 This episode was prerecorded as part of a live continuing education webinar. On-demand CEUs are still available for this presentation through all CEUs. Register at allceus.com slash counselor toolbox. While we're waiting, I just sent you all a link to this resource. It's an amazing resource. It's from Australia. But they have just an amazing amount of handouts and workbooks and things that you can use with your clients on a variety of things. They're eating disorders, golly, where's, I'm trying to find where it's even, okay, overcoming disordered eating part A and part B. Really comprehensive program for working with clients with eating disorders, whether that's something that you do normally in your practice or you have someone with a subclinical eating issue that you might want to start taking a look at. You know, you can click on any of these, like assert yourself. And then each module is actually a PDF that will come up eventually that you can print out, hand out to your patients and go through in either an individual or a group setting or have them do it for homework and then process it later. Really awesome resources. I haven't looked at all of them for every single presenting issue they've got there. But all the ones that I have looked at, I've just been really, really impressed with SAMHSA and the things that you'll find at SAMHSA, they're great for patient education. And the tips are awesome for clinical and clinician education. But they don't have a lot of actual handouts for patients that we can give them and say, let's do this together. Let's do this in group or group activities. This is sort of the supplement to that. They don't have the degree of clinician-oriented stuff, clinician-oriented printed training on this website. But when you've got some free time, you might want to peruse it if you like giving handouts and providing visual aids to your clients. So anyway, that's the link that I just sent you, the CCI.health.wa.gov.au. It's a little tricky to find. When you just start Googling, I came across it when I did a course on working with people with eating disorders and I've referred to it several times since. I will be referring to it several times in the upcoming presentations on working with middle schoolers and high schoolers. So, you know, there's useful information there. But I always like to provide you some helpful resources when I come across them. I still have another couple of minutes. Let me bring up the SAMHSA website again to just in case you didn't get that the other day. The SAMHSA store, you can go and look by issues and conditions. So, bullying, for example. And you can see what they have in terms of apps, handouts, clinical information for professionals, for the general public. You can sort by audience, population group. Again, all of these resources are free. So, you put them in your shopping cart and they will mail them to you for free if they're in stock. If not, you may have to print out the PDFs, you know, funding and all. They don't always get reprinted. These are all either electronic only or out of stock, unfortunately. But they also, if you go to the series and you don't want the cap keys, those are the short ones, treatment improvement protocols. These are the long books that SAMHSA writes to help us stay on top of current best practices in particular settings. So, I will give you this. One last one. C. Here are your National Institute of Mental Health publications. Again, order them. They'll send them to you for free. Nice, glossy, pretty things to hand out for patient education. And all that being said, I'm down to the wire. You may notice in your classroom, you may have noticed or you will notice eventually that I set it for 1.5 hours of CEUs today. We are not going to go until 1.30, promise. But I may end up running up to the wire, running up to, let's say, one o'clock my time, two o'clock your time. But there's some reading information in there and I want you to have time or get credit for the time that you spend taking your class, your quiz. So, it is a 1.5 hour CEU just so you don't look at it and go, well, are we going to be there forever? Promise. I will rein it in and get you out of here. I will quit talking by one o'clock CST, two o'clock EST. Promise. Okay, so that being said, Merry Christmas to everyone. I appreciate you being here this week. I know for some of you, it's easier because you don't have as many patients this week and you may have some downtime and that's really awesome. But the fact that you're spending it here means a lot to me. So, let's see, got that down right here. We're at 12 o'clock, okay. I would like to welcome you to today's presentation on Child Development 101, The Elementary Years. We're going to review the developmental tasks that children accomplish at this stage. If you've had small children, if you've been around small children, or maybe you even remember back to when you were in elementary school, there are a lot of things that are starting to go on and children at this age are really, they're exposed to school. They're going to all kinds of different environments. So, the amount of data they're taking in on a daily basis is just mind boggling, which is one of the reasons sometimes they have a hard time holding it together and we can help them with that. We're going to examine how children's thinking patterns are different than that of both toddlers and adolescents. Piaget says, cognitively, they're very different and, you know, I would tend to agree. Explore the ways to assist children in enhancing their self-esteem. So, as children are moving through, they're taking in all this information, they're going through these cognitive changes and trying to accomplish all these tasks and goals in that we want them to feel successful. We want them to feel competent and we want them to feel good about themselves. So, we'll talk about how to help them do that because they're not always going to succeed at everything. They're not always going to be friends with everybody. We'll help them explore different techniques to handle distress, different techniques to learn to get along with others given their current cognitive abilities. So, at age four to seven, this is the intuitive thought sub-stage before you get into concrete operational. Remember, last time we were talking about pre-operational. Children are beginning to be able to evaluate things on more than one characteristic. So, if you give them picture cards of cats and dogs and you ask them, are there more cats or animals? They're going to say cats because they haven't necessarily figured out that cats and animals and cats and dogs are both animals up until this point. At this point, they might start being able to say, okay, well, you know, cats and dogs are animals. So, how do I answer this question? They may not be able to take it to the finish line. So, we want to help them with reasoning when they answer. We want to ask them why they answered that way regardless of whether they answered correctly or not and then help them process the reasoning. Math and reading are both parts of school. So, giving you an example where a child might internalize some messages over generalize some messages, maybe they are not good at one of those particular topics. And instead of saying, I'm not so good at math, they say, I think it's school. I'm not good at school. So, we want to help them look for different characteristics of the things that they're good at. We want them to help them become more specific in their attributions and not just take big lump things and say, well, I'm not good at