Transcript

Rob

It is a question parents continually ask themselves. How can I instill my children with confidence and support their emotional well-being? To help answer this question and provide parents with guidance for today’s uncertain world is Hidden Shah, the founder and clinical director of Eden Behavioral Health in Illinois. We look forward to hearing your thoughts on this wide-ranging and engaging conversation. Kinect great to meet. Thank you so much for making the time for us. Could you introduce Eden Health to us and give us a little bit more about your background?

Hidayat Shah

I’m a child psychologist. I’m licensed in Illinois here in the United States. I founded Eden Behavioral Health last year and where our primary goal is to provide tailored solution, focused care to children and adolescents, and we also work with some young adults. Clinical background began in inpatient pediatric psychiatry. Was working intensively with young kids who? Had acute mental health needs and after that I’ve specialized in supporting children with autism, ADHD and intellectual disabilities, and I’ve also served in various community mental health settings. So in Chicago and W Garfield Park, working with substance abuse, that was a lot of the community work that I. In my own community trying to adjust. Connect parents and children to resources and in just the suburban area where I live. And it’s like the the combination of these diverse experiences has helped shape the collaborative approach that I take in my own practice. It’s super family. The work that we do at Eden Behavioral Health, it’s super solution focused because I want to make sure parents are confident in the way that they are parenting their special needs children, because I always tell parents that special needs children need special needs parenting. And I try and. Them the strategies that they need to do that and you know the reason I always take that. Approaches because you know, we believe that when parents and caregivers are actively involved, children feel more supported, and the therapeutic approach improves just so much more.

Rob

That’s. I love that the special needs approach. That’s a great way to phrase it. I’m wondering, in your clinical practice, when you meet parents for the first time and they’re they’re coming to you for assistance, is there sort of a misconception that you you see quite often with us thinking of new parents especially, but perhaps parents that have their second or third? With exceptional. Through a misconception that you often see with parents.

Speaker

Yeah.

Hidayat Shah

I think a good way to explain this is the story that the parents kind of find themselves through. And how that that starts? So when I get a call from a parent or a parent is trying to schedule an appointment with any with any child therapist, not just with me. What’s most likely happening is that there’s school challenges, their sensory issues. There’s. Tantrums, meltdowns, their, their have. They’re struggling, eating. They’re struggling with anxiety, there’s compulsive behaviors. Activity they’ve read the books. They’ve looked at the blogs. But this tools that they’re doing, that they’ve learned from those resources aren’t really working and they need a bit more specialized. So that’s when they reach out to, you know, mental health professional. And they’re like, OK, let’s we need some help here to understand what’s happening with our child. We can we can best. Them with me, that’s. Process is unique compared to a lot of other mental professionals where the first appointment is always parent only and we are just I’m collect. Goal is to collect as much background information as much as possible. I want to understand everything that this child is experiencing. Want to go through mental health symptoms? Going to go through executive. We’re going to try and even help label some of the behaviors that the child is experiencing and then with the parent I create treatment goals that touches on the concerns that they’re that they’ve come to me with. Ranges that could range from a bunch of things. If it’s ADHD, which is an executive functioning disorder, we go through, OK. Are the what are the executive functioning? Deficits that are happening. Happening and what goals can we create to start developing those executive functioning skills? From then on, the child starts coming to me one-on-one. I keep the parents updated and as soon as I start to understand the child’s behavior within the appointments, that’s when I start giving. Parents, the very step by step things that they need to be doing at home to emphasize on the work that we’re doing.

Mukund

When you says special needs, what things do you see?

Hidayat Shah

So you know, I’ve worked in a bunch of different areas now, so I’ve worked in. I’ve worked in kind of like the outskirts of the city, and I’ve worked in very much suburban areas, so I I’ve gotten to see it quite a mix of kids and the interesting there is that they all have. Own unique. So when I was in Forest Park working in in inpatient psychiatry. I was seeing very high acuity kids, specifically their risk of harm to others and risk of harm to self like there was there was harm being done there and that’s at the very high end of mental symptoms. And that’s what gets kids admitted into inpatient in the 1st. So that’s where I was seeing there. But since moving to the suburbs and I. Now where I practice and I used to practice in Naperville, the challenges that I see there are different. Not so much the risk of harm to. For others, it’s more so school challenges and you know the risk of harm to self and others does come with school challenges. But. The parents are more so focused on how do I reduce kind of these like more mild to moderate behaviors in a classroom. Do I kind of understand how my child is thinking? Do I? Do I change my own parenting? So the kids that I see now are I’m able to help in an outpatient setting, and that’s usually ADHD, anxiety level 1 and level 2 autism. Yeah, that’s what I’m usually saying right now.

