insomnia. experiences nightmares. displays excessive anger. experiences bedwetting. 7. How Common are AnxietyDisorders?Anxiety disorders are the most commonmental health condition in children andadults. Roughly 6% of children and youthhave an anxiety disorder that is seriousenough to require treatment.How long do they last?Without treatment, some of the anxietydisorders that begin in childhood can last alifetime, although they may come andgo(ementalhealth).http://www.ementalhealth.ca/Toronto/Anxiety-Problems-in-Children-and-Youth-Information-for-Families/index.php?m=article&ID=8872 8. Types of Anxiety DisorderVideo link:http://www.glogster.com/babae/project-glog-by-babae-anxiet-disorder/g-6kruhe125pvmqf10cn0mua0 9. GeneralizedAnxiety Disorder Separation Anxiety (in Panicchildren andDisorder with youth). or withoutAgoraphobia Types of AnxietyDisorderObsessive-Compulsive Phobia DisorderSelective Mutism 10. Generalized Anxiety Disorder Generalized Anxiety Disorder (GAD) isan anxiety disorder. Children andteens with GAD worry excessively anduncontrollably about daily life events(Anxiety BC). Girls are more likely to have GAD thanboys. In fact, 2 out of every 3 childrenwith GAD are girls (Anxiety BC). 11. Strategies for GAD Teach calming techniques such as takingdeep breaths, thinking of a quiet place,counting to ten, and do yoga. Plan plenty of time for play. Inform thechild when there will be transitions. Provide a verbal and visual cue todescribe upcoming activity. For exampleshow pictures and say Five moreminutes, then lunch time.Resource link:http://www.anxietybc.com/sites/default/files/hmgad.pdf 12. Panic DisorderUnpredictable attacks of Dizziness, unsteadiness,acute anxiety that are lightheadedness oraccompanied by highfaintinglevels of physiological De-realization or de-arousal and that last from a personalizationfew seconds to a few hours(Carlson & Heth, 2010). Fear of losing control or going crazySigns and Symptoms: Fear of dying Palpitations, increasedheart rate or pounding Feeling of chokingheart Chest pain or discomfort Sweating Nausea or abdominal Trembling or shaking distress Sensations of shortnessof breath or smothering 13. Phobia an uncontrollable, irrational, and persistentfear of a specific object, situation, or activity.Social Fear of socialsituationPhobiaSpecific Fear of spiders,heights, bloodPhobias etc. 14. Specific phobia Situational phobias: typesclaustrophobia (fear of close space)and acrophobia (fear of heights). Fear of natural environment ex. Stormand water. Blood/injection/injury phobia Animal phobias 15. Selective Mutism Anxiety that interferes with speaking incertain situations, commonly school(SickKids). Children with selective mutism have aspecific worry about speaking, butonly in the situations that make themfeel anxious (CMHO). 16. Obsessive-Compulsive Disorder (OCD) is an anxiety disordercharacterized by persistent intrusive ideas, thoughts, impulses orimages (obsessions) which often result in performing compulsiverituals over and over again. TypicalCompulsions obsessions include Contamination (there are washing germs all over you) organizing Doubt (Did I turn off the stove or the iron?)CheckingDisturbing sexual and countingreligious thought VIDEO:OCD http://www.youtube.com/watch? v=izT40QNFXuM 17. Separation Anxiety when an infant or toddler is anxious aboutbeing away from her primary caregiver . According to Anxiety BC Separation Anxiety Disorder has three peaks: between ages 5-6, 7-9, and 12-14. http://www.anxietybc.com/parent/separation.ph p Physical symptoms: stomachaches, feeling sick to their stomach, or even throwing up out of fear Strategies: Making goodbye easier Timing is everything Practice Be calm and consistent Follow through on promises 18. How parents can help their child: Prepare the child for Transition toschool e.g. Visit the school with yourchild in order to be familiarized withthe new environment, teacher andother staff member. Encourage the child to make friends. Be consistent in the schedule orroutine. Set a realistic expectation and explainto the child. 19. How early childhood educatorsmeet the needs of the child?Provide adaptive learning environment.Examples: Create a welcoming environment withample space without barriers. 