that. I'm not good at school because generally they're good at something, some part of school. And it may be difficult for the small child to figure out specifically what it is they're good at. That's incumbent on the parents. We're supposed to say, yeah, that's awesome. We're also supposed to encourage them when they are learning new things because you know what, most people, adults or children, when they learn something the first time, don't get it 100% right away. So, encouraging them to, yeah, you're learning. Yeah, you're going to make mistakes and that's okay. Let's figure out how to learn from those mistakes. That's going to be an important part during this theory or during this stage of development for children. Four to seven, this is your pre preschool, preschool, kindergarten, first grade, big changes. Big changes going from kindergarten to first grade, a lot more structure, a lot more pressure because first graders start to get into that place where they're being tested. In kindergarten, they weren't tested. In first grade, they are. In kindergarten, they had nap time, they had downtime. In first grade, generally that doesn't happen anymore. So they have to go all day long and learn how to pace themselves, learn how to manage all of this input that they're just constantly getting bombarded with. And even as I say that, I feel a little bit overwhelmed and I'm a grown up. I'm just like, oh my gosh, I remember what it was like being in school all day long from, you know, 7am to 3pm and going from class to class to class to class and trying to take in and stay focused on all that stuff. At this age, children are able to use inductive reasoning, drawing general conclusions from personal experiences and specific facts. So if it happened to me, then I'm going to think that it's the same thing for everybody everywhere always. Remember, at this stage they're also very egocentric. So this inductive reasoning doesn't take the big conclusions or the big overarching rules, if you will, and work down to what does that mean to me. They take what is pertinent and relevant and what they've experienced and then they assume that's true for everybody else. So if something makes them angry, then they're going to assume that it's unfair, you know, and that's just unfair across the board. We need to help them with their inductive reasoning as they start moving into older levels of development as they start interacting with other people because there's a lot of inductive reasoning that they'll use that may be faulty. Maybe they're on the playground and the person we're working with is named Sam and Sam tries to play with Sally and Sally is not in a good mood that day. So Sally is mean to Sam. So Sam's general reasoning from that is you are mean to me today. That specific experience. So Sam's going to generalize that and say Sally is a mean person. That inductive reasoning leads us to overgeneralization. Now stop and think for a second for about clients that you've worked with, no matter the age, who have had experiences like this. They've taken one single experience, one single scenario and generalized it to think that everything of that type is going to be scary, unpleasant, yada yada. People are untrustworthy. One person was untrustworthy. Therefore all people are untrustworthy. As parents, we can help our children look for exceptions. We can help them challenge any faulty inductive reasoning like with Sally. One of the things that we might say to Sam is, you know, I hear that Sally was really mean to you today and that hurt your feelings. Is she always mean to you or, you know, how does she act with other children? What was it that she did that you felt was mean to you? Help them process the situation. They may still come to the same conclusion. And at that point, that's their conclusion because we don't want to invalidate them and go, well, you're wrong. Sally's really a nice person, but we might want to provide alternate explanations. You know, you think maybe Sally was having a bad day today. And it doesn't always play out the way you're expecting it to play out, but we can help children start hearing alternate viewpoints, alternate explanations. Remember, they're still very egocentric. So their mind is not going to go there and they may have a hard time kind of stepping into Sally's shoes and going, yeah, you know, she was tired and she didn't feel well. And she wasn't being very nice, but, you know, generally she's nice. Your four to seven year olds don't think that way. So we can't expect them to think that way, but we can start planting the seeds. We can walk them through it. Ages seven to 11. So, you know, last time we talked about up to age six, I believe. So there was a little bit of overlap in that first stage. Ages seven to 11 are concrete operational. And when you think about concrete operational, think about tangible. This is when kids are working with blocks. This is when kids are writing out things. If they're trying to figure something out, they're drawing representations of it. They're not able to do it mentally yet. So abstract and hypothetical thinking is not yet developed. They're not able to hypothesize about, well, if you combine these two chemicals, what are all the possible reactions? That's not how they think. These are seven. These are elementary school kids. These are kids that go, hmm, well, I'm outside and there's an aunt there and I've got a magnifying glass. And you see where I'm going with this and it's unpleasant, but this is how their minds think. What would happen if, let's try it out. They need to see. They need to experience. They need to do something. Not to say that you have to fry an aunt in order to figure out that that would happen. You could do other things. But at this age, children are still very hands on. One of the things we want to do is help them write down options and discuss their reasoning. If you do this, let's write down what might happen. If you go to grandma's house and you don't want to do some, you don't want to eat your dinner. And you tell her you're not going to eat your dinner. What might happen? And so we talk about the different options, but you need to write them down so the children have something a little bit more tangible. If you're working with an adult who grew up in a chaotic environment, they may never have learned to predict outcomes because some days their needs would get met. Some days their needs wouldn't get met. Some days caregiver was in a good mood and really nice and other days not so much. And they couldn't figure out what it was that made caregiver nice versus unavailable or mean. So it was scary. They never knew how to act. They just kind of tried to walk on eggshells and buy their own. So if you're working with an adult that grew up in a chaotic environment, we want to help them start trying to predict outcomes which will help reduce a lot of their anxiety about people can't be trusted. The world is a scary place. So help them explore that. Rule out fetal alcohol spectrum disorders. A lot of times children who have fetal alcohol spectrum, which can happen very easily, come from parents who also have some fetal alcohol spectrum. There's some intergenerational transmission that we've seen in the research because people with fetal alcohol spectrum issues have difficulty predicting consequences. Even if they've done something before and experienced the consequence, if they get ready and they're going to do that thing again, they can't predict what's going to happen a lot of times. So parents may not be able to predict, well, if I drink, it's going to