Troubleshooting the adolescent years, by Toronto psychologist

Canada online therapy and counselling

Troubleshooting the Adolescent Years
by Toronto psychologist:

A primer for parents

by Dr. Tracey Vieira
600 Sherbourne St., Toronto 416-295-4112

Adolescence: A period of transitions

Adolescence is a very important period in our lives that spans approximately a decade: Early adolescence covers the late elementary school years (ages 10 to 13), mid-adolescence takes place during the high school years (ages 14 to 17), and late adolescence comprises those transition years into adulthood when individuals may be starting college or university, or, their first full-time job (ages 18 to 20). Throughout this ten year period, adolescents are faced with a multitude of challenges and changes – only trumped in number by the vast developmental changes that take place during infancy. Obvious physical transformations are accompanied by behavioral, mood, and relationship changes that can be very difficult for parents to understand and manage. Moreover, when faced with a son or daughter who may suddenly be very sensitive, argumentative, secretive, socially withdrawn, or not achieving the level of academic success that they previously had, it can be very challenging for parents to distinguish normal “growing pains” from genuine learning, behavioral, or mental health concerns.

A Primer for Parents

The following summaries are intended to provide parents (and older adolescents who may recognize some of these signs in themselves) with indicators of learning, attention, and emotional difficulties that warrant investigation by a professional.

Learning Difficulties

Adolescents spend the majority of their day in school, and while in that environment, they are continuously being presented with new information and evaluated about what they have understood and retained. Many students demonstrate “warning signs” at some point in their school career that they are struggling to keep up with the curriculum. Occasional struggles are to be expected; however, when these struggles are persistent, resulting in students falling behind their classmates in one or more subject areas, or not achieving grades that match their efforts, it is important to consider the possibility of a Learning Disability.

Might your adolescent have a learning disability?

Signs to Look For:

§ Started speaking later than other children

§ Development of vocabulary is slow, and they sometimes struggle to find the words to express their ideas

§ There is a longer than usual pause between a question being asked and providing a response

§ Difficulty understanding instructions or following directions, or, misreads information

§ Difficulty learning or retaining the connection between letters and sounds

§ Makes reading and spelling errors such as reversing letters (e.g., mixing up the letters b and d), inverting letters (e.g., mixing up the letters m and w), or changing the sequences of letters (e.g., reading the word “left” as “felt”)

§ Spells the same word different ways within the same piece of writing

§ Avoids or is very reluctant to read out loud

§ Cannot grasp how to perform math computations

§ Confuses arithmetic signs ( e.g. +, - , x, or / )

§ Has difficulty solving math word problems

§ Weak memory skills, for either information that they see or hear (or both)

§ Relies heavily on memorization

§ Takes time and a lot of repetition before they learn a new piece of information

§ Some awkwardness in their fine motor skills (e.g., holds the pencil oddly, difficulty copying or writing, messy or oddly spaced handwriting)

§ Completes assignments slowly

Broadly speaking, learning disabilities affect how easily an adolescent takes in, retains, understands, organizes, or uses information. They range in both severity and type, depending on which type (or combination) of the processes related to learning are impaired. As a result, even though students with a learning disability are at least of average intelligence, they typically struggle to learn in the traditional way or at the typical rate of peers in their age group. Learning disabilities are generally life-long; however, their effects may vary over time depending on the “fit” between a student’s environment and his or her needs. Moreover, there are supports and strategies that can be implemented to help students overcome these challenges and achieve their academic goals.

Nonverbal learning disabilities are less common and less well known, and they present a unique challenge to parents, teachers, and the students who experience them. A nonverbal learning disability is a pattern of difficulties that arise when a student has weaknesses processing visual-spatial information (e.g., patterns, locations). In addition to struggling with certain academic areas (e.g., math), adolescents with nonverbal learning disabilities have difficulty with athletic activities (e.g., they may be clumsy) and social interactions. Due to their solid verbal skills, their deficits can be mistakenly interpreted as laziness, lack of motivation, or a poor attitude. The collection of difficulties faced by a child with a nonverbal learning disability can lead to social isolation, poor self-esteem, and difficulties with school work.

