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Callie Cardamon is a talented artist with a generous heart and deep love for children everywhere. She has a background in counseling and was searching for volunteer work that she could do from her home computer when she found TeenCentral.Net, the KidsPeace website that gives teens a safe, anonymous place to write about their feelings and receive sound advice from trained counselors. Callie signed up as a volunteer, received training and began spending at least two afternoons a week responding to posts from troubled teens.

In the process, Callie began corresponding with Julius Licata, Director of TeenCentral.Net, and a wonderful friendship developed between them. As she got to know more about Julius and learn about the KidsPeace mission and many wonderful programs, Callie decided that she should write a song for KidsPeace that could serve as source of hope to our children and persuade donors to dig a little deeper to help our kids. It was important to Callie to finish this song in time for Thanksgiving and have it be her gift to KidsPeace and Julius.

The result is a beautiful ballad entitled “Love Is On The Way,” which can be heard on Callie’s website,
http://www.calliecardamon.com/publicfiles/Love_Is_on_the_Way.mp3. Callie is donating 100% of the proceeds of this song to KidsPeace in hopes that the song will give KidsPeace and TeenCentral.Net more exposure and inspire people to donate to the organization. “It never occurred to me not to donate 100% of the song’s profits to KidsPeace,” Callie said. The very first letter I answered on TeenCentral.Net said ‘please send hope as fast as you can,’ and that really touched me. Even the possibility of hope can help kids hang on a bit longer. I hope all of the teens who post on TeenCentral.Net will get some hope from this song.”

Callie was not sure that the song was finished, but, when she learned that Julius had been ill, she knew it said what she wanted to say, so she recorded it in order to get it to KidsPeace by Thanksgiving. Callie recorded the song with Kimberly Kim, a former student who moved to friend and colleague. “That is Kim’s angelic voice singing the high harmonies on the song,” Callie told us. Callie has become a second mother to Kim who works for the American Red Cross and has spent months and months of her young life helping out on international health campaigns.

A resident of Pasadena, CA, Callie records her beautiful interpretations of jazz and American standards and shares her gifts on her website, www.calliecardamon.com. KidsPeace feels blessed to have Callie on its side and expresses heartfelt thanks for her amazing contribution. 

KidsPeace believes that it is helpful to our readers to reprint some Healing Magazine articles that are as relevant today as when they were published in our Magazine. This article appeared in our Spring/Summer 2008 issue of Healing Magazine and was written by a KidsPeace psychologist with many years of experience working with foster children.

Treating Foster Children for Psychological Issues

By Gerald A. Zimmerman, Ph.D.

Many children are placed in foster care as a continuing step in helping them and their families readjust and make changes so they are safe and protected in the home environment. The placement comes about because the Children and Youth authority learns that the children were neglected, physically abused, emotionally abused or sexually abused. Each of these categories has specific definitions. For example, emotional abuse refers to non-physical, gross maltreatment that results in the child being humiliated, demeaned or degraded in some way, or failure to respect the dignity of the child as a worthy human being. The impact of the abuse and neglect of the child has implications that remain for many years to come.

A child who experiences neglect will respond in different ways depending on his characteristics. There are two main types of developing characteristics in children: the active, outgoing type and the reserved cautious type.  Drs. Stella Chess and Alexander Thomas have identified these children in a comprehensive developmental study of children. Not all children react the same, and it is the interaction of their environment and their personal characteristics that results in unique responses. For a neglected child, the response may be seen in an outgoing, assertive and bold child to take charge of his experiences and try to prepare meals and comfort the younger children. For a cautious and fearful child, the response to neglect may be to withdraw and become anxious and cower in the corner. With long-term neglect, the patterns become established, and the responses become characteristic of the child, even after the child is given the opportunity to live in a more stable, predictable environment. It takes a great deal of time for the child to make changes and become comfortable and trusting of those around him or her in the new environment.

Regardless of the types of abuse and the child response style, when a child experiences the neglect or abuse, the effect is to lower the sense of self-worth. If the parent is unresponsive to the needs (neglect), the child develops a sense of worthlessness. If the parent is unreliable and inconsistent, the child develops a sense of the environment as unsafe and experiences anxiety. If the child is the victim of sexual or physical abuse, the response is often to fear the adult and to experience the self as weak and ineffective. The different child characters, however, may react to these experiences in different ways. The cautious child may become even more nervous and upset and develop mental health problems, whereas the active child who engages his environment may make attempts to become more aggressive and controlling and develop behavioral problems. 

