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Children & Youth Bullying: How to Spot and Address it

Children & Youth Bullying: How to Spot and Address it

By Tan Su-Lynn, Educational Psychologist

Bullying can be manifested in many forms, and children and youth can be involved in many ways in it. However, with 1 in 4 children in Singapore reporting that they have experienced bullying a few times a month, bullying might be closer to home than you think. 

Bullying is done with the intent to hurt and is repeated or persistent. Often, the target of bullying finds it difficult to stop it or stand up for himself / herself. This is different from peer conflicts or quarrels which typically involve incidents where children mutually hurt each other. As parents and caregivers, how do we support our children as they navigate the complexities of relationship-building, and what are some warning signs that indicate that they are involved in bullying? 

 

Broadly, there are three different types of bullying

  • Relational: When hurtful actions are made with the intention to shame a person and damage the forming of healthy relationships and friendships. This can take the form of leaving someone out of a group, teasing, name-calling, expressing negative thoughts or feelings about a person, and even intimidating them to do things against their will.

 

  • Physical: When harm has been inflicted on a person or their belongings. This can take the form of hitting, punching, kicking, inappropriate touching and persistent damaging or stealing of belongings.

 

  • Cyber-bullying: Occurs on the internet, through mobile phones, computers, video-game systems and other forms of technology. Both relational and physical bullying can occur on this platform. For example, digital technology can be used to gossip and spread rumours or hostile messages, or game accounts can be hacked and items stolen. 

 

How do I identify if my child is involved in bullying?

Recognising these warning signs is the first step in stemming bullying. 

Warning signs of being a target of bullying:

Your child…

  • has unexplainable cuts, bruises, scratches or other injuries
  • comes home with lost, torn, damaged, or destroyed clothing, books, stationeries or other belongings 
  • is unusually hungry after returning from school
Physical Signs
  • seems fearful of going to school, walking to and from school, riding the school bus, or taking part in organized activities with peers, and often finds or makes up excuses (e.g. faking illness) as to why he/she cannot go to school
  • has declining grades, lost interest in school work or suddenly begins to do poorly in school
School-related signs
  • experiences a loss of appetite, or has changes in eating habits like skipping meals or binge eating
  • reports sleeping difficulty (e.g. trouble falling and staying asleep, frequent bad dreams, etc)
  • complains frequently of headaches, stomachaches or other physical ailments
Health signs
  • suddenly stops talking about friends and has few, if any, friends, with whom he or she spends time with during recess or after school
  • is withdrawn and stammers
  • continually ‘loses’ money or starts stealing
  • appears anxious, sad, moody, teary, or depressed when he or she comes home and suffers from low self-esteem 
  • self-harms or talks about suicide
  • becomes aggressive and unreasonable
  • refuses to talk about what is wrong
  • begins to target siblings
Emotional and Behavioural signs

 

Warning signs of engaging in bullying:

Your child…

  • gets into verbal or physical fights
  • suddenly possesses unexplained extra money or new belongings
  • often reacts aggressively towards others
  • has friends who bully others
  • may be excessively worried about their popularity and reputation
  • can be competitive
  • has received many disciplinary warnings and actions 
  • refuses to accept responsibility for their actions 
  • blames others for their problems
  • experiences anxiety or depression
  • has difficulty regulating his/her emotions and behaviour
What should I do if I think my child is involved in bullying?

It is important to talk with children who show signs of being bullied or bullying others. The safety and mental health of our children should remain an utmost concern. It’s painful to think of your child receiving or inflicting harm on other kids, but bullying is a serious issue for both the targeted and the aggressor. According to research, a vast majority of bullies have also been the targets of bullying, and less than 1% of primary school children are “true bullies” – those who were not bullied by their peers.

Bear these three C’s in mind when relating with your child: Communicate, Consult and Connect

  • Communicate
    If you hear from a teacher or another parent that your child involved in a bullying situation, the first thing you should do is talk to your child about the situation. Be direct about the issue, but make it clear that you are open to hearing your child’s side of the story. Stay calm and say something like, “Your teacher called to tell me that you were involved in some bullying. I’m really concerned about this, and we need to talk about it. Please tell me what happened.”Avoid prejudging the situation and reacting based on emotions. It can be tempting to immediately blame the other party, criticise parenting, or condemn the school system, but it is also worth taking time to look inward and reflect on whether your own actions may be influencing your child’s. Some children may be modelling their interpersonal style based on the behaviour they have observed. If so, it is important to start fostering a positive home environment, where members of the family treat one another with kindness and respect, creating a safe space for children to share their worries and failures.

 

  • Consult
    Talking through the situation with your child can help you understand why the bullying is happening, and what steps need to be taken in order to stop it. For example, you may find that your child has incredibly low self-esteem and bullying helped him/her feel powerful and able to control something. He/she might prefer being known as ‘the worst kid in school’ and interacting with other children in the process, rather than not being noticed at all and having no friends. Or perhaps your child might accept being the target of bullying with the mistaken belief that such behaviours are acceptable between friends. Some children may not be able to articulate their feelings. This is especially true of children who are struggling with anxietytrauma, or another mental health issue. If you are having trouble, consider consulting a child psychologist or psychiatrist who has a lot of experience evaluating kids’ behaviours. Your child might need a therapist’s help to work through underlying issues, investigate the root of the problem and guide you and your child in tackling the specific challenges that your child faces in his/her social interactions. 

 

  • Connect
    Ultimately, it is about building a close and lasting connection with your child. Connecting with your child about his/her day-to-day life will put you in a better position to recognise signs of bullying and trouble. Start with asking your child a few open-ended questions on a daily basis. For example, ask him/her to share about one really great thing that happened that day, and one not-so-great thing. It can be tough to get started, but children who are regularly encouraged to share details of their lives with their parents tend to be more comfortable with continuing to do so when they are in their adolescence. Listening to your child in a supportive, non-judgmental way helps them feel connected to your presence and love in their lives, and makes them more receptive to opening up to you about their problems as well as accepting the advice that you give to them. It is always better to handle challenging issues like bullying together so that your child will be able to walk out of the shadow of the bullying with confidence and courage.

