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Chapter 1: What is the main topic discussed in this episode?
The Clare Byrne Show on Newstalk.
With Aviva Insurance. Now, Clare Crowe, member of the Psychological Society of Ireland, is with me in the studio. Good morning to you, Clare. Lovely to see you. We're going to talk about assessments and when a parent should consider one. So things like an assessment for ADHD or for autism or perhaps seeking out play therapy.
So we're trying to figure out how do you work out what is normal and then what needs to be taken a step further? Because I think parents are a little bamboozled about where the line is now. Would you agree?
Absolutely. And it is hard. And the first thing for parents to know is you're not failing if your child is presenting with some symptoms. If your child is anxious, that's not because you failed as a parent. That's because your child is overwhelmed. So it's OK.
Chapter 2: What assessments should parents consider for their children?
And, you know, for the reason we want to address these things at a timely time is because what happens in our brain is when we experience a threat, we get these cortisol neural pathways set up. So that means I'm triggered by something and it gets activated and that's to protect me.
And of course, what happens then is the next time I experience threat or I feel anxious or distressed, that pathway will get activated quicker. So the reason we want to address this in a timely manner is because we don't want to build up this habit or presentation that I'm always using. triggered very readily and easily.
So when you say we want to address it early, what do you mean by addressing it early? Are you talking about medicalising it at that point?
No, not at all. What happens generally from a psychological therapeutic point of view is we want to story things for children. We want to explain what's happening and give it a narrative because that's how we understand it.
Chapter 3: How can parents differentiate between normal emotions and behavioral issues?
That's how children understand it. So for me, I guess the parameters for professional involvement are when we are storing something, but we feel actually this is getting bigger. I'll give you an example. I had a mom ring me and say, you know, I'm chatting to my daughter. She says everything's fine. She keeps on saying everything's fine.
But, you know, I've now put away everything that's sharp in the house and I've locked the medical cabinets. I just feel uneasy all the time. For that parent, my answer was come in, come straight into your GP. In that case, she was linked. So come into me. And the reason is parents are experts in their children. If you have a sense something is wrong, then address it.
Now, there are parameters for that support. So, for example, you know, I would say play therapy, art therapy, sand tray therapy. These are really gorgeous interventions for children. And I would use those if I felt, God, there's a problem. It's, you know, it's either escalating or it's been very sustained already.
Or if it's interfering with our kids job and their job is to make friends, go to school, play. So if those things are impacted, I'm going to start with those levels of therapies.
But parents might worry what message you're sending to a child if you say now we're going to go to play therapy. Like what does that does that tell your child? You are different. You have an issue that your friends don't have or your sister doesn't have. And how do you deal with that?
Yeah, I actually think it tells your child, I see something is wrong and I'm worried. And I would use those words. I see you're in your room a lot on your own or I see it's tricky when you go on playdates to talk to other people. You know, tell them what you see. Explain your rationale. And, you know, particularly as kids get older, you can meet with a resistance or I'm not doing that.
I would always say to parents, use a five minute rule. Go and see. We're not committing to anything. And then I would use that rule because it's like going to a dentist, like going to your psychologist or a therapist. See if you like them. See if you connect. And if you don't, choose a different one. Now, I'm not being naive here because I really understand that.
the waitlists for these kind of services are so extensive and they're expensive and they're difficult to access. So for me, the other message for parents is there is a lot of good work we can do at home with our children. And some of those are the things that we've talked about over the last few weeks, Clare, about, you know, outdoors and playing with your child and
how to show your emotions and regulate in front of the kid. But there's a lovely therapeutic phrase that your therapist will use and it's, children can only change when they're no longer expected to. And what we mean by that is, meet a child where they're at.
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Chapter 4: Why is early intervention important for children's mental health?
It opens up conversation rather than shutting it down. So the child that says I hate school and you respond with that might say, especially lunchtime because I have no one to play with. Or they might say, especially Amy, because she's mean to me. You suddenly have more information. And again, I'm not asking you to fix that, but I'm asking you to validate again and say it's always with Amy.
So you're acknowledging their problem rather than telling them that it'll all be fine. Yeah. You're saying to them, I can understand that that's really hard for you. Yeah. You're just hearing it. And are you saying that sometimes that can be enough?
Yeah, it is amazing when children feel heard how they will de-escalate. So children will continue to prove that they're distressed if they don't feel you're hearing it. So the paradoxical thing is the quicker you can say, oh, I hear it, the quicker they will dampen down their distress.
So instead of saying you'll be OK, saying you're really anxious actually decreases the anxiety rather than the you'll be OK.
