How do I sign my child up for day treatment

In order for us to determine if our treatment services will meet your child’s specific needs, each individual or family who is interested in participating in our treatment completes a telephone screening with a member of our admissions staff.

The screening may take from 30 to 60 minutes. There is no charge for this screening, and the information is confidential. A parent/guardian may provide information for prospective patients under the age of 14.

Rogers Memorial Hospital – Milwaukee
11101 W. Lincoln Avenue
West Allis, WI 53227
414-327-3000
Fax: 414-328-3737

Map and directions

Rogers Memorial Hospital – Kenosha
9916 75th Street
Kenosha, WI 53142
262-942-4000
Fax: 262-942-7740

Map and directions

Rogers Memorial Hospital – Brown Deer
4600 Schroeder Drive
Brown Deer, WI 53223
414-355-9000
Fax: 414-355-9665

Map and Directions

The holidays are generally thought of as “The Most Wonderful Time of the Year”, particularly for children. We associate Christmas with gifts, Santa Clause, Christmas trees, and big family meals. Unfortunately, many aspects of the holidays serve to remind foster children of what they don’t have, what they never had, or what they are longing for.

Foster children, of course, miss their biological families during the holidays. Most children have secret landmarks in their mind that serve to keep their hope up – for instance, children may tell themselves “I’ll be home by Christmas” – and when those landmarks come and go and the child is still not home, there is often a great disappointment that gets expressed behaviorally. To add to this, children may be promised lavish gifts by biological parents at visits. These promises are not always met, which, of course, leads to more disappointment.

For many foster children, Christmas traditions are celebrated for the first time when they are in foster care. While they may enjoy putting up a tree and getting gifts, it can also be very overwhelming. Keep in mind that children are almost always loyal to their biological parent, no matter what abuse or neglect they may have suffered at their hands. To enjoy Christmas at a foster home can feel like a betrayal – and this “betrayal” can elicit feelings of guilt and shame. The child may feel guilty that they are enjoying themselves while their biological parent suffers. Many foster children worry about their biological parents more than they let you know – keep this in mind when their reaction to your holiday traditions is different than you expected.

Foster parents often want to “make up for” the things their foster children have missed out on in their past. Avoid the temptation to over-spend and over-buy to make your child’s Christmas a happy one. Too many gifts can be overwhelming for children who are used to having very little. Many children in foster care carry a lot of shame, and may not feel “worthy” of the gifts they are given. In these situations, the feelings are almost never expressed verbally. It is more common for the gifts to be broken; for the foster family’s efforts to be sabotaged.

Rather than lavishing your children with gifts this year, make efforts to teach them the values conveyed in the “Spirit of Christmas.” Encourage them to pick a toy for the “Toys for Tots” bin and talk about the importance of giving. Let them choose small gifts for their foster and biological family members. Encourage them to make Christmas cards to send to their loved ones. Talk about your family’s traditions while you prepare your meals, wrap your presents, and trim your tree. Ask them how their biological family celebrated the holidays and what traditions they would like to carry into their future. Talking about the events at Christmas and asking questions can help your child to verbalize feelings about not being with their biological parents over the holidays.

Above all, keep your expectations realistic. Do not expect a “perfect” holiday. Do not expect a perfectly-behaved, very grateful child. Even our biological children can disappoint us when we expect gratitude. Your foster children are likely to have a lot of mixed-feelings this holiday which is likely to be reflected in their behavior. Carve enough time and space into your holiday schedule to talk these things through and normalize them with your foster child and with your extended family. This Christmas, give your foster child something they never had – but don’t make it something that comes in a pretty package. The true spirit of Christmas exists among and between us. And it is not something that can be wrapped.

The key to finding the “right gift” for a child with attention deficit hyperactivity disorder (ADHD) is as varied as the child. A little time invested in learning about the child’s specific interests and strengths will help you discover a good match for any child. There are also many hobbies or crafts that emphasize a child’s creativity and make good gifts for children with ADD/ADHD.

Some things to keep in mind

ADD/ADHD has nothing to do with intelligence. Although some children may show signs of social immaturity as a result of their ADD/ADHD, intelligence is not affected. Children with ADD/ADHD many times are above average in intelligence, but may sometimes have difficulty in translating that intelligence to the outside world because of their rapid thoughts.