Attention Difficulties

Over the past several years, Attention Deficit Hyperactivity Disorder (ADHD) has become an increasingly familiar term to parents – in some instances, because periodic lapses in their child’s attention at school have led others to presume that is the appropriate diagnosis. ADHD has previously been very aptly compared to nearsightedness: Adolescents with ADHD just do not focus very well. That said, a periodic loss of focus at school can reflect many issues, including learning difficulties, stress, anxiety, and a number of other possibilities. To make matters more complicated, ADHD comes in all shapes and sizes, so to speak, and while some adolescents may be the ‘daydreamers’ whose focus drifts away in many situations, others may be restless, fidgety, and impulsive, and a third group of adolescents will present with a mixture of these features.

Might your adolescent have an attention problem?

Signs to Look For:

§ A tendency to lose focus, tune-out, or ‘drift away’ in many situations (e.g., not solely at school)

§ Trouble sticking with one task until it is complete, especially when the task requires mental effort

§ Difficulty with organization – their backpacks, bedrooms, and desks may be a mess of crumpled papers, and they may show up for class or other situations without the appropriate materials

§ Excess energy – they prefer to be ‘on the go’, and if they must sit still, they may click their pen, bounce their legs, shift, or engage in other restless behaviors

§ Time management is not their strength, so they are often late or do not finish a task on time

§ Impatient when waiting their turn or standing in line, and they may have a tendency to interrupt others by blurting out a thought or answer

§ Trouble with remembering, planning, and putting their creative ideas in action

§ A history of being called “preoccupied”, “unmotivated”, or “not working up to their potential” at school, largely because of inconsistent grades (often in spite of very good efforts)

§ Irritability and a tendency not to show restraint when frustrated (e.g., react now, think later)

§ Perplexing ability to focus on something very stimulating, engaging, or physically demanding (e.g., video games, television shows, playing sports)

Emotional Difficulties

Adolescents present with a wide range of emotions; however, two of the most commonly heightened emotions during adolescence are anxiety and sadness.

Anxiety

Anxiety is a normal part of life, and as adolescents struggle with the competing needs to become independent from their parents while also facing many life challenges for which they need parental support, some fear and nervousness is inevitable. It is when these fears become too extreme and start interfering with an adolescent’s daily life that parents should consider seeking some assistance. With your son or daughter’s worries in mind, parents can ask themselves questions such as: Are these worries taking up a lot of my child’s time and energy? Are the worries interfering with school performance? Is my child avoiding, participating less in, or deriving less enjoyment from activities because of these worries? Are these worries affecting my child’s relationship with me, other family members, or friends? It is when parents recognize that anxiety is impacting their child’s life in one or more of these ways that action is required.

Anxiety disorders are the most common type of psychological problem during adolescence; however, anxiety is not the most common problem among adolescents who ultimately receive psychological services. There are many possible explanations for this discrepancy, including that parents may feel that the anxiety is consistent with their child’s otherwise shy personality, people may not want to make a “big deal” out of an adolescent’s worries, and these adolescents may not stand out in class as having a problem when compared with angry or otherwise disruptive students.

Is your adolescent’s anxiety a concern?

Signs to Look For:

§ They can be described as a “worrywart”, worrying about many problems that may not even be within their control (e.g., finances, stories on the news) and anticipating problems before they have even arisen

§ They describe thoughts that centre around some type of danger or threat (including non-safety issues, such as the threat of embarrassment in front of others)

§ They require a lot of support and reassurance to try new activities, or in some instances, continue with activities that were not a challenge before

§ They appear to be less focused and more forgetful, particularly in school

§ Withdrawal from activities, including not wanting to participate in extracurricular activities that they usually enjoy, not participating in class (or not wanting to attend school at all), and avoiding places where they will have to interact with people

§ Unusually clingy behavior – they are not comfortable when they are not with you, they become agitated when you need to go somewhere without them

§ Physical complaints that are not due to an actual illness, such as headaches, stomach aches, nausea, or tiredness

§ Disturbed sleep (e.g., having trouble falling asleep, waking up frequently, or nightmares)

§ Irritability or tearfulness

Depression

Sadness or depression during adolescence can also be difficult for parents to recognize, particularly given the general moodiness that is quite common among teenagers. Moreover, adolescents face life events including parental divorce, deaths of loved ones, deaths of pets, illnesses or injuries, or the loss of a romantic partner that can lead to periods of grief that resemble depression. Added to these challenges is the reality that adolescents are not always very forthcoming with their parents about their feelings. It can be tempting to deem it “just a phase” when an adolescent becomes moody, withdraws from family members (and in some instances, friends), and isolates themselves in their room. Sometimes it is just a phase - a ‘stormy’ part of the developmental process; however, the possibility that it is not a phase warrants consideration in light of the potentially serious consequences of untreated depression. Important factors when making the determination of whether an adolescent may require professional intervention include whether there is a clear change in mood over several consecutive days (e.g., at least two weeks), and the change in mood is impacting the adolescent’s daily functioning in some way.

