Everything Parents Should Know about Tic in Kids

by Caitlin CrawshawJanuary 23, 2024

Childhood tics are more common than you might think

During the first lockdown, my daughter’s eyes began darting to the left, over and over again. Not long after that, she started clearing her throat repeatedly and her left index finger began to twitch. Once doctors ruled out an eye or brain disorder, we learned that she had tics—a surprisingly common childhood experience that we really didn’t know that much about.

It turns out up to 20% of school-aged kids experience tics, but at least half outgrow them by adulthood, according to the Tourette Association of America. A smaller number—less than 1% of children—will still experience tics adults.

“It’s more common than most people realize,” says Pediatric neurologist Dr. Mered Parnes, who leads the Pediatric Movement Disorders Program at Texas Children’s Hospital. Fortunately, tics don’t usually cause discomfort. “The majority of people who have tics, I would imagine, would never come to medical attention because they’re mild or at least manageable.”

Here’s what else you should know about tics in kids.

What are tics and what do they look like?

Tics are brief, repetitive, and purposeless movements (motor tics) or sounds (vocal or phonic tics) that typically start when a child is between the ages of four and eight.

Motor tics can take many forms, including:

Grimacing
Blinking
Rapid jerking of a body part
Arm or hand movements
Nose twitching
Shrugging
Eye movements

Vocal or phonic tics also vary and may include:

Throat clearing
Repeating sounds or phrases
Animal noises
Grunting
Coughing

Parnes stresses that it’s rare for people with tics to make profane gestures (copropraxia) or utterances (coprolalia). “The words ‘Tourette Syndrome’ can induce a lot of anxiety for parents because they think about what they see in movies,” he says. “They think about screaming, and they think of obscenities.” In reality, tics and tic disorders seldom resemble the stereotypes in popular culture.

Could my child have a tic disorder?

Most of the time, tics are transient—that is, they come on suddenly and disappear just as quickly. But when tics persist, a kid may be diagnosed with one of three neurodevelopmental disorders:

Provisional Tic Disorder: children with one or more motor or vocal tics for less than a year.
Persistent/Chronic Tic Disorder: kids who have had one or more motor or vocal tics—but not both—almost every day for more than a year.
Tourette Syndrome (TS): children who’ve had both motor and vocal tics almost every day for more than a year.

As littles grow their tics will often subside or disappear. About one-third of those diagnosed with TS will have no tics by early adulthood, and another one-third will have fewer or milder tics.

What causes tics in kids?

We don’t know exactly what causes tics, says Parnes. However, we do know that tics and tic disorders stem from a genetic, brain-based difference related to how messages travel between three areas of the brain: the thalamus, basal ganglia, and cortex. We also know that dopamine, a neurotransmitter used by the nervous system to send messages, plays an important role.

Research shows that 83% of children with TS have also been diagnosed with another disorder—about one-half have Attention Deficit Hyperactivity Disorder (ADHD) and one-third have Obsessive-Compulsive Disorder (OCD).

But the most common comorbidity is anxiety, which can worsen tics. During stressful times—the night before a spelling test or the week before school starts—kids tend to experience a lot more tics.

Can children ‘catch’ tics?

A tic disorder isn’t contagious like a cold or flu, but on rare occasions, tic-like behaviors seem to be socially contagious. In 2012, 19 teenagers in the LeRoy Central School District in northwestern New York began exhibiting symptoms of TS. And during the pandemic, when social media use and anxiety surged, doctors worldwide saw a record number of patients complaining of tics. Parnes wrote a research paper about teen girls developing tics after watching TikTok videos featuring users with tics.

Some think that pandemic stress and social media use contributed to a kind of mass social contagion, says Parnes. But rather than ‘catching’ a tic disorder, these teens more likely experienced tic-like movements caused by Functional Neurologic Symptom Disorder (FND), which is when neurological symptoms appear in the absence of any disease or disorder.

What treatment options are available for childhood tics?

Sometimes, tics can be bothersome or even debilitating. Forceful neck and eye movements can cause chronic headaches or, in rare cases, even spinal injury. Tics involving the arms or hands may prevent kids from playing sports and intense eye-blinking may interfere with schoolwork.

For kids whose tics are impairing in some way, treatment may be necessary and can include:

Oral medications, such as alpha-2 agonists (like clonidine and guanfacine) and dopamine-receptor blocking agents (like fluphenazine and risperidone).
Behavioral therapy like Comprehensive Behavioural Intervention for Tics (CBIT), which teaches children and teens to channel the urge to tic into different behaviors.

Parnes says there isn’t scientific evidence to suggest that patients benefit from dietary changes, vitamin supplements, or other lifestyle interventions.

Are there other ways to support kids with tics?

TS is a stigmatized diagnosis. Parents can help de-stigmatize the disorder by speaking openly about TS with their children and ensuring they have as much information as possible. “We want [parents] to acknowledge that this is normal for them—it’s just like hair color or eye color,” says Parnes. “It’s just part of the way they were made.”

9 Things NOT to Say When Your Kid Is Sad

by Priscilla BlossomJuly 25, 2023

No matter how hard you try to avoid it, there’s always going to be a moment when your child gets down in the dumps. Maybe they lost a beloved toy on a family trip or accidentally dropped their ice cream cone. Perhaps their favorite book or TV series got discontinued. Sometimes they’re dealing with even larger problems, like when a best friend switches schools or a family member passes away.