 


Reference

1 https://bullyfree.sg/wp-content/uploads/2018/12/The-Straits-Times_Bullying-in-schools-stable-and-managed.pdf, https://mothership.sg/2019/12/bullying-singapore-pisa-2018/

2 https://www.theguardian.com/education/2008/aug/29/bullying.schools2 

Tips on Parenting Practices that promote Good Mental Health in Children & Youth

Tips on Parenting Practices that promote Good Mental Health in Children & Youth

Author: Dr Mark Toh, Consultant Clinical Psychologist

The 2nd Singapore Mental Health Study (SMHS) which began in 2016 (reported in December 2018) was initiated by the Institute of Mental Health (IMH) in collaboration with the Ministry of Health (MOH) and Nanyang Technological University (NTU). The study focused only on those 18 years old and above. The findings show that 13.9% or 1 in 7 Singaporeans have experienced a mood (major or bipolar depression), anxiety (obsessive compulsive disorder and generalised anxiety disorder) or alcohol use disorder (alcohol abuse and alcohol dependence) in their lifetime. These are the top 3 mental disorders in Singapore among the conditions assessed in the study. The study also reported that more than three-quarters of those with a mental disorder in their lifetime did not seek professional help. In the first SMHS study in 2010, the lifetime prevalence rate of mental disorders in the Singapore population was 12% or 1 in 8 persons. 

 

In a 2012 publication on Depression by the Ministry of Health, it was reported that depression affects between 2.5% to 18% of youth*. Depression among youths in Singapore is considered common. But it is a serious mental health symptom because of it what it reflects of children’s experiences in their environment. In particular, it is a serious reflection of what they may experience in the family or relational environment. If not adequately treated, the depressed child is likely to bring their depression into adulthood. This means that the emotionally wounded or damaged child is likely to carry their wounds forward as adults. This is a likely scenario because it is estimated that an initial episode of depression increases the likelihood of a second episode by 50%. A second major episode of depression increases the likelihood of a 3rd episode of depression by 75%. A third major episode of depression increases the likelihood of a 4th episode by 100%. Not surprisingly, depression has been found to affect brain structures and functioning. It is this recurrent tendency of depression that the suicide risk often increases over time within the same individual with a history of depression.

 

The risk of depression in childhood needs to be a major consideration for all those concerned with the development of children. Depression among children is a serious health problem because it can impair the emotional development of the child. It can seriously affect identity formation which is foundational to how the emerging adolescent learns to relate to themselves, to others and to the world at large. Later as adults, depression can impair psycho-social as well as occupational functioning. Depression is associated with significant morbidity and mortality. Also, depression can be triggered by, or lead to, other mental health conditions such as substance abuse, anxiety, schizophrenia or personality disorders.

 

Signs to watch for in children who may be depressed:

  • Continuous feelings of sadness and hopelessness
  • Irritability or anger
  • Social withdrawal
  • Increased sensitivity to rejection
  • Changes in appetite — either increased or decreased
  • Changes in sleep — sleeplessness or excessive sleep
  • Vocal outbursts or crying
  • Difficulty concentrating
  • Fatigue and low energy
  • Physical complaints such as stomachaches, headaches that do not respond to treatment
  • Reduced ability to function during events and activities at home or with friends, in school, extracurricular activities, and in other hobbies or interests
  • Feelings of worthlessness or guilt
  • Impaired thinking or concentration
  • Thoughts of death or suicide

 

Not all depressed children display these symptoms. They are more likely to display different symptoms at different times at different settings. When depression is significant, there are often noticeable changes in social activities, loss of interest in school and poor academic performance, or a change in appearance.

 

The young child is most vulnerable to depression due to the quality of relationships with his or her caregivers. This vulnerability increases when the family environment is also accompanied by marital conflict, abuse, violence, illness and/or low socioeconomic status. However, it is in the quality of relationships with caregivers that is crucial because of what it can offer as a buffer or protection from other external events or causes. Therefore, the mental health of children begins with thoughtful parents who genuinely understand and care about their child’s emotional needs and development.

Parenting Practices that promote Good Mental Health in Children:

1. Love your child unconditionally

  • A genuine attitude to decide in the best interests of your child, and not in the parent’s convenience. Children thrive under certain physical and emotional conditions. The long-term view is needed. Parenting must understand the healthy outcome effective parenting can produce. This helps to plan to optimise the emotional development of the child. Loving well in the best interests of the child provides the best head start towards orienting the child to relate to themselves and others in a healthy way. Children’s need to establish a healthy identity, to uncover and stretch their potential, and learn to self-actualise will require parents to stretch their own emotional ‘ceiling.’ This means parents who desire to raise emotionally healthy children have to face their own insecurities so as not to impose them on their own children. Parenting with the best interests of the child will often be at the inconvenience of parents especially if parents do not appreciate the value of nurturing relationships which children thrive on.
  • Loving your child well answers the deep longing for the child to later ask, “Am I worthwhile?” The need for children to recognise their own personal importance, value and worth prepares them to find that their later life will amount to significance. The child at risk of depression commonly struggle with this sense of self regard. Loving the child unconditionally is not based on the social or academic performance that society may hold out for children. Instead, mistakes are accepted as a natural part of their learning. If the parents placed their importance on their children only in reaching their own ambitions, or social or academic accomplishments, these indicate conditional expectations for them to find approval or acceptance. The will view their worth based on what they do instead of who they are. 