Children who react to the inadequacies of parenthood may develop mental health and behavioral disturbances. The behaviors become routine ways of responding. Some children may develop a sense of inadequacy, demonstrating a dependency more pronounced than would be expected typically at their age. The children may vary in severity of disturbance, but almost all experience some type of difficulty because of the problems identified in the dysfunctional family.

All children experience a great deal of transitional stress when they are first contacted by the children’s authority in the county for the purpose of removing them from the home. It is my experience as a therapist for these children that they usually vividly remember the details of the day they are removed. Whether the caseworker comes to the home or the school or the police are involved, the scene is not good for anyone, but is a necessary step in the protection process and also begins the healing process. These transitional episodes can leave an emotional mark on the child, creating apprehension and anxiety, but this is alleviated to a moderate degree once the child becomes familiar and comfortable with the foster parent resource.

Despite the slow development of trust with the new family, behaviors and emotions continue to be present with the child. Often, the children who reacted in a characteristic way in their home of origin will begin to react similarly in the new home, meaning that a child who has become aggressive and demanding in the unstable environment at home will start doing the same thing in the new environment, expecting the parents to react in similar ways to their parents’ behaviors. They try to create the environment they knew. It takes a great deal of patience and experience on the part of the foster parents to help the child through this period of adjustment, as the child learns that the needs will be met without these behaviors.

Typical Problems

Signs of problems in children can be many and varied.  Four categories are identified here: 

The anti-social child may initially present as charming and compliant but, after the shock of the transition wears off, will become passive-aggressive, manipulative and resentful and untrusting. He may demonstrate:

• Sadistic behavior and violence

• Compulsive lying and stealing

• Obsessions about sex

• Seeming lack of empathy or conscience

• Oppositional behaviors

• Defiance

• Controlling behaviors.

An overanxious and insecure child may demonstrate panic when separated from those who take care of her. She might show school avoidance, night fears, thoughts about losing a parent and often ambivalence in the relationship with the caregiver. She may demonstrate the following:

• School anxiety

• Trouble falling asleep at night

• Fear of being alone

• Depression when separated from a parent

• Worries about illness, injury or death

• Nightmares with the theme of loss

• Intense love-hate relationships with caregivers.

The asocial and withdrawn child may have become cool and indifferent and show a remarkable lack of anxiety about his isolation from others. She has developed a thick emotional barrier to protect herself from hurt from the agony of separation from those with whom the child has been intimate. The child appears emotionally blunted and inept socially and may have developed a deep distrust of others. The characteristic features of this type of child may be seen in:

• Defects in the capacity to develop relationships

• Lack of strong social desire

• Lack of concern for isolation from others

• Few observed needs for affection and emotional attachments

• Lack of spontaneous emotional expression

• Oblivious to others

• Lack of self-awareness.

The inadequate/dependent child clings to caregivers and exhausts the foster parent with unbounded needs. She can cling to anyone instantly but is usually superficially attached.  She requires guidance and constant attention. The child may be submissive and show no signs of rebellion or a difference of opinion. She demonstrates very little confidence and may show:

• Insatiable neediness

• Submissiveness

• Learned helplessness and low self-esteem

• Lack of interest in negotiating the environment

• Flatness of emotion

• Lack of vitality

• Sense of apathy and futility, and emotional voids.

There are still other children who demonstrate a combination of factors, and, as such, their behaviors may be hard to predict. Children may demonstrate differing degrees of reactions, with some strong in their reactions and others milder. It is likely that most children who are placed in care will demonstrate some reaction to the transition to care and carry over their legacy of responses from the home of origin. It is the struggle of foster parents to help the child become less reactive in a negative way and to learn to trust and feel secure, safe and encouraged to grow through the stages of development to experience self-worth, confidence and an ability to cope with new stress in a meaningful and effective way. 

Much of the information provided in this article is from the foster parent-training segment for the KidsPeace Foster Care and Family Program. t

Resources:

Chess, Stella and Alexander Thomas (1996). Temperament: Theory and Practice. Psychology Press, Taylor and Francis Group, New York.

Reistroffer, Mary (1972). What You Always Wanted to Know About Foster Care But Didn’t Have the Time or the Chance to Bring Up. Child Welfare League of America, Inc., New York pp 2-3.

Rex, Elizabeth L. A Letter to a Foster Child, in Children Today,  Child Welfare League of America, Inc., New York, May-June, 1973, pp 1-2.

Dr. Zimmerman received his Ph.D. in Psychological Studies from Temple University and has been a Clinical Psychologist with KidsPeace since 1982. He performs clinical assessments and conducts group therapy and consultations and works with children in residential treatment and foster care.