• Children with ADD/ADHD are just that: CHILDREN.
• Every child has a unique talent and ability and if properly nurtured, will allow the child to succeed and thrive. Many children with ADD/ADHD are extremely creative.
• Children with ADD/ADHD do not want to be considered “different.” They want to fit in with their peers, play the same games as their peers, and be accepted for who they are. Focusing on the positive attributes of their personality will help them to feel secure and confident.
• Gifts should focus on the positive aspects of a child’s personality, rather than trying to build upon the negative or underdeveloped aspects.

Finding the passion within

Keeping the above in mind, take some time to determine the child’s interests. Many children with ADD/ADHD hyper focus on a certain aspect of their life. For some children it may be art, for others music, some athletics. Find out what motivates the child you are buying a gift for. Let go of the traditional gifts for a particular age level and look at what passions this child has. For example, many boys, between the ages of 3-10 love cars, trucks and trains. However, these gifts are not necessarily what every boy that age loves. Giving a gift of a beautiful truck to a child that has no interest in such things can be detrimental. It can cause stress to the child, making them feel shame that they do not find the same joy in the truck as other children their age. They may feel they should love the truck, but just do not and that there is something wrong with them for not liking it. The “giver” of the gift feels the child is unappreciative and selfish, causing stress on the relationship between you and the child.

Taking the time to watch the child in play can help. What holds their interest for more than a few minutes? Do they play quietly on the computer or at a video game without fidgeting, fighting or bouncing around? Do they sit quietly and draw or color? Do they work well on puzzles? Or are they best at a one-on-one activity, keeping their focus when being with another person? Do they listen intently to music? Or can they sit still for a story?

Once you have carefully watched the child play, being careful not to judge the child, but simply watching what holds their interest, you will be more prepared to find the perfect gift to fit their unique personality. This gift should ideally provide the child with a sense of themselves and a feeling of self-confidence. The gift should let the child know that you understand them and accept them for exactly who they are. The gift should let the child know that you are attuned to their inner passions.

Suggestions

If you need some ideas to get you started, consider these possibilities:

All by myself box

What are children to do when they are bored, there are no friends or siblings around to play with and they can’t seem to settle down into any one activity? An “All By Myself” box has several different activities in it. This box is best used if the parent puts it away somewhere and brings it out only once in awhile, when needed, to keep it fresh and interesting. Items can be added throughout the year, for birthdays or other holidays or as a reward for accomplishments.

In the beginning, use a colorful large box and place in it age-appropriate items for the child to sit and play by themselves. Some ideas of what to include in the box:

• Markers, crayons, glue, scissors
• Paper – different colors and shapes
• Old magazines for cutting out pictures
• A plastic jar with ideas of projects written on slips of paper: e.g., make a collage of cars, dancers, happy people, use cut pieces of colored paper to make a boat, etc.
• Puzzles
• Books
• Hand-held computer games
• Paper dolls
• Toy cars
• Age-appropriate models

Using your imagination and your time observing the child’s interests, add interesting items to the box.

Once-a-month outings

Although younger children may not be able to understand this gift, many children over the age of 7 would be able to.

Magazine subscription

There are so many magazines available, for every type of interest. A magazine subscription to further the positive qualities and talents of a child would be like receiving a gift every month!

Movie/game rentals

Gift certificates to a local store for movie rentals or game rentals.

Creativity

Gifts that bring out creativity: art sets, craft sets, musical instruments, journals for creative writing, software for designing web pages, book on making paper airplanes (include paper and stickers for decorating the planes), camera and book on photography (include a photo album)

Most importantly, as you walk through stores, don’t just pick out an item that looks appropriate for the child’s age level, pick out a gift that will bring out their talents and potential.

Parents commonly ask about the steps they could take to confront and manage bullying behavior and its consequences. To effectively reduce or eliminate a bullying situation, we need to examine the roles of each of the involved children and offer them strategies for coping.

There are three roles in any bullying situation. We generally easily identify the child who is exhibiting bully behavior since they are often being physically aggressive or intimidating, but we also need to examine more subtle forms of bully behavior such as gossiping and excluding others.

The victims are readily identified as the child or children being intimidated, harassed, or aggressed against. There are times when victims are harder to identify due to their hesitancy to speak up for themselves.

Bystanders are those children in a bully situation that observe the interactions and then either discourage or encourage the bullying behavior based on their response to the situation. In order to effectively impact a bullying situation, interventions need to be made within all three roles.

Remember that everyone engages in bully behavior sometimes. Children who use this behavior as their predominant source of social interaction, however, could benefit from practicing basic social skills. Create opportunities for them to feel powerful and effective in pro-social activities. Encourage them to build skills that create a true sense of esteem and varied proud feelings. Teach them to be empathetic towards others. Help them practice apologizing for their behavior in a sincere manner.