 

2. Ensure safe and secure physical and emotional surroundings

  • Secure attachment, which is offering an ongoing, consistent, soothing, accepting presence to the infant is the important beginning in the parent-child relationship that helps the infant to learn to feel safe and secure in the world. This is a foundational need for positive mental health in infants and children and later adulthood. Emotional safety from the secure bond offered by a secure parent helps young children to trust the caregiver and to experience their world as safe and predictable. Through this quality of care, a child is encouraged to first accept themselves as as lovable, as important. It also prepares them next to want to explore their world as they mature physically. This means parents who wish the best for their children have to prepare them to become independent over time.
  • Punitive, harsh or neglectful parents, especially when physical punishment is employed, leads to children questioning their worth or value and increases the risk for later depression. Parents who frequently employ shame, threats, insults or convey other derogatory messages to their children tend to raise a child who view themselves as defective. This is particularly damaging to children. Indeed, the DSM-V lists the sense of hopelessness or worthlessness as a common symptom of depression. Children can be raised to view themselves as defective, and that their life as meaningless.
  • Promoting a safe emotional environment emphasises listening and empathy as skills, and being age-appropriate supportive as an attitude. Being emotionally present and listening well will foster the child’s wish to share their experiences. It builds on the bond already started from providing a secure attachment. It encourages children to view the parent and other people as a safe resource they can count on later if needed. It answers the important question that children ask, “Is it OK to be me?” This also fosters familiarity with emotional intimacy that better prepare children for friendships and significant relationships later. Familiarity with close and supportive relationships also mean that the child is less likely to isolate themselves socially when they face problems later on. It is a wise parent who value interactional activities with their young children early on rather than let them become overly attached to computer games and the internet to amuse themselves. Excessive computer use at the detriment of other activities has been linked to increased loneliness, poor social development and depression. 

 

3. Nurture Self-confidence and High Self-esteem

  • Self-confidence is most easily found when children grow up feeling loved unconditionally.
  • The foundation provided when the child feels loved should be supported by the child’s search for mastery in the world when they are ready to explore. Starting with simple activities, their need for autonomy and mastery over their environment allows them to gain confidence over the tasks they wish to take on. It is important for parents to support this rather than to over-protect them from exploration. Parents who are over-protective of their children and anxious about possible mishaps will find it difficult to foster the autonomy and independence their children need. To build their self-confidence and nurture high self-esteem, parents should be ready to praise their children’s exploratory efforts, be honest with them about their own mistakes, participate in the children’s  activities, encourage them in activities where their interests match their ambitions and allow them to be tested by the tasks they take on.
  • The child’s ability to overcome, which allows them to be exposed to the frustrations and disappointments along the way, is something they have to face as well. Children should be encouraged to enjoy the process in the process of becoming. Learning to face their own frustrations, disappointments and failures will also serve to build self-confidence. Avoiding frustrations or disappointments or learning through determined effort and even failure tends to undermine self-confidence. The opportunities for children to grow through tasks and responsibilities is the beginning from which they can discover and establish their personal power and resilience.
  • Looking for ways to nurture your child’s self-confidence and develop high esteem answers the child need to know “Can I do it?” It requires that parents focus on building strength or resilience through the children’s autonomy –their learning to exercise control over their environment– rather than emphasize ease or comfort through avoidance.

 

4. Promote opportunities to Play with other children and self

  • Play is an integral part of emotional development of children. It is the primary means in which children learn to explore, to discover themselves in their world, and socially to cooperate, take turns and help in friendships. Studies have even suggested that inadequate play time for preschool children lead to more disruptive behaviour. Besides social interactions, play allows for the development of emotional awareness and fosters empathy where children learn about their own emotions as well as the emotions of others. Play also allows children to enjoy the process of becoming one self. This is important in a goal-oriented world that emphasises only winning or success or grades. Indeed they can discover the truth that frustrations and disappointments are often the price we all pay to achieve success. In so doing, play allows children to learn how to emotionally regulate their feelings when they are presented with opportunities to learn to express thoughts, feeling and behaviours in socially appropriate ways.
  • Play is an important part of the child’s need to learn and experiment. Participation in play individually or in a group is an integral part of this learning process. Parents who are open to social interactions offer their children important advantages because they can facilitate their children’s emotional regulation and social learning when they play with their children on a regular basis. Children are more likely to enjoy other people contact when they already enjoy warm relationships with and have fun with their parents. TV or computer use should be monitored so that children are encouraged to engage more in active learning through participation. Computer games designers have made it easier for children, especially children who are neglected or are alone a lot, to be addicted to computer games. Excessive computer use has been found to be linked to depression in children.
  • Play offers the opportunity to address the questions that children ask, “Am I OK and is it good to be me?

 

5. Provide appropriate guidance and discipline

  • While children need to explore, develop new skills and become more independent and responsible, they also need to learn that certain behaviours are not acceptable. They need to be offered guidance and discipline that is fair and consistent from the family unit. They tend to take these social rules to their school and eventually to the workplace. Expectations may be expressed firmly but they need to be kind and realistic. Again, children learn best within encouraging and nurturing relationships. Parents need to be aware of their own maturity and growth and emotional status as they seek to help their children develop self-control, self-discipline or become kind. Their children cannot be expected to growth in those areas which parents have not grown themselves.
  • Explain “why” the child is being disciplined and the consequences of their actions. Criticism should be focused on the behaviour and not the person. Threats, nagging and the use of threats should be avoided. The power that the parent wields should emphasise guidance and instruction in the best interests of the child that allow for children to learn from their mistakes. Those parents who practice excessive domination or coercion should understand that it is not helpful in the long run if children are forced to accept a place of surrender in order for them to survive in the relationship. They need to be encouraged to exercise their own power when appropriate. What has been described as authoritarian parenting, characterised by high demands with poor feedback or nurturance has also been found associated with a higher incidence of depression in children. This is in sharp contrast to authoritative parenting which is characterised by high demands accompanied by responsiveness to the child’s emotional needs. This approach is found to produce children who are responsible, they can regulate themselves, they can make good decisions on their own, and they are respectful to others and to rules.

 

Parenting is primarily a personal and emotional project in raising one’s children. It is foundationally an emotional process to secure the child before a young child eventually matures to believe in themselves. This is crucial before they begin to actively learn to navigate themselves in an increasingly complex world. It is widely understood as a parent’s most important life task since the emotional outcome show up in emotionally healthy or unhealthy individuals even before adulthood beckons. There is an emotional ‘birthing’ process where the Self of a child arrives at a healthy place in their identity formation. Or the opposite will happen. Quality parenting in this ‘birthing’ process create the foundation in which the next generation of children find the basis for their own survival, happiness and fulfilment. As such, parents learning to parent with optimal outcomes will do well to emotionally mature and be healthy themselves so that their children have the best chance to establish themselves in a healthy place in preparation to thrive in life. 