In our efforts to help our littles, we might offer some words that we think are helpful. But as parents and caregivers, we have to be careful of what not to say when our kids are sad. Sometimes our words can come off as harsh, while other times they can even make the situation worse. Our kids might feel like we don’t really understand or care about their pain. So how do we help them through these difficult moments? For starters, avoid saying these phrases when your kid is sad:

“Why are you being so sensitive?”

Daniel Rinaldi, a therapist with experience working with children and families, says parents should show empathy and understanding, “especially when validating sad emotions for their children.”

“The language and tone we use can help a child to feel heard, understood, and safe,” says Rinaldi. “Try instead saying, ‘I can see you’re experiencing some tricky emotions. Everyone is different and it is okay to show sensitivity. I’ll be here for you while you work through these emotions,’” he adds.

Anything that insinuates that crying is bad.

Everyone should be allowed to express their emotions, and that especially goes for children, who are still navigating emotional regulation. “(Saying “don’t cry”) tends to encourage pushing down and hiding feelings,” says Dr. Sean Akers, a pediatric psychologist at Children’s Hospital Medical Center in Omaha.

“A better way to phrase that would be, ‘I want you to know that crying is a healthy way of expressing your emotions. I’m here to help you if you need it,’” adds Rinaldi.

“Others have it worse.”

While that may be true in some ways, reminding a child about this when they’re in distress isn’t the best time to say it. “Sadness is not a competition, and comparing experiences with others tends to make it worse,” says Dr. Akers.

If your child is frequently getting sad over “smaller” problems, having conversations (when they are no longer distressed) around gratitude, and differentiating between small, medium, and large problems so they can gain more perspective could be beneficial.

“You’re so much more difficult than _____.”

Just like sadness isn’t a competition, we also don’t want to entertain the idea that your child is more “difficult” than a sibling, friend, or other loved one just because they are struggling with their emotions.

“This phrase invalidates a child’s unique way of interacting with and understanding the world,” says Taylor Lindskoog (MHC-LP) from Empower Your Mind Therapy. “It emphasizes that they are wrong or inferior compared to their siblings (or others). This negatively impacts the child’s self-esteem and may damage their bond with siblings due to jealousy, competitiveness, or resentment,” she says.

“It’s not that big of a deal.”

Similar to the previous, Dr. Nikki Hurst, Principal Therapist and Therapeutic Content Lead at Embodied, Inc., makers of Moxie Robot, recommends avoiding this problematic phrase.

“Children’s perceptions of situations and the way they experience things are very different from adults, and a situation that may not seem like a big deal to us may be a big deal for a child. It’s important to avoid phrases such as these because we don’t want to invalidate our child’s feelings and experiences,” says Dr. Hurst. “This could cause them to be less open with us, and more unwilling to talk about their feelings or trust us with them.”

While Dr. Hurst says we don’t have to totally agree that their small problem is actually a big problem or even turn it into one, we can always use language that validates their feelings and encourages kids to talk about the issue.

“You don’t have any reason to be sad.”

“While we know many stressors and loss can make us feel sad, we also know some kids feel sad without clear reason,” says Dr. Myo Thwin Myint of Children’s Hospital New Orleans Behavioral Health. He says this can be due to everything from family history and genetics, to the interplay of mind, body, and environment. Other times it might simply be because the child hasn’t had a chance to share their reasons.

Instead of saying the above phrase, Dr. Myint offers the alternative phrase, “We all feel sad sometimes; I would love to hear if you know why you feel sad” in order to check in with the child and have an opportunity to help them with their stressors or even seek out professional help.

“Act like a big (kid)!”

“Kids are meant to be kids, and being a kid sometimes comes with big feelings and emotions,” says Dr. Hurst. And those big emotions don’t necessarily go away once they’re older, she says.

“We want to encourage children to be able to express their feelings at any age. As they get older, we want to continue to give them the tools to be able to start regulating their emotions on their own as well as the language to ask for help when they need it,” she says. Dr. Hurst recommends using language like, “It’s okay to feel sad. Do you want to talk about it?”

Anything that perpetuates toxic positivity.

Many of us have heard phrases like “turn that frown upside down!” in our lives, especially as children. And many of us also remember how annoying and dismissive it felt. While people who say this might have the best of intentions in wanting to cheer us (or their children) up, there’s no need for it.

Phrases like “Smile and think positive!” tend to be “minimizing and dismissive,” according to Dr. Akers.

Instead of saying something like “Why can’t you just cheer up and be happy?” Rinaldi recommends a phrase like “You are feeling sad and you have the right to feel that way. Take your time and I will be here when you need to talk.”

“Get over it.”

“Just as many physical symptoms may not get better with simple willpower, sadness may not be something kids can get over,” says Dr. Myint. “Changing the way we think when we feel sad may help, such as in aspects of cognitive behavioral therapy, many of us may not know how to do it well and effectively,” he says.

Instead of saying this, he suggests helping the child figure out ways they can feel less sad, enlisting professional help if and when necessary, and explaining to the child that there are people whose job it is to help kids feel less sad.

Kids with Insomnia Symptoms More Likely to Be Sleepless Adults, Study Shows

by Tinybeans TeamApril 26, 2022

We all know the consequences of our kids not getting enough sleep (hello, Grumpville), but according to the Centers for Disease Control, not getting enough sleep is associated with an increased risk for a number of chronic diseases and conditions, including diabetes, cardiovascular disease, stroke, obesity, depression and more. Which is why the findings from a study by Penn State College of Medicine are so important: Kids who suffer from insomnia are more likely to develop an insomnia disorder as adults. Their symptoms don’t only persist, but oftentimes, they worsen.

