Autism spectrum disorder (ASD) is a developmental disability that can cause significant social, communication and behavioral challenges. There is often nothing about how people with ASD look that sets them apart from other people, but people with ASD may communicate, interact, behave, and learn in ways that are different from most other people. The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged. Some people with ASD need a lot of help in their daily lives; others need less.
A diagnosis of ASD now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome. These conditions are now all called autism spectrum disorder.
Signs and Symptoms
People with ASD often have problems with social, emotional, and communication skills. They might repeat certain behaviors and might not want change in their daily activities. Many people with ASD also have different ways of learning, paying attention, or reacting to things. Signs of ASD begin during early childhood and typically last throughout a person’s life.
Children or adults with ASD might:
- not point at objects to show interest (for example, not point at an airplane flying over)
- not look at objects when another person points at them
- have trouble relating to others or not have an interest in other people at all
- avoid eye contact and want to be alone
- have trouble understanding other people’s feelings or talking about their own feelings
- prefer not to be held or cuddled, or might cuddle only when they want to
- appear to be unaware when people talk to them, but respond to other sounds
- be very interested in people, but not know how to talk, play, or relate to them
- repeat or echo words or phrases said to them, or repeat words or phrases in place of normal language
- have trouble expressing their needs using typical words or motions
- not play “pretend” games (for example, not pretend to “feed” a doll)
- repeat actions over and over again
- have trouble adapting when a routine changes
- have unusual reactions to the way things smell, taste, look, feel, or sound
- lose skills they once had (for example, stop saying words they were using)
Information provided by the Center for Disease Control – cdc.gov
ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.
Signs and Symptoms
It is normal for children to have trouble focusing and behaving at one time or another. However, children with ADHD do not just grow out of these behaviors. The symptoms continue, can be severe, and can cause difficulty at school, at home, or with friends.
A child with ADHD might:
- daydream a lot
- forget or lose things a lot
- squirm or fidget
- talk too much
- make careless mistakes or take unnecessary risks
- have a hard time resisting temptation
- have trouble taking turns
- have difficulty getting along with others
There are three different types of ADHD, depending on which types of symptoms are strongest in the individual:
- Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.
- Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.
- Combined Presentation: Symptoms of the above two types are equally present in the person.
Because symptoms can change over time, the presentation may change over time as well.
Causes of ADHD
Scientists are studying cause(s) and risk factors in an effort to find better ways to manage and reduce the chances of a person having ADHD. The cause(s) and risk factors for ADHD are unknown, but current research shows that genetics plays an important role. Recent studies link genetic factors with ADHD.1
In addition to genetics, scientists are studying other possible causes and risk factors including:
- Brain injury
- Exposure to environmental risks (e.g., lead) during pregnancy or at a young age
- Alcohol and tobacco use during pregnancy
- Premature delivery
- Low birth weight
Research does not support the popularly held views that ADHD is caused by eating too much sugar, watching too much television, parenting, or social and environmental factors such as poverty or family chaos. Of course, many things, including these, might make symptoms worse, especially in certain people. But the evidence is not strong enough to conclude that they are the main causes of ADHD.
Deciding if a child has ADHD is a process with several steps. There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, sleep problems, and certain types of learning disabilities, can have similar symptoms. One step of the process involves having a medical exam, including hearing and vision tests, to rule out other problems with symptoms like ADHD. Diagnosing ADHD usually includes a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes, the child.
In most cases, ADHD is best treated with a combination of behavior therapy and medication. For preschool-aged children (4-5 years of age) with ADHD, behavior therapy, particularly training for parents, is recommended as the first line of treatment before medication is tried. What works best can depend on the child and family. Good treatment plans will include close monitoring, follow-ups, and making changes, if needed, along the way.
Managing Symptoms: Staying Healthy
Being healthy is important for all children and can be especially important for children with ADHD. In addition to behavioral therapy and medication, having a healthy lifestyle can make it easier for your child to deal with ADHD symptoms. Here are some healthy behaviors that may help:
- Developing healthy eating habits such as eating plenty of fruits, vegetables, and whole grains and choosing lean protein sources
- Participating in daily physical activity based on age
- Limiting the amount of daily screen time from TVs, computers, phones, and other electronics
- Getting the recommended amount of sleep each night based on age
- National Resource Center on ADHDexternal
- National Institute of Mental Health (NIMH)external
- The Network of Care of Chemung County (New York)external – Information on ADHD in American Sign Language (ASL)
If you or your doctor has concerns about ADHD, you can take your child to a specialist such as a child psychologist, child psychiatrist, or developmental pediatrician, or you can contact your local early intervention agency (for children under 3) or public school (for children 3 and older).