Instruct children who are victims of bully behavior to assert themselves, seek help, avoid the problem situations, or use humor to deflect the bullying. Teach victims self-talk to enhance their sense of confidence in handling these tough situations. Encourage bystanders to support the victims with assertive words directed at the bully. Teach them to seek help from adults or a group of peers as appropriate. Remind them that revenge never makes a situation better. Focus on inclusion and create an environment where bully behavior is not acceptable.

Above all, teach children to engage in kind behaviors and reward these behaviors when you see them demonstrated.

According to summerlearning.org,recent research shows that students typically score lower on standardized tests at the end of summer vacation than they do on the same tests at the beginning of the summer.

At the CADT, we also see that behaviors like poor impulse control, isolation, depression, and anxiety can escalate during the summer because of the loss of structured time at school.

The “summer slide” can have serious impacts on the learning and growth that happens in the next school year. Summer learning — and the lack of it — is tied very closely with academic achievement.

Library reading and parks and recreation programs can bridge the academic gap in summertime, but it’s important to keep a child’s behavioral progress on track over June, July and August, too.

Keep kids engaged all year long to avoid the ‘summer slide’

The Child and Adolescent Day Treatment Program at Rogers Memorial Hospital offers a year-round treatment program that addresses difficult behaviors. In a positive and supportive setting, children and adolescents work with clinical teams to learn about themselves and make positive changes.

Our day treatment programs are managed by dedicated professionals who specialize in mood and behavior problems.

• ADHD has nothing to do with intelligence. Although some children may show signs of social immaturity as a result of their ADHD, intelligence is not affected. Children with ADHD many times are above average in intelligence, but may sometimes have difficulty in translating that intelligence to the outside world because of their rapid thoughts.
• Every child has unique talents and abilities. Proper nurturing of these talents will allow the child to succeed and thrive. Many children with ADHD are extremely creative.
• Children with ADHD do not want to be considered “different.” They want to fit in with their peers, play the same games as their peers, and be accepted for who they are. Focusing on the positive attributes of their personality will help them to feel secure and confident.
• Gifts should focus on the positive aspects of a child’s personality, rather than trying to build upon the negative or underdeveloped aspects.

Finding the Passion Within
Keeping the above points in mind, take some time to determine the child’s interests. Many children with ADHD hyper focus on a certain aspect of their life. For some children it may be art, for others music or athletics. Find out what motivates the child you are buying a gift for.

Let go of the traditional gifts for a particular age level and look at what passions this child has. For example, many boys between the ages of 3-10 love cars, trucks and trains. However, these gifts are not necessarily what every boy that age loves. Giving the gift of a beautiful truck to a child who has no interest in such things can be detrimental. It can cause stress to the child, making him feel shame that he does not find the same joy in trucks as other children his age. He may feel he should love the truck, but just does not and that there is something wrong with him for not liking it. The “giver” of the gift feels the child is unappreciative and selfish, causing stress on the relationship between you and the child.

Taking the time to watch the child in play can help. What holds his or her interest for more than a few minutes? Does she play quietly on the computer or at a video game without fidgeting, fighting or bouncing around? Does he sit quietly and draw or color? Does the child work well on puzzles? Or are one-on-one activities better at keeping the child’s focus when being with another person? Does she listen intently to music? Can he sit still for a story?

Once you have carefully watched the child play, being careful not to judge the child, but simply watching what holds his or her interest, you will be more prepared to find the perfect gift to fit that child’s unique personality. Gifts should ideally provide children with a sense of themselves and a feeling of self-confidence. Gifts should let children know that you understand them and accept them for exactly who they are. Each gift is an opportunity to let each child know that you are attuned to his or her inner passions.

Gift Suggestions
If, after reading this far, you still have no idea what type of gift to get, here are some ideas to get you started:

Children respond to a routine whether they have ADHD or not. Routines provide a sense of familiarity and comfort for children. An example of this is to have a morning, after school, and bedtime routine. A child with ADHD may respond more positively to a routine they can see. In that case, creating a chart that outlines the activities and times may work better for your child. Here is an example of a morning routine chart:

Organization can also be a challenge for children with ADHD. Panic can arise if a child – or parent – is unable to find homework that is due in class today or an overdue library book. To help with organization, consider having a cork board and/or calendar to highlight important appointments or notes to be signed. Plan the night ahead by laying out clothing and shoes that will be worn the next day and put backpacks in a place that will be noticed by the child and parent, perhaps on a bench or chair by the front door.

