October 27, 2017

Article on Anxiety Published in Building Blocks Magazine

Hello Everyone,

My recent article on media anxiety in children with developmental diagnoses and ASD was just published by Building Blocks Magazine.  Please read it below and leave a comment!  Thank you and have a Happy Halloween!


October 4, 2017

Transitioning Youth Resource Fair

Hello everyone,

The Montgomery County Youth Transition Work Group, in partnership with Montgomery County Government is hosting its annual Transitioning Youth resource Fair on October 14, 2017.  I will be presenting several information sessions on dating and relationships for people with autism spectrum disorders and other developmental diagnoses.  Please see the fliers below for more information.  I hope to see you there!



September 8, 2017

Manage Anxiety Around Natural Disasters!

Hello everyone,

Image result for natural disaster precautionsI hope you are all doing well and that those of you with children are getting readjusted smoothly to school.  With Hurricane Irma fast approaching on the heals of Hurricane Harvey, I have seen a rise in anxiety in children about damage and negative consequences of these storms on family and loved ones.  I thought now would be an appropriate tome to share some special considerations for families on managing anxiety around natural disasters whether you are in the path of the impending weather or have loved ones who are there.  I hope this short post will be helpful and, as always, I appreciate your feedback!

Self-Awareness
Do your own “self-work”
Know your triggers!

Are you anxious too?

Listening is Better than Talking!
Listen calmly
Use eye contact to let them know you are listening
Maintain a sense of normalcy
Treat the conversation as important
Validate fears when they pause speaking
Save your questions for after they finish sharing their anxious thoughts and worries. 

Image result for natural disaster precautionsHow to Respond
Be patientbreathe, and move slowly through each part of the anxiety
Give your child as much time as they need
Don’t use euphuisms (ex. nuclear hurricane)
Explain the abstract in simple concrete terms
Ask them “What would make you feel safe?”
Ask the child to come up with solutions
Offer facts that will help them neutralize their anxiety
Help them understand what is meant by "freak storm"; "nuclear hurricane"; "monster tornado" etc.  Remember that children often think in concrete and literal terms so the use of these labels in the media may intensify the fear.

Know Your Child
Children are excellent observers but poor interpreters
Check-in what they know
Don’t assume or give details only if they want to know more
If the child has had anxiety in the past then anticipate its reemergence
Your child has valid fears, concerns and opinions, even if you do not agree with them
Be your child’s expert provide any facts they need
Be your child’s best resource to give them a sense of safety and security

Use your child’s interests to help explain abstract concepts and keep them engaged and understanding.

Part of knowing your child is also about knowing what is more likely to make them anxious.  Spend time with your child discussing what are the most likely consequences of the impending weather event e.g. power outages, fallen trees, damage to property.

Take time to discuss fears around more unlikely, yet often more scary possible outcomes such as death of a loved one or loss of the home or injury.

Take Action

Image result for natural disaster precautionsEducate your child and yourself!  Learn about the type of natural disaster that you are worried about.  Often, the science behind the event, such as a hurricane or tornado, can be fascinating and help alleviate fear.

Take care to normalize the severe weather event (even thought they range in severity) as a part of life that comes with living in the area you or your concerned family lives in.  Be sure to emphasize the preparation that goes into keeping safe and learning from past events to help improve safety precautions.

One of the most helpful things you can do, as a parent, is to take time to focus on what IS going right at the time of the event.  As odd as it sounds, paying attention to the efforts being made to help people prepare to withstand the natural disaster is reassuring.

Make plans with family members in the impacted area to have a time to check-in on safety before, during (if possible), and after the event.
If possible, be sure to let your child know that in the event that a family member(s) lose contact they will do their best to get in touch as soon as possible.  Help your child understand likely reasons why a relative may lose contact during a severe weather event.

If you live in the impacted area, make sure you have a clear plan of action to stay safe or get to a safe zone.  Are emergency supplies ready and do you know your emergency contacts?

Image result for natural disaster precautionsDon't forget the pets!  Having a safety plan for your beloved pets is as important as a plan for your family.  Also, for family in affected areas, it can be helpful to have them reassure your child (if you live in an unaffected area) that their pets are safe and will stay so.

Educate your children about the first responders who would be involved in responding to the weather event and, if possible, take them to open houses hosted by responders so they can familiarize themselves.

Limit screen time to the television, computer, other electronic devices, and social media around the  weather event. 

