Monday 24th Jan between 1 - 2 pm - Live webchat with Dr Sally Hodges, Consultant Clinical Psychologist at Tavistock Centre

[RachelMumsnet]

Dr Sally Hodges will be joining us for a webchat on Monday 24th January between 1 and 2 pm. Sally is a Consultant Clinical Psychologist at The Tavistock and Portman NHS Foundation Trust specialising in child disabilities. The Tavistock and Portman NHS Foundation Trust is a leading mental health trust which delivers high quality mental health care, education, research and consultancy work. The Trust delivers out-patient mental health care to children, adolescents, adults and families, with a particular focus on specialist talking therapies and a developmental approach to the promotion of mental wellbeing and the prevention and treatment of mental ill health.

Sally lead on a brand new project to develop an interactive emotional wellbeing website for children aged 7-10 years in Camden, north London. Cam's Den's aims are to help overcome mental health stigma, address an existing gap in mental health education for young children and explain what actually happens in a therapy session.

Sally is happy to answer your questions on topics covering child and adolescent mental health and why a resource for children like camsden.co.uk is so important. Join us next Monday (24th) between 1 and 2 or send a question to Sally in advance to this thread.

Ds almost 16 has a dx of moderate autism. Despite also having a dx of learning difficulties he appears to be cognitively average and will sit GCSEs this year. Socially and emotionally he has made little progress since dx at 3. I feel it is the gap between his social and emotional ability and his academic ability that is causing him stress anxiety and possibly depression.He is mostly selectively mute although will talk sports statistics as a monologue to a select few.He will not take medication so how can we get him the help he needs?

A young friend of mine (age 15) suffers from intrusive thoughts and mild OCD (dogs' muck, contamination fears etc).

What's the best thing for him to do to stop the intrusive thoughts? As far as I know there are only two main approaches: face the fear or distract yourself.

Another one - more important, maybe.

Do you think that mental health services are going to be able to survive the government's changes to the NHS?

Last year my daughter suddenly without warning lost her sight (for 7 months). After a lot of toing & froing it was diagnosed as non-organic sight loss.

This was 'treated' by weekly sessions for about 2 months, then fortnightly for 4 months at our local CAMHS.

6 weeks after her sight returned (during the 1 session in that time) DD has been diagnosed as 'better' and her appointments have been cancelled.

Do children's mental health problems really "end" that quickly?

Hi, I'm very pleased to have seen this before tomorrow as I won't be able to be online until about 1.45.
I have a 5.10 year old son with moderate spastic diplegia CP who is very aware of what is different about him already. He is academically bright but socially and emotionally immature.

Both his paediatrician and myself feel that he would really benefit from talking to somebody as he does have 'meltdowns' and has started to become very anxious about the many hospital visits, especially any involving anaesthesia. CAHMS have refused him 3 times and we have now been referred to the complex needs team but have been waiting for a response for over 6months - we have chased them up!

I wonder if you have any suggestions of things we could do with him at home to ease some of his anxieties or talk to him about having a disability. I can foresee that if he is not helped in managing his feelings and emotions now it will could easily cause problems in the future. We are very open about it all at home, have photos up of him in the incubator (he was very premature) and prepare him for each appointment, at the same time I have started pulling in all sorts of favours so that I have someone with me at appointments so that they can be with him and I can discuss his needs with Drs without him being there. However I feel he needs more and we are not quite sure how to go about getting him this help.

Is there any particular type of therapy you could suggest? Is it worth giving him yet another set of people to see, probably in hospital which would add to time away from school and further emphasise differences? How can we access this help if the complex needs team refuse to see us?

Thank you.

I don't really have any questions, but I have a son, aged 7 with ADHD and ASD who is a constant ball of anxiety. We have been dealing with a lot of aggression from him, recently. Cam's friends look to be a great tool to help him to identify his feelings and not actually be scared of acknowledging them, as that's something we're working on at the moment.

Several members of my husband's family suffer from mental health issues. One sister is bipolar, the other sister has suffered from depression and a niece has recently been admitted to hospital suffering from a breakdown. A cousin attempted suicide some years ago, after battling depression.

The family are rather secretive, and not good at discussing their feelings. We have only recently learned about the niece, but have no details. It happened several weeks ago.

My husband worries about our children, particularly our daughter - whether the likelihood of her developing some MH issues is higher, because of the family history.

What can we do to help our daughter avoid this?

I have a daughter age 3 who has a Global developmental delay. She has a speech delay and is suspected to be dyspraxic. She is delayed with her gross and fine motor skills. In a nut shell she is like a 2 year old that cant speak. Her understanding is much more advanced than her speech. Socially she is near age appropriate.

She has always been a very happy child and never cried or fussed too much since settling in nursery a year ago.

In December she started to have melt downs. Usually triggered by a change in a situation or not getting her own way. Not related to new people or new places. It seems to be the anticipation of what may happen that sets her off....

The meltdowns are continuing and happening more frequently now but they are getting shorter. I suspect that she is deliberately crying - at home she stops immediately if she realises i am not paying attention.