Rob

On the topic of anxiety, the CDC said that about 10% of children 3 to 17 are showing symptoms of anxiety in a recent. And I’m wondering what is the approach from a sort of tools point of view with a child that’s experiencing anxiety, whether it’s educational anxiety or societal anxiety. What does that initial approach or tools that you would?

Speaker

Yeah.

Rob

Childhood with exactly.

Hidayat Shah

So I like to break down anxiety in two ways. Actually we. Kind of do it in three. 1st is how can we can the anxiety be redirected if the anxiety can be redirected. I help the parent label the behavior and then we kind of redirect the child to a coping skill and then with enough prompting the child can learn to emotionally regulate. The other way we can do it is we take a look at the parenting side. What are the unhelpful accommodations that the parents are doing and often times kids are more aware of the accommodations that their parents are doing more so than the parents even are. I see that clearly when I’m working with them, because when I do an accommodation removal plan, I’m taking. The parenting behaviors that need to be stopped or reduced to help the child start to deal with.

Speaker

This.

Hidayat Shah

And I always ask the kid I was like, hey, like, what do you feel like your parents are doing in this certain situation? And they give me such a longer. Than compared to the list that their parents sent me. And then there’s the other side of it. Where and this kind of goat gets into the obsessive compulsive disorder territory. OCD air. And you know, there’s anxiety attached to that issue. It’s a unique type of anxiety characterized by obsessions and. Right. Compulsions are just behaviors that we can’t stop doing, and it reduces the distress that’s caused by the obsessive thought. But with that, what we’re going to do is we’re going to expose a child to. Higher and higher levels of anxiety that’s related to their obsessive thought, so that they can start, you know, realizing that. The response that I have, which is this compulsive behavior is is causing me short term relief and if I can understand that my brain is causing noise in a situation that is not dangerous, I can just like sit with that anxiety a little bit longer.

Speaker

Replay.

Hidayat Shah

Change my response and understand that I don’t listen to noise and I should be listening to signals, which is my brain is telling me danger when there is real danger and not to noise which is my brain is saying danger when there is no danger.

Rob

How does that when you see a child come in with that level of anxiety? It must be interesting from a step by step point of view to see them from 1:00 appointment to the next. You you’re sort of you. As you said, you’re sort of separating the anxiety, explaining to them a little bit about what’s causing that anxiety and then they get to realize that tangible relief. Is there something that you would notice from 1:00 appointment to the next? It sort of a six month, 12 month. Like, how does that work in terms of like a time frame for treating something like anxiety or something more complex like ADHD, which obviously has interactive components?

