Clinicians

Help! My Child is in Preschool!

The first years of school for young children can be very difficult for parents and teachers alike. It is not unusual for behavioral problems to appear during the initial years of attending a structured learning environment due to the increase in structure, significant changes in routine, separation from caregivers, and interaction with an increased amount of peers. The following symptoms are often reported by parents and teachers:

Parents may receive multiple written or verbal reports from the school and teachers may become overwhelmed with the ongoing behaviors, leaving both feeling frustrated and helpless. For the child, this cycle may persist into elementary years, promoting negative feedback, low self-worth, and poor academic performance.

"Why is my child having trouble?"

Just as older adolescents and young adults in the "launching" period, young children may experience a challenging adjustment period to school. These various changes are especially challenging for child biological factors, such as temperament, sensory, sensitivities, and developmental delays, and environmental factors, such as family stress, attachment, and interaction styles. Children who do not have the appropriate skills and abilities may experience significant levels of stress related to the numerous changes, which often appears in young children through behavioral problems. These children are often labeled as "difficult" or "unmanageable," when, in fact, they are often lacking the resources to effectively express emotion and manage their behaviors. There are specific concerning behaviors or "red flags" that may be observed by the parent or teacher which warrant intervention.

Self-management skills are required at an early age to process internal and external information and early deficits may interfere with an appropriate adjustment to the school setting. Children presenting with initial symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) or a Learning Disorder (LD), anxiety, or lacking adequate adaptive skills (e.g., communication, self- direction, social) are lacking effective self-management skills.

"But what do I do?"

Early intervention services have been demonstrated throughout research to decrease the probability of significant problems in an individual's future, such as major depression, generalized anxiety, violent behaviors, and substance abuse. These services initially consist of involving the parents, child, and teacher to determine specific behaviors and problems and a psychological evaluation to provide information about cognitive abilities, adaptive behaviors, and emotional and behavioral functioning. If any of the above mentioned behaviors are being reported, an initial evaluation will be beneficial in identifying specific problems and appropriate intervention. The following services are provided by Tarnow Center for Self-Management to promote early identification and intervention specifically related to early educational problems:

• Self-Management Evaluation to fully evaluate cognitive, emotional, behavioral, and social functioning to identify strengths and weaknesses specifically related to self- management skills. Evaluations may also include speech and language, educational, and medical assessments. Individualized objectives and goals for increasing self-management skills in the academic, social, and family environments will be provided.
• Teacher Consultation is often effective at identifying providing interventions for specific problems in the classroom. The interventions focus on implementing techniques for behavioral problems, integrating children into the classroom, and promoting social and emotional competence.
• Educational Readiness is provided to evaluate developmental delays in cognitive,motor, and language skills to identify risk factors for school difficulties. The evaluation can range from a formal assessment of multiple domains to an informal observation of specific skills and abilities.
• Individual and Family Therapy incorporates the parents, child, and school personnel into the treatment process which will focus on building self-management skills, including managing impulses, maintaining concentration, behavioral modification, increasing independent behaviors, and building emotional awareness and frustration tolerance.
• Group Therapy is offered to promote social skills with children and provide parent education to build effective self-management and develop plans for inappropriate behaviors, including training in the SMART Family System.
• Speech and Language Therapy is provided to build and enhance these skills with highly effective techniques, such as Fast ForWard.

The Tarnow Center for Self-Management also offers many other services for children, adults, and their families focused on identifying the problems of individual and the entire system through an interdisciplinary approach. Many difficulties can affect the appropriate development of self-management skills including learning problems, emotional distress, family dysfunction, and poor social skills. For young children displaying problems in school, the most encouraging aspect of treatment is that children are not inherently "bad," and building effective self- management skills will increase confidence, independence, and overall functioning.