Take time to be with family and participate in fun activities, noting how life still continues despite the anxiety causing event your child is worried about.


Saying a prayer or doing a concrete good deed helps alleviate the feeling of helplessness.


Special Attention for Children with Disabilities
Monitor non-verbal individuals for reactions, behavioral changes and other symptoms that can signal anxiety.
Non-verbal and verbal individuals can benefit from short, concrete explanations that can be repeated again and again.
A child with special needs may need more physical comfort to compensate for their lack of verbal ability.

Try to maintain routine as much as possible if necessary than allow deviations like sleeping in Mom’s room but pre-plan a designated time of two-nights and provide a concrete chart or way for child to grasp it.

August 30, 2017

Early Fall Parent Information Sessions

AUTISM INFORMATION SESSIONS

Hello Everyone,

In response to numerous questions from individuals with, as well as parents and family members, I will be hosting a series of information sessions on

Coping with Autism Spectrum Disorders:
Open to parents of children with autism – and individuals with autism. 

Location:   3930 Knowles Ave. #200 Kensington, MD 20895

Length:  1 hour

Topics & Dates:

"Back to School: Working with Your Child’s Education Providers on IEPs and Accommodations in the classroom”
Saturday, September 16th at 10:00 AM

"“Cyber Bullying:  What is it and How Can I Stay Safe on the Internet?”
Saturday, September 30th at 10:00 AM

Are you Ready for a Relationship? Dating and Relationship Issues in Autism”
Wednesday, October 4th at 6:00PM

"How Can I Help my Family Member with Autism Manage Inappropriate Behavior?"
Saturday, October 7th at 10:00 AM

"Creating a Safe Haven: Tips for Managing Sudden Transitions and Sensory Issues in the Environment."
Saturday, October 21st at 10:00 AM

"Being a Good Social Media Diplomat: Tips for Appropriate Use of Social Media”
Saturday, November 4th at 10:00 AM

Contact:  Jonathan Rhoads at rhoajo01@gmail.com or at (301)-639-4036 to sign up.  Space is limited!


Jonathan Rhoads, LCSW-C, is a licensed clinical social worker specializing in working with children and teens diagnosed with autism spectrum disorders to develop positive coping strategies to manage anxiety and stress around regulating sensory inputs, especially in the context of developing appropriate social skills.  He is particularly interested in helping children and teens with autism create healthy identities, relationships, and becoming strong self-advocates for their needs.  He currently facilitates several successful social groups for young men with developmental disabilities through Potomac Community Resources and has recently been featured on CBS News for Autism Awareness Month.

August 11, 2017

Teaching Children with Autism about Confidentiality using Social Stories

Hello Everyone,

Image result for confidentialityNo post in July.  I have been working on an article for Building Blocks Magazine, a quarterly periodical focused on individuals with special needs and developmental diagnoses, using my last post on suggestions for parents to help their children manage news and media anxiety.  It is scheduled to be published in their upcoming September, 2017 issue and I will have copies in both their downloadable and published form for you to use. 
In the meantime, I have been doing some research in response to numerous parent questions about explaining confidentiality to their child with developmental diagnoses.  Somewhat surprisingly, there is not much information available, let alone resources, to assist parents and, critically, service providers such as doctors, lawyers, and mental health professionals, in explaining the hugely important topic of client information privacy.  It is all the more surprising considering all the ethical and legal implications of client-professional privilege and regulations around the protection and sharing of private information.
As we all know, the term “confidentiality” is, as we believe, relatively straightforward and means that “the information revealed by a patient or client to a professional is private and has limits on how it can be shared with a third party, usually requiring knowledge and consent of the individual before being shared”*.  Of course, concrete definitions have to be subject to rules and regulations that facilitate professionals in these relationships to do their jobs, namely communicating important information to other providers and family members that may assist in the care or advocacy of the individual.  Often times, such information may be considered private by the individual in the care of these providers and therefore fall under the scope of “confidential information”.  What the individual may reveal to his/her therapist, he/she may not reveal to their primary care doctor.  However, this information may be critical to the doctor’s ability to provide competent, comprehensive care to the individual, leading to a most necessary document called a “release of information”.
The complexities of multi-systemic care for individuals with developmental diagnoses, particularly children, make the understanding of confidentiality and use of releases of information critical to the child and family.  It is all the more important when considering children generally do not, due to their developmental/cognitive stage, grasp the more abstract aspects of implications and consequences stemming from confidentiality around private information beyond a basic understanding of the concrete definition “My information is private and not to be shared”.  Consequently, children and those with developmental diagnoses may not understand the importance of sharing information with providers or the limits on sharing and may run the risk of sharing too much; the consequences of doing so are often irrelevant or not understood in that moment.
Image result for confidentialityHelping children with developmental diagnoses understand confidentiality and its uses and limits, along with release of information, is important to ensuring smooth flow of helpful information to all service providers so the best care can be given.  Since many children with developmental diagnoses often struggle with the pragmatics (day-to-day appropriate usage) of social interactions, and the crux of confidentiality is the appropriate management and protection of information shared in a social setting, a social story can be an excellent tool for teaching your child about confidentiality, its uses, limits, and most, importantly, its relevance to the them. 
Image result for confidentialityI have created a social story, which you can find at the end of this post, explaining confidentiality and explaining releases of information.  Please note that social stories are more effective when images are included to help establish the retention of the concept; I have purposely not included images with this story for that very reason.  You know your child best and what visuals they respond to best.  Please use the stories and add your own images that your child will respond most to.  The story can be used as is or broken down into confidentiality and parental consent and releases of information, depending on how your child processes information.  The story will be all the much more powerful.  Also remember that you can tailor this social story to a specific provider or providers as you need to.  I have opted to use “therapist” for purposes of creating the example.  The stories here are templates and more effective when made relevant to your child’s situation.  Lastly, your use of the social story will be enhanced if you introduce it in advance of the situation where your child needs to know about confidentiality and releases of information.  Please refer to my post about social stories for further information and suggestions.  Good luck and remember that understanding confidentiality does not need to be complex or something requiring memorizing government regulations!


