Bi-Polar Condition in Children Laura A. Riffel, Ph.D.
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Characteristics of Bi-Polar in Children Symptoms Which May Show
Up ADHD Symptoms Distraction Hyperactivity (restless and fidgety)
Impulsivity (risk taker) Overly gregarious Racing thoughts
Pretentious
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Characteristics of Bi-Polar Condition in Children More Symptoms
Crave Carbohydrates Binging
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Characteristics of Bi-Polar in Children More Symptoms Anxiety
being separated from parents Irritable Oppositional behaviors Mood
Swings Depressed Lethargic Low Self-Esteem Hard to get up in the
morning Social anxiety Oversensitive Migraine headaches
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Characteristics of Bi-Polar in Children More Symptoms Meltdowns
(long lasting tantrums) Compulsive behavior Bossiness
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Characteristics of Bi-Polar in Children Symptoms Rapid or
pressured speech Motor & vocal tics Lack of organization Poor
short term memory Destruction of Property Hallucinations and
Delusions
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Characteristics of Bi-Polar in Children Extreme Symptoms
Bed-wetting (especially in boys) Night terrors Learning
disabilities Fascination with gore or morbid topics Hyper-sexuality
Lying Suicidal
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Bi-polar Condition 4000% increase in diagnoses since the mid
1990s in childhood bi-polar condition.
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Is it Bi-polar???? Temper Dysregulation Disorder: (New DSM-V
Diagnosis for Children) Brain based disorder or biological
dysfunction Not necessarily life-long condition Children over 6-
must begin before age of 10. Symptoms: Frequent temper outbursts
when dealing with common stress Has to last for at least 12 months-
can not be free of symptoms for more than 3 months at a time. Looks
like: Yelling Physical aggression Over reacting Tantrums more than
3 times a week Tend to be negative daily
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Barometric Pressure I have found a correlation between
barometric pressure and bi-polar condition in children and adults.
Appears to be unique to each individual. "Barometric pressure,
emergency psychiatric visits, and violent acts," Thomas J. Schory,
Natasha Piecznski, Sunil Nair, and Rif S. El-Mallakh, Canadian
Journal of Psychiatry, Vol. 48, October 2003, 624-7. Address: R. S.
El-Mallakh, Mood Disorders Research Program, Department of
Psychiatry and Behavioral Sciences, University of Louisville School
of Medicine, Louisville, KY 40292,
[email protected].
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Schory et al. (2003) "The data suggest that total numbers of
acts of violence and emergency psychiatry visits are significantly
associated with low barometric pressure low barometric pressure is
associated with impulsivity. low barometric pressure is associated
with changes in cerebral blood flow, increased risk of rupture of
intracranial aneurysms, premature labor, changes in the
norepinephrine metabolite HMPG (at least in women), (adrenal gland
hormone) and changes in cerebrospinal fluid concentrations of the
serotonin metabolite 5-HIAA in people with depression. They also
note that weather fluctuations are known to influence certain
mental disorders, including seasonal affective disorder (SAD) and
bipolar disorder. The researchers hypothesize that "barometric
pressure may alter the propensity toward impulsive behavior through
changes in brain monoamines or cerebral blood flow."
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http://www.wunderground.com/weatherstation/WXDailyHistory.asp?ID=KKSOVERL7
Type in your state and you will get a list of cities in that state
Check the pressure for the city closest to you- it will tell you if
its steady, rising, or falling Barometric Pressure is measured in
inches. Graph it daily and watch for patterns: Website for graphing
daily barometric pressure: http://tinyurl.com/bptemplate
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Parenting Tips
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Sleep Routines are of utmost concern- Go to bed like a farmer
Sunset to Sunrise Do not vary unless absolutely necessary
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Exercise Exercise is a good counter to depression and stress
Good for: Anger reduction Anxiety amelioration Tension reduction
Releases endorphins which calms the body Ideas for exercise:
Trampolines- outdoor or indoor Wii fit Treadmill Punching bag Dance
video Kick boxing Martial Arts
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Active Listening Learn and use good listening and communication
skills. Ask open ended questions- think Late Night Talk Show Host
Whisper in right ear- the right ear is connected to the side of the
brain that is more conducive to compliance.
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Choose your battles Is this the hill you want to die
on?????
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Relaxation Practice and teach relaxation techniques to your
child. Use: music, 60 bpm sound, headphones lighting,
www.huelight.netwww.huelight.net Yoga breathing
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Relationship Narratives Help your child anticipate, and avoid
or prepare for, stressful situations by developing strategies in
advance. Make PowerPoint Relationship Narratives about possible
barriers and how to handle them.