Researchers conducted a longitudinal study (which means it took place over an extended amount of time with the same participants) of 502 kids aged 5-12. The study began in 2000 and involved check-ins 7 years and 15 years later. The key takeaway was that insomnia symptoms aren’t as likely to go away over time as we thought.

While this particular study didn’t address outcomes of poor sleep hygiene in children, multiple previous studies conclude that not getting sufficient sleep in early childhood can be tied to problems with attention, working memory, reasoning, problem-solving, and behavioral problems in older children. The findings from Penn State suggest a continuation of sleep problems into adulthood, which could lead to some serious adult-sized problems.

“Although adults’ sleep issues tend to be triggered by their most recent life stressors, for some people, their insomnia may track back to sleep problems starting in childhood,” said Julio Fernandez-Mendoza, associate professor of psychiatry and behavioral health and one of the authors of the study. His team found that nearly half of the kids who initially presented with insomnia symptoms in the study continued with those symptoms into adulthood. About a quarter of them seemed to experience remission of their symptoms in adolescents, and roughly 15% of them experienced symptoms off and on throughout their developmental years into adulthood.

So what’s a parent to do? Beat yourself up over the bedtime routine you established at age 2-weeks-old that’s messed up your kids’ sleep habits? No (but we know you’re doing it anyway). Instead, consider an early intervention of cognitive behavioral therapy, regarded as first-line therapy for sleep disorders in adults and proven effective for the younger set, especially adolescents. It addresses bad sleep habits, such as “using electronics or watching TV in bed, worrying in bed, sleeping in on weekends, [or] napping during the day, among many others,” Fernandez-Mendoza said.

One thing Fernandez-Mendoza cautioned against? Sleep medications as a go-to. “Melatonin should only be used in very specific cases, despite its widespread and incorrect use,” he said.

‘Heartbreaking’ Delays in Autism Diagnoses Got Even Worse during the Pandemic

by Tinybeans TeamMarch 28, 2022

Research shows early treatment of autism can be crucial for children’s long-term development, which is why the delays in not only diagnosis but also onset of treatment during the pandemic are particularly heartbreaking. While we all can identify losses during the pandemic—family gatherings, time with elderly relatives, participation in important life events—families whose children with autism didn’t get the treatment they needed are realizing that these losses will have particularly long-lasting effects for their children—and for their families.

Brandie Kurtz, mom to son Wylie James Prescott, 3, told CNN that he had to wait more than a year after his autism diagnosis to begin behavioral therapy. In fact, his therapy wasn’t approved through Georgia’s Medicaid program until just recently, despite her continued requests. “I know insurance, so it’s even more frustrating,” said Kurtz, who works in a doctor’s office near her home in rural Wrens, Georgia.

Parents navigating a child’s autism diagnosis are no strangers to battling with insurance. Awareness and access to autism treatments are on the upswing—all states now have laws requiring private health plans to cover applied behavior analysis, a widely used autism therapy—but it’s sometimes a year or more to receive a proper diagnosis and develop a treatment plan. Once you overcome that hurdle, widely-accepted therapies can cost $40,000 or more a year. The financial burden of these specialized therapies are especially out of reach for families who don’t have insurance or have high-deductible health plans, and kids from minority communities and those who live in rural areas are least likely to get the treatment they need.

And those are just the run-of-the-mill hurdles families face. During the early months of the pandemic, many families canceled in-home services (or they were cancelled by their providers) and virtual therapy—particularly for nonverbal and younger children—was often a bust. Even in a metro area, getting a child an appointment can take months. “We cannot get these families in fast enough,” said Dr. Alan Weintraub, a developmental pediatrician in suburban Atlanta. “It’s heartbreaking.”

When early detection of autism in kids is essential to minimizing their symptoms, a wait—for any reason—has long-term effects. The pandemic added a layer of delay to an already arduous process, and now years have passed and children who would have—and should have—begun treatment in 2020 are still in a holding pattern. Dr. Kristin Sohl, a pediatrician at University of Missouri Health Care and chair of the American Academy of Pediatrics’ Council on Children With Disabilities Autism Subcommittee told CNN, “You would never allow a kid with cancer to experience these waits.”

The New TikTok ‘Orbeez Challenge’ Is Very, Very Unsafe

Teen ER Visits for Eating Disorders Doubled During the Pandemic

Teen Girls Are Getting TikTok-Related Tics

by Karly WoodMarch 27, 2022

As if teens and parents don’t have enough to deal with already, reports from the medical community show a new issue emerging. According to the Wall Street Journal, teen girls are heading to the hospital with sudden verbal and motor tics. The culprit? TikTok.

Studies are showing that adolescent girls are reporting that they have spent time watching TikTok videos of people claiming they had Tourette syndrome and then developed symptoms themselves. While the onset of the tics appears to mimic the disorder, most of the cases are actually “functional neurological disorders, a class of afflictions that includes certain vocal tics and abnormal body movements that aren’t tied to an underlying disease,” according to the WSJ.

photo: cottonbro via Pexels

While this situation appears to be just another disturbing trend coming out of the TikTok platform, it also coincides both with the pandemic and adolescent girls who had pre-existing mental health issues. A study from Australia’s Journal of Paediatrics and Child Health reports that it is “highly plausible that the increase in functional tic disorders in recent months is related to multiple stressors stemming from COVID-19 pandemic, in addition to modelling present on social media.”

