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.

I will be very interested in your answers to sundaytoast and leningrad- our issues seem somewhere between the two...

I want to know how we can help our daughter.
She is about to turn 5, and has had issues with sleep from birth. She needs a lot of sleep, always has, but finds it almost impossible to drop off- she cannot stand to lose control it seems. We have had a consistent bedtime routine from birth, and bedtime is 6:30 (it was 7 until she started nursery school 18months ago, but she was too tired so moved it forward).

She has suffered nightmares from around 14mo, and night terrors from around 2yo, she talks in her sleep (every night) and we recently had our first sleep walking incident.

None of these things wake her usually, but obviously her sleep is far from restful. On a normal night she will yell/scream out probably 6-8 times over 12 hour period, night terrors once a week or so. At the moment the yelling is reduced because she is sleeping in our room (at her insistence) but still 2 or 3 times a night, and I don't mean just calling "Mummy!", I mean full-on blood-curdling, being murdered type screaming!

Like Lenin's DS, us informing her of upcoming events (to prepare her) sends her loopy behaviourwise before bedtime- running screaming round the house, hitting and kicking us (if we restrain her she screams that we're hurting her), if I shut her in a room to contain her (and prevent her waking toddler DS) she will hammer with her palms on the door- you can hear her halfway down our street my DH and MIL have confirmed this!
She will be up until 10, then will stop, calm down and sleep normally (for her). Rewards (star charts, stickers etc), sanctions, ignoring, and shouting at her do not work!

She is (almost abnormally) interested in people who are asleep- especially when it is time for them to wake up- and always begs to be present when my toddler is woken from his naps. I think it stems from a perfectionist streak- she didn't say a word until 19mo, then started talking in sentences within 2 weeks, she refused to crawl, pull herself up, or toddle until 16mo, then stood up and walked one day- no wobling/falling over. She is perfectly behaved in school, and has many friends, and is doing very well academically (is Reception, but free reading already); she rarely ever (or has ever) tantrums - they are almost exclusively over sleep.

Sorry (turned into an essay) but I really want to help her get over this- for all our sakes... DH and I have no evening times some weeks whatsoever, DD is obviously disturbed by her behaviour but lacks any capacity to change it, DS is suffering from being kept awake/woken up by her noise and is also (as an impressionable toddler) starting to copy her antics at bedtime... grrrr.

@PixieOnaLeaf

My daughter is 12 and was discharged from hospital last week. She was admitted in November after an asthma attack which was so severe that she had to be ventilated.

She is finding it very difficult to 'come to terms' with the attack and is, I think, frightened that she is going to have another attack which will prove fatal, although she won't admit this to me, or her counsellor (who she is doing Play Therapy with).

She finds most aspects of life very difficult, but is having a number of panic attacks every day and is really struggling to cope with them. We have been told that we just need to be there for her and support her and that she'll get better with time.

Is this a normal reaction to what's she's experienced?

Is there anything other we can do than just waiting for her to get better?

To be honest, I just feel useless.

Please dont feel useless, your capacity to think about your daughter and her distress will be helping her, even though she is still anxious; it will get better. What you are describing can happen, she went through an extremely traumatic experience and she is trying to find a way of dealing with this, but clearly with thoughtful support.

hi this is what we are experiencing too we are also being fobbed off by school it is soul distroying.

@wasuup3000

Hi Sally

My daughter is in year 7 at school she has a non verbal learning difficulty (assessed as significant 0.1 on her scores wisc tests), selective mustism and since a extended virus some weeks ago has developed pains in her arms, legs, hands and joints in general.

She goes to a small, friendly secondary school which she wanted to go to at first but now it seems that we are getting into the old "I don't want to go" cycle that we have been on for two extended periods twice before.

Everyday she has a headache, feels sick or can't walk. I sometimes have to shove her out the door ( she has home school transport). It is very draining just to get her off to school and she has 3 brothers one who has ASD as well who see this daily. Then she comes home upset saying its all my fault if she has had a bad day.

Can you advise?

Thanks.

Your daughter is clearly showing her distress about something and it sounds like you have been working hard to try and support her. Is the school working with you to help her, sometimes having someone from school come to the home to talk through options eg shorter days, support/counselling in school ?

@devientenigma

hello to you Sally,
Please help my son, no one acknowledges his issues and he is being left by the wayside.

