Thursday, January 31, 2013

Increasing Task Completion in School Aged Children


Increasing Task Completion in School Aged Children

Parents' concerns regarding their children's task completion are something I hear about all the time in my practice.  This concern is common for many parents, especially those who have children with attention and learning difficulties.  Difficulties with task completion are commonplace and children, parents, and teachers all benefit when plans are in place to support children to increase their task completion.

There are many things that can impact task completion including:
1)  Difficulties staying focused and a low arousal rate for children
2)  Distractions occurring in the classroom
3)  Difficulties for children understanding what is expected during certain times in class regarding task completion
4)  Frustrations for children having difficulty learning certain concepts
5)  Children becoming overwhelmed by the size of an assignment

It can be important to first assess what might be getting in the way of successful task completion since based on the type of struggle a child is having a different intervention strategy would likely be needed.  For example; children with difficulties related to attention difficulties typically benefit from systems that help them learn what is expected, assist them with managing organizational details, and stay on task, while children who might be having more difficulties due to low frustration tolerance or anxiety may benefit from different strategies.

Common strategies that can be helpful for children with attention difficulties include:
1. Provide as engaging assignments as possible that often are hands on and multi-sensory in nature.
2.  Provide many prompts to help children regain focus if their attention drifts.
3.  Limit distractions when possible in such areas as seating children with attention difficulties next to positive peers who are most likely to be on task and creating quiet study environments.
4.  Have auditory and visual cues that clearly define what is expected at times since children with attention difficulties often miss cues like seeing that their peers are working quietly and they should be too.
5.  Create incentive plans for kids so that they can be rewarded for completing work and demonstrating on-task behavior.  Please click here for a form that I often use for children that allows for teachers to target task completion and various behaviors such as talking at appropriate times, staying in one's seat, etc.  This type of form can be monitored by teachers and rewarded at home.  The attached form can also be altered to be specific for your child given their school schedule and targeted behaviors.  I know a lot of parents have concerns about providing rewards for children for doing behaviors that they "should just do anyway."  What I find is that the reason that these types of programs work is that they flood dopamine into the reward centers of the brain, thus increasing attention and task completion.  This is crucial since children with true attention difficulties regularly do not process dopamine in the frontal lobe of the brain as efficiently as children who do not struggle with attention difficulties.

Common strategies that can be helpful for children with anxiety and low frustration tolerance include:
1. Teaching strategies for better emotion regulation including learning how to take deep breaths, use imagery, count to ten, think a happy thought, etc. to calm down.
2.  Provide positive counter thoughts for children if they tend to say or think negative or self-doubting statements.  Creating new positive thoughts such as, "I am bright and I work hard.  I will be able to figure this out.  I just need to go one problem at a time.  I can ask for help if I need it." can be incredibly helpful for children who struggle with negative thinking.  I often write these types of statements down for the children I work with on notecards when appropriate and it is common for their teachers to help them by reminding them to read their notecards when they appear anxious or frustrated.
3.  Cover up several of the work problems with another piece of paper so that children are less likely to get overwhelmed and can just focus on one problem at a time.
4.  Provide rewards for utilizing coping skills and completing steps along the way.

The great news is there are many ways in which children, parents, teachers, and other service providers can work together to support children who have difficulties with task completion.  Establishing high levels of communication between school and home and teamwork can greatly improve children's work completion, but also their self-esteem regarding themselves as good students.

Monday, December 31, 2012

Increasing Happiness and Goal Attainment in the New Year


Increasing Happiness and Goal Attainment in the New Year--A Review of The Happiness Project by Gretchen Rubin

As many of you prepare to ring in the new year it seems like a good time to write about increasing happiness and goal attainment.  I thought that this would be a good topic for the month as many people are mentally preparing this week to set resolutions for the upcoming year.  I have chosen to provide a review of The Happiness Project (Or, Why I Spent a Year Trying to Sing in the Morning, Clean My Closets, Fight Right, Read Aristotle, and Generally Have More Fun) by Gretchen Rubin.  Reviewing this book felt like a good start since this book is a true life tale of Rubin's own quest to fulfill her New Year's resolution to increase happiness in her life through a yearlong systematic approach.