—-

References:

Institute of Mental Health, Latest nationwide study shows 1 in 7 people in Singapore has experienced a mental disorder in their lifetime, 2018. https://www.imh.com.sg/uploadedFiles/Newsroom/News_Releases/SMHS%202016_Media%20Release_FINAL_web%20upload.pdf

The Ministry of Health, Depression: MOH Clinical Practice Guidelines, 2011.

Woo BSC, Chang WC, Fung DSS, Koh JBK, Leong JSF, Kee CHY, et al. Development and validation of a depression scale for Asian adolescents. J Adolesc. 2004 Dec; 27(6):677-89.

Woo BSC, Ng TP, Fung DSS, Chan YH, Lee YP, Koh JBK, et al. Emotional and behavioral problems in Singaporean children based on parent, teacher and child reports. Singapore Med J. 2007 Dec; 48(12):1100-6. 

Helping Your Kids Survive And Thrive With Home Based Learning

Helping Your Kids Survive And Thrive With Home Based Learning

Written By: Tan Su-Lynn, Educational Psychologist

In the midst of this current COVID-19 crisis, there is so much uncertainty for parents and children, which translates to overwhelming stress about family members’ health and safety, as well as an upheaval of school and work routines.

With no external help from grandparents, or the essential childcare centres to mind the kids of dual- income parents, no part-time helper to clean the house, and with the panic that ensues with each announcement from the government about the tightening of circuit breaker measures, it can feel like the end of the world. Foreboding desire to tear your hair out and scream in exasperation. And to top it off, parents now find themselves playing the role of “teacher” in supporting and facilitating their child’s Home Based Learning endeavours.

Yes, I hear you.

Singapore has just heard from its Prime Minister, who has decreed that current circuit-breaker measures will extend beyond the initial 4th May deadline, which is now 1st June, which adds the novelty (if you are so inclined to be a paragon of good cheer) of an additional month of government sanctioned acronyms that must be helping ministers and bureaucrats find their feet too!

Families in Singapore and the rest of the world are experiencing increased stress and anxiety right now. So, amidst this chaos, here are some tips for you to help your child cope with HBL, which will hopefully help in restoring some order in this otherwise chaotic household atmosphere..

As we all practice social distancing, it also provides an opportunity to slow down and pause, and to find our own footing in learning new ways to live. Children continue to grow and develop as they encounter new life experiences, including coping with this inescapable global pandemic, so it is important to continue fostering positive relationships and strengthening emotional connections with our children.

  1. Work out a daily routine with reward system

Research suggests that children benefit from schedules and engaging in productive activities, so plan activities that will create structure and fun memories. Set aside specific times for doing online lessons, doing homework, and reading or visiting virtual museums. To keep your child engaged and motivated, consider breaking up the day into smaller manageable blocks, taking care to cater to the short attention spans of your kids.

Visuals are especially great for reminding younger children what to do and how to do it, and these visuals can be simply hand-drawn and paired with keywords and then stuck on the wall. For some children who have completed their online lessons and are getting restless and fidgety, you may want to give them a to-do list of activities that they can complete independently, empowering them.

Guiding your child in setting goals and scheduling tasks are part of valuable life skills of time management and task organisation. Once their tasks are completed satisfactorily, they can be rewarded. Hence, if you would like your child to be more independent, polite, helpful, then rewarding them for their good behaviour in which these traits are displayed will be a good starting place for you.

For example, you can explore the effectiveness of “if/then” statements such as, “if you finish this piece of homework, then you can play 15 minutes of computer games with your brother”, or the use of a token system like “each time you can stay seated for 15 minutes, you get a token, and after you get 5 tokens, you can exchange them for something of your choice”.  Tokens are  reinforcers that the child earns which are exchanged for a larger reward based on their achievements. This system also helps in gaining instructional control, as well as acquiring self-monitoring skills and delayed gratification. Just as with any behavioural reinforcement strategies, the token system can be adjusted over time as your child’s skills develop and can be utilised less frequently. It is up to your parenting style and the temperament of your children to devise token systems that keep them engaged.

  1. Recognise and praise efforts

Change is difficult for everyone, including for your child. If they are able to conduct themselves in an appreciable manner  in certain scenarios in which they were previously unable to, this in itself is an accomplishment worth celebrating! Remember to give credit for their displays of maturity – praise them, show affection, or give a little treat. Children and adolescents learn very quickly by receiving direct feedback from adults. By reinforcing appropriate and desirable behaviour, the more likely your children will repeat this behaviour and overtime will coalesce into a good habit.

While it is part of being a parent to have to say “NO” to some of your children’s inappropriate requests or behaviours, it is important to ensure that you  mindfully maintain a balance of more positive than negative interactions with your children. Try to focus as much as you can on the good things that your child is doing. After all, having more positives throughout the day helps in those moments when you have to say “NO”. Be deliberate and consistent in praising and rewarding them, and to follow through with providing the reward as soon as your child demonstrates the desired behaviour. In working out the goals with your child, it will be reasonable to start by picking 1 to 3 behaviours or skills to focus on for reward and praise throughout the day. Items used as rewards have to be of value to the child and should not be easily accessible unless earned – this would keep your child motivated in completing the tasks and meeting the goals.

  1. Manage screen time

In this circuit breaker period, having extra screen time will not hurt, especially to reach out and to stay socially connected with friends. However, do set expectations with your child that the change in rules is a time-limited exception and regular limits will be put back in place when this circuit breaker is lifted.

While flexibility is important during this period, by no means should you allow unlimited screen time. Work out with your child on managing screen time. In the local mainstream schools, your child can be expected to be using technology to support HBL consisting of about 2-3 hours of online learning every day. With your child already spending time on online learning, work out with them on an agreement to take short breaks in between their online lessons and reduce their recreational screen time. This can be replaced by partaking in creative projects such as painting or baking, or using recycled materials to make toys or playing board games with the entire family. This also means that parents should also monitor their own digital device usage. Make use of this time to nurture new healthy habits for yourself and your children.