The Centers for Disease Control and Prevention (CDC) funds the National Resource Center on ADHDexternal, a program of CHADD – Children and Adults with Attention-Deficit/Hyperactivity Disorder. Their website has links to information for people with ADHD and their families. The National Resource Center operates a call center (1-866-200-8098) with trained staff to answer questions about ADHD.
For more information on services for children with special needs, visit the Center for Parent Information and Resources.external To find the Parent Center near you, you can visit this website.external ADHD in Adults
ADHD can last into adulthood. Some adults have ADHD but have never been diagnosed. The symptoms can cause difficulty at work, at home, or with relationships. Symptoms may look different at older ages, for example, hyperactivity may appear as extreme restlessness. Symptoms can become more severe when the demands of adulthood increase. For more information about diagnosis and treatment throughout the lifespan, please visit the websites of the National Resource Center on ADHDexternal and the National Institutes of Mental Healthexternal
- National Resource Center on ADHDexternal
- National Institute of Mental Health (NIMH)external
- The Network of Care of Chemung County (New York)external – Information on ADHD in American Sign Language (ASL)
- Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., . . . Wang, Y. (2021). The World Federation of ADHD International Consensus Statement: 208 evidence-based conclusions about the disorder. Neuroscience & Biobehavioral Reviews. doi:10.1016/j.neubiorev.2021.01.022
How often are you fully and completely present when you are with your children? One of the greatest gifts we can give to our children is to be fully present with them. Being fully present can often be a big challenge.
When my children were growing up, I worked full time as a counselor, wrote books, traveled on book tours, and pursued my passion as an artist – in addition to spending time with my husband. The only way I could be fully present when I was with my children was to set aside “time alone” with them. “Time alone” was the daily quality time I spent with each of my children, doing whatever they wanted to do. During this time, I did not answer the phone or deal with the many running issues. It was time set aside to be fully present with them, not even thinking about other things.
When you don’t spend quality time being fully present, the message you give to your children is that they are not important. When answering the phone, or getting things done, or thinking about what you have to do tomorrow is more important than being present with your children, they get the message that being with them and knowing them is not very important to you.
When I was growing up, my mother was always busy. She never had the time to be with me. She never wanted to know about my thoughts and feelings or how things were going at school. She never had the time to play with me or hang out with me. While she said that she loved me and that I was important to her, I never felt it. Words don’t cut it when the actions don’t follow.
If it is not important to you to be with your children – talking with them, playing with them, taking a walk, holding them, listening to them, sharing love with them – then they will likely not feel loved by you. No matter how many things you buy them or how often you tell them you love them, if they are not important enough to you to be with them, they will likely not feel loved and cherished by you.
Your children need your focused attention, and when they don’t get it, they may pull for it in various ways. They may chatter on and on, trying to keep your attention. They may act out by fighting with each other, or by not listening to you, or going into resistance regarding chores, homework, hygiene, bedtime, and so on. For many children, even negative attention feels better than no attention. This may create a very negative vicious circle, in that the more they act out, the less you feeling like being with them, but the less you are with them lovingly and attentively, the more they may act out.
Think about how you feel when someone gives you his or her full attention. Doesn’t it feel wonderful? How often does someone look you in the eyes and give you his or her full attention? How often do you feel listened to and heard by someone? Unfortunately, many people are so intent on being listened to and heard that they don’t listen and hear.
The simple act of being fully present with your children will do more for them than you can imagine. You have an opportunity to give your children a great gift – being fully present with them with your love, compassion, empathy, interest, sense of humor, playfulness, and affection. Each day, you have the opportunity, even if it is just for half an hour, to fully cherish them.
They grow up so fast. Don’t miss this opportunity each day.
Here are some easy ways to incorporate instilling the virtue of gratitude in your children. Then, as you go through your day, show them the wonderful events behind the scenes that we most usually take for granted.
- Set the Right Example.
Teach them by using the appropriate words at the right times yourself. For example, how many parents do you see saying “Thank You” to their two or three-year-old children? For example, kids learn best, and teaching gratitude is no different than anything else in that respect. “Children Learn What They Live!”
- Teach It Through Role-Playing.
You can play games with your children that implement the virtue of gratitude. For example, play the second chair and practice showing them how it feels to be on the receiving end of an unexpected “Thank You!”
- Teach by Showing Them How to Be of Service to Others.
Even simple things such as holding a door for an older adult are small ways to show them how others appreciate us and our actions. It is also a way to put a smile and a lift into a stranger’s day, which always creates a good feeling within the person who is doing the kind act.
