One of the goals I have when working with each of my clients is to tailor treatment to their unique needs.  I'd like to do the same with my blog!  With the school year beginning, what is your child worrying about?  Fill in this survey and I will write some blog posts to address YOUR concerns (confidentially, of course!).

Want some tips for coping with worry?  Click on the link to hear me speak about putting your worries in a box!

​lifespeak.com/lifespeak-video-training-excerpt-a-cognitive-strategy-for-generalized-anxiety/

Yesterday, we were on a flight and my husband and I were seated in front of a mom and her kindergarten-age child.  As we were waiting to take off, this mom reviewed the seat back safety card with her son.  She had him practice how to brace should the plane make an emergency landing.  She talked about water landings.  She discussed why it is unsafe to smoke on planes and reminded her little boy how nanny had died from lung cancer from smoking.  We were relieved when the sounds of the engine began and drowned out the painful conversation behind us!

Even in the context of my work with anxious kids, this was an extreme example of how parenting can prime anxiety.  This child did not ask a SINGLE question about air safety.  In fact, he sounded like he was having a fun time on the plane.  But, I have no doubt that as he gets older, he will become anxious about air safety.  This experience made me think.....

How do we balance educating our children with preventing unneeded anxiety?

-Talk about what is likely to happen, instead of what is extremely unlikely to happen.  Do planes crash?  Yes, they do.  But, with extremely low likelihood.  Air travel is extremely safe.  What should we talk about on an airplane?  How about all the fun things we will be doing at our destination?  The shape of the clouds?  The beautiful sunrise or sunset?  Rather than instilling a sense of fear in our kids, we can instill a sense of wonder.  

-Let kids ask the questions, and answer as briefly as possible.  I noticed yesterday that the little boy behind us did not ask a single question about air safety.  My advice would therefore be - don't talk about air safety!  If kids ask questions, answer them but as briefly as possible.  Do planes crash?  Yes, but barely ever.  Why can't people smoke on planes?  Because it stinks and pollutes all the passengers' lungs.  Why do we go through the Xray machines before boarding the plane?  Because those are the rules.  Yesterday, my son asked why we can't take liquids through security.  Before I could even answer, he said, "I know mommy!  They want us to buy our drinks at the airport so they make money."  I am totally fine with him thinking that rather than knowing about people using liquids to try to blow up planes.  After all, he is nine!

-Make your answers age appropriate.  Related to the previous comment, answers to our kids' questions are obviously going to vary depending on age.  If a three year old asks if a plane can fall out of the sky, it is totally fine to say a simple NO WAY!  If a thirteen year old, with access to the internet, asks the same question, it is appropriate to have a more detailed discussion about airplane safety.  

-If you are a nervous flyer, try to not transmit that anxiety to your children.  Children learn by example.  If you are a nervous flyer, try not to share your fears with your kids.  Wouldn't it be nice if they can grow up enjoying something that you fear?  Read a self-help book on fear of flying.  Attend one of the wonderful classes offered at your local airport.  Seek treatment from an expert.  Have your kids sit with the adult in your family who is not afraid of flying so that they can learn to associate flying with calmness and enjoyment.  And, remember, the nice thing about kids is that they are distracting!  You might find that flying becomes easier ones you have children and your attention is diverted from your fears to tending to their needs on the flight!

Last weekend, we went skiing for the first time as a family.  Not only was it fun, but I also found it immensely helpful for both of my kids - in very different ways.

-Conquering fears - One of my kids tends to be on the slightly more anxious side.  She has always been a little reluctant to try new things and a little fearful of bad things happening.  On the way up the chairlift for the first time, she was scared of falling.  At the top of the mountain, she was terrified she would not make it down.  There were a lot of "What if's!"  We had some really useful discussions on our way down this first run - great for skiing and great for life!

• The more you do it, the easier it gets.
• What's the worst thing that could happen? - If you fall, you get up and keep going.
• Your brain is playing tricks on you.  The hill looks very steep, but once you start, it is actually manageable.  Just do it!
• You are scared now, but think how great you'll feel when you make it down!

-Being Gritty! -- This child is also a typical "gifted kid" - so many things naturally come easily to her that she sometimes gives up on things that are really hard.  Skiing is hard for everyone at first!  It was great for her to see how she could build on new skills over the course of just two days and know that with more work and practice, she could get better and better.  This lesson applies to skiing, and to really anything new that we want to learn.