Sorry to waffle - my first question is in these early days what advice would you give to me to help my daughter with frustration now and in the future? Is there anything that I should look out for?

We have a great team at a specialist nursery helping my daughter - she is in good hands.

My second question is that my husband has decided that 'tough love' is needed. He loses his temper with her and shouts at her. Sometimes he finds her irritating and it is so obvious, and horrible for me to see. I wonder if my daughter is affected by it too.

I know that she is upset by other children crying and cries if she is shouted at. So she is aware.

I feel that his anger is confusing her. She now behaves differently with each of us. He is spending less an less time with her.

Home life is now becoming difficult as he feels that I should also be shouting at her and telling her off. I feel that this is not fair.....on either of us I want to address his behaviour.

Is it possible his shouting and short temper could affect her at this age......could this have a long term effect?

Sorry if this is a daft question. I know this may not be easy to answer without speaking with me but its on my mind at the moment.

Many thanks

Hi Sally,
My son is nearly 10. He is primarily down syndrome, SLD, tetraology of fallot part repaired, lung issues, mobility issues, sight and hearing problems, unknown seizures and severe sensory issues. However has many traits of other diagnosis, including asd, adhd and ocd.
A few professionals involved feel he should have a proper diagnosis and help for that. Though everyone seems to sit on the fence. The latest thoughts on him are pathological demand avoidance.
He is an extremely anxious child, has major problems in loads of areas, often causing extreme meltdowns, he is getting no support for any of this and some also impact on his health, such as stress and the lack of toothbrushing.
What should we be doing and what would all this mean for him?
Thanks.

Hi Sally

What an interesting website - and I agree there should be more resources for children to find out about feelings in a neutral way...

I have an 8yo DD. From a young baby, she has always seemed tense, always striving for the next thing. She hates not being the best, is exhaustingly competitive. At the same time she is charming, caring, empathetic, insightful, very popular, talented at sport, academically able, socially at ease.

However, once at home, quite often the pressure of being such a 'golden child' becomes too much and she crumples - often with extreme rage and violence towards her sister and us. Once calm she can rationalise her anger, but she can remain fiercely cross for a couple of hours at a time. By violent I mean hitting, kicking, smahing things. She is too big to restrain now so has to be put into a room where the door can be locked until she calms down.

She hates feeling like this and knows when it is coming, but says she cannot stop it coming. She also finds it very hard to sleep - often taking 2-3 hrs to fall asleep - despite trying every tactic known to woman to help her. She then struggles to wake in the morning.

She has experienced nothing in the way of family trauma at all, although did have gastro issues as a child/toddler which caused her some degree of pain for an extended period of time.

Sorry for this lengthy background! My question is - is this within the realms of 'normal' for a child who measures high on perfectionism, or should we look into some sort of takling therapy for her and run the risk of her classifying herself as being 'mentally in need of help' which she would interpret as failure...help!

Thanks for any insight...

Hi Sally,
My son has (HF)autism and is very keen on self-harm and suicide/ murder threats. He's 9 and considered too young and lacking in self-awareness for CBT. How would you treat a child with these problems?

I have a question about the best way of dealing with my 11-year-old son's anxieties. He performs a lot of OCD-type rituals to cope with his anxieties, such as repeated hand-washing, counting things, checking doors are closed, looking around him a certain number of times when he sits down and so on. He refuses to eat in restaurants or go to cinemas because he is worried he will be sick. He won't go to friend's houses for the same reason. He was treated for his fear of vomiting two years ago (CBT) and we are going back to CAMHS, but my question is: how best can I help him to overcome these anxieties? I never know how much I should push him to do the things he is afraid of.

Hello Sally

Just been and had a look at the Cam's Den website. Its great, I think my son would really enjoy using it. He would be really pleased to see the feelings diary in particular, as I have designed one for him to use and its really seems to be helping him.

He's nearly 9 and was diagnosed with Aspergers just last week.

In addition to the ASD, he suffers from really bad anxiety and is highly reactive emotionally (not violent, just angry - lots of shouting and meltdowns etc). Until recently his anger was saved for home, where he felt safe, but its now seeming to erupt at school more and more often and I can see this becoming a huge issue if things don't improve quickly.

When we were told about his diagnosis, they told us that all they do is diagnose and that they couldn't help us with any help or support. Instead we were given a lot of leaflets for voluntary organisations and charities, most of whom are currently having their funding cut and are already really overstretched. Effectively we were told - your child has Autism, thank you for coming - goodbye.

I have worked hard to understand the SEN process over the past two years and we are finally starting to make some progress with his educational support. (Although it has been anything but easy and there's still a lot more fighting to do.)

My question is, where should we go - or what route should we take to get him emotional support and help with understanding and handling his own emotions? He is a lovely, bright boy with such a lot of potential, but I fear without some help around handling his emotions he will never realise his potential.

The assessment centre suggested we contact CAMHS, but we've already done that via our GP and been turned down flat, despite at the time having an extremely anxious, school refusing 8 year old. Is there anyone else out there that can help?