You would be surprised how often a simple gesture like this can occur in your normal daily activities, in places like grocery stores, doctors’ offices, or shopping trips.
- Make a List.
It is an easy way to get them to make lists of what they are thankful for and how each thing makes their life better.
- Teach Gratitude While Going Without Things.
Recently my family and I had to deal with a full 24 hours of no power. This outage caused by a storm was an ideal opportunity for me to teach my children what we had to be thankful for that we normally took for granted. Simple things like lights, heat, and watching TV were just a few that quickly came to mind.
- Show them How to Be Thankful for the Little Things in Life.
As in the previous example, although most of us would not consider heat and light little things, they are always there for our kids, so they are simple things that they usually don’t pay much attention.
Other simple examples could include; having food to eat all the time, friends to play with, and having plenty of toys and school supplies. Showing them examples of third-world country children who go without these things is a way of teaching them an appreciation for what they have.
- Teach them to see the good in someone they don’t like.
You can even use a negative experience to teach them the value of being grateful. When I think of this, immediately what comes to my mind is the Walt Disney movie “PollyAnna,” where she played the “Glad” game and found many things to be grateful for in every situation she encountered. Renting this video, watching and discussing it with them would be a great, gratitude-building quality time family activity.
As you go through your day, show them the wonderful events behind the scenes that we often take for granted. For instance, things like the police, who protect us, the firemen who are there for those who need them, and the clerk at the grocery store doing her job to help us get our food. Simple thank you comments to all of these daily activities is the easiest way to model appreciation that your children will learn and emulate.
Providing breast milk is one of the best things you can do for your baby’s health and development. Pumping your milk is one way to provide breast milk to your baby. However, germs can grow quickly in breast milk or breast milk residue that remains on pump parts. Following these steps can keep your breast pump clean and help protect your baby from these germs. If your baby was born prematurely or has other health concerns, your baby’s health care providers may have more recommendations for pumping breast milk safely.
- Wash hands. Wash your hands well with soap and water for 20 seconds.
- Assemble. Assemble clean pump kit. Inspect whether the pump kit or tubing has become moldy or soiled during storage. If your tubing is moldy, discard and replace immediately.
- Clean if using a shared pump.Clean pump dials, power switch, and countertop with disinfectant wipe.
- Store milk safely. Cap milk collection bottle or seal milk collection bag, label with date and time, and immediately place in a refrigerator, freezer, or cooler bag with ice packs.If milk collection container will be stored at a hospital or childcare facility, add name to the label
- Clean pumping area. Especially if using a shared pump, clean the dials, power switch, and countertop with disinfectant wipes.
- Take apart and inspect pump kit. Take apart breast pump tubing and separate all parts that come in contact with breast/breast milk (for example, flanges, valves, membranes, connectors, and milk collection bottles).
- Rinse pump kit. Rinse breast pump parts that come into contact with breast/breast milk under running water to remove remaining milk
- Clean pump kit. As soon as possible after pumping, clean pump parts that come into contact with breast/breast milk in one of the following ways.
- Clean by hand.
- Use a wash basin. Place pump parts in a clean wash basin used only for washing infant feeding equipment. Do not place pump parts directly in the sink, because germs in sinks or drains could contaminate the pump.
- Add soap and water. Fill wash basin with hot water and add soap.
- Scrub. Scrub items according to pump kit manufacturer’s guidance. If using a brush, use a clean one that is used only to clean infant feeding items.
- Rinse. Rinse by holding items under running water, or by submerging in fresh water in a separate basin that is used only for cleaning infant feeding items.
- Dry. Allow to air-dry thoroughly. Place pump parts, wash basin, and bottle brush on a clean, unused dish towel or paper towel in an area protected from dirt and dust. Do not use a dish towel to rub or pat items dry because doing so may transfer germs to the items.
Clean in a dishwasher (if recommended by pump kit manufacturer).
- Wash. Place disassembled pump parts in dishwasher. Be sure to place small items into a closed-top basket or mesh laundry bag so they don’t end up in the dishwasher filter. If possible, run the dishwasher using hot water and a heated drying cycle (or sanitizing setting); this can help kill more germs.
- Remove from dishwasher. Wash your hands with soap and water before removing and storing cleaned items. If items are not completely dry, place items on a clean, unused dish towel or paper towel to air-dry thoroughly before storing. Do not use a dish towel to rub or pat items dry because doing so may transfer germs to the items.
- Clean by hand.
- Clean wash basin and bottle brush. If you use a wash basin or bottle brush when cleaning your pump parts, rinse them well and allow them to air-dry after each use. Consider washing them every few days, either in a dishwasher with hot water and a heated drying cycle, if they are dishwasher-safe, or by hand with soap and warm water.