As a parent of a teen, it can be tempting to see the tics as a ploy for attention or just drama, but that’s not the case. Pediatric neurologist Mohammed Aldosari, MD explains to the Cleveland Clinic that “These tics are a complex way for the brain to release overwhelming stress. Essentially, their brains express an emotional stressor as a physical disorder…These teens don’t intend to take on tic-like behaviors, and so they become distressed when their families or medical professionals just dismiss them or even doubt them. The worst message they can get is that they’re ‘faking it’.”

So what’s the solution? Doctors report behavioral therapy and limited social media consumption is key. Most teens will benefit from therapy not only to combat the tics, but to also reveal a likely underlying condition that made them susceptible in the first place.

Reducing time on TikTok and other social media platforms is one of the best ways to avoid situations like these in the first place, in addition to talking to your kids about responsibility and moderation. You can also read more about how TikTok is working to promote a safe environment here.

Teen ER Visits for Eating Disorders Doubled During the Pandemic

TikTok Announces New Protective Measures to Keep Teens Safe

Why Parents Need to Schedule Their Own Worry Time

By Sally Baird

Tinybeans Voices Contributor

January 4, 2022

Last year I wrote a popular article on using scheduled “Worry Time” to help shrink kid’s anxiety. One common response was that parents need their own “Worry Time” too. “We are as stressed as our kids!” wrote one mom. And I agree. Therefore, this article is for all parents who want to have less worry and more fun.

There are hundreds of reasons parents get stressed. Too many expectations of self, too much food, altered routines, visits with relatives, and money concerns are just a few of the stressors. And you probably have kids who are needier than usual, partly because they pick up on their parents’ levels of worry.

The most useful and best researched anti-worry techniques come from Cognitive Behavioral Therapy (CBT). These strategies include talking back to the worry, holding the worry in a box, and scheduling worry time. The last two techniques are best understood as containing the worry.

Containing Worry

Imagine an immature dandelion flower. The seeds are contained in the seed head and do not scatter. Now imagine a fully mature dandelion seed head which is round, white, and fluffy with parachute-like seeds. The slightest wind will scatter the seeds everywhere—all over the yard, next door, and down the street. Soon there are hundreds of dandelions coming up. If only you could contain those dandelion seed before they spread.

Now imagine those seeds are your worries. You can’t contain a field of mature dandelion seeds, but you can contain your worries (which makes them more manageable). Excellent techniques include naming the worries and then containing them in time or space. These very effective strategies are widely used for both kids and adults. This article is about containing worries in time for adults (parents). Containing worries in space for adults will be the subject of another article.

Steps for Scheduled Worry Time: The Parent Version

The steps for scheduling “Worry Time” with kids is outlined in my previous article. The steps include scheduling the worry, explaining the worry to the child, using the One Rule, and what to do when it isn’t worry time. These same steps can be adapted and be as effective for parents.

Step One: Schedule Worry

Do you have trouble giving yourself any “Me Time”? Of course you do! Yet, this is one of the biggest gifts you can give yourself and your family. In order for this to work, you have to pick a time that is just for you and then take it! The amount of time could be from 20 to 60 minutes for you to sit quietly and be undisturbed. Some people actually sit in their car, go to a library, wait until everyone is in bed, or ask their spouse to “contain” the kids.

Set a timer for how much time you have given yourself. Then focus only on your worries during that time. Write about them in a journal or draw them in an art book. You are not to worry whether your writing or art is good quality. No one will see it but you and you are just using the paper medium to get the worries out of your head and onto paper. When the timer goes off, put away your tools and resume your life. Your worries are now safely contained on the paper.

Step Two: Understand What You are Doing

Just like explaining “Worry Time” to your children, you need to understand what you are doing. You are giving yourself time to control your worries by putting them down on paper through words or art. You may wonder whether bringing up all these worries will only make things worse. The answer is no. You are taking charge of the worries by naming them, getting them out of your head, and then not thinking about them after the timer goes off.

Step Three: The One Rule

There is only one very big rule with “Worry Time.” When it is not “Worry Time,” you will work very hard to push your worry thoughts away. You may not talk to your family and friends about your worries (within reason). Instead you need to distract yourself with other things. Ask yourself whether worrying 24/7 really accomplishes anything. And remind yourself that you can focus on your worries during your scheduled time.

Step Four: What to Do When It Isn’t Worry Time

Now you need to think of other things to do when it isn’t scheduled Worry Time. Here are some ideas:

Write or draw the worry and put the paper into a jar
Imagine putting the worry in a safe and locking it up
Exercise
Call a friend (you may not talk about your worries)
Read a book or go to a movie
Do something fun

The important part is that you try not think of your worries during the 23 or so hours you are taking off from worrying. You can tell yourself that you will return to “Worry Time” the next day.

Some adults find they need to schedule two “Worry Times” per day as they begin. Soon they may find they can space out the “Worry Time” to once a day. Hopefully you will get to the point where you don’t have that many worries to write down. That’s good news. Then you can change the “Worry Time” to “Me Time” and just think about what you want to do with your new time. If your worries do not get better, do not hesitate to get professional help.

That’s it! If you can provide “Worry Time” for your kids, you certainly can provide it for yourself. Give yourself this gift of containing your worries this year. Your family will thank-you.

