Why Maintaining a Daily Routine for Children in the Summer is So Important
These last 14 months haven’t been easy on children, for several reasons. The phrase “daily routine” morphed into a quaint, almost yesteryear-like premise during that time. It’s even more challenging for children who experience mental and/or behavioral health issues. Our School-Based Services assist children in conquering all types of barriers to school success, including social, behavioral, and developmental, through 1-on-1 therapeutic support & skills development. Naturally, these types of students face challenges whenever something disrupts their daily routine. When school ends and summer vacation begins, it’s inevitable. We talked with Kelly Esposito, Team Leader on Adult & Child Health’s Marion County School Based III team. She emphasized the importance a daily routine has in children’s lives, particularly those with mental health issues. RELATED CONTENT: Why School Reopening Might be Challenging for Your Students How our School-Based team works with students During the school year, Esposito and her team meet with students as issues arise, but the dynamic changes when the school year ends. She said therapists and skills development specialists will meet with students anywhere from one to three times weekly, depending on need, and take them to places like a park, library, or an A&C building where they can build on the skills they’ve learned throughout the school year while they participate in fun activities. “When we’re in school, it’s not as structured as far as session time,” Esposito said. “You’re often responding to needs that arise in the moment and we find ourselves putting out a lot of fires. In the summers, we typically have a much more structured time with the kids. It’s usually a set appointment each week, which gives the providers time to plan a lesson, curriculum or activity ahead of time. We go from seeing the kids in the school setting 90% of the time to being home-based or community-based once school lets out.” Kelly works with Indianapolis Public Schools students, and she said each therapist or skills development specialist works with anywhere from 15 to 35 kids at a time. She added that it’s common for caseloads to decrease significantly during the summer, although it’s typically due more to circumstances than apathy. “We have a lot of transient families that move during the summers due to circumstances that are out of their control,” Esposito said, adding, “If that student ends up back in one of our schools next school year, we are often getting another referral for them once school starts back up because a lot of skills were lost during those summer months without services.” RELATED CONTENT: See How Our Youth Development Program is Helping its Participants Excel Why daily routine is so important Kelly said a big reason those referrals happen again is because the kids don’t have much structure to their lives during the summer months. “Mental health issues don’t stop just because school’s not in session, so it’s important that families continue sessions with their mental health providers if they are able to do so,” she said. “Structure is very important, and it can look different for everyone. Some kids need more structure, while others are better at managing their free time. You can gauge what each kid needs based on behavioral changes. If they’re acting up and starting to have outbursts, they might need a little more structure. Wakeup times, bedtimes, set meal times … that transition when school starts up again will be much easier. If the parents are good about keeping some sort of structure, for example, not letting them sleep until 2 p.m. or stay up until 2 a.m., it’s pretty good for the most part.” Esposito said the summer can be a crucial time for developing better therapist-student relationships. With no school day to interfere, there’s more time for 1-on-1 care. “We don’t always have that full picture of what they’re like outside of school,” she said. “We’re not always able to have fun sessions a lot of the time during the school year. We often don’t have time to play games because we’re responding to meltdowns or misbehaving, but during breaks we can spend more time together, get to know them more holistically, and make it more fun for them. In the summer, they don’t have those stressors of school, so instead of putting out fires, we have ample time to teach clients the skills to use during future situations that might arise.” What can parents do? Child Mind Institute suggests several tips to keep children on track during the summer months, so when school resumes, they can hit the ground running. Here are a few ideas they provided: Maintain your schedule. While you may never be able to duplicate the structure school provides, it helps to maintain the school year’s daily schedule, right down to meal times and bedtime as much as possible. Make it visual. Kids who thrive on predictability and are prone to panic over transitions — including those on the autism spectrum —benefit from posted schedules that outline what will happen throughout the day (i.e., 7 a.m.: wake up, go to the bathroom, wash face…8 a.m.: breakfast…) Depending on your child’s developmental level, simple pictures can also help. Make plans. Try to schedule as many activities as possible, as early as possible, and keep your kids posted. This can mean anything from “we’re going to Aunt Mary’s house at 5 p.m. Thursday for dinner” to having a set routine that every day, weather permitting, you’ll be going to the playground or pool. Ingrid Prueher, a pediatric and adult sleep expert, added a few more suggestions: Don’t forget about nutrition. While you focus on good nutrition during the school year, you may be tempted to substitute less healthy choices in the summer. Be sure to keep your child hydrated, and don’t sugar them up with too much juice and candy and, as always, avoid processed foods. Have a weekly family planning meeting. Since children thrive on a daily routine and become anxious when they can’t predict what’s coming, have a
How Our Assertive Community Treatment Team is Helping the Homeless