Rubin starts her book by deciding to focus her resolution for the next year on happiness since she reflects on how, while, overall she has a pretty good life and is generally happy, she really should appreciate her life and experience more happiness than she currently is.  From this decision, she sets out on a course of goal attainment for the next 12 months with several goals set in a single area of her life per month with additional goals to keep up with changes she had already put in place in other areas the previous months.  For example: Rubin sets several parenting goals for herself in April related to "lightening up" in her relationships with her children including: 1) sing in the morning; 2) acknowledge the reality of people's feelings; 3) be a treasure house of happy memories; and 4) take time for projects.  These goals are then added to her previously set goals for January, February, and March related to boosting her energy, having more acts of love in her marriage, and "aiming higher" in her work.

One of my favorite parts of The Happiness Project is how Rubin provides a wealth of research supporting the importance of happiness in life and how to increase happiness in a variety of areas.  Many of her chosen areas for change have been carefully picked based on her thorough examination of current scientific research.  She provides a funny, firsthand account of the trials, tribulations, and successes on her journey to bring further happiness to herself and those close to her.  Many of the studies she cites are often used in therapeutic settings since a lot of this research can increase happiness, but also are key areas often targeted to either decrease or prevent anxiety and depression.

I also really appreciate Rubin's systematic approach to how she works to achieve her goals.  While I know this approach will not work for everyone, I find her organized and methodical approach helpful.  Rubin also provides a nice personal example of how a person can set many small goals in one area over a period of time and have a large amount of success at making both small and large changes that improve the quality of her life.  She is thoughtful on her journey, setting up a lot of ways to reflect on her progress as a means to both evaluate and celebrate her successes along the way.  Rubin's approach is a nice illustration of several key characteristics associated with success in goal attainment.  As a psychologist who often journeys with others on their road to change, there are a lot of great pieces of Rubin's book that will ring true for others.

Rubin also provides great lists of tips in her book including her 9 tips for keeping resolutions:
1)  Write it down
2)  Review your resolution constantly
3)  Hold yourself accountable
4)  Think big
5)  Think small
6)  Break your main resolution into manageable tasks
7)  Keep your resolution everyday
8)  Don't let the perfect be the enemy of the good
9)  Consider dropping a resolution if you keep breaking it

Beyond the advice dispensed in The Happiness Project, Rubin also provides further support through her website with a happiness project starter kit for others inspired to start their own quest.  For those of you wanting more support in the area of making changes please Click Here for last year's newsletter article "Making Changes Count and Last" to learn more about how motivation can affect goal attainment and lasting change, as well as some strategies that people can use to make changes successfully.  Whether the new year finds you looking to increase happiness or make changes in other areas of your life, I wish you success and happiness in the upcoming year.  Just as Gretchen Rubin discovers that there is much to celebrate and be happy about I wish you the same in the year ahead.
 
Rubin, G. 2009. The Happiness Project.  HarperCollins Publishers. New York.
www.happiness-project.com

Friday, November 30, 2012

Helping Prepare Teens with Attention and Learning Difficulties for College


Helping Prepare Teens with Attention and Learning Difficulties for College

As many teens and their parents are feverishly completing their final applications to attend college in the fall it seemed like an appropriate time to write about some of the strategies that can help parents to best prepare their children with attention and learning difficulties for college.  The college years can be a unique time in a person's life filled with both a large opportunity for growth and positive experiences, as well as presenting a variety of challenges.  Luckily there are many things that parents can do to support their children both prior to attending college and while enrolled in college to best support their learning and positive development.

For families not yet at the point of applying for college it can be very helpful to allow children to practice necessary skills while still in high school with varying levels of support based on each student's unique needs.  Some of the strategies that parents can utilize to help their children to be more successful academically include:

1.  Talk regularly with children about the importance of education and how advanced training whether in college, junior college, trade school, etc., may work to set them up for a positive future.  While this can be challenging to do without nagging or sounding like a broken record these conversations can be helpful for children.  The more that parents can take their own emotions (such as their fears) out of these conversations and allow their children time to express a variety of interests and ideas the better.  Conversations focused on hopes for your children's future and what you think they are capable of, given their unique abilities, will often be more successful than lectures about the pitfalls of not furthering their education.  For children with attention difficulties making short, brief points (25 words or less) will often be more effective.  For example: "My hope is that you will go to college and major in something that interests you." or "You have so many great abilities like your enthusiasm and creativity. I hope you use these qualities in the future in a job you love."