-Maintaining Focus - My other child can be a little unfocused at times.  He has a really busy, inquisitive brain.  It is a super thing about him, and can also pose challenges when he needs to do just one thing at a time (like getting dressed in the morning without chatting with his sister, getting immersed in a book, or looking at a beautiful sunrise out his bedroom window!).  We were so proud of his focus on the slopes!  He was 100% in the moment, attentive to making those big C's across the mountain, filtering out unimportant information (like the annoying snowboarders swooping around him).  Since we returned home, we have been talking about how this focus led to success!  All that attention made him ski beautifully and he also saw how enjoyable it can be to have your brain and body do just one thing at a time.  

-Being in the moment - We must all be teaching out children about how to be in the moment.  Skiing is a beautiful exercise in mindfulness.  When you are actually skiing, you can become completely immersed in the swishing sound of your skis, the wind on your face, the beautiful scenery.  We can re-create that experience when practicing mindfulness at home.  Picture a beautiful mountain and imagine skiing down it at a relaxed, even pace.  In your imagery, you can remove the annoying snowboarders and the whizzing five year olds (who make us adults really notice our aching knees!).  Just you, a gorgeous spot, and the side to side rhythm of skiing.  Try it and have your kids try it -- it's really good for your body and mind!

I am happy to announce two new offerings for 2017:

Parent Introduction to Anxiety Group

This group is for parents who are new to my practice.  It is a great opportunity for families who are waiting for treatment, or for families who are not sure that they need a full course of treatment but rather just want to learn the basics.  We will cover the reasons that anxiety is maintained over time and discuss strategies for reducing the hold that anxiety has on your child and your family.  Once you have attended the Parent Intro to Anxiety Group, you can attend the monthly Parent Anxiety Support Group.

Parent Anxiety Support Group

This monthly support group is for parents whose children are in ongoing treatment for anxiety with Dr. Ledley.  There is no need to come on a monthly basis - come as you need to.  During this group meeting, parents can bring up their concerns and questions about parenting a child with anxiety.  Dr. Ledley will facilitate the group and parents will offer each other ongoing support.  

Dr Penny Moldofsky, Director of the Literacy Institute at the Woodlynde School in Suburban Philadelphia is a super human being and an even better teacher (is that possible?).  I love this summary she just sent around regarding the most recent Literacy Institute Speaker, Dr. Cheryl Chase.  We all hear so much about EXECUTIVE FUNCTIONS -- but what exactly are they?  

​
The Literacy Institute Newsletter:
What Are Executive Functions?
November 2016


Penny Moldofsky, Director of 
The Literacy Institute

​
Dear Woodlynde Families, Friends, and Colleagues,
Most of you have heard the term "executive functions" and may wonder, "how is this different from a learning difference or a problem with attention?" On November 3, Dr. Cheryl Chase, a psychologist from Cleveland, Ohio, and a nationally recognized speaker on executive functions, clarified executive functions and provided specific strategies for parents and educators for helping students who are coping with executive function deficits. 

Here are some highlights of Dr. Chase's presentation:

1. Executive functions include a group of cognitive processes that we need for mental and behavioral self control.
2. Students with executive functioning difficulties know what to do and usually have the skills for the task, but they have trouble putting what they know into action. This is a "doing" problem, not a "learning" problem.
3. Most executive functions develop in the frontal lobe. Fortunately, our children's frontal lobes keep developing until they are in their late twenties. Parents and teachers can be frontal lobe "supporters" in the meantime.
4. Using clear, consistent, visual reminders along with repeated, consistent, concrete modeling works over time.

The Big Five
Dr. Chase follows the model of executive functions explained by Dr. Russell Barkley:

1. Inhibition: the ability to stop and think before acting - the mental stop sign.
2. Sensing to the Self: the ability to keep nonverbal information (pictures, patterns, time, social cues) in your head so that you can apply them in the tasks you are engaged in now.
3. Self-speech: the ability to reflect on rules, problem-solving, and how you are doing (this is key for ethical behavior, reading comprehension, math problem solving, and other real-life tasks).
4. Motivation to the Self (Emotions): the ability to manage feelings to complete activities or reach a goal.
5. Reconstitution to the Self (Play): the ability to brainstorm new ideas, adapt to new situations, and problem solve.