When Cory Britton was 5 years old, he already knew he was different from the other kids. But not in a physical or obvious sense. It certainly didn’t look like a homeless life awaited him. “I felt I was different from everyone else,” said Cory, who’s now 22. “My mood swings, and how I would cope with different things. My mom didn’t know how to deal with it. She told me to pray and hope for the best. It was pretty rough. I didn’t understand me and what was going on, but I knew something was wrong.” RELATED CONTENT: Overcoming Trauma: The Power Behind Skills Development and Therapy Cory was looking up ADHD at age 10, thinking that might have been his issue. He came from a family that encouraged prayer and working through problems. That wasn’t working for Cory. By age 17, he was diagnosed with depression. He received a bipolar disorder diagnosis shortly thereafter. Cory was well-adjusted enough that he was able to enroll at Central State University in Wilberforce, Ohio, but that didn’t last. He dropped out of school, and was homeless for about four and-a-half months. RELATED CONTENT: A&C Launches Telehealth to Serve Wheeler Mission Guests How A&C helped Cory and other homeless clients Eventually, Indianapolis’ Coordinated Entry System referred Cory to A&C, where he met our Assertive Community Treatment (ACT) team. The group was formed in 2020 and serves clients with significant mental health needs that have impairment in their functioning. “It’s a barrier to them being able to access things that you and I would take for granted,” said Tiffanie Barnes, Team Leader. The team currently has 39 clients, including Cory. The team of nine has helped house about half of its caseload so far. “It’s amazing that we are able to do that,” Barnes said. “We want to continue to introduce people to housing and we would like to grow our caseload and offer our services to more individuals.” Each client is a team effort, but Alison Ruess and Abigail Wainman work most closely with Cory, and both have been amazed at his progress. “It’s been inspiring to see Cory reach a goal,” Ruess said. “He wanted to spend more time with his mother and he’s spent multiple weekends with her since then. He’s working with the employment specialist in the team to help him find a job.” “It’s very inspiring,” Wainman said. “I’m the same age as Cory and I could not imagine going through what he has been through. I love working with Cory.” The team helped Cory obtain an ID and Social Security card, but his therapists credit him with most of the improvements he’s made. “He’s been meeting us consistently on a weekly basis to do these IMR (Illness, Management and Recovery) sessions,” Ruess said. “Cory has done his home practice where you talk about what you’ve learned with someone. He’s really accomplished all of that.” What’s next for Cory Now, Cory is affiliated with the Blue Triangle Program, which is designed to provide safety, security and comprehensive health care for people who are experiencing homelessness, and help them rebuild their lives. He’s looking for permanent housing, and he eventually wants to return to college and start his own marketing firm. “Just be open to it,” he said, offering advice to anyone who’s homeless and considering getting help. “When I first heard about it, I was very reluctant because I don’t like talking to people as much. It can change your life and put you in better places. They help with anything and everything I need. “I was homeless before coming here. That really shaped me a lot. I was on the street for 4.5 months. When I first met with A&C, they were commending me on how strongly I handled the situation. I definitely had help, but no one’s supposed to survive in those circumstances. I came out stronger than I was.” Do you know someone who’s experiencing homelessness? Our Homeless and Housing Resource Team could help. Call 1-877-882-5122 to learn more. Would you like to donate to our mission? Here’s how you could help our homeless or other programs.
Why School Reopening Might Be Challenging for Your Students
As we return to full-time in-person school reopening, we might be tempted to think our students will easily transition back to their pre-March 2020 lives. As we’ve come to discover in recent weeks, that isn’t necessarily the case. Lindsay Alexander, Beech Grove School Based II Team Leader with Adult & Child Health, has witnessed this phenomenon firsthand. She completed her Masters in Clinical Psychology from the University of Indianapolis. She has since focused her mental health career in children and adolescent psychology. Lindsay is passionate about increasing protective factors in youth to decrease the risk of suicidality, working with caregivers in the family setting, and utilizing play therapy with younger children. She shares her thoughts and expertise on the topic below: RELATED CONTENT: Adult & Child Health Receives $321,000 Grant from Lilly Endowment to Support Youth Services Under COVID-19 The Return to Normal Isn’t All That Normal Many parents and educators have asked us how to best prepare their child or student for the change from virtual learning, to hybrid learning, to back to the traditional learning setting and school reopening. We have affectionately been calling this phase the “return to normal,” but it seems our kids may not be adapting well to these back-and-forth changes. We know our local schools have been working tirelessly toward doing what is best for their students in their district, and educators have been feeling the stress to “return to normal” learning. During this time of change, there can be shifts in a child’s emotional and behavioral language in the classroom and at home. Many parents expected their child to embrace more hours in the physical classroom, and to have joy regarding some recent changes. Mental health providers have found the opposite to be true, and at our one-year mark of the pandemic, our children are exhibiting more signs and symptoms related to difficulty of constant adjusting. What to look for during school reopening Some signs and symptoms that your child or student may be experiencing mental health challenges related to ongoing changes over the past year include: general changes in mood, lack of optimism, anger and irritability, somatic complaints (i.e. headaches, stomachaches), difficulty sleeping, changes in appetite, sadness, and a general state of anxiety. RELATED CONTENT: See How Our Youth Development Program