Now that the government mandated circuit breaker has been extended, you shouldn’t worry about having to keep the children entertained.  Yes, it is inevitable that they will whine and complain about boredom, but remember that boredom can be harnessed. It is through boredom that  allows them to create their own meaning and purpose, to be resourceful and to get to know themselves better. When young minds are free from distraction and constant torrents of information, they discover ways to create and find their own fun, or to further explore something that they are already interested in. This could be writing a book, staging a performance, drawing and painting, and the list goes on with endless possibilities!

  1. Encourage emotional expression and validate your child’s feelings

Children need to be secure about accessing their emotions rather than fearing them. To do this, they need to cultivate essential skills of being aware of their emotions and dealing with their experiences and concerns in manageable doses.

Being able to express our emotions allows others to understand how we feel, helps us to manage our own stress, worries, disappointments and sadness, and prevents us from spiralling into negative and maladaptive ways of coping. Holding in or denying our emotions  sometimes unconsciously results in angry outbursts or aggressive behaviour. One way to teach children about expressing and managing their emotions is by using books or through videos, and even modelling for them in the sense that adults are role models for their children, who ‘model’ the behaviour of their parents through observing and imitating.

For older children and adolescents, perhaps the most painful part of this COVID-19 crisis and HBL is the loss of important school experiences such as school or national competitions which they have trained very hard for, or performances which they have put in hours of rehearsals into, and the daily interactions with friends.  Give them a safe space to share their feelings and listen without judgement and without giving advice or reassurance. Some will be worried about missing out on activities expected to help them with school admissions, and these feelings of worry and stress are indeed valid. So again, allow them to acknowledge and share their feelings, and then express confidence in their ability to rebound.

  1. Practice empathy

With all the changes happening around us, it is indeed a challenging time for yourself and for your children. Start by having empathy for yourself as you navigate through uncharted waters in this battle against COVID-19 and its impact on routines and lifestyles. Yes, it is messy and chaotic, and it is OK to be not OK with any of this.

Children learn by watching the behaviours and reactions of the adults around them, so use this as a critical opportunity to prepare them to deal with uncertainties in life. Other than using books or TV shows to help children learn about empathy, you could also talk about how doctors and nurses are working to care for others with COVID-19 and to elicit their thoughts and feelings as they imagine what the healthcare workers are experiencing. Another example would be imagining what their teachers are experiencing with WFH (working from home) and HBL. By teaching and practicing empathy, your children will grow up being more compassionate and altruistic with the genuine intention to help others without expecting anything in return.

For children with special needs, it is likely that they would have had access to regular therapy services or remediation support either provided by external agencies or are school-based.  It would be beneficial to maintain collaboration with the therapists to see if there are workable options that can be carried out at home so that your child’s learning is not impeded. It’s indeed a challenging time for everyone, and more so for children with special needs and their parents/caregivers. With big changes happening, it can get really overwhelming especially for a child with special needs. Remember that these behaviours are not personal but are the manifestation of a skill deficit which occur to meet a need. Professionals can help to support you through this. Reach out to a professional here. You are not alone.

For children with anxiety or mood-related concerns, this circuit breaker period will likely exacerbate their mood swings, emotion dysregulation, and problems with attention and focus. This is the time to be even more patient and supportive of your child. For younger children, you may notice some behaviours or physical complaints, for example, having tummy aches, headaches or nausea, which are somatic manifestations of underlying anxiety or worry.  If you or your child feels overwhelmed, do reach out to a professional here that is in tune with your needs.

 

Anxiety and the Covid-19 Pandemic – Ways to Help Your Child Cope

Anxiety and the Covid-19 Pandemic – Ways to Help Your Child Cope

Author : S C Anbarasu, Senior Clinical Psychologist

All children have fears. Most simply complain about their worries and move on. However, there are some whose fears get more intense over time instead of naturally fading away.

The World Health Organization (WHO) officially classified the novel coronavirus, also known as COVID-19, as a pandemic on March 11, 2020.   Children’s responses to such stressful events are unique and varied. Children who are privy to information from a variety of sources can be disappointed, confused, angry, or sad. Some children may be irritable or clingy, while some may regress, and demand more attention, or have difficulty with eating, sleep or self-care.

Amidst the COVID-19 outbreak, it is a given that everyday life will change, and will continue to change for most people. Children may have difficulties adjusting to their routines (e.g., schools and child care closures, home confinement and social distancing), which may interfere with their sense of structure, predictability, and security.

To help your child cope with his/her anxiety around the current COVID-19 situation, the following recommendations can be considered:

  1. Validating your child’s feelings is important. 

For example, if someone in the family is unwell,  acknowledging and validating your child’s concerns, in addition to reassuring them that the affected family member has the best available medical care to manage the illness, is helpful. When you talk to your child or teen, it’s also important to use words and examples that are developmentally appropriate for their maturity.

  1. It is important to help your child maintain a sense of structure if they are needed to be away from school.  

Take a break from social media and the news. Use this time to play with your kids and build an even better parent-child relationship. When it’s safe for them to return to school, be patient while helping them return to their routine so that they can gradually readjust to their normal, everyday activities.

  1. Be a source of stability for your children. 

Children are more likely to be intolerant of uncertainties. This means that children tend to view uncertainties as harmful or overwhelming. As such, they may react with fear and avoid preparing for the unknown. It would be helpful if parents focus on the current facts about the situation instead of predicting.  Predicting and guessing can become a problem at times, as this may cause anxiety to escalate. If you don’t have an answer to your child’s questions, don’t feel like you’re obliged to play the all-knowing parent. Say you don’t know but you’ll try to find out. While teens and young adults are old enough to understand the risks that COVID-19 bring, be careful when talking to others when in the presence of preschool kids as they may potentially scare themselves with misguided misinterpretations.