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Use PowerPoint as a visual schedule to help your child
anticipate, and avoid or prepare for, stressful situations by
developing strategies in advance. Learn safe ways to talk your
child down from a rage fit. Do not restrain unless life is in
danger. Talk to the school about implementing some stress reducing
techniques. Engage your child's creativity through activities that
express their gifts and strengths. Provide routine structure while
allowing freedom within expressed limits.
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Classroom Ideas for Teachers of Students with Bi-Polar
Information from: The Child and Adolescent Bipolar Foundation The
Bipolar Child: The Definitive and Reassuring Guide to Childhoods
Most Misunderstood Disorder The Explosive Child: A New Approach for
Understanding and Parenting Easily Frustrated, Chronically
Inflexible Children Understanding the Mind of Your Bipolar Child:
The Complete Guide to the Development, Treatment and Parenting of
Children with Bipolar Disorder
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Flexibility Flexibility to modify assignments, curriculum and
teaching style as needed
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Patience Patience to ignore minor negative behaviors, encourage
positive behaviors, and provide positive behavioral choices. Most
important is the ability to stay calm and be a model of desired
behavior.
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Conflict Management Good conflict management skills to resolve
conflict in a non-confrontational, non-combative, safe, and
positive manner
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Collaboration Receptivity to change and to working
collaboratively with the childs parents, doctors, and other
professionals to best meet the needs of the child.
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Humor The ability to laugh at oneself and at situations.
Teachers who can laugh at their own mistakes, and bring fun and
humor into the classroom reduce the level of stress that students
feel.
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Teacher Characteristics The most important factor in these
childrens success is the way adults respond to and work with them.
The teachers who work best with these students are resourceful,
caring, calm and know how to work positively with childrens
shifting moods and cognitive weaknesses. Praise, encouragement, and
key words elicit positive behaviors, while negativity helps the
child spin out of control.
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Accommodations Suggested accommodations for children with
bipolar disorder include: Back and forth communication between home
and school Consistent scheduling that includes planned and
unplanned breaks. Prior notice of change or disruptions in routine.
Scheduling the students most challenging task at a time of day when
the student is best able to perform, allowing for medication
related tiredness, hunger etc. Seating with few distractions,
providing a buffer space and model students. Small class size
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Accommodations Continued Annual in-service training for
teachers by professionals Designated staff member to whom the child
can go as needed (Preferred adult) Homework reduced or excused and
deadlines extended when energy is low Safe place at school where
the child can retreat when overwhelmed. Unlimited access to the
restroom Unlimited access to water
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More teacher qualities Be resolved and consistent when
possible. Continue to supervise the student closely at recess.
Defiance and aggression are probably the most challenging moods to
manage. The best strategy for addressing these behaviors is to get
a Q-TIP (Quit Taking It Personally). Keep your poise and do not get
involved in power struggles. Imprint calmness by modeling calmness.
If the student says something rude, do not threaten to punish him
or her. Hear this for what it is: A cry for help. The child is not
capable of verbalizing that they cant handle what is
happening.
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Teacher qualities continued Focus the students strengths and
point them out to him/her privately. This disorder takes a toll on
a childs self esteem. Use the 4Ps for raising self-esteem. Give the
student equal choices and have him/her participate in problem
solving. For example, the student might say, I dont want to go to
music today. Show empathy by using an I statement, I hear you
saying you dont want to participate in music today. Is that
correct? You can then ask him/her simply Tell me more about that?
He/she may say they just dont want to go to music and thats final.
You then can tell him/her what your concern is i.e. the class is
going to music and you dont want to leave them alone. Ask him/her
how both of your concerns could be addressed. When you find a
mutually agreeable solution to both of your concerns, go for it! Do
not say, You can go to music or you can lose your recess. This is
not a choice. You are giving him your choices and not hearing
his/her concern.
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Teacher qualities continued If the student is becoming more
ill-tempered, allow him/her to go to a predefined safe place. This
should be done in a discrete way so as to not disrupt the class or
make a scene. Limit those classes that are triggers, i.e. gym,
music, recess. Note that circumstances involving physical contact,
competition, and perception of fairness, are triggers for many
children to become aggressive. Notice when the student has low
energy levels or high ones and communicate these observations to
parents and/or therapist. Its important to learn the signs of a
cycle change.
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Teacher qualities continued Notice when the student seems more
irritable or giddy and communicate to parents and/or therapist.
Again, this is critical to identifying any potential patterns of
behavior in order to monitor his/her condition. Notify the students
parents of any changes in routines, group projects, known
substitutes etc. When he/she seems to want more attention, greet
him/her as he/she enters the room, give him/her opportunities to
work with other students and acknowledge him/her when he/she stays
on task.