is Helping its Participants Excel What you can do to prepare for school reopening There are plenty of strategies we teach parents and educators to help prepare your child or student for the continued change and transition from hybrid learning to traditional learning and school reopening. Here are a few of our focal points: Validate: Validate that “the return to normal” is difficult. Many of us have used phrases like “when we get back to normal” for over a year. An 8-year-old learner has made up around one-third of their school career of waiting for this “return to normal!” For our older youth who have been engaging in a hybrid system, they may be experiencing big emotions in the back-and-forth this school year brought. Example: “I know you were looking forward to staying at home. It sounds like you are feeling very disappointed right now with these changes. It is OK to have these feelings.” Prepare: Prepare your child for change and talk to them about how they feel versus assuming how they feel. Be prepared to continue to check in with them as their feelings (and yours!) are allowed to change. Example: “I know you were really excited about going to school 5 days a week. How are you feeling about it now?” Notice: Use your noticing skills to make your child seen and heard. Examples: “I’m noticing when you come home from school, you want to take a nap every day. How are you feeling?” “A few weeks ago, you were very excited about a project at school. I notice you haven’t talked about that recently.” Model: Model how to manage the big feelings and make a point to say how you are feeling and why. Example: “I was really looking forward to seeing my friend for their birthday how we do every year. I am really sad that I am not able to do that. I think I could call her on video chat today and listen to our favorite music to spend time with her instead.” Focus on what you can control and stick to your routine Many of our routines have been flipped upside down this year. But healthy bedtime routines are still a must for your child. Make sure your child is getting enough sleep. Lack of sleep can drastically affect the ability to cope with even minor changes. Create a routine that works for you at home. This could include adding time when the whole family can be together when possible. As we continue with school reopening, we still have some unknowns despite the goal of “returning to normal” fully by the beginning of next year. Continue to be honest with your child in an age-appropriate level and check in about their feelings. Example: “I’m not sure exactly what school will look like next year. What are some things that concern you?” In my career in mental health, I have had the opportunity to read many books on parenting and parent young children myself. I seem to have forgotten to buy a “How to parent during a pandemic” book. I have found that the best advice continues to be build connection and empathy with your child. You are doing a great job during a really difficult time. RELATED CONTENT: Adult & Child Health Receives Kendrick Foundation Grant to Provide Support for Morgan County Students in Response to COVID-19.
ADULT & CHILD HEALTH EXPANDS FOCUS ON PEDIATRIC CARE
INDIANAPOLIS (March 3, 2021) – Adult & Child Health (A&C), a Federally Qualified Health Center (FQHC) Lookalike, expanded its historically behavioral health-focused services into family medicine by opening four health care clinics in 2016 and 2017. Due to demand, A&C Health is broadening its focus to include more services to the pediatric population and Marion and Johnson counties. A&C, operating three primary care clinics in Indianapolis and a fourth clinic in Franklin, recently welcomed Dr. Melissa Collier as Associate Medical Director for Primary Care. Dr. Collier is a board-certified pediatrician who has worked for the CDC and for the Indiana State Department of Health (ISDH). Dr. Collier has extensive experience as a health care leader and a pediatric clinician. “We’re so happy to bring such an experienced pediatrician on board at A&C,” said Dan Arens, A&C Chief Operating Officer. “Dr. Collier is amazing with patients of all ages and her vision for pediatrics integrates well with A&C’s behavioral health and social service programs we have for youth.” Under Dr. Collier’s clinical leadership, A&C Health is accepting new pediatric patients at each of their clinics with additional medical support from a strong team of Advanced Nurse Practitioners. 222 E. Ohio St., Indianapolis: Dr. Melissa Collier and Tracy Moseman, MSN, FNP-C 234 E. Southern Ave., Indianapolis: Dr. Melissa Collier and Jennifer White, MSN, NP 8320 Madison Ave., Indianapolis: Dr. Melissa Collier and Kim Douglas, MSN, FNP-C 1860 Northwood Plaza, Franklin: Dr. Melissa Collier and Hope Lowhorn, MSN, FNP These recent physician and nursing staff additions reflect A&C’s commitment to pediatric care and the organization’s focus on providing affordable integrated health care services to persons of all ages. A&C’s primary care clinics offer a wide range of services to ensure our clients stay on track for long and healthy lives. In addition to pediatrics, A&C’s services include physical health exams, sick visits, chronic conditions, immunizations, medication-assisted treatment for addictions, psychiatric services, on-site lab work, and women’s health services. RELATED CONTENT: Adult & Child Health Awarded $3.9 Million in Grant Funding for Mental Health and Substance Abuse Services Expansion “Adult & Child Health is excited to be increasing our focus on pediatric care,” said Dr. Christine Negendank, A&C Chief Medical Officer. “Children deserve a medical home where care is accessible, family-centered, comprehensive and compassionate. Whole health care for the child benefits not only the patient but also the patient’s family and the community at large.” Adult & Child Health is a community mental health center and Federally Qualified Health Center (FQHC) Lookalike that offers primary care and behavioral health services. We strive for caring communities, where every child, adult and family have the opportunities they need to live healthy, happy, productive lives. For more information about Adult & Child Health programs, please contact Adam Wire, Marketing and Communications Specialist, at 317-882-5122.