Hidayat Shah

Well, every child is so, so unique. If a child comes in and they’re. On the very much the mild side of things and their symptoms aren’t really challenging them on a day-to-day basis. I can teach the parents some basic prompting and redirecting skills, and usually in six to eight months the child is is living a life where they can. Themselves a lot more. But if a child is coming in. There are just. Tantrums and meltdowns happening all the time at school and at home. We need a more thorough plan at that. We need, especially if things are happening at school, we need to provide school resources, which usually come from an IEP or a 504, which are just school resources like extra time on a test or going to a different room when they’re feeling overwhelmed, just resources to. And when it comes to things on the more severe side, where prompting isn’t going to help the child, that’s when I see lasting into the year. There’s kids that I’m that I’ve been seeing from the very first day that I’ve started. It’s been probably 4 close to four years now, and they’re they’re kids that I’ve been seeing for the a good chunk of that time. The whole goal here in that time. Is giving parents the foundation so that when they are done with me working with a child, they’re able to handle all of the challenges that comes with anxiety or ADHD without having to come back to me. And of course, you know, they can always come back to me. I want them to feel confident in what they can do and generalize the skills across a variety of situations where they know they’re just confident in their own parenting. Abilities. So one of the one of the first things that I always start with and this is where a lot of my strategies start from is. How do we label a child’s behavior and child’s behaviors usually fall into one of four categories, and that’s access to an item or the way something is done? Process access. So there’s access. There’s attention, which is to a person or a group of people. That’s access. Attention. Than their sensory so sensory behaviors and the common one with ASD or autism is the one that people might often see as like the hand flapping, the other sensor behaviors that kids might see is rubbing things or pulling things or proprioceptive input, which is pressure, and this could. Be avoided. Or this could be seeking behavior in terms of I like the sensory input and there’s other behaviors that are I don’t like the sensory input. Then there’s escape, which is the removal from a task or situation. Let’s put that in context of. So let’s say a child is in the classroom and he keeps getting out from his desk to walk around now. Teacher is going to look at that child and say this child is. He’s not doing any of the homework that I’m telling him to do, and then the parents are going to look at it. Well, like, are you teaching him properly? Like what’s going? He hungry? What? And then the school is just going to be sending emails and emails to the parents and saying, hey, your kid keeps getting up from the desk. Can you, can you please, like, feed him? You please let him give him some out outlet. Teach him some regulation skills, but none of that is going. Work if. Know why the behavior is happening? Let. One by one, the child could be getting up from his desk because of access. He’s trying to get something from his backpack that he needs. Maybe it’s even something to regulate. So he can complete the task, but he ends up. In trouble for. And then he never ends up getting the thing from his bag in the first place. That’s access. And if it’s access, we wanted to provide a healthier way of receiving his. Or. And that’s what I mean by redirecting behaviors. Just giving the child a healthier way of receiving their wants or needs. And then there’s attention. If is the child getting up from his desk because he’s trying to make people. If that’s the case, then we should move his. Don’t let him sit in the area where his friends are. Have him sit closer to the board. Him sit closer to the teacher. That way there’s less behaviors related to that attention seeking.

Rob

Just just I’m not on that. Is. Is there a sort of a risk that say you move a child when they’re, you know, with their friends and you moved on to another place? You then do. You then risk the child saying becoming more oppositional? Example do. Do you then risk that? And then how do you deal with that if the child? Do you then explain to the child we’re doing this for this reason and how does that process EVOL?

Hidayat Shah

Yeah, I’m a big fan of telling the. What we’re doing?

Rob

OK.

Hidayat Shah

If the child is aware, that’s just so much. With what’s happening, and I also asked like, why shouldn’t a child be aware also in the in the in the case of removing accommodations if the child doesn’t know that the parent is going to stop doing certain things?

Rob

100%.

Hidayat Shah

The behaviour is obviously going to increase. But to your point though of. To your point though of is there going to be some negative things happening because of this resource? Or intervention they’re putting on the. So there’s this thing that happens where during any transition period or when. The external environment is changing I I say 6 to 8 weeks. It’s called an extinction burst. And what that means is. A child’s negative behaviors will increase during this transition period, but that’s a temporary thing that happens. It usually normalizes once a child is like, OK, the transition period is over.

Speaker

OK.

Hidayat Shah

Kind of been accustomed to the new thing, and that’s that’s the one thing that I’ve seen. That really holds parents back is I. I changed my behavior for the for the good, but my child is getting worse. But we have to remember that there’s an extinction. That is most likely going to happen and that we have to stay consistent with the parenting behavior. We can see the behaviors normal again.

Rob

I really appreciate you explaining that because from a child’s point of view, trying to understand the logic of these sort of actions, it must be interesting for them to sort of go through that process and then you, as you said the parent is saying, well, hang on. Second, my child is not. They’re getting worse from this behavioural standpoint, so I really appreciate you explaining the science behind the process and that’s really. Putting it.

Hidayat Shah

Yeah. You know, a lot of the work with kids is educating them. The majority of the work during Sessions is with the children. Wild, but I also have to remember that the parents are my patients just as much as the child is at the end of the day, the parents are the one who are going to be making the changes that they need for the child. Going back to that child. Who’s getting up from from his desk if the child is getting up from his desk to fulfill some sensory need in his legs because of. Activity I’m going to teach the parents. Hey, when he’s at home, give him some stretches or some activity that he can do so he can get this energy out of his leg so that when he’s in school, he’s able to focus a bit more. Or if it’s es. From a task. And you know, is he struggling with reading or writing? He have dysgraphia or dyslexia. Does he have issues with his hands? Like fine motor. What is leading to that escape behavior? And the parents are the ones who are going to be practicing, you know, do they need to do some occupational therapy at home to improve the fine motor skills so that the child? Sit down and not escape the task that the teacher is giving. So you know the parents are the ones who are implementing the interventions that I’m telling them to do.