Sally Baird, PhD, is a retired child psychologist and co-author of the book Shrinking the Worry Monster, A Kid’s Guide for Saying Goodbye to Worries. See her website and blog at http://www.drsallyb.com. She is available for zoom events about anxiety, sleep, and children throughout the year.

This post originally appeared on www.drsallyb.com.

Photo: Tengyart via Unsplash

Sally Baird

Tinybeans Voices Contributor

I am a child psychologist who specializes in children's anxiety. I just published a top seller children's book titled Shrinking the Worry Monster, A Kid's Guide for Saying Goodbye to Worries. I love sharing ideas about decreasing worry in children, especially now. I also love to hike and bike in beautiful Pacific NW.

How Scheduling “Worry Time” Can Help Combat Anxiety in Kids

By Sally Baird

Tinybeans Voices Contributor

December 2, 2021

Childhood worry seems to be rising as rapidly as COVID-19 cases. More and more children are acting fearful, having trouble sleeping, doing poorly in school, and showing physical symptoms. Does this sound like your child? What if you have you tried everything, but your child is still anxious? What if you already made the Worry Box as described in this article on Tinybeans.com and your child’s Worry Box is overflowing with worries? If so, I have the perfect strategy for you to try called, “Worry Time.”

Like the Worry Box, this technique is so simple and so effective that it should be in every parent’s toolbox. Both the Worry Box and Worry Time strategies are forms of containment or ways to contain worries in both physical space and time. Like the strategies in the book “Shrinking the Worry Monster,” they come from Cognitive Behavioral Therapy (CBT), a highly regarded form of anxiety intervention. A fuller description of CBT and containment is in the above-mentioned Worry Box article.

Thinking versus Worrying

First, let’s look at the difference between thinking versus worrying. Thinking is a good thing. It can involve reflecting, reasoning, and problem-solving. It can lead to purposeful action which allows the mind to move on.

In contrast, worrying is problem solving gone amiss. What starts out as a concern, can turn into an unhealthy obsession of unresolvable problems. Most chronic worriers believe they cannot control their anxious thoughts. It is as if worriers are caught in a downward spiral where an anxious thought arises, the problem seems unsolvable, and then physical symptoms of anxiety take over. This pattern repeats over and over. It is so emotionally painful that people try anything to avoid the worry thoughts, but that usually doesn’t work. Just look at a picture of a purple cat and then tell yourself that you will not think about that cat for one minute. Chances are you will think about that cat the entire minute.

The good news is that anyone can learn to control how and when to worry. It takes using good, research-based strategies and practice. My favorite tools come from CBT and include talking back to the worry, containing the worry in a “Worry Box,” and using “Worry Time.” The last two strategies contain worries so they aren’t just running amok in the brain 24/7.

Steps for Scheduling Worry Time

The goal for Worry Time is not to stop worries, but to reduce the time spent on the anxious thoughts. The steps are a template for training your child to contain his worries within 15-20 minutes a day. Of course, it will take regular practice, but it is a very achievable goal.

Step 1: Schedule Worry Time

Set up a daily Worry Time where you will listen to your child talk about his worries for 15-20 minutes. Worry Time should be the same uninterrupted time everyday, but not 1-2 hours before bedtime. Late afternoon is often a good time.

Step 2: Explain Worry Time to Your Child

Tell your child that you and he are going to start having a special time together called Worry Time. It will happen from 4:00 to 4:20 (let’s say) and he gets to tell you everything about his worries. You will listen closely, but this is his time to talk. You may not say that any of his worries are silly, but instead you will mostly accept what he has to say. When Worry Time is over (maybe you set a timer), tell your child that you really appreciate all the concerns he has told you and you look forward to Worry Time tomorrow.

Step 3: Teach the One Rule

Teach him that there is only one rule with Worry Time. You will not listen to his worries when it is not Worry Time. You know this will be hard, but you will give him other things to do with his worries. His worries will become smaller because of Worry Time.

Step 4: What to Do When It Isn’t Worry Time

Discuss other ways to contain his worries. He can write them down and put them in the Worry Box, he can write or draw his worries in a notebook, or he can imagine putting them in a safe and locking them up. At the next Worry Time, he should pull out his Worry Box or his notebook and share everything that is in there.

Tell your child that he can also do something else when he is worried (distract). How about going outside, running the stairs, reading a book, or calling grandparents? You and your child can have fun writing down all the things he can do while he is waiting for the next Worry Time. He can also read the children’s book, Shrinking the Worry Monster, to learn ways to talk back to the worry on his own.

Most parents find this strategy seems hard at first, but their child’s worries often dissipate after time. After a few weeks, some kids actually have very few worries to report, but they want to continue their special time with their parents. If your child is very anxious, you might try scheduling Worry Time twice a day at the beginning. Of course, if your child is extremely anxious, please do talk to your health professional about getting outside help. You do not want your child’s anxiety to turn into a serious adult anxiety disorder.

Worry Time is a clever strategy that contains your child’s worries in time. When it is combined with a method to contain the worries in physical space like a Worry Box or a notebook, it is a very powerful anti-anxiety tool. And it is so easy that every parent may want to give it a try. This is such an anxious time for all of us, having anxiety-reducing tools in our parenting skill set seems imperative.

This post originally appeared on www.drsallyb.com

Feature image: Janko Ferlič on Unsplash

Sally Baird

Tinybeans Voices Contributor

How to Use Social Media Without Judging Yourself—or Your Kids

By Christina Furnival

Tinybeans Voices Contributor

June 10, 2021

Who uses social media? *Counts sea of hands*

Do you ever notice how social media can mess with our understanding of our individual children’s developmental paths? We often start to question where they are in their development compared to everyone else’s kids. And we then allow this comparison to determine our feelings of parental success—or failure.