KidsPeace believes that it is helpful to our readers to reprint some Healing Magazine articles that are as relevant today as when they were published in our Magazine. This article appeared in our Spring/Summer 2008 issue of Healing Magazine and was written by psychotherapist and expert on relationships between children and parents Loren Bruckner.

By Loren Buckner, MSW, LCSW

More than ever before, doctors are prescribing antidepressants and anti-anxiety medications to kids and parents who are overwhelmed by how they feel. Practically every day, newspapers are filled with stories about families and children in crisis. Overeating, under-eating, addictions of varying kinds have become common ways of coping with unwanted feelings.

Parents can change this trend. Emotions, even the painful ones, need to be understood instead of avoided. Hateful feelings don’t have to become destructive. However disagreeable, feelings can be talked over, worked with and tamed. Learning to be curious about emotions, instead of afraid or critical, can make accepting them much easier.

Dedicated parents are better informed than ever before about what their kids need. Understanding their child’s psychological, emotional and physical development is one of their highest priorities. How to handle potty-training, temper-tantrums, learning disabilities and the stress of adolescence are all pressing issues parents never feel they know enough about.

Parents have a tendency, though, to pay much less attention to understanding their own emotional lives, missing an important link in the process of conscientious parenting. Of course, reading about how to best raise kids is important. But how can parents help their sons and daughters feel comfortable with their feelings if they are uncomfortable and frightened by their own?

Parenthood stirs up a wide assortment of emotions. Mothers and fathers eagerly look forward to the delightful and satisfying ones. But there are others – feelings that rock parents to their core. The painful nature of parenting is not a topic most parents like to talk about, but, because the parent-child relationship is so intense and so personal, these feelings are inevitable and nothing to be ashamed of.

It is not uncommon for parents who have done their “preparing for parenthood homework” to feel frustrated and disappointed in themselves. Knowing what to do and having the ability to do it are two very different skills. Parents know they should be consistent, for example, but how do they accomplish this when what feels acceptable can change from day to day depending on how tired they are or on what side of the bed they awakened? Parents know that they should not lose their tempers, but it is something that happens to all parents. How do parents cope with the guilt, worry, disappointment, anger and loss – as much a part of family life as the joys and rewards – without these feelings fueling self-doubt and ruining their most important relationships?

The first step is to recognize that feelings – even the painful ones – are a normal part of parenting. Painful feelings are disturbing and confusing, but even good parents sometimes feel bad about themselves and do not always feel loving toward their children and partners either.

Maybe a child has a different temperament from his parent, gets into trouble or doesn’t like school, sports or playing a musical instrument. Maybe she won’t be as religious or choose the life-partner or career the parent had hoped for. These are just a few of the many possible disappointments parents must learn how to accept without letting their feelings overwhelm them or their children.

Parents must also find a way to put their worry into perspective. There’s no escaping this feeling either. Parents can’t wait until their children can walk, but then they’ll worry about them wandering away. Parents worry about their children making the right friends and doing well in school. They’ll really worry if their child gets into trouble or becomes ill. And in addition to their never-ending concerns about their kids, parents periodically question themselves. Sooner or later all parents, regardless of their particular situation, ask, “Am I a good enough parent?” Worries like these, to one degree or another, begin with pregnancy and continue throughout parents’ lives. 

Guilt is another emotion with which parents are quite familiar because they do lose their tempers, say the wrong thing, give in when they know they shouldn’t or feel grouchy because they’re tired or upset. Parents often know they’re not living up to the good parenting advice they’ve read about over and over and therefore feel guilty, angry and disappointed in themselves. This, too, is parenthood.

Conscientious parents know how important it is to provide kids a home filled with safety and security. But as they’re building this solid foundation for their kids, they are also establishing a strong bond to their kids. Bravely encouraging children to begin individuating means parents will battle feelings of being left behind. The experiences of separation, letting go, watching as children develop independence, are rewarding for sure. But it also triggers feelings of sadness and loss – emotions parents must accept without making their kids feel guilty or afraid. The pain this creates may be another aspect of parenting for which mothers and fathers feel completely unprepared.

Anger is a feeling parents expect to have, but they are often shocked by its intensity. Hateful feelings directed at the people parents love the most are painful and difficult experiences, but managing them is crucial. Although seemingly contradictory, it isn’t so bad for parents to occasionally lose their tempers, as long as they don’t lose control. Saying or doing something damaging to self-esteem or their children’s ability to trust them is the kind of anger to avoid. Protecting children, no matter how upset the parent is, is essential because hurtful words and frightening scenes have long echoes.

It is a parent’s obligation to recognize when there’s a problem. Self-doubt, and even worse, self-hatred are depressing, distracting and not very conducive to effective parenting. And when parents, in spite of their efforts to do otherwise, have frequent emotional outbursts, find themselves retaliating against their children, or when family trust and stability have become undermined, then it’s a good idea to seek help.