Rob

I was also wondering, we speak a lot on this podcast about the role of technology and society in. I’m just wondering whether the role of cell phones and sort of distractions from technology, whether that has any impact on a child psychology and what you’ve noticed just from your general day-to-day experiences with your.

Hidayat Shah

You know, across the board. When screens are reduced or removed, there is improvement in the child’s behavior and you know there’s this other question that I get too is do screens cause something like ADHD? And that is that is very much not the case. I I like put it in context of senses. Like a sensory based. We’re all sensory based humans. We’re just like, just naturally occurring sensory beings, so. When it comes to screens, it that is a large sensory experience of those child’s having right like their sounds or slights, there’s a lot of movement happening. They might be eating something, so that’s adding oral input into their visual experience.

Speaker

No.

Hidayat Shah

So when a child who has sensory needs and is having this over stimulation happening, there’s going to be dysregulation. And that that dysregulation doesn’t necessarily mean it’s ADHD. So what I like to tell parents is. Screens don’t cause ADHD. Screens can make behaviours look like it’s ADHD, when it when it’s really not. Especially when it when it’s the case of my child suddenly became like 100% better when the screen was removed. Obviously the child is going to be better because you’re removing a sensory input that was causing overwhelm. There is obviously going to be improvement there and especially if that’s the case then you know good on you. You learn that your child is getting overwhelmed by this. Now you can parent a little bit better, but your question of how are screens impacting child? I would say that it’s overwhelming. It’s. I also see the case of parents are busy. Know they’re. They’re just doing like lifes stuff. And a lot of times they’ll resort to the. Because how else are they going to keep the child busy? And that’s no fault of them. They’re also trying to get through their day-to-day and then. What else are kids going to do? Kids are already in a ton of activities. How many activities are you going to put them in? There’s going to be like an hour a day where they’re just going to be completely bored out of their minds and that’s why limits are good screen time limits. I think the better way to be describing that is. Get a child to listen to the screen time limit. And what I what I always tell parents is practice giving up the item. So again, let’s go back to our back to our access attention sensory. Right when you pull the iPad away from your child, the behaviour that they’re most likely going to engage in is access behaviour. They’re going to tantrum outburst and yell because they want access to the iPad again. So tell the child when am I going to get the iPad again? Show them visually that hey, look at the calendar. This is when you’re going to get the iPad again. Add in a visual timer for them to see the countdown of when they get the iPad again. That’s helping them meet their need in a healthier way instead of tantruming and screaming, they can look at the visual timer and say oh, I’ll get my iPad again here at. This time. So practicing and that’s also an example of redirection. So practicing giving away and adding a way for them to. To receive their need in a healthier way.

Rob

Also, I read 1 of the posts on your website about the use of toys and the kids that have a bunch of toys and you take away a few. You can help with a child’s. I. I might have misunderstood the actual the scientific logic behind it, because I don’t quite understand it, but the idea of. Having a child with a lot of toys. If you take some some of them away and limit their use of toys, you actually help them with their creativity and sort of creative thinking. I was interested in that idea of. Obviously we live in a society where consumption is a huge. Children have basically every, as we talked about technology, they have access to all these different options in terms of toys and different stimuli. You speak. A little bit about childhood creativity and the role of parents in in encouraging that and what. Steps they can use, sort of, encourage a child’s creativity.