  1. Children learn better from modeling behaviour. 

Demonstrating how to cough or sneeze into a tissue and discarding it properly,   trying to keep your hands from touching your face, and washing your hands regularly can foster good basic hygiene. When you see your kids practicing good hygiene praise them for it.

  1. In stressful times, when children feel helpless, there’s a tendency to blame others.

If they are seen to blame a certain group of people, for example those who have recently travelled, listen to them and address such concerns in your conversation. Importantly, do ensure that you do not reinforce negative stereotypes in your own conversations or behaviours.

  1. Foster a home environment that allows your children to express their feelings. 

In some families, when one child in the family has a severe mental illness, the other children can sometimes feel left out. Parents need to bear in mind that this can be a hard time for all children in the family; hence, it’s important to let all siblings have the latitude to express their feelings and feel like they can retreat to safe spaces in your home environment.

  1. Children are capable of picking up on their parents’ emotional energy.

In dealing with the situation, it’s also important that you acknowledge and manage your own anxieties so as not to amplify your child’s fears. This is even more important for parents of children who are generally anxious or have significant worries about something.

This current situation of COVID-19 is challenging and new to most of us. As there is no template to rely on to approach this crisis, we’re in the dark about how long this situation will last or when we will be able to return to life as we knew it. Nevertheless, parents and others can help children navigate these uncertain moments by equipping them with the right resources and instilling resilience in them.

Supporting your child’s learning needs

Supporting your child’s learning needs

Author:  Tan Su-Lynn

If you’re a parent who believes in taking a proactive approach to your child’s education, then you’ve probably realised by now that comparing your young one to the school’s resident whiz kid(s) is ill-advised. There is truth then, in this kernel of wisdom: “Every child is a unique gift from God”.

Understanding how your child takes in information, assimilates it, learns, is perhaps the first step to making their education a better experience for them. When parents start getting a grasp of what their child’s preferred way of learning is, they can start taking steps to work with that style of learning, instead of foisting the next flavour of the month upon their child. Individual learning styles don’t necessarily dovetail with the school’s pedagogy – but that’s OK. This just means that you’re blessed with more opportunities to help your child grow up with the values and convictions you hold dear.

Conventional wisdom tells us that people generally fall into one of three categories – visual, auditory, or kinesthetic learning. But before you pigeonhole your child into one of those convenient boxes, it is worth noting that while a child may have a dominant learning style, a combination of all the styles is required to learn about the wonderful, wider world that they’re growing up in. Once you have figured out their style, you can then begin to take steps to ensure that they have ample opportunities in the classroom and at home to take advantage of that particular style.

However, there are some children who constantly struggle when they are subject to the traditional classroom setting. Despite your efforts to supervise and coach them, they might continue to face persistent difficulties with reading and writing skills, as well as attention and behavioural regulation in terms of their academic performance.

A child with learning difficulties is affected in different ways, with the impact ranging from mild to moderate or even severe, with symptoms surfacing when the time comes for them to learn literacy and numeracy skills in the classroom. Children with learning difficulties are at risk of developing low self-esteem, which in particular is a consequence of the condition going undiagnosed and/or untreated. Imagine a dewy-eyed child who, with all the innocence of  youth, proudly strives and strains to do well at school – yet never reaping a jot of acknowledgement. Imagine (or remember) what it feels like to have the purity of childlike endeavour constantly rebuffed by the shame of underperformance. To have effort always met with negativity is tough for even the most motivated child, which may lead to the development of a poor self-concept that ends up causing further social-emotional issues in future.

All children, learning difficulties or not, need love and support for them to cultivate a strong sense of self-worth, build confidence and develop resilience. In seeking ways to help your child who has a learning difficulty, bear in mind that your role as a parent is not to “cure” the difficulty, but to arm your child with the social and emotional tools they will need to work through challenges and develop strategies for compensating with their difficulties. In the long run, your child will emerge stronger and more resilient.

Even though everyone’s been a kid before, I know that the new and bewildering responsibilities of parenthood can sometimes make us forget what we, as children, wanted to have for ourselves. I’ve outlined some tips which can be invaluable to our efforts to support a child with a learning difficulty.

  1. Knowledge is power – learn everything you possibly can about your child’s learning difficulties and needs.

Doing your own research and keeping abreast of the new developments in evidence-based learning and behavioural interventions not only helps your child, it helps to foster a sense of solidarity with your child. The more you know about your child’s needs, the better you are equipped to help your child. Start with your child’s teachers and consult with professionals (e.g. educational psychologists, school psychologists, or child clinical psychologists) who are best positioned to work together with you and your child in this journey. Collaborating with your child’s school teachers and fostering a good relationship with them helps in the overall understanding of your child’s needs – this facilitates consistency between home and school, which is particularly essential for children with challenging behaviour.

  1. Be an advocate for your child by raising awareness.

While society has made great strides towards the goal of inclusivity, awareness of special education needs and learning disabilities is still limited (but growing). Embrace your role as a proactive parent, taking responsibility not only for your child’s welfare but also contributing to the child who does not have a dedicated guardian in their life. Yes, your journey will be fraught with challenges and frustrations, but always remember to remain calm and to persevere. We often don’t realise just how much children internalise behaviour and views that they perceive in their parents. As a parent, you are entrusted with the very delicate task of moulding a young mind. Your healthy optimism, perseverance, and sense of humour doesn’t just benefit you – it positively influences your child to be a self-advocate, which is a very important goal for a parent in these circumstances.

Some parents choose to hide their children’s learning difficulties in secrecy, for fear of stigma or unjust treatment by others. They might honestly feel that they’re serving the best interests of their child. On the contrary – it is this very lack of understanding and awareness from family and friends that causes the misattribution of a child’s developmental needs to ‘laziness’ or ‘poor parenting’ or ‘mischief’. By shining a light on the condition, you help others develop empathy and come to be more supportive of your child. Within the family, siblings might feel that there is more attention and preferential treatment towards the brother/sister with learning difficulties, despite being aware of their condition. Hence, it is also important for parents to reassure all their children equally that they are loved, to provide support to their work, and to include them all in routines for the child with learning difficulties.