harm my baby. So it's important to understand that if you have a client who has difficulty predicting outcomes, especially if they're further along towards the 10 or 11 age group, you might want to look and say, hmm, I wonder if there's anything cognitively going on here. Now, people with fetal alcohol spectrum issues, fetal alcohol syndrome can learn how to predict. They can learn some of these skills. It's not going to come as naturally as maybe to some others. But it's important to kind of rule out any underlying biochemical causes, biological causes of any cognitive problems that the person may be experiencing. One of the things that's common that we see in people with fetal alcohol spectrum issues is the fact that they do the same thing over and over and over again and don't seem to learn. When they get older, you see these youth and ultimately adults committing the same crimes. A lot of times criminal behavior progresses. You start out with lower crimes and you progress to more dangerous, more risky crimes, things that'll have a bigger payoff. A lot of people with FAS keep doing the same thing. They shoplift and shoplift and shoplift and they get arrested and they shoplift and they get arrested and they don't seem to be able to predict, well, if I do this, I'm going to get arrested. The other thing with people with FAS is they tend to be really wanting to please others and they tend to be very amenable. So if somebody tells them to do something, they do. They don't question it at all, whether it's an adult or a not-so-kind peer. So we do want to be aware of this. It happens a lot more frequently than I think we probably pay attention to. Emotional dysregulation can interfere with decision-making. So we want to teach distress tolerance and emotion regulation skills. If the person you're working with has a lot of difficulty handling any kind of distress, it's important that we help them figure out how to deal with that. Think about the last time you were upset. I mean like really upset, really mad, really devastated. One of those really intense dysphoric feelings. How clearly were you thinking and how effective was your decision-making in the heat of the moment? Most of the time we've already started talking to clients about you don't want to make decisions when your adrenaline is just running through because you've got tunnel vision. Same sort of thing here. If our clients have difficulty with emotional regulation, we want to teach them some skills to get that under control because they're going to hypothesize and make rational decisions more easily if they are not in an adrenaline haze. We also want to help them develop reasoning and goal-setting skills. 7 to 11, this is not too early to start setting goal-setting skills or teaching goal-setting skills. I'm not talking about what you want to be when you grow up. I'm talking about how are you going to get your chores done this week or what are you going to do accomplished today? At the breakfast table you can start talking and say what's on your agenda for today and how are you going to get these things done? Encourage children to start planning, learning some time management. If there's something that they want to do, encourage them to figure out how to set goals to achieve whatever that is. At this stage, these children are struggling with deductive reasoning or using a general principle to predict an event. Again, the chaotic environments can interfere and cause the child to perceive the world as unpredictable and threatening. So there's no general rule that actually sticks. Every time they try to apply a general rule, it falls apart or it hits 50 or 60% of the time. I don't know about you, but if I'm right 50 or 60% of the time, I'm still pretty darn uneasy. I like being up around the 85-90% at the very lowest. So it's important for us to help them figure out how to interpret their world and how to apply these general principles. For example, if I go to school every day and if I study, I will get good grades. That's a general principle. Now, if that doesn't happen, then how do we help them reconcile that? So we need to help them figure out, okay, you went to school every day and you studied, but you didn't get a good grade. So what happened there? Why did that rule not apply in this particular situation? We also want to help them look for exceptions when that rule actually did apply and help them learn the kind of rule of percentages and encourage them to embrace the concept, even in general, but not always. In general, when I go to school every day and I study and I do my best, I'm going to get a good grade, but not always. You know what? Tests are written by teachers and teachers can sometimes write harder than anticipated tests. So it's not always that you didn't know the material. You know, the test may have been harder than usual. So we want to look for exceptions. Children at this age are still struggling with dichotomous thinking. Every time I talk to this person, they're mean to me. Every time I try out for a team, I don't get selected. You can see how we're still using those extreme words every time, always and never. We want to encourage children even at this age to start becoming aware of those extreme words and alter it. Look for exceptions to when they have been successful. Maybe every time they try out for a sports team, they don't make the team. Okay. You know, sometimes that's true. Not everybody has the gift of athleticism. Okay. What does that mean about them? You know, have them process how they're internalizing that. And what things have you tried out for? What things have you tried that you've succeeded at? So help them see that there is a yin to a yang, if you will. At this stage, hallelujah, they're starting to be able to see, although not necessarily agree with other people's perspectives. Think about it from a parent's perspective or from a child-parent relationship. My children can see my perspective a lot of times. They don't necessarily agree with me, but they can see how, you know, it's important that they get their chores done. It's important that they do their lessons. So we want to start encouraging them to take these perspectives. It doesn't mean they have to agree with them. And that's the take-home message here, is that just because somebody's perspective is different than yours, doesn't mean that yours is wrong, but it also doesn't mean theirs is wrong. It can be a both and instead of an and or, or or. So we want to encourage them to step into someone else's shoes. What would it be like to be in that person's shoes? Or sometimes when we go to the grocery store or Walmart or whatever, and we run into somebody who's in a particularly unhappy or unpleasant mood. One of the things I'll ask my kids later on the drive home is, you know, that person seems really unhappy. I'm wondering what do you think might have happened in their world today or this week or whatever? What might be going on in their head that is causing them to feel so unhappy? And I encourage them to hypothesize. We don't know anything about that person. We don't know him from Adam's house cat. So I can't say you're right or you're wrong, but I can say those are all good alternatives. So I'm encouraging them when someone's in a bad mood, even if they are nasty to them, to try to take that person's perspective and go, okay, what must be going on in this person's head for them to be feeling, acting, reacting this way. And our rule or general principle is to identify three explanations. Give me three reasons why your brother might have reacted that way when you