LET’S LEARN ABOUT CONFIDENTIALITY AND SHARING PRIVATE INFORMATION!

Today I am going to meet with my therapist for the first time.

A therapist is someone who is specially trained to work with children, like me, deal with tough problems happening in my life. 

Some examples of tough problems a therapist can help me with include dealing with bullies, being in charge of my emotions and understanding them, and how to express myself appropriately.

When I meet with my therapist, I am creating a special relationship where I can trust them to help me and I can share what is bothering me.  I know they will listen to me

This type of special relationship is called a client-patient relationship.

Because of this relationship, my therapist and I are able to talk about my (insert what child is seeing therapist for) together. The information I share will remain private and will not be shared with anyone.

My therapist will not share what I tell him/her with anyone else because it is CONFIDENTIAL.

This protection of my private information by my therapist is called confidentiality.

I understand that I do not know my therapist when I start working with them.  My therapist understands I may need time to trust them before I will be willing to share my private information (insert what child is seeing therapist for).

The more comfortable I am with my therapist, the more private information I can share with them about my (insert what child is seeing therapist for).  My therapist can be more helpful to me when I share information with them.

Because of our special client-patient relationship, my therapist understands that it is very important to keep what I share with them private so I feel comfortable sharing (insert what child is seeing therapist for).

My therapist knows not to share what I tell them unless I tell them they can do so.  This is called giving permission. 

My parents are also responsible for keeping my information safe since they take care of me.  When they give permission to my therapist to know my information this is called PARENTAL CONSENT.

Parental consent is very important because my parents have to decide who can know my private information so they can give me the best help. They consent to providing information about me because they believe it will allow others to help me.

There will be times when it will be important for my therapist to get consent so he/she can share information from my parents with other individuals who help me such as my doctor, school teacher, or school counselor.  He/she will talk to my parents to get permission to share my information.

My therapist needs to share information that helps keep me safe, such as if I tell them I am being bullied, or if I am in danger, and to help my other care providers do the best job they can taking care of me.  (You can add your own relevant examples).

In order for my therapist to share my information safely, my parents need to sign a RELEASE OF INFORMATION.

A release of information allows my parents to give permission to my therapist to speak only to care providers my parents and I want him/her to speak to.

My parents and I will describe what information my therapist can share with other care providers on the release of information before signing it.

I know my parents and therapist will help me understand why my information is being shared and answer any questions I have.

Confidentiality, parental consent, and a release of information are very important and are required by law.

I can feel comfortable working with my therapist knowing he/she has to follow the law and wants to help my parents keep my private information safe.

END OF STORY


 "© Jonathan Rhoads (2017) PERMISSION TO USE OR MODIFY GRANTED IF CREDITS ARE MAINTAINED" 


*Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.