It sounds like you are having a tough time, have you talked this through with your sons GP ? they should be able to think with you about local services that might be able to help ?

Thanks Sally - She has a statement and some support at school via a TA. One of the main difficulties she has is that she doesn't like talking( communicating her feelings) so will just tell whoever it is whatever she thinks they want to hear to get rid of them.

hi Sally, the Gp and social worker are doing there best, just not getting anywhere. His problems have remained the same since being small. I just don't know how to help. He's sitting here with me as he is scared of school. His teacher came out for him this am, to no avail.

@LolaShh

Hi :)
DD is 17, she has been diagnosed with a whole host of anxiety related disorders and AVPD.
She's attended CBT since she was 16, but currently she's at an inbetween stage. She's now too old for CAMHS but not old enough for the adult MH services - what on earth can I do to help her?
Are there any books you can recommend for either me or her, or just any advice would be welcome.
Thank you!

She shouldnt be too old for CAMHS, the service is funded through to age 18 and many areas have specialist young people/adolescent services. I would go back and talk to your GP about this, to see whats available in your area.

Hello
My 7 year old son suffers from night terrors most nights. He wakes up after about 1.5 hours screaming, sweating, with his hands clasped over his ears to block out the 'noises' and his eyes wide open and terrified of the 'things' he can see around him. He always breaks down after about 5-10 minutes saying 'I'm scared, I want my mummy' and I am always saying 'Mummy's here'. It's very distressing for us, but he never has any memory of it the next day.
I worked out that if I disturb his sleep pattern, ie. I go into the room and semi-wake him after about 1 hour, I can sometimes prevent the terror from happening, but not always.
What I have noticed is that he is soaked in sweat after about 1 hour of sleep, and his hair and PJs are drenched in sweat.
For reference, in his early years, he had a lot of difficulty with sleep and I found Millpond, the sleep therapists, very helpful and since he was about 5 his sleep seems to be good, apart from these night terrors. They are much worse at the moment because he had a bad bout of flu-B over xmas/New Year, when he had such a high temperature that he was sometimes having visual hallucinations. I suppose my question is : is this something that he will grow out of and is there anything else I should do? Could the latest patch of terrors be linked to the illness over xmas?
Thank you for reading this message.

Several of you have asked for references for relevant books, which I do have, but not with me, will get them to mums net for posting later.

It's also whats all this stress and anxiety doing to his heart. HIs fingers are all broken and sore where he has been biting them etc.

Hi, I am as the name says putting things in place to move. The children are year 7 and 8, and I am thinking of moving out of area. The only link we have here is their school and friends, and up to now it has been holding us. I feel for me to feel free and move on, I need to move out of the area, for many reasons, one being in the past few years I had a breakdown, after emotional abuse from exh and the various court cases, and then I realised my own family were emotionally abusive so I have cut contact with them and some friends. I have had some therapy.

I am concerned that I may hurt the children by putting my needs first, what do you think?

hi sally, we are having real problems with school accepting our childs needs,currently awaiting diagnosis asd,the school punish him like a naughty child would be, but the things he does he cannot help,i'm always on the phone to school ,and at meetings,but nothing ever gets properly sorted out.

Just going back through the messages. thank you very much for your kind comments on Camsden, and I would welcome any further feedback. We developed this owing to our research at the tavistock that showed that there is very little support and information for younger children about emotional issues.

A couple of you have asked about diet, and I guess exercise would come into this category. I think there is a good research base to show that having a rounded approach to 'emotional well being', that does take into account life style issues is important, and can make a difference to mental health, for children as well as adults.

I would love to ask Dr Sally why it is that the behavioural methods of ABA are so hated by the education and health establishments in this country, when they are so successful in helping autistic children like my son? Every time I mention to one of the experts I come across, either in Education or Health, that ABA is having good results in improving my son's concentration span, ability to learn, ability to talk, and anti-social behaviours, they look at me as if I have just confessed to using witchcraft! Why is this country so anti behavioural methods, whereas in the US ABA is the absolute standard for young autistic children as an early intervention. Actually, the only exception to this universal prejudice is the nice clinical psychologist who I saw at CAMHS, who was very much more open-minded.

I like the ideas on your cams website particularly the feelings diary which maybe useful for my daughter.