Realistically, we can't afford to pay for him to have private support/therapy, but if there really is nowhere we can get help on the NHS obviously we would have no choice, so where can we go to find him the right therapist? My Mum is a clinical psychologist herself, but not a child psychologist and doesn't know of anyone locally who specifically works with children, let alone children with ASD and anxiety.

How can I help my child to deal with anxiety over school?

My 9 year old is becoming increasingly worried about changes in teaching staff ( even just to cover a day's sickness, friendships, disruptive pupils etc) to the point where she is becoming very emotional, easily upset, sensitive etc. Although I realise her worries have some foundation in what she has experienced at school, her worries seem far greater that the issues would seem to demand. I have spoken to staff before about her concerns, and now intend to spend some time helping out to observe for myself, but I think my child needs some support and some strategies to find a way of coping.

I am also interested in scubagal's post as my son doesn't go to school due to his fears of noise, friends, crowds, dressing up, assembly etc.

Would you agree that as a nation we have huge issues related to self esteem and the fostering of such in our children and that this in turn often leads to poor mental health in our communities?

What can be done to raise self esteem in individuals and to help parents raise their children in ways that create a positive sense of self when 'permissive parenting' seems to be the antithesis to pre and immediately post war parenting styles; perhaps creating as much of a problem with regard to behavioural and emotional problems in children/young adults?

Hi Sally. My ds is profoundly deaf and has Aspergers syndrome as well. While i am very happy with the help we get from Deaf CAMHS i think there is not enough information for parents of children with both deafness and Aspergers. There is an online Yahoo Group but nearly everyone on there is in America so they have different facilities. What can be done for families like ours??

Hi Sally

D2 is 12 (nearly 13) and is waiting for PDDAG assessment. I'm fairly certain she has some form of Aspergers.
We were referred a year ago and because she has been passed on she is no longer seeing CAMHS. She has a long list of 'issues' resulting in a hatred of school and frequent phases of school phobia/refusal.

My questions....

Is a label (HFA or AS) going to be useful or more harmful long term? I am vry concerned abou other people's perceptions in the future (things like driving licence, jobs etc).

would having an explaination for how she is be a help to her? she hasn't much self confidence at all.

Would it be worth looking into getting a private ssessment done? Where? Who? How?

Thanks v much.

My son is 7 and is awaiting a formal assessment for ADHD. I have noticed a change in him since starting junior school. He has developed a short temper and prone to crying easily My question is: is it the ADHD that makes him angry or is it the way 'people/teachers' react to his behaviour that upsets him? He started school a happy, lively 4 year old who made loads of friends. He's becoming a sad, angry 7 year old hating school life as he finds the demands made on him somewhat 'out of his reach'. I have considered home educating him, but he is a social child and I feel I would be depriving him of this natural contact - which is even more important for a child with ADHD as he needs to learn how to socialise effectively

Hi Sally

DD1(11) has been diagnosed with Aspergers. DD 2(6) has no issues.

Do you have any advice please concerning relaxation/dealing with stress for children. I am asking specifically for children, as my idea of relaxation (reading a book etc) is very different to my DCs!

I wonder what has been proven to be beneficial for children, to cope with the stresses of their lives?

I'm guessing hobbies, physical activity etc but I would love to hear your professional opinion on what all families can do for their children?

Many thanks

Hi Sally

What self-help measures would you recommend for general anxiety disorder?

My daughter is 10 and is on the waiting list to see a psychologist.

Before she is "put into the system" so to speak, what can we do as a family to help her overcome her intense anxieties?

Hi Sally
I'm an educational psychologist and regularly meet families where ASD/Asperger's has been diagnosed or is suspected.
Whilst on a personal level I have a good relationship with several colleagues in CAMHS, we seem often to get into the situation of each agency saying 'it's not us, it's them', to address difficulties, especially around anxiety/non-attendance, which is no help to the families and frustrating/professionally embarrassing for the agencies.
We've been talking about 'joined up services' for years, but so many families still get let down. Where do we go next, and how do we make schools (especially in the seocndary phase) more accessible/helpful/safe/enjoyable places for this increasing population of young people?
Big question, I know!
Thanks

Awww - Hi Sally! I used to work with you at the Tavistock Clinic many years ago now - I was the Child and Family Services Manager!

Anyway, ds1 is now 9 years old (where did that go..?!) and we've discovered over time he finds it very difficult to settle into school at the beginning of the academic year. He doesn't show it at school - the teachers love him because he loves order and processes (and gets lots of stars reminding them when it's time to do things ) and academically he's great, but at home we see how difficult it is for him.

This year he started not being able to eat in September - almost forgot how to chew and swallow food and although he's much better now (it tends to ease up by December/January), he had several choking episodes at home, and is still taking around an hour to eat any meal.

Do you have any advice on how we can best prepare him for each September starting in a new class, with a new teacher? Is it worth approaching the school in the July before to talk to his new teacher?

At the moment school are unaware he struggles, because it doesn't impact on them and we've debated about how much of a 'big deal' to make of it...

Sigh. I won't be able to make the web chat live so thanks in advance for any tips on how to help him - we're starting to look ahead to him starting secondary school in a couple of years, so want to get prepared really before this huge change happens for him.

Thank you and hope life's good at the Tavi!