Emotions, however powerful, don’t define a person’s character – it’s how parents react that’s important. Parents love their kids but sometimes can’t stand them; they wouldn’t trade places with anyone but, from time to time, imagine walking out and changing their names. They struggle with painful, distasteful feelings alone, believing that something is wrong with them. These darker emotions are far from what young couples imagine when they decide to take the leap into parenthood. But this is parenthood.

Parents have an important life-defining opportunity – teaching children how to incorporate feelings into their lives instead of judging, ignoring or hiding them. They can help kids understand that anger, worry, sadness disappointment and fear are not signs of weakness but are signs of life. Before parents can do this for their kids, they need to learn this for themselves. It’s only after parents are comfortable in their own skins that they can teach their children to be comfortable in theirs.

Loren Buckner lives in Tampa, Florida, and has been a psychotherapist in private practice for more than 20 years.  She is the author of a forthcoming book on parents and their emotions. She can be reached at 813-915-0076 or at lorenb@tampabay.rr.com.

KidsPeace has been helping children and  adolescents deal with grief and other emotional and mental health issues since  1882. Therefore, we are delighted to support Highmark Blue Cross in its third  annual "Children's Grief Awareness Day" on November 18, 2010. Originated by  the Highmark Caring Place, A Center for Grieving Children, Adolescents and Their Families, this awareness day acknowledges the impact that death and loss  have on children and families and encourages all caring individuals to offer  comfort and assistance to grieving children. Highmark encourages everyone to Wear Blue on November 18 to commemorate the day and  show support for children experiencing grief.

KidsPeace believes that it is helpful to our readers to reprint some Healing Magazine articles that are as relevant today as when they were published in our Magazine. This article discusses how parents of special needs students should strive to interact well with their children's teachers and is written by author and Autisim advocate Ellen Notbohm. It was published in the Spring/Summer 2007 issue.

The View from the Other Side of the Desk: Are you a ‘challenging parent?’

What special education teachers want you to know

by Ellen Notbohm

As transitions go, my son’s transition to middle school had been smoother than any parent with an Individualized Education Plan (IEP) in hand could hope for. It had been a very good year with very good teachers. But, as the year wound down with alarming speed, the scheduling of the annual IEP meeting just wasn’t happening. Repeated requests – at increasing decibel level – to resource teachers went unresolved amid scheduling problems, administrative issues, illnesses and other roadblocks. When we finally did meet, five days before the end of the school year, I told the excellent resource teacher only half-jokingly, “You’re almost there. Only five more days and then you are done with me.”

And this excellent teacher stopped in his tracks and looked at me with surprise. “Oh no,” he said.  “No. I have had some challenging parents this year, and you are not one of them.”

At that, it was my turn to stop in my tracks. What, I wanted very much to know, constitutes a “challenging” parent?  It was too intriguing a thought to leave on the table so, a few months later, we came back to it. His very thoughtfully painted portrait of a “challenging” parent led me to ask other special educators, teachers of students aged toddler to high school across several different school districts, the same question. And, while each came from his/her own unique situation, the common threads in their thoughts were striking. A number of these common threads formed the basis for my book Ten Things Your Student with Autism Wishes You Knew. Here then is the view from the other side of the desk, the voice of your special education teacher:

Be team-oriented

A combative attitude does not enhance our ability to make progress with your child. Our relationship should be an alliance, not an adversarial face off. We are all here because of the child; he or she is our common interest, and it is important not to lose sight of that. It is not about me or you, or whether we like each other. 

Give me the courtesy of a clean slate. You may have had bad experiences with previous teachers or schools, but putting past conflicts or issues onto me, coming in with guns blazing before you even have a chance to get to know me or my program is counterproductive. “This is what has happened in the past, and I expect the same from you” is looking for trouble where it is possible that none exists. 

There is a difference between being assertive and being aggressive – and there is a cost. Teachers appreciate parents who are knowledgeable, effective advocates for their children. Knowing your rights and knowing the facts of your situation, and requesting services and accommodations firmly but respectfully are light years removed from being a fist-pounder.

We are not here for the money or the recognition. We are here because we love these kids. In an ideal world, I want to share with the parent any inside perspective I have about ‘the system’ and how it affects decisions made about their child. But, if I sense in any way that the parent will use the information in a way that comes back on me or threatens my job, it is only natural that I will not share.

Undermining me undermines your child’s learning.  Communicating to your child that everything that is going wrong is the school’s fault undermines your child’s ability to trust me, to comply with necessary classroom boundaries and, ultimately, to learn.