Ideal Settings
Some students have difficulties with one or two executive functions, but many have difficulty with many or all of these areas, and their difficulties depend on the setting. These students do better in settings that:


Don't overload working memory.
Tools are made available and students are shown and cued to use them with adult guidance and reminders gradually diminishing as students become fluent in using the tool. At home and school, we can provide consistent picture clues, consistent graphic organizers or note-taking forms, consistent schedules, and readily available reference materials. Separate note taking from listening - you may be able to do both simultaneously, but kids with executive functions can't. Don't pass around that cool geode you found in the desert while you are providing information that students need to hear and process. 
Demonstrate again and again using the actual task. 
When teaching new strategies, demonstrate in a step-by-step manner how they are applied in the real-life task you want the student to accomplish. If you show a video on a topic, you first provide the organizer that will help them enter the ideas from the video that they will need for the quiz/test/project. Then, pause the video frequently to demonstrate how to pull the information from the video and where to enter it in the organizer. 
Explicitly teach when, how, and why to use one tool rather than another. 
Demonstrate to help students understand when to use detailed notes in a comparison organizer vs. when to jot down a few key words. Demonstrate repeatedly how and when to use a tool like a calculator, a recording pen, or text-to-speech software, and be very clear in showing how each tool works better or not as well for different activities.
Predictable and consistent = reduced stress and anxiety.
When a student with executive function weaknesses feels stressed and overloaded, it is even more difficult to access skills they have practiced. Break down activities that load working memory into small chunks for the student. Have them work toward smaller, single day goals. Post activities in the same place and with the same format so that students don't have to copy or figure out your intentions. The topic and activity can be vivid and riveting, but the format should be predictable.
 
For more ideas from Dr. Cheryl Chase, visit her website.


Penny Moldofsky, M.S.
Director of The Literacy Institute at Woodlynde School
moldofsky@woodlynde.org
610.293.6628Upcoming Speaker Series Events
All Literacy Institute Speaker Series events are FREE and open to the public.

Thinking Differently: Reframing Learning for a New Generation


Presented by David Flink
Thursday, February 9
7:00 p.m.
Registration opens December 1

Raising Kids to Thrive


Presented by 
Dr. Kenneth Ginsburg
Thursday, 
April 6 
7:00 p.m.
Registration opens February 1
About The Literacy Institute
The Literacy Institute is one of only six Wilson® Accredited Partner Schools in the country. As such, it provides research-based instruction for Woodlynde students in the Wilson® Reading System as well as high quality professional development for the Woodlynde community and the greater Philadelphia area. Throughout the year, The Literacy Institute offers a free series of nationally-recognized speakers in the field of learning differences for area parents and professionals.

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Today, I saw seven patients - middle schoolers, high school students, and college students.  Although they were all there for different anxiety problems, one theme ran through my day: anxiety about Election Day.  Even my youngest patients have been voicing concerns for months about who is going to win the election and what the consequences of that outcome will be.  These worries seemed particularly palpable today, with only two weeks to go until Election Day.

The New York Times published an interesting article about last week called, Talking to Your Therapist about Election Anxiety.  It is a great read, but I felt it was important to write about some tips for kids and teens who might feel even more anxious than adults because they can't even vote!  

-Acknowledge what our kids are feeling.  Anxiety is all about the unknown and at this late date, the probable outcome of this election seems to depend on the source that one consults!  Not knowing makes people feel uncomfortable.  It is okay to say to kids, "Yup, it is hard to not know.  It makes me feel uncomfortable and worried too."

-And, to the extent that we can, boss back that anxiety!  Although we do not know who will win the election until Election Day, we can remind ourselves that our government is set up to prevent really bad things from happening.  Kids have been expressing their worries in my office for months and I find that we can boss back many of these worries by saying, "Not gonna to happen!".  The media has stirred up so many worries and kids need a reminder that there are checks and balances in place to prevent many bad outcomes.  

-For some kids, DOING something in service of the electoral process makes them feel more empowered.  One of the kids I met with today decided she would like to volunteer for her preferred candidate with her mom over the next few weeks.  Many kids value going into the voting booth with their parents.  Although they aren't casting a vote per se, they feel they have contributed by participating in the family vote.  

-For other kids, tuning out is a better strategy.  If reading the newspaper or watching the news is causing your child undue anxiety, it is okay to encourage him or her to stop for the next two weeks.  If Election Day is going to be excruciating (especially for kids who have the day off of school), make a plan to keep your kids' brains busy with something else.  Go to a museum.  See a movie.  Set up some playdates.  Logging on to the computer every few minutes to check the polls is likely not a good strategy for making it through the day (for adults or kids!).  