For extra germ removal, sanitize pump parts at least once daily. Sanitizing is especially important if your baby is less than 3 months old, was born prematurely, or has a weakened immune system due to illness or medical treatment (such as chemotherapy for cancer). Daily sanitizing of pump parts may not be necessary for older, healthy babies, if the parts are cleaned carefully after each use. Sanitize all items (even the bottle brush and wash basin!) by using one of the following options.
Note: If you use a dishwasher with hot water and a heating drying cycle (or sanitizing setting) to clean infant feeding items, a separate sanitizing step is not necessary.
- Clean first. Pump parts, bottle brushes, and wash basins should be sanitized only after they have been cleaned.
- Sanitize. Sanitize the pump kit, bottle brushes, and wash basins using one of the following options. Check manufacturer’s instructions about whether items may be steamed or boiled.
- Use a microwave or plug-in steam system according to the manufacturer’s directions.
- Place disassembled items that are safe to boil into a pot and cover with water.
- Put the pot over heat and bring to a boil.
- Boil for 5 minutes.
- Remove items with clean tongs.
- Allow to air-dry thoroughly. Place sanitized pump parts, wash basin, and bottle brush on a clean, unused dish towel or paper towel in an area protected from dirt and dust. Do not use a dish towel to rub or pat items dry because doing so may transfer germs to the items.
Allow the clean pump parts, bottle brushes, and wash basins to air-dry thoroughly before storing to help prevent germs and mold from growing. Once completely dry, the items should be stored in a clean, protected area to prevent contamination during storage.
- Wash hands. Wash hands well with soap and water.
- Reassemble. Put together the clean, dry pump parts.
- Store safely. Place reassembled pump kit in a clean, protected area such as inside an unused, sealable food storage bag. Store wash basins and bottle brushes in a clean area.
- When used correctly, breast pump tubing does not touch the pumped milk and does not need to be cleaned routinely.
- Keep a spare set of tubing on hand in case the set you are using gets soiled or damaged.
- If your tubing has water droplets in it at the end of a pumping session, disconnect the tubing from the flange/pump kit, but leave it attached to the pump. Run the pump for a few more minutes until the tubing is dry.
- If your tubing has milk or mold in it, throw it away immediately because it is difficult to clean properly. Replace it with a new set of tubing, and check to see if the problem happened because
- The valves or membranes need to be replaced.
- The tubing was attached to the pump incorrectly.
- If the outside of your tubing is soiled, wipe it with a damp cloth or disinfectant wipe.
Reading to your child has many benefits, one of which is simply having time to snuggle together.
Here are ten reasons to read to your child.
1.When you read to your child, he/she will learn that reading is important to you, therefore reading will become important to him/her.
2.The more your child hears sounds, the better he/she will process these sounds into words. When a child is preschool/kindergarten age, the listening word starts to become the written word.
3.Reading has a calming effect on a restless or fussy child. Who doesn’t want an easy way to calm a fussy child?
4.Reading is a wonderful before bed routine. Studies have shown that a child will thrive in an atmosphere in which routines are present.
5.Reading will help to develop your child’s imagination. Have you ever gotten lost in a good book? Your child can do the same while you are reading to him/her.
6.Reading will foster your child’s ability to listen and pay attention. With all the problems we hear concerning attention spans, this is a great way to avoid that.
7.Reading to a young child will teach him/her the correct way to hold a book and turn the pages.
8.Reading to your child will develop in him/her the desire to become a reader.
9.Teachers will thank you.
10.When a child is read a personalized storybook, he/she will be able to recognize his/her name in print at an early age.
Isn’t it exciting to think that you can have such an effect on your child’s ability to readjust by reading to him/her? You have the power to develop a lifelong joy of reading and learning in your child. WOW! Just read.
Children with optimistic thinking skills are better able to interpret failure, have a stronger sense of personal mastery, and are better able to bounce back when things go wrong in their lives.
Because parents are a major contributor to the thinking styles of their children’s developing minds, it is important to adhere to the following five steps to ensure healthy mental habits in your children.
How Parents Can Help
Step 1: Learn to think optimistically yourself. What children see and hear indirectly from you as you lead your life and interact with others influences them much more than what you try to ‘teach’ them.
You can model optimism for your child by incorporating optimistic mental skills into your own way of thinking. This is not easy and does not occur over night. But with practice, almost everyone can learn to think differently about life’s events – even parents!
Step 2: Teach your child that there is a connection between how they think and how they feel. You can do this most easily by saying aloud how your own thoughts about adversity create negative feelings in you.