2.  Have systematic programs in school (often through Individualized Education Plans or 504 Accommodation plans) to support children academically and help them build their skills and provide a safety net for times when their attention or learning difficulties could potentially get in their way.

3.  Provide high levels of support to help ensure that needed skills are developed such as ways to improve task completion, develop study skills, be more organized, and to think critically about the world around them.

4.  Explore various options for further development for your children such as helping them set up internships or jobs in areas of interest.  Often children with attention and learning difficulties are great hands-on learners and these type of experiences can build skills and confidence.

5.  Consider what type of higher learning options your child may be ready for.  Some teens are really ready to attend a four-year university, while others may struggle to live away from home and might originally be more successful in a junior college program initially.  There are also some colleges and trade school programs that specialize in working with young adults with various academic and emotional challenges.

For families in which their children are either preparing to begin or who have already started higher learning opportunities many things may help their children who are now young adults to succeed.  Some strategies include:

1) Access a large variety of services through the disability services center on campus.  These programs are available at all levels of higher education from the junior college to graduate program level and can be instrumental in a student's success.  Often in order to qualify for services in these programs you need to be able to show documented proof of either a learning disorder, attention disorder, or other mental or physical condition.  Depending on the program and type of unique difficulty of the student differing levels of documentation are needed from a letter from a physician or psychologist up to a comprehensive psychoeducational assessment.  Often programs require that young adults be reevaluated after turning 18 to qualify for services.

Typical services and accommodations at the college level include:
a) Having extra time for tests and assignments
b) Testing in a quite room
c) Note-taking support (I strongly encourage accessing this support since often college can be so lecture intensive)
d) Extra tutoring services
e) Priority registration
f) Options to be considered a full-time student even if taking less coursework
g) Academic and/or mental health counseling

I often find that for many students these accommodations make the difference regarding their success in college.

2) Having a high level of communication with your children about how to balance their school work and college life may also be important if your young adult children are open to the idea.  Otherwise, having young adults work with tutors, coaches, or therapists may provide these same type of supports without involving parents in the mix to help increase independence and decrease conflict between parents and their adult children.

While the transition to college or other adult learning options can be stressful and challenging at first, there are many ways to help students to access services and build skills that will help them to be successful.

Wednesday, October 31, 2012

Teaching Children to be Honest


Teaching Children to be Honest 

Teaching children to be honest can be one of the most challenging tasks for parents.  The importance of honesty as a value comes up repeatedly in my work with families since it is such a crucial and complex issue.  Luckily, there are many steps that parents can take to assist their children in being more honest.

Some of the strategies that parents can use to help their children to be more honest include:
1.  Talk regularly with children about the importance of honesty in your family as well as how to appropriately take accountability when needed.
2.  Provide significant rewards to children for demonstrating honesty and taking accountability for their actions.
3.  Remind children that consequences are typically worse in situations in which children choose to be dishonest about their negative choices.
4.  Clearly illustrate how honesty works in your family by providing good role modeling and clear examples of being honest and accountable.

One area in which honestly can come into play for children specifically is in the area of cheating.  A recent Dateline episode focused on honesty and the pressure on children to cheat in today's society.  The piece was interesting since it had parents watch their children on camera being peer pressured to cheat in a variety of instances.  In many situations children looked uncomfortable and at times voiced slight objections to cheating, but would often engage fully in the cheating as more peer pressure was applied by the child actor in the challenges.  Unfortunately it was rare in the television clips for children to take a firm stand and risk peer isolation by speaking out and refusing to cheat.  Rosalind Wiseman, a writer and educator on ethical leadership, noted that the behavior of the children filmed for the television show is consistent with children in a variety of settings.  She provides several suggestions to assist parents in teaching children to be honest and to avoid cheating.  Her tips for parents include:
1) talking with children about family values;
2) provide specific situations for them where it might be difficult to be honest such as when they have access to test questions prior to a test and what you would expect them to do in this type of a situation;
3) admit that it doesn't always feel good to be honest;
4) to use real examples in the media for discussion with teaching opportunities such as when someone famous lies or when an athlete gets caught utilizing performance enhancing drugs to have a discussion with your child and get them to share their point of view.