All children, even special needs children, need to assume some level of responsibility for their behavior and its consequences. We are sometimes faced with parents who say, “I cannot believe my child would do such a thing. It must be somebody else’s fault. If you had been doing this, he wouldn’t have been doing that.” Sometimes that’s the case. However, when a parent insists it is always the case, I need to gently suggest that a closer look be taken at what is actually going on.

Step back and listen as open-mindedly as possible when faced with information that makes your blood pressure rise. It’s very common for children to exhibit a different set of behaviors at school than they do at home. 

Having to be both teacher and case manager can put me in a very difficult position. Especially in early childhood education, it often falls on the teacher/case manager to identify the fact that my particular classroom or program isn’t the best fit for your child.

Please know that, when I tell you we need to transition your child to a different setting, it isn’t because I ‘don’t like him.’ Hear me as objectively as possible when I tell you that he is struggling too hard in the current placement and would benefit from a different setting, that we need to modify the Individualized Family Service Plan (IFSP) or IEP and find a better environment.

Don’t assume I know everything about your child. I may only have the prior year’s academic information, and perhaps no personal information at all. Tell me anything you think is important for me to know about your “whole child.” Be a resource for us, a bridge between programs.  Share with us what has worked or not worked with your child in the past.

We cannot do everything for your child. Your child is entitled by law to a free and appropriate education in the least restrictive setting. That is not equivalent to the best possible education. Think of it this way: You get the Chevy; you don’t get the Cadillac. You get safe, reliable transportation, but you don’t get the CD player and the leather seats. It’s a distinction many parents don’t understand that special education is intended to provide for adequate growth, not maximum possible growth.

Federal law mandates that we make sure that kids who have a disability are making adequate progress, as defined and measured yearly in their IEPs. The idea behind it is that, without accommodation, they wouldn’t make adequate progress in general education, and therefore would not be getting a free and appropriate public education.

Let’s say you have a fifth grader who is reading at a 2nd grade level. It happens; teachers commonly look at their classes and see a developmental range, so there are kids who end up in 4th or 5th grade reading several grade levels behind. So we set a goal, in a calendar year, for the child to make a year’s growth, which is what his peers would make.  But he is still behind; he is not catching up. In order for him to catch up, he would have to outpace his peers. Some kids do that, but it’s very difficult and not realistic.

We have many commitments to multiple content areas. If we were to spend half the day on reading alone – sure, we could catch the kid up. But that’s not appropriate because we give up everything else. And so we always have that discussion every year in an IEP meeting. We have a certain amount of time. How do we set goals? How much time do we need to meet each goal? How much are we going to be able to accomplish given math, science, social studies, all of these other content areas required and from which kids benefit?

Your child is not my only student. When I am meeting with you, when we are in a discussion and problem-solving mode – in that moment, your student is the only one I am concerned about. But back in my classroom, I have anywhere from a few to a few dozen other students in my caseload, and I have the scheduling restrictions that naturally come with that caseload. It simply is not possible for the needs of one child to dictate my entire day. Asking that of me is painful for both of us.

Early intervention works

Here is an extension of a universal truth:  The earlier the better – and the better the earlier the better. Catch things early, intervene well and include your family, not just the school. No one was ever sorry they intervened early, but legions of families regret “waiting to see if he outgrows it.”

See the positive in your child

Have an honest understanding of what the range of your child’s disability means, but also recognize his strengths. Too often, the most difficult parents to work with are the ones who cannot see the positive qualities of their kid. Their focus is stuck on what the child can’t do. Perhaps they do not want to have a child with a disability. Perhaps they are stuck in the grieving process. But, for the teacher, it is very hard to deal with. 

Promote independence. Help your child learn to do things for himself, rather than doing them for him. Many teachers are parents themselves and understand the time stress families are under. But, whether it’s homework or personal organization, expedience in the moment will impede his learning to be independent in the long run. If you pack and unpack his backpack for him every day, how will he learn the importance of being organized, knowing where things are when they are needed, how to find items or information? The parents who are most effective are the ones who teach as well as parent. The two are synonymous.

© 2006 Ellen Notbohm. This article is based on the book Ten Things Your Student With Autism Wishes You Knew, a 2006 iParenting Media Award winner.

Ellen Notbohm is author of Ten Things Every Child with Autism Wishes You Knew, a ForeWord 2005 Book of the Year Honorable Mention winner, and co-author of the award-winning 1001 Great Ideas for Teaching and Raising Children with Autism Spectrum Disorders. For article reprint permission, book excerpts, to learn more or to contact Ellen, please visit www.ellennotbohm.com.