Finally, communication is an important factor for the success of your child with ADHD. It is crucial that parents communicate with the school and their child’s teachers. It will help the teachers to know about the child with ADHD and how they can help in the success of that child throughout the year. It will also be important for parents to hear from teachers on how their child with ADHD is doing in the classroom. This will provide parents with important information to use in supporting their child at home in the form of praise, rewards, and consequences. Furthermore, it is just as important for parents to communicate with their child with ADHD, to understand the needs of their child, to offer support, and to stay connected.

Children with ADHD may encounter challenges throughout the school year, but these can be minimized by following some of the suggestions listed above. When parents and children have routine, organization and communication in their lives, they may have a better chance of success in school and at home.

Signs of Inattention:

• Highly distractable
• Difficulty staying with an activity until completion
• Inattention to details and careless mistakes
• Losing and forgetting things

Signs of Hyperactivity

• Always on the “go”
• Fidgeting and restlessness
• Difficulty sitting still
• Easily bored

Signs of Impulsivity

• General lack of self-control
• Difficulty waiting for turn/standing in line
• Blurting out answers
• “Acting before thinking

According to the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), there are three subtypes of ADHD that are based upon the above characteristics: ADHD – predominantly hyperactive-impulsive type; predominantly inattentive type, or combined type (both hyperactive-impulsive symptoms and symptoms of inattention).

The symptoms must appear prior to age seven and must continue for at least six months. Because most children display the above characteristics during the introductory and pre-school years, it is important that a child who is suspected of having ADHD see a specialist to determine if the demonstrated behaviors are actually due to ADHD, or whether they are typical for the child’s age and development.

Additionally, the behaviors must impair the child’s functioning in at least two areas, such as at home, in school, with peers, or in the community. So, a child who displays hyperactivity and impulsive behavior whose schoolwork, friendships, and relations at home are not impaired by these behaviors would not be diagnosed with ADHD.

In addition to the above, a child with ADHD will often display additional characteristics that may vary considerably in degree, such as disorganization, poor peer relations, aggressive behavior, trouble with authority figures, poor self-esteem, lack of motivation, sensation-seeking, poor fine motor coordination even though gross motor skills are intact, daydreaming, memory problems, obsessive thinking, and inconsistency. Inconsistency is perhaps the hallmark of ADHD, as a child with ADHD will have good days and bad days.

Some days the child may be able to focus on his work and control his impulsivity, but other days completely struggle. As a result, caregivers and teachers may believe that the problem behavior is purposeful and vindictive, when it is not. One of the foremost experts in ADHD research, Dr. Russell Barkley has stated, “The child with ADHD succeeds one time and we hold it against him for the rest of his life.”

Treatment for ADHD typically involves the combination of medication management and behavioral treatment. Indeed, the results of the National Institute of Mental Health’s Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder revealed that long-term combination treatments were generally superior to medication management, behavioral treatment, or routine community care only. A particular advantage of the combined treatment over medication management alone was that children could be successfully treated with lower doses of medication.

In summary, ADHD is a treatable condition that is not a “life sentence” for a child. However, it is important to obtain early and proper intervention. ADHD can often be difficult to distinguish from the spectrum of “normal” behavior as well as other conditions, such as anxiety, depression, parenting practices, abuse, and adjustment difficulties. Therefore, it is important that a qualified professional evaluate any child suspected of having ADHD.

Dr. Mirhoseini is a clinical psychologist licensed by the State of Wisconsin and is the program manager of the Child & Adolescent Services Day Treatment program of Rogers Memorial Hospital – Kenosha. Dr. Mirhoseini has more than 15 years of experience working with children and their families. She has worked extensively with at-risk youth and victims of abuse.

Dr. Mirhoseini received her Doctor of Psychology and master’s degree from the Nova University Center for Psychological Studies. She completed her bachelor’s degree in psychology from the University of Wisconsin – Milwaukee. She is listed with the National Register of Health Care Providers in Psychology.

Dr. Kim is a clinical psychologist licensed by the State of Wisconsin and is the program manager of the Child & Adolescent Services Day Treatment program of Rogers Memorial Hospital – Brown Deer. Dr. Kim has nearly 20 years of experience working with children and their families.

Dr. Kim received her Doctor of Psychology degree from the Wisconsin School of Professional Psychology. She completed her master’s degree in psychology from Loyola College in Baltimore and her bachelor’s degree in psychology from Indiana University.

Dr. Kim has served as an instructor for graduate students, mental health professionals, and as a community resource for families in crisis. She is a member of the American Psychological Association and is listed with the National Register of Health Care Providers.