20. Creating a PositiveEnvironmentConsider the following to create awelcoming and positive environment: Physical SpaceConsider the size and function of eachplay area. Make sure that there is anample of space for the child to movefreely. 21. Change in the environment AccessibilityConsider the location and materials ofeach play area. Make sure that thechildren can reached them easily. VisibilityUse visuals to reinforce play areaexpectations. Adding/Reducing Sensory Stimulation 22. Using Visual Aides Label routines by using pictures with words. use a maximum of six or seven visuals inthe sequence. label pictures with the exact words. 23. Label cont labeltoys and toy shelves with pictures of the items on them. 24. Use a Mini-Schedule providepictures for the main steps required to complete the task. 25. Visual of First/Then Is a transition or skill-building activity. Show the first/then board to the childand name the activities while pointingto the pictures. 26. Calming Activities Breathing Exercise Blowing up balloonsBlowing out Birthday CandlesPhysical Activities Sticking Hands Tense and RelaxStretching Yoga Sensory PlayListening Centre Feeling BoxVisual Centre 27. Cont Follow the childs lead and implementactivities that involved interaction. Keep consistent routines. Give warnings for transitions. Provide adaptive devices such ascalming music and activities. Collaborate and communicate with thefamily about the childrens need. 28. Strategies to use to help thechild: Personal Stories Role Play Problem Solving/Brain Storming Positive Self Talk Story Book: Social Story Fun Games 29. Plan an intervention for children withemotional and behavioral problem. Make sure activities aredevelopmentally appropriate andbased on the interest of the child. Get to know each child. Asks parents about childrens likes,dislikes, and special interests. Get parents involved they know whatis best for their own child. 30. Anxiety Disorder NeedsTreatment Anti-anxiety medications: Selectiveserotonin reuptake inhibitors (SSRIs).Drugs that help regulate brainchemicals, and cognitive behavioraltherapy (CBT). 31. Who can help the child with heranxiety? Early Childhood Educator Therapist Psychologist Public Nurses Psychiatrist Family Doctor Pediatrician Behavioural Consultant Behavioural Interventionist Social Worker 32. Resources for Faiths Parents:Complete Home Toolkits http://www.anxietybc.com/parent/complete_home_tool_kit.phpIncludes:Helping Your Child Face Fears:Exposurehttp://www.anxietybc.com/sites/default/files/HelpChildFaceFears_2b.pdfHow to do Calm Breathinghttp://www.anxietybc.com/sites/default/files/calm_breathing.pdf 33. Meeting the Needs of theFamilyHelping Your Anxious Child Make Friendshttp://www.anxietybc.com/sites/default/files/HelpingYourChildMakeFriends.pdfHelping Your Child Cope with Back toSchool Anxietyhttp://www.anxietybc.com/sites/default/files/CopingwithBacktoSchool.pdfDeveloping and Using Cognitive CopingCardshttp://www.anxietybc.com/sites/default/files/coping_cards.pdf 34. 1. Centre for addiction and Mental Health public hospital, Funded by Toronto Central Local HealthIntegration Network (TC LHIN). accessible for people who have problemswith mental Illness or addiction. Serves children, youth, senior and supportsfamily. Provides multi-lingual resources. Follow thislink:http://www.camh.ca/en/hospital/health_information/Pages/information_in_other_languages.aspx 35. Referral process:1. The referral could be completed by a Family Physician or Psychiatrist.2. Faxed to our intake fax line: 416-260- 4208.3. The referral will be reviewed by our Intake Coordinators.4. Then it will be directed to the appropriate clinic to book an appointment for an assessment. http://www.camh.ca/en/hospital/about_c amh/who_we_are/Pages/who_we_are. aspx 36. Contact CMHOCanadian Mental Health Association,Ontario180 Dundas Street West, Suite 2301Toronto, ON M5G 1Z8416-977-55801-800-875-6213 (toll-free in Ontario)Fax 416-977-2813E-mail info@ontario.cmha.ca 37. SickKidsThe Anxiety Disorders Clinic assesses andprovides individual or group treatment forchildren ages four to 17. Diagnoses describedin the DSM-IV includes: Specific phobia Social phobia Generalized anxiety disorder Panic disorder Separation anxiety disorder Obsessive compulsive disorder Selective mutism Acute post-traumatic stress disorder 38. Referral Who can refer:Pediatricians and family physicians. Parents can call to inquire about theprocess but a physicians referral isrequired. How to send your referral:1. Send your completed referral via ARMs, our on-line Ambulatory Referral Management system or2. Fax a completed referral form (available in PDF format) to us at 416- 813-7361. 