KidsPeace believes that it is helpful to our readers to reprint some Healing Magazine articles that are as relevant today as when they were published in our Magazine. This article discusses how communication is so important when doctors prescribe psychotropic medications to children. This article was published in the Spring/Summer 2006 issue.

Children’s Psychotropic Medications: Communication is key

By Pat Sullivan

Millions of children take prescription psychotropic medications to treat a wide range of conditions that can destroy their quality of life. According to Dr. Adnan B. Zawawi, Psychiatrist at KidsPeace Psychiatric Hospital, it is imperative that parents and physicians establish open communication early in a child’s treatment. “At KidsPeace, we provide parents with written information on any medications we might prescribe in the admissions packet so that parents can make informed decisions regarding their children’s treatment. They must give us written consent before we start any medication,” Zawawi says. He also wants to dispel a common myth: “These are not drugs; they are medications. Just as we prescribe medications for hypertension, diabetes or infections, we prescribe medications for illnesses of the mind.”

There are several classes of psychotropic medications that are typically prescribed for youth:

Antidepressants

• Tricyclics – Older drugs. These medications (some brand names include Adapin, Elavil, Pamelor and Tofranil) are typically only used when SSRIs (see below) are ineffective.

• SSRIs (Selective Serotonin Reuptake Inhibitors) – Newer antidepressants (some brand names include Prozac, Zoloft, Paxil and Lexapro) used more commonly because they restore deficits in certain neurotransmitters that facilitate communication between brain cells (neurons) and return the brain to normal functioning with few side effects.

Dr. Zawawi emphasizes that depression is a serious medical problem that causes the brain to function differently from those of individuals who are not depressed. The benefits of taking antidepressants far outweigh the risks associated with them. Dr. Zawawi also notes that NIH studies have shown that patients treated with a combination of SSRIs and therapy had higher success rates than those taking SSRIs alone or those undergoing therapy alone.

Typically, antidepressants are used for a year or two, with cessation being gradual and closely supervised by a physician. One should never abruptly stop antidepressants. Dr. Zawawi emphasizes that starting a child on an antidepressant or other psychotropic medication is a major decision that is based on improving the child’s quality of life, happiness and productivity.

Mood Stabilizers

• Lithium – A salt that has been used since the 1970s to treat bipolar disorder, particularly manic episodes; depression while on Lithium may indicate that a higher dosage is needed. It is important to monitor levels of Lithium (some brand names include: Cibalith-S, Eskalith, Lithane, Lithobid, Lithonate and Lithotabs) in the blood stream and to consult with prescribing doctors before taking any medications, including, but not limited to, ibuprofen, antihypertensives, muscle relaxers and diuretics.

• Anticonvulsants – Helpful in controlling mood swings, although their main use is to prevent seizures (some brand names include Depakote, Topamax, Tegetrol, Lamictal and Clonazepam).

• Atypical Antipsychotics – Used alone or in combination with mood stabilizers can be quite effective, although it is very important to use as directed (brands include Abilify, Navene, Risperdal, Seroquel).

Bipolar disorders in adults are marked by wide-ranging mood swings from deep depression to unbridled mania, but, according to Dr. Zawawi, children experience fewer “top of the world” highs and deep troughs. Instead, bipolar children are typically irritable, cranky and miserable, with sometimes explosive mood swings that can result in unhappiness, difficulty in school and trouble with the law. “Mood disorders require medication,” Zawawi says. “Lithium is the standard and has been used for a long time, but the atypicals are gaining popularity. All mood stabilizers must be used as directed.”

Antipsychotics

• Antipsychotics – Older medications that effectively reduce symptoms of psychosis but can have severe side effects and do not control mood swings (some brands include: Thorazin, Mellaril, Haldol and Prolixin.)

• Atypical Antipsychotics – Very effective in controlling psychosis and mood swings (brands include: Abilify, Zyprexa, Theraciule, Geodan and Clozoril).

Psychosis and schizophrenia are serious conditions that cause people to experience visual and auditory hallucinations and delusions. The side effects of some antipyschotics can be very serious, but schizophrenic patients need to take them long term in order to function within society. The two most serious types of side effects, although rare, include: (1) extraperonial symptoms such as rigidity, stiffness, tremors and tardive dyskinesia, which is uncontrollable movement of the mouth, arms and other body parts, and (2) metabolic disorders such as diabetes, high cholesterol and weight gain. Therefore, Dr. Zawawi warns that anyone taking antipsychotics have regular blood sugar, lipid and liver function tests, as well as family history screening and close supervision. Zawawi stresses that doctors are very careful about putting children on these medications and try to use antipsychotics for as short a time period as possible.