fill in the blank. Give me three reasons why Sally might not have been nice to you today. Now, this is obviously going to be a lot more challenging when children are younger because they have such a small frame of reference and they don't understand grown-up stresses and all that other stuff. But they can understand a bad day. They can understand didn't sleep well or don't feel good. You know, from a kid's perspective, those are really important. So helping them understand what might be going on with other people so that A, don't take it personally and B, don't jump to incorrect assumptions. Think of examples for children and adults when they have gotten into all or nothing thinking. Now, if you've worked with children, you can think of one of your child clients. If you've worked with adults or even thinking in yourself because we all do these occasionally. Let's think about some of these cognitive distortions that CBT highlights as being problematic and think about what sort of cognition, cognitive process might have us there. So all or nothing thinking is very dichotomous. And what have we been talking about up until now? Children's thinking is very egocentric, centrated and dichotomous. So it's all about me. I'm only going to focus on one little aspect of the situation and it's going to be all or nothing. There's no middle ground, there's no multiple explanations. So as adults, when we get into all or nothing thinking, we're still going back to that very primitive, if you will, drop back and punt sort of reaction. So we want to encourage people to look at exceptions or look for exceptions. If it's not all or it's not nothing, it's a sometimes. So it could even be a most of the time, but generally there's exceptions. And then we want to figure out what causes those exceptions. I like to think that I'm a nice person, but I can tell you, I am not always nice. There are times when I've been vulnerable, if you will, I haven't paid attention to everything that's going on and I've bitten somebody's head off. And I apologize for it, but I am not always nice. Nobody is always nice. I have a really good friend of mine who's a nun and I love her to pieces, but she's not even always nice. She has her moments and it's important for children as well as adults to be able to understand that we all have moments, we're human, we're not 100% on all the time. So let's focus on the most of the times. Overgeneralization, this goes back to that ineffective reasoning process. All people fill in the blank. A lot of times your stereotypes come from ineffective, inductive or deductive reasoning. So maybe going back to Sam and Sally, maybe Sally was a little brunette and Sam had this interaction with her and she was unpleasant. And maybe he had another interaction with another little girl who was brunette who was having a bad day too or they just didn't get along for whatever reason. So he determines that all brunettes are mean. So that's oversimplifying and kind of blowing it out of proportion a little, but you can see where children can take one set of characteristics because they're taking, remember they have centrated thinking. They're focusing on one aspect. It's a girl, maybe it's a brunette, maybe, maybe it's a girl who wears pink dresses because they're starting to focus on a little bit more than one aspect. But the hypothesizing is inaccurate. So we need to step back and go, okay, that happened with these two or three people. Let's think of some brunette females that have been nice to you. What about teachers? What about other girls in your class? What about boys? If we're just talking about brunettes here, there's brunette boys too. Are they nice or are brunette boys mean too? So let's look at that reasoning process and see if it's on point or if it's faulty. Having a mental filter. I think most of us know someone or have worked with a client or ourselves who have a mental filter and they only see the negative or the positive. People who only see the positive can be really uplifting, but they can also be really annoying if you haven't had your first cup of coffee yet. But this aspect of centration, very few things in the world are all positive or all negative. Now you don't have to go, okay, there's these wonderful positive things. Now let's make sure to balance it with the negatives. But understanding that there can be some drawbacks to just about everything. You get a really awesome new job and that's fabulous. It's going to pay you what you think you deserve. It's going to let you work with the people that you want to work with. It's in a great new city. That's all wonderful, but you're going to have to move and you really like your house. So there's a little bit of a drawback there. The person with the mental filter would start looking for all the negatives and using sometimes ineffective reasoning going, well, I've had other jobs before. They seemed great within six months. I was miserable. I'm going to have to give up this house that I love and just kind of preparing themselves for failure ahead of time. So being aware of the mental filter and encouraging people to look for the positive. Emotional reasoning is an inductive reasoning error. I feel bad in some way, mad, angry, scared. Therefore, this situation and all situations like it are intimidating. Not to give dentists a bad rap, but I know there are a lot of people who have fears of dentists and fears of going to the dentist. A lot of times it kind of stems back from this emotional reasoning. When they were children, they may have somehow come across the idea that going to the dentist was scary or painful or something. And they generalized it. So now every time they go to any dentist, it's just really traumatic. Encourage them to look at, you know, why was that particular situation traumatic? What is it that you expect is going to happen? And then, you know, start disputing some of those expectations as, you know, well, it could happen, but what's the probability? And also encourage them after the dental appointment, if we're going to stick with that metaphor, to go through their expectations and go, okay, how many of those really awful things that I was expecting? How many of them actually happened? Most of the time they're going to find out that it's very few to none of them. Shoulds indicate, again, centration. I should do this. Focusing on one aspect or one thing. Somebody told me I should do this today. Somebody told me I should be filling the blank. So they're only focusing on this one aspect. But you know what, as humans, now it's not so much with middle schoolers, but even in middle school, middle schoolers have shoulds. And they're trying to fit in. They're trying to be liked. So in order to be liked, they should behave a certain way. But mom and dad told them they should behave a different way. So the children are stuck between these shoulds and trying to figure out and reconcile what they should do, which can cause a lot of distress. Labeling with global, internal, and stable attributions. Children do this a lot because they're overgeneralizing, because they don't have a frame of reference for, does this always happen? Or is it just occasionally? Global attributions means everybody all the time, any situation. Internal means it's about me. Some sort of deficiency or failure. And stable means I can't change it. And we're going to talk more about that a little later. Personalization. That's, you know, straight up egocentrism. Thinking that somebody walked down the hall and gave you a dirty look because they don't like you is personalization. Assuming that their