Specifically regarding the topic of preventing cheating, Rosalind Wiseman recommends that we also need to change our school systems by decreasing the value we place on grades, and instead focusing our attention on how much children are actually learning since research demonstrates that when the emphasis is placed on celebrating what is actually learned children are significantly less likely to cheat. [1]

In my practice I often find that an area where dishonesty occurs regularly is having children lie about whether they have homework or not.  I believe this is so common for children with attention and learning difficulties since lying in this case is a means to try and avoid homework since this is often such a painful and stressful time for children.  I find what typically works best for children is to get out of the trap of asking children if they have homework or not since this creates an opportunity for children to say they don't have homework.  Instead, I recommend for parents to set a clear structure for how homework time is handled everyday.  This structure starts with statements such as "Show me what you have for homework today." versus questions such as "Do you have homework today?"  Making it a requirement that each assignment is shown directly to the parent each day as a step of the homework structure also helps versus just letting children say their work is complete.

Ultimately, it is a process teaching children about the importance of honesty and assisting them with navigating the complexities of the world around them in which some people do choose to take short cuts or be dishonest.  Helping children to understand the types of situations that they will likely find themselves in and what behaviors you expect based on your values is also important.  Hopefully, parents can feel better knowing that speaking to children about family values and providing rewards and praise to their children for making good choices do add up and help children to demonstrate more honesty over time.

[1] Inside Dateline. How to talk to your kids about cheating. NBC. April, 29, 2012

Friday, September 28, 2012

Why Rock Climbing?


Why Rock Climbing? The Benefits of Rock Climbing as a Therapeutic Intervention 

In the six years that I have facilitated a rock climbing therapeutic social skills group I have been asked many times why I selected rock climbing as a means to work with children with a variety or concerns including attention and learning difficulties, social skill deficits, anxiety, depression, trouble with emotion regulation, low self-esteem, and behavior problems.  My personal experience of being a rock climber for twelve years help make rock climbing a clear choice for a great medium to work with children.  The repeated question over the years of "why rock climbing?" has led me to reflect a great deal on what I believe are the array of benefits of rock climbing as a therapeutic intervention.  I can say whole heartedly that I believe that rock climbing is a wonderful way to work with children and in my experience I have seen opportunities to climb as a member of a group be transformative for a lot of different children with a wide variety of needs.  Trying to breakdown the components related to this transformation or positive change can be difficult, but I think it is related to various aspects including that rock climbing provides a clear opportunity to participate in experiential learning, is beneficial due to being a good form of exercise, and key areas such as trust, teamwork, and communication are inherent in climbing as part of a group.  I think it is the sum of all these aspects that can make rock climbing such a wonderful and beneficial thing for many children.
 
The Quest Therapeutic Model focuses on providing children with rich experiential learning opportunities in which they are able to build and practice new skills in a supportive environment.  This type of model emphasizes creating chances to learn through doing in a fun, interactive way.  Rock climbing has always stood out to me as a unique way to engage children and provide this type of rich experience due to aspects that naturally arise while climbing with a group.
 
There is clear research that demonstrates that any type of exercise can be beneficial and therapeutic in its own right.   Please click here for more information regarding the research that shows the benefits of exercise as a treatment for ADHD, anxiety, depression, and learning difficulties, as well as a healthy intervention to improve physical health.  Beyond the research that clearly establishes exercise in general as a positive intervention for both children and adults, sports such as rock climbing, martial arts, and skateboarding provide opportunities to engage in technical movements such as complex motor skills that have been found to alter chemicals and specific areas of the brain related to attention.