Psychostimulants

Psychostimulants are used in the treatment of Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) and have been the standard for many years. Zawawi explains that these medications are not addictive and can be used into adulthood to help patients focus and control impulsivity. Although classified as stimulants, these medications (including Ritalin, Concerta and Adderal) have a calming effect on patients who suffer from ADD/ADHD. Side effects may include sleep problems and weight loss, but psychostimulants help children perform better in school, engage in less impulsive behavior, focus on tasks, have more positive social experiences and generally stay out of trouble. Zawawi says that dosage and symptoms should be closely monitored and appropriately adjusted.

Anxiolytics

Many children suffer from extreme anxiety and school phobia, which can incapacitate them socially and academically. Medications that treat anxiety are used short term for acute panic attacks because they can be addictive. Anxiety disorders are more frequently treated with SSRIs and therapy, but anxiolytics such as Xanax, Librium, Atavan and Valium can help children through especially difficult periods. Zawawi warns that use of these medications must be closely monitored and carefully tapered off in terms of dosage to prevent withdrawal symptoms.

Communication

Dr. Zawawi stresses that parents must communicate with all of the physicians who treat their children regarding prescription and over-the-counter (OTC) medications. “Parents think that they are bothering their doctor with calls to see if it is safe to give decongestants or cough syrup or even pain and fever relievers to their children, but, believe me, we would rather answer your question beforehand than have to treat serious side effects after the fact,” he says. Combining psychotropic medications with others medicines can cause serious and even life-threatening reactions. “Be sure to tell your family physician about any psychotropic medications your child is taking and encourage them to contact the psychiatrist if there are any questions,” Zawawi says. Many psychiatrists monitor a child’s psychotropic medications for a few months and then turn administration over to the family physician, who is more familiar with the child’s history.

In general, antibiotics and asthma medications are safe when taken in conjunction with psychotropics, Zawawi explains, but it is still important to report all new prescriptions to all of your child’s doctors. Steroids and birth control pills can cause serious medication interactions with some psychotropics, as can fever reducers and decongestants.

Many parents do not realize that herbal and natural supplements can cause severe interactions with psychotropics as well. Dr. Zawawi tells parents that he respects their decisions if they want to try the natural route to treat their children, but herbals should not be taken in combination with any of the psychotropics. Also, parents should not administer larger doses than suggested by the manufacturer of natural or herbal remedies to their children. The adage, “if a little’s good, a lot’s much better” does not apply to natural or herbal supplements.

When it comes to alcohol and street drugs, Zawawi is very clear with his patients. He tells them if they combine alcohol and street drugs with their prescribed medications, they can suffer extreme sedation, excessive irritability, seizures or comas. It can truly be a lethal combination.

School

It can be difficult to make a decision to inform teachers, counselors and school nurses that a child is taking psychotropic medications. There are several points to keep in mind:

• Most schools do not allow children to carry and take medications of any kind in school. If your child needs mid-day administration, this has to be done by the school nurse, and the medications must be kept under lock and key in the nurse’s office.

• Teachers often spend more waking hours with your child than you do. If they know what your child is taking and the possible side effects or reactions, they can watch for anything out of the ordinary and report to you and the school nurse.

• Investigate confidentiality issues in your school system to increase your comfort level. Having an illness does not mean that your child will be “labeled” or suffer discrimination of any kind. There are laws that protect against this.

• Teachers can make adaptations to accommodate your child’s condition, including reduced homework, tutoring, modified tests, frequent visits to the nurse or rest room, the need to eat more frequently, rest periods in the nurse’s office if overly tired, reduced physical activity, not going outside, etc.

• Often, teachers or school counselors were the first to pick up on your child’s condition and referred him or her for an evaluation in the first place. They are trained to recognize possible problems.

• Teachers can arrange for your child to have a quiet place to go during over-stimulating activities, gym or even lunchtime.

• Your child may be more comfortable knowing that the teacher, nurse or counselor understands what he or she is going through and is approachable if the child does not feel well.

• Teachers can “run interference” if your child is struggling with a social or academic issue and make the situation less stressful.

• Your child may be eligible for placement in a smaller class that better meets his or her needs on a short- or long-term basis.