How Social Media Can Negatively Affect Us

First, let’s look at how social media can affect us as individuals in general. Social media has been shown in several studies to be correlated to a decrease in self-esteem and an increase in depressive symptoms. Psychologist Melissa G. Hunt published an article in the December 2018 issue of the Journal of Social and Clinical Psychology that even went so far as to say that there is a causal link between social media use and “decreased well-being.” Causal link!

This effect is similar to how we feel after looking at fashion and beauty magazines where we compare ourselves to a photoshopped (read: not possible) “ideal.” I’ve always wondered how supermodels feel seeing themselves in photos looking, well, not like they actually look. It has got to be bizarre. I guess at least they know the truth while the rest of us look on in awe, putting ourselves down.

Social media is no different. People post the best events, vacations, moments and often don’t share the behind-the-scenes reality. Can their lives really be THAT perfect? The definitive answer is a resounding NO WAY!

No one’s life is as perfect as they make it seem. And we know that, really. We know that there are 20+ photos taken before “the one” is captured for someone’s fashion blog. We know that props are purchased and arranged “just so” for someone’s food styling post. We know that bordering the picturesque square image posted to Instagram there are piles of laundry and dirty dishes. But it still can eat at us.

How Social Media Can Negatively Affect Us—as Parents

Unfortunately, our opinions of our children are not spared when it comes to social media comparisons. It usually begins innocuously enough: we post pictures of our beautiful children, share their growth and share our pride—and our friends and connections do the same.

Everyone is sharing the positives, which should be great, right? Well, on the one hand, it is beautiful. Boast! Be proud! Applaud your little ones! But, the other hand holds the negative reality.

We see our friends’ children sitting, crawling, walking, talking, running, singing, sleeping, and toilet training sooner than ours. We then launch into hours-long google searches of our specific comparison and concern, which prompts us to believe that our child’s supposed delay is absolutely, without a doubt, due to our excessive consumption of pizza bagels in high school.

And then the judgment turns inward. We feel that somehow our child’s natural timeline is a reflection of our parenting. My child’s path means I am a success or a failure. I wish we parents had that much power, but the reality is, we don’t.

Remember the age-old “nature vs. nurture” debate? Well, it continues, but I feel that when it comes to general development, nature is quite strong. Personally, I never knew how little control I could have over another human being until I had my children. A serious lesson in humility.

Social Media Is Not All Bad

So, it looks like I just wrote an *ahem* social media article that describes *ahem* social media as a mental health monster. I guess I kind of did, but here’s the other side of the coin: I also don’t think it’s bad all the time or to everyone.

Social media is ubiquitous in this day and age. Kids from one to 92 (Nat King Cole, anyone?) use the internet on the daily. In a lot of ways, it’s wonderful. Social media has enabled the world to become a smaller place in which living thousands of miles from family doesn’t have to mean only hearing their voice occasionally. Now you can see their faces on their pages or even use video calling apps to have as close to in-person conversations as possible!

If your family is military and you’ve moved a lot, I am sure you can attest to the beauty of the internet and social media. I personally love that my children know their grandparents in the United Kingdom so well through social media that when we visit them, they don’t miss a beat engaging with them.

With social media, you learn about how your friends are doing and even if you aren’t in person to be with them through life’s milestones, you are there digitally. That can be priceless.

You will have your own opinions about social media and its effect on your life. Whatever your current relationship with the virtual world, I suggest following these five steps to maintain your positive sense of self and your well-deserved pride in yourself and your perfect-as-they-are children:

1. Do a surface-level clean of your feed.

If you love seeing your best friend’s posts because her kids are a hoot, keep checking them out. But, if you compare yourself or your child to another friend’s posts, unfollow them (you don’t have to “unfriend” to not see their content!).

2. Find pages or groups that lift you up or that show the real side of life, like this one!

I will post the good, the bad and all the in-between, because I know we all experience it and I want you to know you’re not alone. Full disclosure: I was starting to get on myself for that danged chipped toe polish, now clearly displayed in both picture and video form!…but instead of envying those mamas that get regular pedis (I can still hope to be one someday), I will simply celebrate when I choose to do something about it, which may be tomorrow or may be next week… or may be I’ll wait until it grows out and I can start fresh.

3. Remember the mantra: “Their Own Path at Their Own Pace”

Follow whomever you want to follow online, but remind yourself that every child is on their own path. Some will walk at 10 months—super exciting of course—but may not show any more athletic prowess than that. Some will start to speak around then—music to a mama’s ears—but may be so shy they only speak in the home. Some do everything late but go on to be a world leader or famous singer or Olympic athlete. You never know! And honestly, it seems like most children’s skills are caught up in one way or another by the time they start school.

So remember: Your child is special and your child is perfect for himself or for herself. He or she is following their own path at their own pace. The sooner we can embrace that, which is hard of course, the sooner we can see our child as they are and love them all the more.

4. Do a deep clean.

If you’ve done all of the above, then maybe it really is time for the big-time, deep-cleaning social media purge. Go through your connections and remove anyone who is bringing you down. I know everyone is on a #KonMari kick in their homes and why not online too? If someone is not “sparking joy,” then good riddance!

Ensure your main feeds are chock full of sources of happiness. After all, you are an amazing mama and you deserve it.