According to the broad science, exercise tempers ADHD by increasing the neurotransmitters dopamine and norepinephrine-both of which play leading roles in regulating the attention system. With regular physical activity, we can raise the baseline levels of dopamine and norepinephrine by spurring the growth of new receptors in certain brain areas. Any of the martial arts, ballet, ice skating, gymnastics, rock climbing, mountain biking, whitewater paddling, and-sorry to tell you, Mom-skateboarding are especially good for adults and children with ADHD. [1]

Rock climbing activities also create rich opportunities to target specific areas that are key to children's positive development.  Several areas that it is possible to address in rock climbing include:
1.  Problem Solving and Sequencing
2.  Teamwork
3.  Trust
4.  Communication
5.  Emotion Regulation
6.  Pushing Personal Limits

Having opportunities to problem solve and practice sequences is a great thing about rock climbing.  One of my favorite aspects for problem solving is that rock climbing always presents different challenges.  Not only can a person select an easy climb there are always opportunities to pick difficult climbs--really stretching one's ability.  This can often lead a person to really push past his or her own personal limits and achieve way beyond what the person thinks is possible.  I see this all the time in my work with children at the rock climbing group.  One of my favorite aspects of the group is working with children who challenge their fears, climb higher than they think is possible, and persevere to reach goals that they have set.  Sequencing also comes into play frequently, which is often specifically helpful for children with attention and learning difficulties, since children with these special needs often struggle to complete full sequences or see how different steps link together.  What I see over and over again in the group is that the children are able to take their success experiences of reaching their climbing goals and carry that with them into other areas of their lives.  For example: I have had several children tell me that they knew they were capable of challenging a fear or accomplishing an academic task because they have climbed to the top of the wall, gone off the zipline, or had a successful climb outdoors that leads them to know that they "can accomplish anything."

Rock climbing provides rich opportunities to also have children work together in situations that demand high levels of teamwork, trust, and communication. At Quest, we actually push this even further by creating advanced challenges for the group members to complete that are impossible to finish successfully if they are unwilling to work together.  These team based challenges also focus heavily and teaching prosocial skills to assist our children in being positive members of a team and to demonstrate the skills necessary to build high levels of trust and communicate at much deeper levels.  Trust is crucial in rock climbing since it is so difficult to be successful when you don't trust the other person.  We teach our children a lot of things to successfully build trust with others in many areas from the language used, to ways they maintain a teammate's safety.  Having our children complete extra challenges like climbing blindfolded or tied together further serves to link our children together as a unit and build their communication, problem solving abilities, and trust levels.  Pushing limits in these ways create wonderful possibilities for our children to practice skills necessary for emotion regulation in the moment versus other types of therapeutic activities that do not have this type of experience to work through in the moment.  I don't know if rock climbing as a therapeutic intervention has the power to be beneficial for some children because of any one of these aspects in particular or if it really is a summation of all of these different components.  What I do know, after running these groups for years, is that there is something that is transformative for some of my campers through this type of group and for that I am truly thankful.
 
[1] Ratey, J. J. Spark: The Revolutionary New Science of Exercise and the Brain, 2008

Tuesday, August 28, 2012

Supporting Children's Academic Growth Through 504 Accommodation Plans and Individualized Education Program


Supporting Children's Academic Growth Through 504 Accommodation Plans and Individualized Education Program

The start of another school year can be a source of excitement and anxiety for children and parents alike.  This can be especially true for parents of children with attention, learning, and/or social difficulties.  The new school year can reflect a fresh start and a new opportunity for children to make friends and educational gains.  Having systematic plans can be incredibly helpful and crucial for the success of many children with special needs to be successful in their academic environments.  I believe that in most instances where a child has documented attention or learning difficulties that a formal plan with the school is incredibly helpful.

The two types of written plans include an Individualized Education Program (IEP) or a 504 Plan.  These are plans that can be created with your child's school.  Both are federally mandated but fall under two separate laws. They each provide for the student to receive a free and appropriate education within the least restrictive environment. However, these two plans serve different purposes, according to the needs of the child.