attitude, their behaviors are because of you, when there could be seven different explanations for why that happened. Young children, you know, elementary school children can start wrapping their head around this. It's going to take until, you know, they get into upper elementary school and middle school before they really start getting the hang of understanding what's going on. And blaming. Children like to blame. Number one, if you blame somebody else, you don't have to take responsibility and then you don't get in trouble. So from a moral developmental perspective and not wanting to get punished, totally can see that. But blaming can also become dysfunctional when it stops the person from seeing their part in it and doing things they need to do to become better. As if you work with adults who are still struggling with some chaos from their childhood. They can blame a lot of people for a lot of stuff. And you know what? A lot of those people probably did a lot of stuff that was not great. However, how effective is blaming them going to be now because we can't change the past and most likely you're not going to change them. So what is it this blaming doing to you? How can you change yourself? So the effects of whatever happened are lessened. That's an intervention. Obviously you're going to use with adults who are struggling with childhood issues as opposed to the child themselves because that's cognitively a little advanced for middle schoolers. But encourage them when they start blaming. When you blame two fingers point out three fingers point back at you. So what was your part in it? Biological needs and preventing vulnerabilities sleep. In this stage, children are starting to, you know, grow and with a lot of children, their bodies can't keep up. So they kind of switch off between physical growth and cognitive growth. Some children will even switch off between like reading development versus math development, right brain versus left brain. And when one is taking off, the other one might slow down a little bit. So you'll notice that a child who is excelling and developing skills in reading may start making mistakes that they hadn't made before in math. And then they may start getting frustrated. And they're like, well, I knew that. So why am I making these mistakes now? Helping them understand their brains just trying to catch up. It's got to balance its energy can help them not internalize it and think, you know, again, I'm always bad at math. No, right now you're kind of struggling. However, let's look at how awesome you're doing in reading. So during this period, we want to help them prevent as many vulnerabilities as possible because they're developing so fast and they're being bombarded with so much information. If you've ever volunteered in a preschool classroom, kindergarten classroom, or been at a child's birthday party or heaven forbid, gone to Chuck E. Cheese, love the place just a little too much stimulation for me. Imagine, imagine being in that environment eight, 10 hours a day every single day. Imagine how exhausting that would be because there's just so much stuff that you need to attend to. There's so much input coming at you all the time. This is kind of what it's like for little kids because everything is new. Everything is interesting and it's hard for them to filter out what's important and what's not important. And even when they do filter some of it out, they're still encountering so much new stuff. So they're exhausted. We want to help them learn how to develop an effective independent sleep routine. Make sure they continue to wind down. Make sure that they are getting adequate sleep. Ask them how they slept. Help them learn what they need to do to deal with anything that might be keeping them up. Nutrition, they need building blocks for a healthy body and brain. They're building those neurotransmitters just like you do when you're adults. But they also have so much other stuff going on because they're growing and developing. They may be kind of hungry a lot. Mindfulness for eating for hunger and attending to nutritional cravings. Encourage children even at this age. The first eating disorders in some people will start, their first dieting will start as early as eight years old. So when you see children that are eight years old starting to diet, it makes you kind of think what's going on here. So we want to encourage them to be mindful of eating for hunger. And if they are hungry or if they're craving something to think of what it is that they're craving. When we're dehydrated, sometimes we'll crave salty or sugary foods. So try drinking some water first. If you're deficient in certain minerals or vitamins, you may have other cravings. Your cravings are kind of dependent on the person. So talk it out with the child. Review what they've been eating. You know, as a parent, hopefully we have some inclination about what they've been eating and maybe what they haven't. So we can identify things that we might need to amp up a little bit in their diet like heaven forbid, green vegetables. Increase their awareness of the impact of stimulants and sugar. If your kids drink a lot of high sugary drinks, make sure they're aware of how that affects them. Obviously, you know, nutritionally most doctors recommend that they don't drink a lot of high sugar drinks. Also help them understand that just because it's healthy, like orange juice or apple juice doesn't necessarily mean it's not high in sugar. So helping them become aware of how different foods affect them. They need sunlight, not just, you know, not sitting in front of the video or the iPad or whatever it is. And I see a lot of little kids doing that and it's not bad in certain amounts. But they also still need sunlight. It sets their circadian rhythms and helps them get the vitamin D that their body so desperately needs for brain, bone, muscle tissue development. So make sure they get some sunlight, which means they probably need to get outside for at least 20 minutes today. Medical care kind of goes without saying if they're in pain or they're sick all the time. It's going to be a lot harder for them to deal with life on life's terms. And then we want to start talking about exercise. Exercise is great for stress relief. It's a self-esteem builder because they can say, you know, I did that. I ran a mile or I did 10 push-ups or I did a pull-up or whatever it is. It raises serotonin levels when you exercise and it can help them develop healthy movement habits so they want to move. But they're also learning to get comfortable in their own body because beginning now and going through middle school and sometimes through high school, their bodies are growing at such a rapid rate. Sometimes it takes a little practice to get used to working within this machine and it feels kind of awkward. So exercise can help with that. But what is exercise? Exercise doesn't mean necessarily going to the gym. It doesn't necessarily mean playing a sport. It can mean dancing. It can mean cleaning the house. It can mean doing anything that your kid likes to do that has them standing up and moving around. That's exercise. I don't want to get kids. I mean, ideally I'd love to see them working in their target training zone and all that kind of stuff. But in reality, I just want a child to be up off the sofa for a little bit each day. I have reasonable and realistic goals. Encourage them to go out and play with the dog, play with their little brother or sister or maybe they're in some kind of lessons like judo or ballet or gymnastics. Okay, safety from internal and external