5. If needed, have your child assessed.

If you are honest with yourself that your concern about your child’s development is deeper than social media comparisons, then please, have your children assessed! (And stop Googling!) Most big cities have programs in place, that are often free or low cost, to evaluate your child for speech, developmental delays, occupational therapy and behavioral therapy needs.

Or, you could do an at-home assessment. I personally like to use the Ages and Stages Questionnaire (ASQ3) as a gauge of how my children doing in terms of their communication, fine motor, gross motor, problem-solving and personal-emotional development. Early intervention often leads to better long-term outcomes.

Christina Furnival

Tinybeans Voices Contributor

I am a mom to two young kids, a licensed psychotherapist, and a children's book author. My passion is to help and empower moms and children to understand themselves better, navigate challenge confidently, and live the life they want. Visit me at ChristinaFurnival.com

The 9 Most Helpful Children’s Worry Books

By Sally Baird

Tinybeans Voices Contributor

December 17, 2020

Photo: AnitaJankovic@dslr_newb

Many books on children’s anxiety have been written, but which ones really help? How many of these books are based on Cognitive Behavioral Therapy (CBT), a method considered to be the most effective in lowering anxiety? Not so many. This article will help you separate the “cute” worry books from the really effective ones that you and your child will use over and over.

For this article, I reviewed many children’s anxiety picture books. I was somewhat dismayed that only a few are solidly based on CBT (described below) or any other research-based techniques to reduce worry. The first 5 books listed are rooted in CBT and are highly recommended. The remaining 4 are popular children’s worry picture books that will give your child an opportunity to discuss worry. These picture books go up to age 12 years.

CBT in Children’s Worry Books

First, let’s learn about CBT. This science-based method is based on changing the thoughts and behaviors that trigger or worsen anxiety. There are three main steps in CBT:

1. Identify the negative thoughts. For example, “My Worry Monster is telling me that Mom won’t pick me up after school.”

2. Challenge the negative thoughts. Following our example, “You are wrong Worry Monster, you lie!” The child can say it, write it, or draw it. It is very empowering to talk back to a worry.

3. Replace the negative thought. Ideally, a child should replace the worry with what is true. For example, “You are a liar, Worry Monster. My mom is coming to pick me up after school!!”

Another strategy in CBT is containment, which means containing a worry in space or time as discussed in the fifth book.

1. Shrinking the Worry Monster, A Kid’s Guide for Saying Goodbye to Worries by Sally Baird, Ph.D. and Kathryn O. Galbraith

“Worry Monster has been whispering mean things to kids and making them feel terrible. Now it is up to Brooklyn and Jackson to discover the monster’s secret—and stop him!” This delightful story, written by a child psychologist and a children’s book author, is based on all three steps of CBT and offers time-tested methods to help overcome worry and fear. Several appendices help parents and caregivers use CBT tools most effectively.

2. Wilma Jean and the Worry Machine by Julia Cook

Meet Wilma, who worries so much she is a worry machine! This fun book, written by a school counselor, offers CBT strategies in the form of identifying worries and then challenging the worry by deciding whether it is controllable or not.

3. What To Do When You Worry Too Much, A Kid’s Guide to Overcoming Anxiety by Dawn Huebner, PhD

“Did you know that worries are like tomatoes? You can’t eat them, but you can make them grow, simply by paying attention to them.” This clever workbook uses CBT to help kids overcome anxiety. It contains lively metaphors and how-to-steps sprinkled throughout. This may be the “grandmother” of all worry self-help books!

4. Help Your Dragon Deal with Anxiety by Steve Herman

Dragon was wasting time “over worry and distress. He suffered from anxiety and fretted to excess!” The pet dragon has many identified worries and asks numerous “What if” questions. Worries are identified in this rhyming book with steps 2 and 3 of CBT subtly identified.

5. The Worry Box: A Picture Book for Comforting Anxious Children by Suzanne Chiew

“Murray Bear is supposed to go to the waterfall with his sister, Molly, to meet a friend, but Murray is worried.” This lovely picture book uses the CBT technique of containment. Murray has many worries which keep him from activities, but he finds that when he puts the worries in a box, he can have fun.

6. When My Worries Get Too Big by Kari Dunn Buron

“Sometimes kids have worries, but they also have things they are very good at.” The book does an excellent job of identifying worries with a focus on rating the worry and then using relaxation techniques to lower anxiety. Although not CBT, it is a very useful book.

7. Ruby Finds a Worry by Tom Percival

One day Ruby “finds something unexpected. A Worry. It’s not a big Worry at first. But every day it grows a little bigger.” Ruby identifies that she has a worry, however there are no examples of what worries she has or how to talk back to a worry.

8. The Don’t Worry Book by Todd Parr

“Sometimes you worry. Worrying happens when you feel afraid something bad is going to happen.” The author identifies numerous worries for small children. The worries are not challenged or replaced, but rather distracting and comforting activities are provided.

9. Wemberly Worried by Kevin Henkes

“Wemberly worried about everything.” “Then it was time for school to start. And Wemberly worried even more.” This book does an excellent job of identifying many worried thoughts. There are many online activities related to this book.

What You Need to Know about Children’s Worry Books

When choosing a worry book for your child, do get one that really helps your child with anxiety. In one creative form or another, the first five reviewed books give children and caregivers important CBT steps to identify, challenge, replace, or contain the worry thoughts that are plaguing them. The remaining books are valuable in opening a conversation with your child about worry and in offering other strategies to reduce anxiety. If you know of other researched-based books on worry, please do submit your thoughts on my website so others can see them.