What is an IEP and Who Qualifies?
IDEA (the Individuals with Disabilities Education Act) provides federal funds to state and local agencies to guarantee special education and related services to children with disabilities. To be eligible for an IEP under this law, your child must be between the ages of 3 and 21 and have an identified disability that impedes learning to the point that the child needs specialized instruction in order to close the gap between the child's own academic achievement and that of his/her age peers.  Whether your child has a qualifying disability is determined at an IEP meeting, using the results of standardized assessments as well as other informal and formal data collection. It requires unanimous agreement from the members of a multidisciplinary team that includes one or more of the following: special educator, psychologist, parent, related service provider, and general education teacher. The team must agree that your child's disability falls under one of the 13 federally mandated categories and that it interferes with the child's education and performance. [1]

What is a 504 Plan and Who Qualifies?
As part of the Rehabilitation Act of 1973, Congress passed Section 504. This civil rights law protects people with disabilities by eliminating barriers and allowing full participation in areas of life such as education and the workplace. Section 504 is intended to prohibit disability discrimination by recipients of federal financial assistance and by public entities.  A 504 Plan is for students who have a disability, have a record of a disability, or are treated as having a disability but do not qualify for special education services under IDEA. [2]
 
An IEP typically has specific goals created that are monitored in various areas to support children in their areas of disability.  These goals often reflect specific education needs in areas such as reading, writing, or math.  For children with attention difficulties it is also common to have specific goals set regarding task completion or following directions.  A 504 Plan doesn't have these detailed goals, but instead lists several accommodations that should support the child's success.  Typical accommodations for children with attention difficulties generally include things like extended time for tests and assignments, preferential seating close to the teacher by a positive peer, note taking support, extra communication between school and home, behavioral reward programs, etc.  

If your child has not had their attention or learning difficulties officially documented information is provided on when an assessment may be helpful in our September Newsletter from last year For this article please click here.  Assessments are often completed by the school district or by private psychologists.  School psychologists diagnose various learning disabilities, while speech pathologists and occupational therapists assess children in related areas that may be affecting children's ability to access their academic curriculum.  In the specific area of documenting an attention difficulty, school psychologists are not allowed to diagnose in this area and children instead qualify typically under the criteria of Other Health Impaired for a 504 plan from a letter or report from a qualified professional such as a psychologist, pediatrician, or psychiatrist.

IEPs and 504 Plans are formal documents and agreements that are established with the public school.  Plans offer a structure so parents, teachers, and administrators all know what is going to be provided and expected to best help children to access their academic surroundings.  Private schools do not have to honor these plans, but I have found that the large majority or private schools are willing to offer these same plans in an informal way since we know that providing children these extra supports and accommodations greatly increase their success.  Hopefully parents can feel better knowing that there are many ways to help children be successful in their academic environments with the right supports in place.

[1-2] Bennett, A., & Frank, L. (2009). Special Education Process: IEP vs. 504 Plan. 2e Newsletter, Jan/Feb Newsletter. http://www.davidsongifted.org/db/Articles_id_10671.aspx

Saturday, July 28, 2012

Relaxation Strategies for a More Happy, Calm Life


Relaxation Strategies for a More Happy, Calm Life

At Quest Camp, we teach all of our campers several strategies to help them calm down when they are sad, mad, or worried. Our campers are taught how to take deep breaths, use progressive relaxation, and engage in imagery among various other relaxation and coping strategies. We have our campers practice these three strategies every single week of camp since these three techniques are well known, common strategies that have been found to significantly help people to calm down and feel better in times of stress. I believe that these three strategies are so helpful to both children and adults that it is rare for me not to discuss these same tools for relaxation with almost every client that comes into my private practice office. Building relaxation into the lives of all people is crucial since research shows that people who generally devote 20 minutes per day towards relaxation are found to have less anxiety and depression than others. Some people tell me that they don't have the time to engage in relaxation. I typically respond to this sentiment that the benefits are so high for relaxation that I don't think people can afford not to make the time since this kind of self care decreases difficulties and improves things like productivity. I view these tools for relaxation as primary for all people and believe that this type of skill building should occur for all children from an early age. Just as children are taught to read and write, they should be taught how to label their feelings and use coping skills.