harm. So remember, we're talking about the Maslow's pyramid. We just finished talking about the biological needs. Pretty self-explanatory, but remember from DBT theory as well as, you know, a lot of others, not getting those biological needs makes people more vulnerable to emotional upset. It's really hard to be happy and have good self-esteem and want to hang out with a lot of people if you're sick, you're hungry and you're exhausted. So let's get those biological needs met. And then we move up to safety and it's not just from people hurting you, from other people bullying you. It's also from your own internal negative critic and negative self-talk. So at this age, what are they facing? Low-grade chronic stress creates brain changes. There's an excellent video from, oh golly, I'll think of his name in a few minutes, about the effect of early childhood neglect on brain development. It messes with something called the HPA axis, but basically what you want to understand is it's exhausting to the child and the brain starts to adjust to the child's high level of anxiety by kind of turning down the stimulation sensitivity, because the brain's just like, I can't deal, which may end up leading to children who are depressed, who don't feel a lot of happiness. When that sensitivity knob is turned down, not only do they not get as anxious as easy, but they don't feel happy as easy, because you need norepinephrine, you need that get up and go chemical to feel any sort of excitation emotions. Home stress can be a cause of low-grade chronic stress. We want to look at anything that's going on in the home that may make the child feel fears of abandonment or just stress. You know, if parents are always arguing or even if parents aren't arguing, but they're constantly discussing stressful topics like finances, it can cause stress for a child. So we want to help them figure out how to remove the child, parents help parents figure out how to remove the child from that kind of situation. Children often can't remove themselves from home stress, but we can talk about what can you do? If things get stressful, can you go to your room? Can you go outside and play? And we also want to talk about the media. When you turn on the news, it is not generally a real happy place to be. They're not talking about the kids that may be on a roll and all the good things that are going on in the community as a general rule. All of the highlights are so-and-so got shot. This person's house burned down. It's devastation. For a child who doesn't have a bigger frame of reference, who can't say, well, happy stuff isn't newsworthy, they think that that is the picture of the world. And when they see it over and over and over again, it's devastating. So it's important if the children are exposed to the news to make sure to process it with them and highlight some of the good things that are going on and talk about probabilities. Bullying starts in elementary school, so it's important to help children learn how to deal with people who are not so nice. And what does that mean about them? If somebody says something ugly to them or somebody's mean to them, help them develop their own sense of self-esteem. And it's going to be hard for them to understand the other person's perspective and what they might get out of bullying at this age. But we can start kind of planting the seeds again, helping them understand that whoever's being a bully needs power for some reason. They feel like they need to be mean to other people in order to be okay. And for children, a lot of times that doesn't make sense, especially young children. What we want to focus on is what can we help you do to deal with it? When somebody says this and it hurts your feelings, how can we help you deal with that? Do you talk to a grown-up? Do you, you know, go out and play with your dog? What is it that makes you happy? And help them start developing distress tolerance skills. Unfortunately, at this age too, some children start using drugs and alcohol. I worked with a lot of clients that started smoking marijuana as early as age nine or ten. It's in the house. It's easily accessible. If the child is already stressed out and they see that that's what mom and dad or big brother do when they're stressed out, guess what? Young child might go, well, wonder what that's like and try it themselves. So we want to make drugs and alcohol unavailable. At this age, it's really hard for them to make a decision about, well, is this good for me? It's just they see something. It looks like mom or dad is having a good time when they do it. So I want to have a good time too. Emotional abuse from others, bullying, critical others. What we want to have them understand is what's good about them. You know, it may have more, it probably has more to do with the other person. So how does this make you feel? How do you deal with it? If someone is negatively critical and there's a difference between constructive criticism and negative criticism or destructive criticism. So how do you handle that? What does it mean to you? If you're working with an adult who grew up in an environment who came from an environment where people were bullying and critical and it was just a really unpleasant environment, they may be extremely hyper vigilant to not only verbal behavior. Anything you say is automatically perceived in terms of how could this be an attack on me. But nonverbal behavior, looking at them cross-eyed, any kind of disparaging, what they perceive as disparaging nonverbal can make them go from zero to a hundred in terms of reactivity. Because their past experience has been when somebody acted that way or their nonverbals were the same way, it got ugly real fast. So we want to help them address that hyper vigilance. And yes, it could mean that somebody is giving you a disparaging look. But as a 26-year-old, you know, we're talking about reparenting now. As a 26-year-old, how is this different than as a 6-year-old? You know, as a 6-year-old child, what did that mean to you? As a 26-year-old, what does it mean? Does it mean the same thing? And what do you need to do to deal with it? Emotional abuse from self. A lot of our clients are very self deprecating. So when we're working with children, we want to nip this in the bud. Instead of them saying, I'm stupid, I'm ugly, I'm fat, I'm, you know, global attributions. We want them to make them more specific. We want them to be mindful. So they notice when they are saying ugly or disparaging things to themselves. And they can correct them. As the children get older, it will be easier for them to look at these attributions. But even as early as 7 or 8, we can start talking about global versus specific attributions. And you might not use those terms. You might say, you know, it seems like you're thinking about everything this way. You know, you're bad at everything at school. But are you bad at everything at school or is it math? Are you bad at any sort of athletics or is it football? You know, there are some people that's on baseball teams. Why not everybody's a pitcher? Not everybody's a pitcher. Some people are better at catching. Some people are better at fielding. I don't know much about baseball. But I know that not everybody's a pitcher. But everybody on the team has their own strengths. And it's putting those strengths together that makes a really good team. So we want to help them identify their specific strengths. And yeah, they're going to have specific weaknesses. But discourage them from making global attributions using terms like everybody always, etc. Internal versus external. You