For example, if you are driving your child to school and a driver cuts you off, verbalize the link between your thoughts and feelings by saying something like “I wonder why I’m feeling so angry; I guess I was saying to myself: ‘Now I’m going to be late because the guy in front of me is going so darn slow. If he is going to drive like that he shouldn’t drive during rush hour. How rude.’”
Step 3: Create a game called ‘thought catching.’ This helps your child learn to identify the thoughts that flit across his or her mind at the times they feel worst. These thoughts, although barely noticeable, greatly affect mood and behavior.
For instance, if your child received a poor grade, ask: “When you got your grade, what did you say to yourself?”
Step 4: Teach your child how to evaluate automatic thoughts. This means acknowledging that the things you say to yourself are not necessarily accurate.
For instance, after receiving the poor grade your child may be telling himself he is a failure, he is not as smart as other kids; he will never be able to succeed in school, etc. Many of these self-statements may not be accurate, but they are ‘automatic’ in that situation.
Step 5: Instruct your child on how to generate more accurate explanations (to themselves) when bad things happen and use them to challenge your child’s automatic but inaccurate thoughts. Part of this process involves looking for evidence to the contrary (good grades in the past, success in other life areas, etc).
Another skill to teach your child to help him or her think optimistically is to help your child see that the bad event may not be as bad or will not have the adverse consequences imagined. Few things in life are as devastating as we fear, yet we blow them up in our minds.
Parents can influence the thinking styles of their children by modeling the principals of optimistic thinking.
- Who should NOT use cloth face coverings: children under age 2, or anyone who has trouble breathing, is unconscious, incapacitated or otherwise unable to remove the mask without assistance.
- Cloth face coverings are NOT surgical masks or N95 respirators. Currently, surgical masks and N95 respirators are critical supplies that should be reserved for healthcare workers and other first responders.
Wear your Face Covering Correctly
- Wash your hands before putting on your face covering
- Put it over your nose and mouth and secure it under your chin
- Try to fit it snugly against the sides of your face
- Make sure you can breathe easily
Wear a Face Covering to Protect Others
- Wear a face covering that covers your nose and mouth to help protect others in case you’re infected with COVID-19 but don’t have symptoms
- Wear a face covering in public settings when around people who don’t live in your household, especially when it may be difficult for you to stay six feet apart
- Wear a face covering correctly for maximum protection
- Don’t put the face covering around your neck or up on your forehead
- Don’t touch the face covering, and, if you do, wash your hands or use hand sanitizer to disinfect
Follow Everyday Health Habits
- Stay at least 6 feet away from others
- Avoid contact with people who are sick
- Wash your hands often, with soap and water, for at least 20 seconds each time
- Use hand sanitizer if soap and water are not available
Take Off Your Cloth Face Covering Carefully, When You’re Home
- Untie the strings behind your head or stretch the ear loops
- Handle only by the ear loops or ties
- Fold outside corners together
- Place covering in the washing machine (learn more about how to wash cloth face coverings)
- Be careful not to touch your eyes, nose, and mouth when removing and wash hands immediately after removing.
Children and teens react, in part, on what they see from the adults around them. When parents and caregivers deal with the COVID-19 calmly and confidently, they can provide the best support for their children. Parents can be more reassuring to others around them, especially children, if they are better prepared.
Watch for behavior changes in your child
Not all children and teens respond to stress in the same way. Some common changes to watch for include:
- Excessive crying or irritation in younger children.
- Returning to behaviors they have outgrown (for example, toileting accidents or bedwetting).
- Excessive worry or sadness.
- Unhealthy eating or sleeping habits.
- Irritability and “acting out” behaviors in teens.
- Poor school performance or avoiding school.
- Difficulty with attention and concentration.
- Avoidance of activities enjoyed in the past.
- Unexplained headaches or body pain.
- Use of alcohol, tobacco, or other drugs.
Ways to support your child
- Talk with your child about the COVID-19 outbreak.
- Answer questions and share facts about COVID-19 in a way that your child can understand.
- Reassure your child that they are safe. Let them know it is ok if they feel upset. Share with them how you deal with your own stress so that they can learn how to cope from you.
- Limit your family’s exposure to news coverage of the event, including social media. Children may misinterpret what they hear and can be frightened about something they do not understand.
- Try to keep up with regular routines. If schools are closed, create a schedule for learning activities and relaxing or fun activities.
- Be a role model. Take breaks, get plenty of sleep, exercise, and eat well. Connect with your friends and family members.
- Spending time with your child in meaningful activities, reading together, exercising, playing board games.