A brief description of deep breathing, progressive relaxation, and imagery is provided below. These strategies are great when used in times of calm, but are also to be utilized in times of stress such as when feeling anxious, depressed, or angry. I often have people combine these together as well since that can add to feeling more relaxed. For example: a person might continue to focus on taking nice slow deep breaths while engaging in progressive relaxation or imagery. I often recommend that people take deep breaths, use progressive relaxation, and imagery first thing in the morning, while getting into bed for the night, and throughout the day when they are feeling stressed. Imagery can be particularly helpful at night since some of the same brain waves associated with daydreaming are the same brain waves that are found to be the precursors to sleep.

Deep Breaths:
Deep breaths are good for children and adults since these breaths reset our system since when we are upset or stressed we naturally don't breathe as deeply as we do normally when not under stress. By taking breaths that are much deeper than normal we can send messages to our body to calm down and restabilize.

1. Breathe air in through the nose and into the diaphragm, with air exiting through the mouth. If done correctly the stomach should rise for each breath (instead of the chest). I actually have children put their hands on their stomachs while they are learning to take deep breaths since their hand should rise if they are taking deep breaths correctly.
2. Each breath takes about 10 seconds. Breathing in for a slow 4 count (1, 1000, 2, 1000, 3, 1000, 4), holding for 1 second then out for a slow 5 count.

Progressive Relaxation:
Progressive Relaxation is a systematic process with the body that involves tightening various muscle groups one at a time and focusing on releasing the tension in that part of the body.
1. Tighten a muscle for 3 seconds, and then say, "relax," focusing all thoughts on having the tension leave that part of the body.
2. First tighten fists for this 3-second process listed in step 1, then forearms, then biceps. It is then helpful to focus all thoughts on tension draining out from this whole section of the body.
3. This process is then repeated for different sections of the body.               -First bringing shoulders up toward ears, then tightening muscles in      the forehead, then squeezing the eyes together, clenching teeth,  tightening chest muscles, then abdominal muscles. Next, focus all  thoughts on tension draining out from this section of the body.                 -Proceed to tightening quadriceps, then calves, arches, down to the  toes. Again, mentally focusing on all the tension draining out through  the whole body.

Imagery:
Imagery is basically engaging in a thought process to think about your "happy place." I sometimes think of this as a 2-minute vacation, where someone can transport himself or herself anyplace. Often people pick things like a beautiful place to visit such as the beach, mountains, vacation spot, or in an old memory. Children will also often pick made up places in their imagination or places in video games. The key is to pick someplace that is a happy place where it is impossible to think of this place without feeling happy or smiling. The imagery exercise below also focuses on engaging your senses since this can make the image more real and a more powerful tool for relaxation.
1. Imagine that you are in a place that makes you feel happy, safe, and/or relaxed.
2. Take in all that you can see as you enjoy being in your favorite place.
3. Take in all that you can hear as you enjoy being in your favorite place.
4. Take in all that you can taste as you enjoy being in your favorite place.
5. Take in all that you can smell as you enjoy being in your favorite place.
6. Take in all that you can touch as you enjoy being in your favorite place.
7. Take in all that you can feel as you enjoy being in your favorite place.
8. Feel at peace knowing that you can always return to your favorite place when you need to.

Imagery can also be a powerful tool for building self-confidence. I will often use imagery with children and adults who are struggling with things like test anxiety. In this case instead of thinking of a relaxing memory, we will work to find a moment of success where the person felt like they could accomplish anything such as success in a sporting event, getting an "A" on a test, etc. The person will then take a few deep breaths and call up this image for a short time period when it is time to start the test that they are anxious about.

My hope is that you and your children will find these strategies helpful. The exciting thing to me is that I typically find that these techniques often work better for people the more often they practice them and that the these techniques should continue to work for children as they grow to be adults. In addition, children and adults are often able to find which of these tools work better in different types of stressful situations. The analogy I often give is of how in a toolbox both a hammer and a screwdriver are incredibly helpful, but they both have different uses and benefits. Relaxation is viewed as so important that there are many great resources for people interested in learning more. Two of my favorite books with information regarding relaxation and stress management are the Anxiety and Phobia Workbook and the Mind over Mood Workbook. There are also good relaxation CDs available that guide people through progressive relaxation and imagery. I hope that as you and your family try out these strategies you will see their usefulness.