know, sometimes it is something about you. You know, sometimes you trip because you're clumsy. But most of the time you trip because there was something in the sidewalk or because you were typing on your phone and not paying attention. Not because it's about you, but because of something else, some external force that made you trip. When we're talking about test taking, you know, is it because you're not skilled or you didn't know the information? I try to avoid the word stupid because that is a very ugly word. Versus was the test harder or did you study the wrong materials? You know, you may have a whole bunch of knowledge about the Civil War. But it may not have been the knowledge you were tested on. So does that mean you're stupid or you have the wrong knowledge? Stable versus changeable. Okay, so maybe something happened and you took this test, you didn't pass it. You're good at a lot of things. You generally pass tests. You didn't study the right stuff for this exam. What can you do this time? Does it mean that you're going to fail every exam? Is it stable? Does it mean you're going to not succeed from now on? Probably not. It's changeable. So how can we change it? How can we help you pass the next test talking to the teacher, figuring out different study strategies? You know, there's a whole realm of things we can do to explore this. We can go through this with our adult clients too. Because our adult clients that are struggling with anxiety and depression generally have negative global internal stable attributions. So if we can help them start changing those, we can help them start relieving some of their anxiety and some of their hopelessness and helplessness. Because they start seeing that there are positives and there are some things that are changeable and it's not necessarily about them. Encourage them to do self-esteem exercises and introduce the concept of acceptance and commitment. At this point, we're just teaching them to accept themselves for who they are and accept what is, is what is. Okay, you failed the test. You know, that really stinks right now and you feel bad about it. What are you going to do so you don't fail the next test? We're not going to dwell on feeling bad about this right now. I'm not going to invalidate their feelings and I don't want them to invalidate their feelings and say I shouldn't feel this way. You feel how you feel. And so what can I help you do? So you can change future situations. We want them to commit their energies to becoming the best you that you can be. And this works in adult groups as well as when you're working with children. And hopefully this will come up. 50 examples of words using core values. Now you're going to have to edit some of these for small children but I just wanted to give you an example of values that people have. They want to say yes, I am that type of person. That describes me because that's going to help them start feeling good about themselves because all of these values are good words, good things to have and you're not going to be every single one. Have them identify two or three or four that describe them. The nice thing about values is independent of activities. You know, even if you fail a test, it doesn't necessarily mean that you're not dependable or respectful or humorous or nurturing. Values are independent. That's the best word I can come up with for it. So encourage them to do that. You can put values on different pieces of paper around the room and have children go around or, you know, young adults go around and write down what each value, how to show that. Like how do you show respect? How do you show nurturance? For younger children, obviously you're going to use different words like kind. What does it mean to be kind? Love and belonging. The toddler was learning new skills and right from wrong and started to assert their opinions and desire to do it on their own and this is how they got self-esteem. They started figuring out that, hey, I can do it. I can put on my own pants. I can choose my own clothes. At three to six years, children were developing the sense of self-esteem and confidence and ability to be lovable as they started planning and achieving goals and developing social skills, playing nice with others on the playground and having others want to play with them. This helped them develop a sense of initiative and a sense of ambition as they started to explore their environment and things started to go pretty good. Every once in a while, there's going to be a hiccup. It happens. So as parents, we can help children process. Why didn't that go as well as all of these other situations? What can you learn from it? Or, you know, is this an outlier? And, you know, obviously with children you're going to talk about, is this something that was just kind of weird because outlier doesn't mean anything to a six-year-old? Once you start moving into elementary school, you're talking about self-efficacy and esteem through learning, creating and accomplishing new skills and knowledge. They've moved into elementary school. This is big kid's school. They're taking tests now. They're getting report cards. They're trying out for sports teams. They are doing all kinds of other stuff and they're figuring out what they're good at and what they're not good at. So they're developing a sense of confidence, but they're not always going to win. They're not always going to be good at everything. So as parents, we can help them process when they have a failure and help them understand that, you know, you're really awesome at all these other things. Don't forget about these over here. All right, you may not be a gold medal-winning gymnast. It happens. Not everybody's going to be one. So let's focus on the things that you're really good at or, you know, if they really want to do that, how can we help remediate that? We want to encourage them to learn how to set goals and accomplish them. But we also want them to understand that losing and failure is a learning process. It teaches us that we either need to learn something more or do something different. This is a social stage of development leading to self-esteem and social confidence or feelings of inferiority and inadequacy. So if every time they try to make friends, it doesn't go so well. Or they have multiple unsuccessful attempts at things, especially without parental cheerleading and processing, it can start making them feel inadequate or inferior. Like I said, they're not always going to win. What we want them to take away from that is, you know, I really showed a lot of courage when I tried. I have all these other skills. What else can I do? So children at this stage are mastering new physical, interpersonal, emotional and cognitive skills. They're striving to develop a sense of competence. As parents and clinicians working with children, we can encourage risk-taking, help the child evaluate and learn from failures, help the child begin to develop effective reasoning skills. So deductive reasoning starting with that general hypothesis and developing a conclusion about a single person or event inductive reasoning starts with an observation and works up to a general hypothesis. At this age, they're doing more inductive reasoning because they don't have a lot of broad knowledge. They're dealing with tangible stuff. What have they experienced? So help them, you know, if you're going to a new church, when we went to our old church, what was it like? What was expected? All right, what do you think is going to be expected at this new church? Begin to identify and address thinking errors, including