-Coach kids through the complex social aspects of this election season.  Many of the kids who I work with have told me about conflicts among friends due to the candidate that their families are supporting.  Some kids have told me that they have noticed an increase in disrespectful behavior toward girls and female teachers during this election season.  Kids need our help with these situations.  The best way to do this is to model appropriate discourse with our own friends, relatives, and work colleagues.  We need to model to our kids how to respect people who hold different opinions than us.  

Yesterday, I attended the Scholastic book fair at our school with my almost 9-year old son.  Although he is drawn to those huge, pricey Star Wars books that come with mini-figures, we had already agreed that these were off limits!  I find it interesting that he is drawn to totally different books than my 11-year old daughter.  Whereas she loves fiction, he wants to learn about history, wars, how things work, and so on.  This brings up a controversy in my house -- does reading fiction build better reading skills than reading non-fiction?  


This morning, I decided to turn to the literature to find out.  Here is what I learned:

• Independent reading of any kind is awesome!  Kids who read a lot have a better vocabulary, become more proficient readers, and enjoy reading more than kids who don't read much.  And this proficiency and enjoyment builds on itself - if kids like reading, they continue to read more and become better and better readers (see Stanovich, 1986).  
• The Common Core Curriculum places equal weight on fiction and non-fiction texts, but this is not without controversy.  Without getting into that controversy....here is the thinking....
  • "One reason reading nonfiction may be so important is that it helps students develop their background knowledge, which itself accounts for as much as 33 percent of the variance in student achievement (Marzano, 2000). Background knowledge becomes more crucial in the later elementary grades, as students begin to read more content-specific textbooks (Young, Moss, & Cornwell, 2007) that often include headings, graphs, charts, and other text elements not often found in the narrative fiction they encountered in the lower grades (Sanacore & Palumbo, 2009)."
  • Greatschools.org suggests: "In order to create a foundation for later learning, educators now agree that students should begin reading informational texts in all subjects from the earliest grades."
•  As I noted, each of my kids has a preference for either fiction or non-fiction.  It seems I should be encouraging each of them to read broadly from the genre that is less appealing to them.  The case for non-fiction is stated above.  As for fiction, check out this great article by fiction writer Jane Smiley.
• The bottom line is that kids need to read books that interest them!  My daughter who loves the Percy Jackson series could read some non-fiction on Greek Gods.  My son who loves reading non-fiction about history and wars can read some historical fiction.  Find a great Children's Bookstore in your area (like Children's Book World in my neighborhood!) -- the staff will be able to help you make these connections and find great reads for your kids!  

www.metro.us/boston/ocd-foundation-advocates-share-the-reality-of-the-disorder/zsJpjm---33AAM2qA7Ay3k/

• KRISTIN TOUSSAINT

The average time between an OCD diagnoses and proper treatment is 14 to 17 years, says the foundation's director.When Ethan Smith was 14 years old, he constantly worried about getting sick and knew only way to cope with that anxiety: He took his temperature 70 times a day.

Smith was diagnosed at that age with OCD—obsessive compulsive disorder. But he didn’t receive proper treatment for his mental disorder until he was 31 years old, when he came to McLean Hospital’s Obsessive Compulsive Disorder Institute.

“I lost 31 years of my life to some extent, so I really feel like I was reborn after [getting treatment] because living in the moment was completely foreign to me,” he said. “When I got better, I felt like an alien. It’s really strange, and it’s still amazing.”

Now 38, Smith returned Boston on Friday as a spokesperson for the International OCD Foundation, which has its headquarters here. The IOCDF is celebrating its 30 years as an organization and just commemorated the end of OCD awareness week.

The IOCDF has made great strides for people with OCD in the last 30 years, but it still has a long way to go, said Executive Director Jeff Szymanski.

The IOCD started in Connecticut where a group of people with OCD participated in one of the first studies about the disorder, Szymanski said. The foundation moved to Boston in 2008 to be closer to its vibrant medical community because the organization focuses on financing OCD research. (Although there is no cure for OCD, the compulsions can be managed).

Though the foundation has made great strides in terms of growing OCD awareness—more than 1,600 people attended IOCDF’s annual conference this year, four times as many as the first conference in 1993—Szymanski said the mental health community still struggles with the diagnosis and how to treat it.