Hidayat Shah

My office is filled with toys and. It’s kind of overloaded. So when kids come in, they’re usually bouncing around my office. Have AI have a foam pit. Have a basketball hoop. I have art stuff. Have board. It’s a lot of options for kids, and they’re just like transitioning so fast. Before they really let themselves experience 1 toy or item in the 1st. So what I started doing was rotating out the toys that I had so I would keep a few away and I would keep a few there and then once I see children get a little bit tired of the toys that I have, I’ll switch them. And it sparked some new joy again. But the idea is that when children have fewer. Toys. They’re more likely to engage in imaginative play. You know, we want to create narratives. We want to experiment with different roles and using everyday objects in inventive ways or not even objects. Just like different toys in different ways is how we get the brain working. And this speaks also to the point of. Kids are engaging in imaginative play if we want them to develop the skills that the parents want their child to have, is it also forces us to join and play with them? Because when we join and play with their child, we automatically add a layer of imagination that. Not used to. And that’s when the real magic. They start to develop the ideas that my parents that my parent has, they start. Start to model. We can role play better to teach these skills. And it’s always surprises me that, you know, companies. Like love everywhere, where they send those like kits to to. Yeah, I’m sure you guys ever heard of. The mail delivery kits, but, and they’re marketed as this, this developmental tool for kids. But the the real developmental tool is literally parents playing with their kids. That that’s all it is. The more the more, the more toys you have, the more distraction that’s. But when you reduce that toy, you can engage a little bit better, and that’s that idea there. There’s also. It’s also studies that show that open-ended play, like using blocks or art supplies. Fosters things like cognitive flexibility and problem solving curitivity, so having fewer toys also encourages children to explore their environment a little bit more deeply, which is, you know, to that point of I see kids moving around. Too fast and just develop a stronger attention span for the toys they do have.

Mukund

And changing gears a bit, right? Just a question on. How parents can address issues happening around them? What I’m asking is especially. Age when they turn 12/13/14, when they are slowly getting into the young adult phase. How can parents explain what’s happening, especially in today’s political, economic, social environment? Have you had any questions related to that on how could parents address that issue?

Hidayat Shah

Wait, so I want to make sure I’m understanding the question. Can you say that? I want to make sure I’m understanding it.

Mukund

Yes. So just how can? Parents explain situations like the political landscape or social landscape that’s happening currently in the US. And they translate that into something that kids can understand. They’re not 100% plugged into what adults are going through. At the same time, they’re not kids anymore.

Hidayat Shah

Yeah, usually the big topics that parents ask me is like, how do I talk about war with my child? How do I talk about death and? And how do I talk about Internet safety from predators? Do I talk about those things? And I tell parents to watch child base content with your child, like related to those topics. There’s actually a really great resource on this. There’s a there’s a. It’s called a kids book about. They also have a. It’s called a kids book about podcast and what they do is they take these big topics that parents don’t know how to talk about. And that’s everything from. Environmental challenges and space and death and healthy Internet behaviors and strangers. And you know all these like crazy, wild topics that we don’t know how to tell a child. It’s important for them to know. I tell parents just go through their list of resources and you know, just absorb the content with your child. Ton of kids. A ton of kids love reading, and if it’s not that specific book or podcast, I’ll send books related to the themes that they want to talk to. About. Child and then parents will end their nighttime routine. What they’re doing already is they’ll just read a book. That touches on the themes and in that way they’re not addressing it explicitly, but. They are telling a story to help a child understand it, and in the way that is best for them, because if you’re going to just tell them one-on-one like hey. There’s a new president coming in this and this is happening. War going on like child is going to. Like I. Don’t know what that means, but if you put it into their world, if you enter a child’s world through friendly child content that is already geared towards those themes that you want to talk to your child.

Mukund

Right.

Hidayat Shah

About. That’s how you want to start giving. Information, yeah.

Mukund

Relevant in. What’s relevant to? So this gives that association. Yeah, makes sense.

Speaker

Yeah.

Rob

Yeah, I was thinking about the the context of the communication tools that that you’ve talked about and and it feels like making that connection between the parent and the child and speaking to the child. In a way that they understand it at the age group that they’re at and the level, they understand that that seems to be a crucial element of what we’re talking about. Seems to be giving the context that the child understands, helps them then grow from that sort of standpoint is that is that correct?

Hidayat Shah

Yeah. And parents, you know, like parents are always learning like, that’s the one thing that I just have seen. They’re open to learn. Willing to learn. I I have never had a parent that doesn’t take my feedback. And I try and always give it in a healthy way and I I’m saying like it’s always in benefit for them and the other big point that I bring to parents is when you can enter your child’s. You’ll. Get much less friction, so if I. A child to put away all their. I’m immediately asking the child to enter my adult world, but if I if the child is painting and there’s blocks over there that I need them to clean up if I join in in the me joining in on their world is just showing my interest. What they’re doing? I can ask them like, what are you drawing?