over-generalization, look for exceptions, personalization. What are some other explanations besides it was about you? Blaming, what was your part in it? And all or none thinking, you know, what are some exceptions or what are some other reasons? In re-parenting scenarios, we want to examine schemas that are still based in cognitive distortions such as all green vegetables are disgusting. Obviously, we hear this one a lot. So help them examine those cognitive distortions. All people in power fill in the blank. Explore why they may have been created that way, those cognitive distortions, and explore the functionality of maintaining that current schema given the person's situation and their ultimate goals. If you want to proceed, if you want to hold on to this stereotype of this dysfunctional or not accurate over-generalization, what is the effect it's going to have and is that something you're willing to take? Help children develop effective cognitive strategies in order to help them feel more effective and empowered. Avoid using global stable negative internal attributions. You're a bad boy. That's, you know, I don't like your behavior. You're a good boy, but you made a poor behavior choice. And be more effective in relationships through helping them with multiple perspective taking, learning to compromise, planning and executing goals, and effectively identifying their own thoughts and feelings and communicating those in a way that is effective and doesn't intrude on others' emotional boundaries. And I got in just under the wire. What questions do you have? Parenting the toddler, working with parents who have toddlers. The biggest thing that I've found in clinical work, working with those parents, is helping them understand how children think differently and also helping them start to catch those cognitive distortions early and start addressing them with the child in order to prevent that from becoming a habitual way of thinking later in life. The other thing that I found effective in recent years is teaching them distress tolerance skills, going back to the DBT handbook, and helping them learn how to help their child deal with distress, help their child distract from emotional upset until they can deal with it in a different way. In response to your question about is this the highest time of risk for adverse childhood experiences or does that come later? I would have to look that up because my mind is going in a couple different directions in terms of vulnerability for abuse is a lot higher when the children are younger. But when they get into high school and when they get into middle school then they also have peer pressure and they have a lot more risk of negative experiences from their peers and from bullying and peer pressure and experimentation. So I will look that up and I will have the answer for you Thursday. When a child's being left out by others, do you primarily manage their stress by teaching mindfulness and DBT stress reduction or best advice? It really depends on the situation if the child is being left out. Let's look at what's causing that child to be left out. Are they doing not that they're bringing that on themselves but they may be withdrawing? Temperamentally, it may be an overwhelming situation for them. And yes, I will interrupt myself for a second. If you need to go, feel free to go take your quiz. Like I said, you will get a little bit of extra credit because I knew this was going to be a little bit of a long presentation and I will see you in the next class. But back to the playground. Let's look at what's going on and figure out, you know, does Johnny not have social skills? You know, maybe Johnny doesn't know how to interact with the other children. So observe how the child interacts with others in the classroom and outside of the classroom. Talk to them about why they're not participating with the other children because they may have some ideas about why they're getting left out. We also want to ask them if they want to be included. Not every child wants to be included. Some children, when they come to playground time, it's the only time they don't have stimulus input and they just, they want some quiet time. So, you know, I'd really look at talking with the child about what's going on and seeing how they feel about it. Over and above that, I will re-emphasize that my main training is not with children. So we would want to look more towards a child therapist, one who's used to play therapy, one who has worked with situations exactly like this and help them, help figure out exactly what's causing this particular situation. In substance abuse, can an adult individual be analyzed during the time they started, an adult individual interaction be analyzed during the time they started using substances? Well, I see you're adding on to that question. I will start by answering, my experience has been over, you know, 20-some odd years of working with people and obviously I have not worked with everybody everywhere. But my experience has been as a general rule, people's cognitive and self-esteem and socio-emotional development kind of stagnates at the point at which they started heavily using. Now, there's a difference between experimentation. I'm just going to smoke a joint here or there, you know, sneak a little bit out of mom's liquor cabinet, versus actually moving into that addiction where they're using regularly. Once the addiction actually is in full swing, if you will, it seems that a lot of other development gets arrested or is put on a moratorium because the person is focused on that addiction and just numbing what pain they're in right then. Did that answer your question? Okay, cool. The really, really cool thing is, you know, people, as they develop things that they learn when they're 11, then they practice all through high school and then they become adults as years and years and years. But if an adult goes back and has to learn those things that, you know, they didn't learn, it goes a lot faster because cognitively they are so much further developed. Their brain, at least, is ready to handle that information and just waiting for it. So it's really interesting to see how resilient people can be when they're provided with an environment that is supportive and conducive to learning and positive change. Alrighty, everybody. I am always interested in knowing what you would like to learn more about. If there's something I didn't cover in these presentations, please let me know. Shoot me an email to supportatallceuse.com or, you know, you can always message me either before, after or during a presentation. And, but until, until, I think we're doing another one tomorrow. Yes, we are doing a, a repeat presentation tomorrow and then we will be doing another developmental on Thursday. So until then, have an awesome, amazing week. Stay warm if it's cold where you are and I will see you on the flip side. If you enjoy this podcast, please like and subscribe either in your podcast player or on YouTube. If you want to attend and participate in our live webinars with Dr. Snipes, you can subscribe at hgtbs.com slash slash allceuse.com slash counselor toolbox. This episode has been brought to you in part by allceuse.com providing 24-7 multimedia continuing education and pre-certification training to counselors, therapists, and nurses since 2006. You can use coupon code, Counselor Toolbox to get 20% off of your current order. If you're a podcast listener, especially on an Apple device, it would be extremely helpful if you would review Counselor Toolbox. 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