Smith was lucky that he was correctly diagnosed so early. More than 3 million adults live with OCD in the United States, but physicians misdiagnose patients 50 percent of the time and mental health professionals a third of the time, Szymanski said. It took Smith 17 years to receive proper treatment, and that’s a common reality.

Szymanski said the average time between a diagnosis and proper care is between 14 to 17 years.
“If you had cancer, who is waiting 14 to 17 years? It’s not acceptable anywhere,” he said. “Yet, it’s the state of things with OCD.”

Both Smith and Szymanski highlighted how OCD has been warped in the public’s eye: It’s not about being “neat” or liking things a certain way. It’s a debilitating medical disability stemming from obsessive, anxious thoughts.

“When we’re in our rituals, we don’t want to be doing them,” Smith said. “No one wants to wash their hands 100 times. We know it’s irrational, but we believe we have to do it anyway.”

After his diagnoses, Smith met with multiple different therapists, but none of them had ever specialized in OCD treatment or were able to refer him to a specialist.  “What I mean by proper treatment is that a general psychologist is not equipped to treat OCD but roughly most of them think that they are,” Smith said. “And attempting to treat OCD by doing psychotherapy, called talk therapy—well, what happened was it ultimately made my OCD worse and harder to treat in the future.”

Szymanski worked as a clinical psychologist at McLean’s OCD Institute before joining the foundation. He explained that while most therapists are trained in psychotherapy—where you talk through your issues and try to uncover how they may have started in your childhood—that’s actually damaging for OCD patients.

Instead, professionals need to be trained in Cognitive Behavioral Therapy, and specifically a subset of that called “exposure and response prevention.” In that practice, those with OCD are forced to confront the very things giving them anxiety and prompt their obsessive thoughts. Instead of giving in to their compulsions to ease their anxiety, the patient is forced to sit with it.
​
If someone’s OCD centers around germs, for example, the therapy would involve them touching the floor or something else they consider germ-infested without allowing them to wash their hands repeatedly.  “The best way to get over a phobia is to repeatedly expose yourself, and over time your brain stops putting out those anxiety signals,” Szymanski said.

Smith, who underwent the therapy while living in Boston, described it as “torture.” But it’s the reason he’s alive today, he said. He had told his mom that if he ever got better—and for a while, he never thought he would—he wanted to help others like him.

“Coming back to Boston and being able to speak in Boston, where I struggled so much, on a national stage, it’s full circle and emotional, but it’s also extremely gratifying,” said Smith, who now lives in Los Angeles where he works as an actor. “This is where I discovered the strength and power of the human condition. This is where I learned what I was made of as a person.”

I am so excited to share this announcement.....The Penn Center for Mindfulness is super!


Our teens and tweens are stressed out. 
They need tools to deal with their complicated modern lives. 
Mindfulness techniques have been shown to help kids be less stressed, 
anxious and happier in their lives.
This four week program provides a thorough introduction to mindfulness to help your child: 

• Learn about stress and have tools to decrease the effect of stress in their lives;
• Increase focus and attention; 
• Help with emotional regulation; 
• Improve communication in their relationships; 
• Increase a sense of wellness; 
• Be less reactive and instead more able to respond to the challenges of modern teen or tween life, and 
• be happier!

Dates: 4 Sunday afternoons:  10/9, 10/16, 10/23, 10/30 
Times: 
  - Tween Stress Management: 12:30 pm - 2:30 pm
  - Teen Stress Management: 3:00 pm - 5:00 pm 
Location: Ralston Center, 3615 Chestnut Street, Philadelphia, PA 19104
Instructor: Bidi McSorley, MD
Cost: $195
Description: The course meets for four consecutive weeks for 2 hours each week.  There are two separate classes, one for teens and one for tweens.  
Your child will learn a variety of mindfulness techniques inducing formal meditation practice such as breath awareness, body scan and movement meditation, as well as informal practices to use in daily life. 
Requirements:

• For the tween or middle school group: your child must be in grade 6 through 8 grade as of September 2016.
• For the high school teen group: your child must be in grade 9 through 12 as of September 2016.
• Commitment to attend all four classes
• Commitment to practice daily for 10 to 20 minutes

   Questions? contact Bidi McSorley directly at drmcsorley@bidimcsorleymd.com. 

CLICK HERE TO REGISTER.
registration deadline, October 3rd.