  1. Focus on your child’s strengths, not just weaknesses.

No one is defined by disability or need. And no one is perfect either. As you embrace your child’s flaws, celebrate their strengths in the same breath. As with all other human beings, a child with learning difficulties too will come into their own personality, interests, strengths and weaknesses. Focus on the gifts and talents which your child is blessed with, and help them to nurture their areas of strengths such as in activities they excel in.

  1. Praise effort rather than outcome.

Children with learning difficulties may not always excel academically, and if they do, they likely have put in a lot more effort than their peers to have achieved a similar good grade. Acknowledge the effort made, which deserves recognition – no matter if the child has gotten the answer right or wrong. Your child is demonstrating courage when they try out new approaches to assignments and study strategies, and if you want them to learn from mistakes and be receptive to feedback, credit and praise must be given where due. It will take time for new practices and interventions to work and for new skills to be acquired, so bear in mind to focus on the long term goals, and to break larger tasks down into smaller, more manageable milestones which can be spaced out over time.

Everyone’s definition of success is different, but the aspirations you have for your child probably extend well beyond the fulfilment of good grades. Working with parents, it has been my experience that most, if not all, express the desire for their child to lead an independent life, in which they are capable of providing for themselves, and above all else, to be happy. This being the case, then success in life definitely isn’t based on just academic success, but rather on things like having a sense of self-worth, the willingness to ask for and accept help, the ability to bounce back in the face of adversity and the emotional depth to form healthy relationships – values and qualities that are not quantifiable like the metric of exam grades.

  1. Keep your child motivated.

As school is most likely a source of frustration for your child who puts in much more effort than in proportion to the reward of good performance, it is important to find something in school that brings your child enjoyment, that they are motivated to pursue without much prompting. Sometimes, to taste the fruit of serendipity, one must eschew his comfort zone. This may involve having your child participate in a CCA of their choice, attend camps or other school-related activities, and encouraging your child to have good relationships with peers and teachers. It can be difficult to motivate your child to learn, and to invest time in subjects which already make them feel inferior and bad at. You will probably meet less resistance if you start from your child’s level of ability, carefully choosing lesson topics that already are of interest to them. Give them some measure of autonomy to choose how they study or complete homework – building in breaks and breaking down challenging tasks into smaller chunks gives them ownership in the crafting of their own timetable, helping to keep them motivated to follow through with their plan.

Finding a role model who has flourished in spite of their learning difficulties can show your child that success is attainable, and that it is their own choice not to allow their current difficulties to define them. Celebrity, athlete, friend, neighbour or pastor, the only requirement to those role model shoes is that your child feels comfortable talking to them.

  1. Encourage healthy lifestyle habits.

Stress may manifest differently in children than in adults. While some signs may be more overt, such as trouble sleeping, agitation, acting out, or meltdowns, others may retreat inwards – shutting down, spacing out, withdrawing and isolating. Even as adults ourselves, we may lack the prescience to recognise that our internal systems are under stress, let alone children who have not yet matured into such skills. Hence, it is your responsibility to be vigilant of signs of stress in your precious one.

Your child’s eating, sleeping and exercise habits are also vital to their overall learning ability.  With a healthy routine which incorporates a balanced diet, quality sleep and sufficient physical activity, children will be better able to focus and concentrate.

Other than the physical, paying attention to your child’s emotional needs is also important. When they are faced with the frustrating challenges presented by their learning difficulties, allow them to express their feelings in a safe space. Validate them by acknowledging that the cause of their gripe is an issue, but be careful not to coddle them into poor self-restraint. Be ready to listen when they are ready to talk, and be a grounding, reassuring presence which helps their mind integrate with their body, and re-orient into a sense of calm.

Above all, remember to take care of yourself! The uniquely sacrificial dint of parenthood sometimes diverts needed attention from our own needs. If you are to project an empathetic sense of warmth, you will first need to cultivate self-compassion, and allow yourself the space to tend to your own needs. The quality of support you are able to provide to your child is dramatically affected by your own levels of stress and exhaustion. Parenting is a full time job, but don’t let yourself burn out emotionally.

In order to do this, you need to be mindful of your own limitations. You are the best gauge of when to rouse the oarsmen to right your ship. If you have a supportive spouse, or friend, or family member, take heart. Lastly, there is great benefit in the solidarity of support groups, which serve as useful support and also reminders that you are not alone in your unfolding journey!

 

 

 

Child Suicide is Preventable: How to handle suicidal ideation in children

Child Suicide is Preventable: How to handle suicidal ideation in children

Author : Joachim Lee, Senior Pscyhotherapist

The Samaritans of Singapore (SOS) reports that the number of suicides in Singapore rose 10 per cent in 2018, with suicides among boys aged 10 to 19 at a record high. Suicide mortality among youths and males is a “significant societal concern”, SOS said, highlighting that for every 10 suicides in 2018, at least 7 involved males. Among boys aged between 10 and 19 years old, there were 19 suicides last year – the highest since records began in 1991 and almost triple the seven cases recorded in 2017.

Suicide does affect children and adolescents, and avoiding the topic does nobody any favours – burying your head in the sand won’t help them learn how to get help if they find themselves needing it. One common misconception about the discussion of suicide is that talking about it plants the idea in people’s heads, causing children and adolescents to think about it. The simple truth is that parents won’t ever know if their child harbours suicidal thinking if they are too afraid to broach the topic. Suicidal behavior in children is complicated. It can be impulsive and associated with feelings of confusion, sadness, or anger. The so-called “red flags” people are cautioned to look for can be subtle in young children. While a young adult might say something along the lines of, “You’ll be better off when I’m gone,” in contrast, a child might say some something similar to, “No one cares if I’m here.”

Warning Signs

While the warning signs in children can be subtle, learning to identify potential red flags plays a crucial role in intervention.