Involvement

Dr. Zawawi stresses the importance of parents being as involved as possible in their children’s treatment, medication, school life and healing. Acknowledging that parents are very busy and often do not have a great deal of time to spend with their children, he says that, at the very least, parents must:

• Monitor and administer their children’s medications

• Communicate regularly with all professionals involved in their children’s treatment

• Spend time with their children to observe and discuss how they are feeling, progressing, regressing, reacting to medication and getting along in school and socially

KidsPeace assists thousands of children by finding them safe, loving homes with caring foster parents in 11 states and the District of Columbia. The Baltimore foster care office sponsored a 5K race and one mile walk to raise funds the KEYS Program(KidsPeace empowering Youth to Succeed), which teaches foster teens life skills that they will need to use when they age out of the system and live independently in the community. With the odds  stacked high against them, teens who age out of the foster care system must suddenly find jobs, secure a place to live, stick to a budget, link up with transportation and make their way in the world, often with little or no preparation. KidsPeace is committed to helping these teens prepare for adult life and move smoothly to independent living.

The 5K fundraiser was the first of its kind for the Baltimore foster care office, and the participation and enthusiasm of sponsors, volunteers and runners was wonderful. From employees of the Baltimore, DC, and Virginia KidsPeace foster care offices to staff from as far away as Pennsylvania, volunteers to the Board of Associates that supports the efforts of the office, to local businesses and sponsors, everyone worked extremely hard to make the event profitable and lots of fun for all who attended. The positive media coverage has attracted the interest of more individuals and businesses that would like to become involved in future fundraisers.

The most exciting outcome is the nearly $25,000 in cash donations and in-kind sponsorships from the businesses in O'Donnell Square in Baltimore where the finish line was set up. Many people in the running community commented that this was an impressive amount for a 5K to raise. Business owners arrived at the finish lines with their families to provide crafts for the children, food, beverages and even electricity for the speaker system from one enthusiastic restaurant. All of the merchants and volunteers truly embraced the race/walk and the foster children KidsPeace serves. Many of the sponsors also volunteered to work with our teens to help them with interview skills and internships in the future.

Baltimore City DSS was very supportive and an active partner.  Ray Syndor from the Philadelphia Eagles was part of the event and was so impressed with KidsPeace that he is working on continuing a partnership in the form of a camp and other programs for our kids. One of the event's very generous sponsors (a local hotel) wants to partner with KidsPeace for next year to help plan the event. The Baltimore Foster Care Office Board of Associates and their families were very generous with their time and their donations, and Chairperson Lee Anderson provided immeasurable professionalism for the post race program. Each board member worked side by side with  staff to make this event such a success, and their dedication to KidsPeace is very inspiring. Board members, interns, staff and their family members were joined by folks from Johns Hopkins, Baltimore students and local community members.

The foster families who attended and volunteered were amazed at the magnitude of the race and the community involvement on their behalf. One of the foster children summed it up by saying "Wow, This is all for us!" A big thank you to everyone who helped out and an invitation to bring friends and family to make next years race an even bigger hit.

Saturday, October 30, was a special day for the children and associates of KidsPeace Georgia, as the campus was transformed into a shady oasis that will provide many peaceful places for relaxation and contemplation. Thanks to a Georgia Forestry Commission "Making the Shade" grant, volunteers planted a total of 22 trees, watered and mulched 51 trees, planted 25 bushes and spread 25 bushels of wood chips. According to Executive Director Scott Merritt, these trees will not only beautify the campus, but they will also shade HVAC units, playground areas and buildings, lowering energy consumption and making it more pleasant to be outside during the summer.

Some 52 volunteers worked very hard on the planting, including 10 youth who are in residence at the Bowdon facility and several KidsPeace Georgia associates. State Forester Joe Burgess was there to instruct the volunteers on how the trees should be handled, planted and tended. Adding great energy to the event was KidsPeace Georgia Board of Associates Chair and KidsPeace National Board Member Dick Tisinger, who organized the army of volunteers with staff from his law firm, Tisinger & Vance, and his Agape Sunday School class from First United Methodist Church.

On Friday, October 29, Fletcher Landscape of Carrollton planted 29 larger trees, which Gene Hughes provided to KidsPeace at a huge discount. Additionally, Landscape Architect Chris Threadgill donated many hours to plan exactly where the trees would go. Carroll County EMC donated more than 30 loads of wood chips, which were placed under the ropes course to make landings softer and used as mulch around the campus.

According to Carol Doyle, a KidsPeace Georgia Board of Associates member and the person who made this entire event possible, the adult volunteers told her how much they enjoyed working with the KidsPeace kids. It was a great opportunity for them to get to know the kids and relate on a more personal level to understand exactly what KidsPeace is accomplishing with these boys and girls. It was also a great chance for the kids to see that people are willing to donate their time and efforts to make life more pleasant for them. 

Scott Merritt is very appreciative to all of the volunteers and donors who made this major planting event possible and is delighted that the kids took such an interest in making their surroundings more beautiful and more pleasant for their daily activities and visits from family members, community members and neighbors.