Might your adolescent be struggling with depression?

Signs to Look For:

§ Sadness or low mood on a daily (or almost daily) basis for a period of time

§ Irritability and anger with greater frequency than is typical (either in addition to, or in place of sadness)

§ They no longer enjoy many of the activities that they usually do

§ Low energy, and may spend a lot of time lying around on their bed or the couch

§ Overeating or oversleeping (although, some adolescents may eat and sleep less than usual)

§ Difficulty making decisions, even relatively simple choices such as what to wear or what to eat

§ Very critical of their appearance, abilities, or performance in activities

§ Feelings of hopelessness

§ Engaging in self-destructive behaviors such as cutting themselves, drinking, using drugs, or in some instances, talking about ending their life

Taking Action: Seeking Psychological Services

No two adolescents are the same; therefore, this information is intended to highlight broad similarities among adolescents struggling with these difficulties rather than provide an exhaustive list of all possible symptoms. Certainly, learning, attention, and emotional difficulties do not necessarily occur in isolation and many adolescents present with symptoms that fit within multiple areas, or, are struggling with overlapping difficulties. If you feel that your son or daughter may benefit from support or further investigation of their functioning in any of these areas, a registered psychologist can be of assistance. A psychologist who works with children and adolescents can help you to make sense of your child’s difficulties and provide guidance and recommendations to promote healthy functioning and well-being.

Dr. Vieira is a registered psychologist for children, adolescents, and families. She has provided psychological services in schools, community mental health agencies (Centre for Addiction and Mental Health, Child and Adolescent Services of Hamilton), and hospitals (The Hospital for Sick Children, Sunnybrook and Women’s College Health Sciences Centre). She currently provides consultation, assessment, and intervention services for clients through her office in the Rosedale Medical Centre, as well as assigned schools in the Toronto Catholic District School Board.

To learn more about Dr. Vieira’s services, you can visit www.anopendoor.ca or contact her office at 647-295-0555.

References

Fonagy, P., Target, M., Cottrell, D., Phillips, J., & Kurtz, Z. (2002). What works for whom?: A critical review of treatments for children and adolescents. New York, NY: The Guilford Press.

Hallowell, E. M. & Ratey, J. J. (2005). Delivered from distraction: Getting the most out of life with Attention Deficit Disorder. New York, NY: Ballantine Books.

Hallowell, E. M. & Ratey, J. J. (1994). Driven to distraction: Recognizing and coping with Attention Deficit Disorder from childhood through adulthood. New York, NY: Simon & Schuster.

Koplewicz, H. S. (2002). More than moody: Recognizing and treating adolescent depression. New York, NY: The Berkley Publishing Group.

Learning Disabilities Association of Ontario. (2010). Learning Disabilities Association of Ontario: LDAO working description of learning disabilities. [On-line]. Available: http://www.ldao.ca/aboutLDs/introduction_to_LDs.php

Levine, M. (2002). A mind at a time. New York, NY: Simon & Schuster.

Mamen, M. (2007). Understanding Nonverbal Learning Disabilities. London, UK: Jessica Kingsley Publishers.

Muskat, B. (2004). What is a Learning Disability: Helping children and youth. (Available from Integra, 25 Imperial Street, Toronto, Ontario, M5P 1B9).

Rapey, R. M., Spense, S. H., Cobham, V., & Wignall, A. (2000). Helping your anxious child. Oakland, CA: New Harbinger Publications, Inc.

Steiner, H. & Feldman, S. S. (1996). General principles and special problems. In H. Steiner & I. D. Yalom (Eds.), Treating Adolescents (pp. 1 – 41). San Francisco, CA: Jossey-Bass.

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