Mukund

Or.

Hidayat Shah

I can speak towards the effort that they’re engaging in, or I can provide information to some action that they’re engaging in, and that’s me entering their world and just by doing 5 seconds of showing my interest, I’m entered their world and now I can say, hey, can you? Up those blocks. So instead of thinking it. Of acknowledging feelings. Think of it in terms of enter your child’s world and now suddenly instead of saying, oh, I see you’re having a good time right now, which I know a lot of parents do. You know, they just don’t want to find themselves repeatedly saying the same phrases. Think of it in terms of enter your child’s world show interest and then state the task. And now suddenly you’ve built an emotional connection without having to say, hey, I see you’re having a. Time right now, and now they’re a lot more likely to complete the task.

Rob

That’s a fascinating way of looking at it, but you’re flipping the script a little bit in in terms of, rather than being didactic and telling the child exactly what to do, you’re sort of engaging with them within the context of their own mind and what what they’re Eng. With and that’s a great way to sort of phrase things. I really appreciate that. And so this has been a very tight ranging conversation. I know we’ve touched on a bunch of different. Right now I’m just wondering if we could sort of sum up the the tools that we’ve talked about today and some of the lessons learned that you sort of give maybe like 5 or 10 main points that parents could take home for this conversation. How can they better engage with their young child and? Some of the. Things that their child’s experiencing.

Hidayat Shah

Yeah, the the biggest thing that you can start doing is have some foundation to your parenting. And the foundation is a really good way of doing that is start labeling your child’s behavior. Is it? Is it a tension? Is it escape? It sensory. It. Is it access behavior? So what is? That’s access attention sensory escape. Start labeling it, because if your child is engaging in sensory behav. And you’re attending to it based on access? Not going to go anywhere. So just by the simple fact of labeling the behavior, you’re going to tend to it differently. Labels are not only for negative behaviors, they’re for positive behaviors also. So that’s one point. If you want to better understand your child, to start labeling the behaviors because it’s automatically going to change the way that you pair. The other. Is if you are busy on ensuring that one to two hours of constant effort that it to have that emotional connection with your child. Just enter their. Show interest. What they’re. Do that 10 to 50 times a day. You know it takes 3. Just make a comment on what they’re doing, seeing, hearing, wearing, eating point to something and that’s entering their world and it takes literally 3 seconds. The other thing is this is more so on the on the parenting side rather than really super child focused and it’s the accommodations if if you feel like you’re doing something that bothers you, you know, talk about it with your partner and. See how you can start reducing or removing that. But before that’s done, tell your child hey. I see. That your mom and I have been doing this thing that hasn’t really been helping you. We know that we can do better and we know that you can do better too, and because of that, every Saturday or Sunday we’re going to start adding things to a calendar. So that way on weekends when you ask us what we’re going to do today, we’re going. Talk about. So you know. It’s we never have to jump into anything, but we can start to add systems that remove and reduce the unhelpful accommodations that we feel like we are doing. So the labeling, the behaviours, showing the interest, and if something bothers you, you can be systematic about removing or reducing it.

Rob

That’s. We really appreciate your time. This has been so enlightening for. I’ve learned so much in just a short time talking with. We’d love to have another wide-ranging episode with you on different topics and we always appreciate someone with your expertise coming on and sharing. The tools and takehams with us. You so much.

Hidayat Shah

Yeah, of course. Thank you for. You for having. I love talking about. I can keep going in forever if parents do want their own questions answered. I do have a newsletter on my website. Completely. It’s called a parent club. And you parents can register for it at edenbehavioralhealth.com. It’s just at the bottom of the web page. Every month. Send we answer parent questions and we send insights, actionable things that parents can do in very relevant things.

Rob

edenbehavioralhealth.com.

Mukund

Yeah, we. We will include it in the podcast episode link.

Rob

Yeah, we’ll put a link right there so people can click on it and learn more about eating behaviour health. You so much. This has been fantastic and it’s been really enlightening for us. Thank you again bye for now.