@moosemama

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.

I am really sorry to hear that your son has not been offered support from CAMHS and its really hard to understand why given your thoughtful description of his difficulties. Sadly with reduced resources, CAMHS sometimes do have to make difficult decisions, but you are right to be concerned, there is considerable evidence to show that intervening early can make a big difference to outcome, and that waiting for a more serious problem to develop is not the most sensible response. At the tavistock we run a specialist service for children and adults with autism/ASD, are you able to travel to us, we are an NHS resource ?

@sickofsocalledexperts

I would love to ask Dr Sally why it is that the behavioural methods of ABA are so hated by the education and health establishments in this country, when they are so successful in helping autistic children like my son? Every time I mention to one of the experts I come across, either in Education or Health, that ABA is having good results in improving my son's concentration span, ability to learn, ability to talk, and anti-social behaviours, they look at me as if I have just confessed to using witchcraft! Why is this country so anti behavioural methods, whereas in the US ABA is the absolute standard for young autistic children as an early intervention. Actually, the only exception to this universal prejudice is the nice clinical psychologist who I saw at CAMHS, who was very much more open-minded.

I cant really speak for all professionals, but I would take the view that each child with autism is an indvidual and different approaches work for different people, if its help to you and him then thats great.

Hi Sally,

My question is, does a schools attitude towards a childs personality/ traits have a negagtive effect on their learning as well as self esteem? My son is 'quirky' but this years teacher seems to laugh and/or ignore them. He seems genuinely happier. Also when he is 'naughty' he now gets upset. I think this is positive as now it means something. Could this be he is finally believing he's not a 'bad boy' just a child who sometimes does things wrong?

Sorry should have said I was ready to go to GP and ask for CAMHS referral, but the different attitude my son has received I no longer (atm) feel it necessary. We are coping.

@ellnlol

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

I agree that this can be a problem, and in times of even more pressurised resources, I guess it might be easier to hope that others are picking issues up. I also agree that this is not acceptable and that we know that outcomes are better for children where there is greater linking up, its a big question indeed. For what its worth, face to face contacts with the professional network at the begining of involvement always helps me understand where other professionals are coming from.

@crazypanda

hi sally, we are having real problems with school accepting our childs needs,currently awaiting diagnosis asd,the school punish him like a naughty child would be, but the things he does he cannot help,i'm always on the phone to school ,and at meetings,but nothing ever gets properly sorted out.

I guess this might be a case of the school not really understanding his needs, can you get the school to link up with the diagnosing professionals to get a better understanding of his needs ?

Hi,
Trying to be a proactive mum, wanting to have dd (age 5.5) assessed by an educational psychologist for various questions: ie she has problems with concentrating, she is far too quiet and shy, clumsy, confidence issues, problems with fitting in socially and reading social clues... with past speech problems ( now discharged by SALT), problems with learning at school...she may be dyslexic as she confuses some letters and also may be adhd etc all in my lay-person observations but also with a mother's insticts!
I tried KUMON lessons etc as supplement to her school work but her learning is progressing slow. I would very much like to find her learning sytle, her strenghts and weaknesses etc and specific advice.
School and one specific edu psychologis that I found from internet, both say she is far too young for dyslexia assesment, not before she is 7! whereas dyslexia specialists say 7 too late. I do not want to pay the odds for unnecessary things but I am willing to pay privately if it is useful.

Where do I find reliable starting point? For a full educational psychoilogis report? Apart from the randon names on the internet?
Dyslexia centre I think only asess dyslexia and not much else am I wrong? I want a fulkl picture.
Would you pls put us in the right direction? Many thanks.

@HairyMaclary

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.

Again another very thoughtful question. It is worth helping your son access somekind of talking treatment, it doesnt have to be in a hospital, many CAMH services can be provided somewhere locally and even in school if this was appropriate. Re what you can do at home, its hard to say if there would be anything more than you are already doing, which is being receptive to his needs and helping him prepare for things. Good luck with accessing help.

Hi Sally, hope I'm not too late - unexpected guests!

Thank you so much for answering my question.

We are near Warwickshire, so it would be a long way to travel, but we are willing to do anything to help and support our son and would be happy to do whatever's necessary to get him there if you thought you could help.

What would we need to do for him to be seen at your centre?