Changes in baseline behaviour:

Take note of behavioural changes that aren’t short-lived.  While suicidal behaviour is often associated with symptoms of depression, you might also notice the following changes in your child:

  • Changes in sleeping habits (too much, too little, insomnia)
  • Changes in eating habits (overeating or eating too little)
  • Withdrawing from family and friends (social isolation)
  • Psychosomatic symptoms: headaches, stomach-aches, other aches and pains that can’t be explained

Changes at school:

It’s perfectly normal for children to experience ups and downs during the learning process, but a pattern of negative change can be a red flag that a child needs help. Make a note of the following:

  • Drop in academic performance
  • Decreased interaction with teachers and kids at school
  • Lack of interest in school
  • Refusal to attend school
  • Loss of interest in normal daily activities (playing, sports, co-curricular activities)

Preoccupation with death:

It’s natural for children to think about death at times, particularly when they are coping with loss or hear about tragic events in the news. Preoccupation with death, researching ways to die, and/or talking about their own death can be red flags. Watch for the following warning signs that involve thoughts about death:

  • Frequent questions about or looking up ways to die
  • Statements about dying or what will happen if the child dies (Examples: “You won’t miss me when I die, I wish I was dead, I won’t bother you anymore when I’m gone.”)

Feelings of hopelessness:

Children who have suicidal thoughts might communicate feelings of hopelessness for the future. They might also make statements about helplessness. These kinds of statements indicate that the child feels as if there is nothing to be done to improve their outcome, and no one can help.

Child-sized wills:

Some children give away their favourite possessions or tell parents, siblings, or friends who should get their favourite possessions. While talk of dividing up possessions might seem like fantasy play to parents, it can signal thoughts of suicide when combined with other changes in behaviour.

Writing or drawing about death or suicide:

Young children often struggle to verbalize intense emotions, but they are likely to take to the diary or drawing block to explore these emotions. Poems, stories, or artwork depicting suicide or, frequent writings and drawings about death should be evaluated.

Significant changes in mood:

Kids experience changes in mood as they grow and work through stressors, but significant changes in mood signal a problem. If your child suddenly shifts from calm and relatively happy to aggressive, completely withdrawn, or very anxious, it’s important to get help.

In addition to the warning signs that a child might experience suicidal ideation, there are also certain factors that can elevate the risk.

  • Previous suicide attempt (regardless of how serious)
  • Experiencing a loss (this can include grief and the loss of a relationship due to divorce or family discord or break-up)
  • Chronic bullying
  • Family history of suicide or suicide attempts
  • Violence or witnessing violence
  • Impulsivity
  • Acute rejection
  • Feelings of hopelessness
  • Feeling like a burden

 

Communication Tips with your Child 

Any signs of suicidal ideation or behaviour should be taken seriously.

Parents should ask specific, direct questions about suicidal thoughts – “Are you thinking about hurting or killing yourself?”

Parents should also talk openly about depression by asking questions like, “Are you feeling depressed or very sad lately?” These questions show your child that you understand and that you care. Conveying empathy in a time of emotional crisis is crucial. You may be concerned about saying the “right” thing. But the truth is that just having an open and honest discussion with your child can provide them with much-needed support.

Keep the Talk Age-Appropriate

  • Make sure that your child understands what you are saying and is not confused or bored by the discussion.
  • Use words that your child can understand. Words such as “depression” or “emotional reaction” are probably too complex for a younger child but may be appropriate for an older child or adolescent.
  • Try comparing your child’s depression to something that your child is already familiar with like a physical illness such as the flu or an ear infection.

Keep the Conversation Positive

  • Depression is a serious illness that causes emotional and physical pain, but try to keep the conversation focused on the positive.
  • By maintaining a positive and hopeful outlook in your discussions, you will avoid unnecessarily alarming your child.

Prioritize the Positive

Another important way to prevent suicidal behaviour is to prioritize interacting with your child in positive ways. Sometimes we get into a sort of vicious cycle with a child. The child does something concerning; the parent gets critical; the kid does something more concerning; the parents get more upset. All interactions turn contentious. Interacting in positive ways means doing fun things together, hanging out and chatting about things that aren’t controversial, that aren’t difficult.

Be Honest

  • Don’t make promises you cannot keep.
  • Don’t go into detail about topics that you are not certain of.
  • Do tell your child what you do know.
  • Make a list of questions to discuss with your child’s mental health professional.

Be Compassionate

  • Your child needs to know that you recognize and respect their feelings.
  • Even if you do not quite understand their thoughts, don’t dismiss their feelings.
  • Avoid comments like “What do you have to be depressed about?” or “Don’t be ridiculous.”
  • Dismissive comments can cause a child to hide their feelings or become defensive.

It may seem obvious to you that you love your children, and that they know you love them. But when they’re having a hard time, children need to hear over and over again from you how much you love them, and how much you care about them. It’s not good enough to just say, “You know I love you.” You need to convey that in small and big ways. These days, we all have so many things we’re juggling that our children can end up unsure of where they fit in, and whether you really have time for them. Let them know how important they are to you.

Be a Good Listener

  • Allow your child to talk openly and express their opinions and thoughts.
  • Avoid interrupting, judging or punishing them for their feelings.
  • Listening demonstrates that they have someone they can confide in help to sort out their feelings.

If there are any safety concerns, do not provide judgment or discipline; simply remove your child from immediate danger, do not leave them alone, and get them immediate help.

Never dismiss suicidal thoughts in a child and any suicidal thought or behaviour should be brought to the attention of your mental health provider immediately. If needed, bring the child to an emergency room or call an ambulance.

If for some reason the above options are not available, make a referral to the Samaritans of Singapore (SOS) by writing to pat@sos.org.sg, or calling its 24-hour hotline at 1800-221 4444.

The author hopes that the suicide prevention/awareness workshops he conducts at schools and corporations are doing some good.

 

Bibliography

https://www.channelnewsasia.com/news/singapore/suicides-number-2018-teenagers-boys-highest-11761480

https://www.health.ny.gov/prevention/injury_prevention/children/fact_sheets/10-19_years/suicide_prevention_10-19_years.htm

https://www.psycom.net/children-and-suicide

https://www.verywellmind.com/suicidal-thoughts-and-depression-in-children-1066661

https://childmind.org/article/youre-worried-suicide/

https://www.sos.org.sg/get-help/helping-someone-in-crisis