So, I mean, we hear a lot about people getting assessments now, both adults and children for ADHD and autism. Are you concerned about the level of assessment that is happening?
I, yeah, my preference is always an understanding first. Let's, we call it a formulation. That's where we put all the symptoms in context because it's very quick, easy to take something in isolation and call it ADHD. So for example, you see a five-year-old who's, you know, flying around the place, can't sit and attend and we're very quick to go, oh, that kid is an ADHD kid.
But actually a formulation would be, all right, so they've just moved house and they're There's a bigger sibling who, you know, kind of gives him a hard time. And actually, when we do some gorgeous, you know, regulation in the evening, he can calm really nicely. So, you know, when there's... I'm always looking for the pockets, the sparkly moments, is what I call them,
The moments where actually we're doing well, because that tells me as much as the pathological moments. So I do think, you know, the benefit of a therapeutic space first is you'll get to put things in a wider context. I'm not saying assessment isn't a natural and important aspect sometimes for some children. It's just never my first step. I don't want to I don't want to label you.
I think the Irish language is just so intrinsically linked to psychology. I know this sounds mad, but I always think of a teacher I had who used to always talk about Tobrone Irm. So the direct translation is sadness is on me. It's not I am sad.
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Chapter 5: What types of therapies are available for children?
Yeah. So, you know, so like so that it's not everybody needs to know that. Like it may be that only the school principal needs to know that diagnosis. And it may be that other parents or other family members are going to say, no, did you do something? You don't need to share anything. It's your child's information. So you can hold it yourself as much as you feel is necessary for the child.
For some parents, they'll feel actually everyone responds differently in a way that's helpful. when I share a label. So in that instance, absolutely share the label. It's about the unique child themselves.
But think about it carefully is what you're advising. Yeah, exactly. Just some messages that are coming in. We had a child in our school that had extra energy. The school wanted an assessment that was an absolute over-focus and over-medicalisation. This listener says, almost all children grow up to be functional adults. They just need to be children, not forced to be something else.
There's a fine line, though, isn't it? Because you explained to us really well there, Clare. Some children will need that assessment and they will need a diagnosis to get the services that they ultimately require. And my sister has a two year old who I'm convinced has a need. The tantrums are incredible, but I know she's not having any of it. Is there a way to bring it up in a sensitive way?
It's a two year old, though. You have to be careful, don't you?
You really do, because actually it's on your sister. Your sister is the parent. And actually, maybe the best way you can support your sister is by being with her and say, gosh, it must be hard when they have those tantrums. How are you doing? Our children learn coping through us.
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Chapter 6: How should parents communicate the need for therapy to their children?
So we have this thing in neuroscience called mirror neurons. So it's easy to remember actually with a baby. So with a baby, a baby smiles and we smile back or they get distressed and we go, oh, you're distressed. We're always mirroring their emotions. What we can sometimes forget as parents is that our children and older children continue to do that.
So if we can model, you know, not that I'm coping perfectly, but rather I'm really stressed in this moment. These are the things I'm doing to soothe. So I'm going for a walk or I'm taking a breath. So again, with your sister in that instance, I would say, gosh, what do you do to help yourself in those moments? Your child is watching the whole way through.
So then you're helping your sister to have a moment where actually she feels regulated and calm. And that's greater support for than telling her your child needs an assessment because she may already know that or she may not be ready to know it. But it's not your place to do that just yet.
Good advice. Another one. I was lucky to have a wonderful doctor where my child was put in the system for assessments over her stimming. He refused to label her as ADHD or autistic. I'm so thankful that it was worked through with understanding rather than starting with a label. And she's definitely the better for it. So in some cases that will work.
But in other cases, you will need the label to get the services. Yeah, absolutely. OK, but it is possible to work through something like stimming, which people might be familiar with in a way that doesn't involve putting a label on that child.
And you can tier your levels of intervention. When you think about the play therapy, art therapy, those types of intervention, you're less likely to get stimming. a label in those areas. When you move up to psychiatry, they're looking for, you know, the diagnostic manual to explain your symptoms. They're also going to formulate as well, like a psychologist.
So I guess if you feel I'm afraid to do something because of a label, maybe go in at a different level and work on that story. Your play therapist or art therapist will tell you if they feel there's more to this, I need you to link with a clinical psychologist now. So it's okay to start maybe at a level that you're comfortable with.
Okay, start small. Clare, thank you so much. Dr. Clare Crowe there. This has been fascinating. Keep the messages coming in on WhatsApp 087 1400 106.
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