This post originally appeared on www.drsallyb.com.

Sally Baird

Tinybeans Voices Contributor

This Clever DIY Worry Box Helps Kids with Worry & Sleep

By Sally Baird

Tinybeans Voices Contributor

October 14, 2020

Photo: SallyBaird@www.drsallyb.com

What if there was a DIY Worry Box that helped reduce your child’s worry, improved her sleep, and gave you a fun activity to do with her? What if the idea behind the craft was based on research-based strategies that successfully lowered anxiety? Would you be interested? Of course!

More than ever, we need help reducing our anxiety. Research shows that the mental health toll on children (and their parents) from the pandemic is growing. In other words, our children are showing ever more symptoms of anxiety, poor sleep, and feeling lonely and uncertain. With online school, we expect anxiety to only get worse. In addition, many parents are with their children 24/7 and are desperate for activities that will calm their kids. A DIY Worry Box offers a way to keep the worries in check, improve sleep, AND make a fun craft.

As a child psychologist who specialized in work with anxious children, I often had kids write down their worries and put the paper in a “Worry Box.” The relief for most children was immediate because they could name their worry, write it down, and then put the paper into a closed container. The worry was contained and felt more manageable. Initially, I used a simple box with a lid and named it the Worry Box. With the writing of my children’s book on worry, the Worry Box was enhanced to be a child-created monster that can be as unique, crazy, or silly as the child wants.

The simple-sounding idea of putting a written worry in a Worry Box (containment) comes from Cognitive Behavioral Therapy (CBT), which is widely regarded as the most effective way to manage anxiety in both children and adults. Before learning to make the Worry Box, let’s learn more about containment and why it is so effective.

Containment

Containment is one of the basic principles of CBT. An analogy can help to understand it better. Imagine a yellow dandelion flower. The immature seeds are contained within the yellow flower and are not reproducing. But when the flower changes to a white fluffy seedhead, the mature seeds scatter in the wind. The seeds are no longer contained and they spread everywhere! Soon there are hundreds of new dandelions. If only you could contain all those seeds before they spread.

Now imagine that the mature dandelion seeds are worries. With the slightest provocation and without a container, worries can scatter everywhere. The worries can spread to bother a child (or an adult) anywhere and anytime. If you were just able to hold the worries in a container, they would feel manageable. You know you CANNOT contain mature dandelion seeds, but you CAN contain worries!

How to Make a Worry Box

Children will feel more in control (and have fun) if they are the ones to make their own container to hold their worries. You can make a worry box out of any kind of container. This Worry Box is designed to look similar to the big green Worry Monster in the author’s book. The difference between a Worry Box and Worry Monster is that the Worry Box holds your worries for you (a good thing) and the Worry Monster takes the worries in so he can grow bigger and scare you more (not so good).

For this Worry Box, supplies include a tissue box, chenille pipe cleaners, wiggle eyes, glue, an egg carton, acrylic paint, markers, stapler, puffballs, and foam sheets.

1. Paint the tissue box with acrylic.
2. Cut the foam to make teeth and hands.
3. Stick pipe cleaners into the box sides for arms and then staple the hands to the arms.
4. Cut and glue an egg carton for the top of head and glue on eyes.
5. Stick a pipe cleaner in for the sign and write “FEED ME WORRIES!”.

That’s it! A tutorial on how to make the box will be available on my website.

Your monster could be any color and have anything added to it. There are endless ideas on the internet. Let this monster be your child’s creation. The important concept is to have a mouth or a slot where your child can insert a paper with a written or drawn worry.

How to Use a Worry Monster Box

The Worry Box is ideal for preschoolers through teens. After the box is made, show your child how to use it. Tell her that when a worry pops up, she can write or draw the worry to put into the monster’s mouth. If necessary, you can write the worry for her, but you shouldn’t get into a big discussion about the worry at that time. The main ideas are that the child is learning to contain her worry with very little adult help and the worry is being released from the child into a container. Tell your child that any number of worries, big or small, can be put in the monster’s mouth.

Ideally don’t peek at the worries, instead make it a safe place for your child. Then set up a Worry Time (another form of containment in time) each day to discuss the worries.

To help with sleep, have your child write down her worries just before bedtime and then put them in the Worry Box to be safely held. She can also put the Worry Box under her bed so she can write down worries that might bother her in the middle of the night. Children often have great success with this.

Of course, you want to help your child with his or her worry and sleep problems and you want to have fun with your kids. So get out your crafts and get to work!

Sally Baird, PhD is a retired child psychologist and co-author of a new book titled Shrinking the Worry Monster, A Kids’ Guide for Saying Goodbye to Worries. See her website at www.drsallyb.com. If your child has worries about COVID-19, you may want to read Dr. Sally’s blog on helping kids who worry about the pandemic, school, illness, and so much more!

This post originally appeared on www.drsallyb.com.

Sally Baird

Tinybeans Voices Contributor

ML Interest Tag: behavioral-therapy

9 Things NOT to Say When Your Kid Is Sad

“Why are you being so sensitive?”

Anything that insinuates that crying is bad.

“Others have it worse.”

“You’re so much more difficult than _____.”

“It’s not that big of a deal.”

“You don’t have any reason to be sad.”

“Act like a big (kid)!”

Anything that perpetuates toxic positivity.

“Get over it.”

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