39. Treatment Recommendations: Information and advice for parents tohandle the problems without ongoingprofessional support. Referral to a mental healthprofessional near where the familylives. Ongoing treatment at Sick Kids.Note: Waiting time for assessmentappointments is approximately 6months. 40. 211http://www.211ontario.ca/#context:m=QUICK&r=0&z=contextUrl:about Is a non-profit, community-based orgovernment organizations that providea direct service to the public (211). Compose of 56,000 agencies andservices. Service is open 24/7 Available to all residents of ON with150 languages. 41. Kids Mental HealthChildrens Mental Health Ontario(CMHO) represents and supports theproviders of child and youth mentalhealth treatment services throughoutOntario. Consist of 80 community-basedchildrens mental health center. Link for the list of community center:http://www.kidsmentalhealth.ca/about_us/memberslist.php 42. Anxiety Disorders Association ofCanadaIs a registered Canadian non-profitorganization whose aim is to promotethe prevention, treatment andmanagement of anxiety disorders andto improve the lives of people whosuffer from them (ADAC).http://www.anxietydisordersontario.ca/ 43. Mental Health Helpline is an organization funded by thegovernment.Services: provide information about counselingservices listen, offer support and providestrategies to help you meet your goals provide educational informationhttp://www.mentalhealthhelpline.ca/ 44. Canadian Mental HealthAssociation Ontario is a non-profit, charitable organization. CMHA is to be the primary source ofinformation about mental health, mentalillness, and policy in Ontario. Population: Aboriginal, children & youth,immigrants and refugees, women, andseniors.http://www.ontario.cmha.ca/about_mental_health.asp?cID=23091 closely with its 33 local branches incommunities across the province.http://www.ontario.cmha.ca/branches.asp 45. Toronto Distress Centrehttp://www.torontodistresscentre.com/about.shtml24/7 Distress and Crisis Line Provide supports to those experiencing emotionaldistress or in need of crisis intervention and suicideprevention.General InformationDistress CentresBox 243, Adelaide P.O.Toronto, Ontario M5C 2J4Telephone: 416-598-0166Email: Info@TorontoDistressCentre.com 46. Supporting the Families:Centre for Addiction and Mental HealthAnxiety Disorders Clinic100 Stokes Street, 4th Floor, Bell Gateway Building (Queen St. Location)Toronto, Ontario, Canada, M5T 3L2Director: Ash Bender, MD, FRCP(C)Tel: 416-979-6819Fax: 416-979-6853Fees: OHIP-coveredHospital for Sick ChildrenAnxiety Disorders Clinic555 University AvenueToronto, Ontario, Canada, M5G 1X8Director: Katharina Manassis, MD, FRCP(C)Tel: 416-813-7464Fax: 416-813-5326Fees: OHIP-covered 47. Humber River Regional HospitalSunnybrook Youth Anxiety ClinicAdult Mental Health Program Department of Psychiatry,Sunnybrook Health Sciences CentreToronto, Ontario, Canada2075 Bayview AvenueContact: Heather Wheeler, PhD,CPsychToronto, Ontario, Canada, M4N 3M5Tel: 416-658-2003 Director: Sharon Reiter, MD,FRCP(C)Fax: 416-658-2009Tel: 416-480-4098Fees: OHIP-coveredFees: OHIP-coveredSocial Phobia Support Group ofToronto http://www.martinantony.com/anxiety-referralsToronto, Ontario, CanadaContact 1: Earla L. Dunbar, GroupfacilitatorContact 2: Paul M. Rennie, GroupfacilitatorTel: 416-746-4819Email 1: dunbarlamont@aol.comEmail 2: pmrennie@yahoo.comWeb: http://www.socialphobia.ca/ 48. Free Resource Book http://www.martinantony.com/downloadsOvercoming Animal & Insect Phobias: How to Conquer Fear ofDogs, Snakes, Rodents, Bees, Spiders & MoreBy: Martin M. Antony, PhD, and Randi E. McCabe, PhDOvercoming Medical Phobias: How to Conquer Fear of Blood,Needles, Doctors, and DentistsBy: Martin M. Antony, PhD, and Mark A Watling, MD 49. References:Canadian Mental Health AssociationOntariohttp://www.ontario.cmha.ca/about_mental_health.asp?cID=23091 50. References:http://www.flickr.com/photos/pinksherbet/3372060864 http://www.anxietydisordersontario.ca/ http://connectability.ca/2010/09/23/using-visuals/ Photograph by Jocelyn De Plata Photograph by: Jocelyn De Plata 51. Anxiety Disorders Association of Canada.http://www.anxietydisordersontario.ca/http://www.anxietybc.com/sites/default/files/hmgad.pdfhttp://www.martinantony.com/anxiety-referralsCanadian Mental Health Ontario. Retrieved fromhttp://www.anxietyuk.org.uk/about-anxiety/young-people-and-anxiety/generalised-anxiety-disorder-gadhttp://www.youtube.com/watch?v=loRC9T8qUGkCanadian Mental Health Association of Ontario.http://www.ontario.cmha.ca/about_mental_health.asp?cID=23091http://www.ontario.cmha.ca/about_mental_health.asp?cID=23091ttp://www.ontario.cmha.ca/branches.asp 52. Carlson & Heath 2010. Psychology the science of behaviour. Pearson Canada Inc. Toronto,OntarioCentre for addiction and Mental Healthhttp://www.camh.ca/en/hospital/about_camh/who_we_are/Pages/who_we_are.aspxhttp://www.camh.ca/en/hospital/health_information/Pages/information_in_other_languages.aspxDeveloping and Using Cognitive Coping Cardshttp://www.anxietybc.com/sites/default/files/coping_cards.pdfHelping Your Anxious Child Make Friendshttp://www.anxietybc.com/sites/default/files/HelpingYourChildMakeFriends.pdfGlogster http://www.glogster.com/babae/project-glog-by-babae-anxiet-disorder/g-6kruhe125pvmqf10cn0mua0Helping Your Child Cope with Back to School Anxietyhttp://www.anxietybc.com/sites/default/files/CopingwithBacktoSchool.pdfHelping Your Child Face Fears: Exposurehttp://www.anxietybc.com/sites/default/files/HelpChildFaceFears_2b.pdfHogdon, L. (1995). Visual Strategies for Improving Communication. Quirk RobertsPublishing. 53. http://connectability.ca/2010/09/23/calming-strategies-to-use-with-children/http://connectability.ca/2011/10/11/anxiety-for-young-children-2/http://www.anxietybc.com/parent/complete_home_tool_kit.phpHow common are anxiety disorder.http://www.ementalhealth.ca/Toronto/Anxiety-Problems-in-Children-and-Youth-Information-for-Families/index.php?m=article&ID=8872How Early Childhood Educators can help.http://connectability.ca/2011/10/11/anxiety-for-young-children-2/ 54. How to do Calm Breathinghttp://www.anxietybc.com/sites/default/files/calm_breathing.pdfKids Mental Health . http://www.kidsmentalhealth.ca/about_us/memberslist.phphttp://www.kidsmentalhealth.ca/parents/anxiety.php#Selective MutismMental Health Helpline. http://www.mentalhealthhelpline.ca/Home/AboutObssessive Compulsive Disorder. Retrieved from http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/diseases-maladies/anxiety-anxieux-eng.phpPanic Disorder. Retrieved from http://www.phac-aspc.gc.ca/publicat/miic-mmac/chap_4-eng.phpPhobia. http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/diseases-maladies/anxiety-anxieux-eng.phphttp://www.sickkids.ca/Psychiatry/What-we-do/Clinical-care/Anxiety-disorders-program/index.html 55. Separation Anxiety. Retrieved from http://connectability.ca/2011/10/11/anxiety-for-young-children-2/Separation Anxiety. Retrieved fromhttp://kidshealth.org/parent/emotions/feelings/sep_anxiety.htmlhttp://www.anxietybc.com/parent/separation.phpLisa classnotesSign of Anxiety in children. Retrieved fromhttp://connectability.ca/2010/10/28/what-is-child-anxiety/Supporting the Families. http://www.martinantony.com/anxiety-referralsTypes of Anxiety Disorders. http://www.anxietycanada.ca/english/index.phpToronto Distress Centre. http://www.torontodistresscentre.com/about.shtmlUsing Visual Aides. Hogdon, L. (1995). Visual Strategies for ImprovingCommunication. Quirk Roberts Publishing.http://connectability.ca/2010/09/23/using-visuals/Wood et al. 2011. Generalized Anxiety Disorder. Pearson Education, In. Toronto,Ontario211 http://www.211ontario.ca/#context:m=QUICK&r=0&z=contextUrl:aboutYou tube-Videoshttp://www.youtube.com/watch?v=i-jHGYWAFTQhttp://www.youtube.com/watch?v=OBbgw3mSwiUhttp://www.youtube.com/watch?v=4RSdV9R8wXQ