Mental Health

In recognition of Autism Awareness Month, On the Pulse is shedding light on the COVID-19 pandemic and the impact it has had on children, teens, and young adults with autism spectrum disorder (ASD) and how we can support them through these uncertain times.

As a society, we often rely on routines. With the COVID-19 pandemic uprooting our daily activities, we are being challenged to adapt to what we’re considering the “new normal.”

This is an especially challenging time for those with autism. Routines are critical for individuals on the spectrum, as they thrive on structure and consistency.

In recent data from March 2020 released by the Centers of Disease Control and Prevention (CDC), autism now affects 1 in 54 children. According to the CDC, ASD is a developmental disability that can cause significant social, communication and behavioral challenges. Individuals often repeat certain behaviors and might not want change in their daily activities. Many also have different ways of learning, paying attention or reacting to things. Signs of ASD begin during early childhood and typically last throughout a person’s life.

James Mancini, a speech and language pathologist with the Seattle Children’s Autism Center, and Tammy Mitchel, program director of the Alyssa Burnett Adult Life Center, share ways individuals with autism and their families can cope during this unique time.

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As coronavirus disease 2019 (COVID-19) continues to spread, adults, children and teens are trying to make sense of what the outbreak means for their families and communities. Those with anxiety disorders may feel more worry than usual.

On the Pulse asked Dr. Jennifer Blossom, a psychology postdoctoral fellow at Seattle Children’s Psychiatry and Behavioral Medicine Clinic, how to share information with the children and teens in your life in a way that helps prevent too much worry. The good news is that just as there are steps you can take to help you and your loved ones try to avoid the illness, there are steps you can take to help your child or teen cope with the situation.

“There are a number of ways parents can successfully help their child stay on track during this time,” Blossom said. “In general, the goal is for parents to encourage their child’s participation in routine activities, such as going to school (as informed by the most recent public health recommendations or decision by your child’s school district), while helping their child think realistically about the risks.” Read full post »

This past December, Nataly Cuzcueta was brought to tears by a word from her 4-year-old daughter, Kira.

With her little arms outstretched, Kira looked up to her mother and said “up.” It may seem like a simple request, but for Cuzcueta, it was a major milestone and cause for celebration. Immediately and happily, she obeyed. She lifted her daughter into her arms and excitedly twirled around the room, a smile beaming across her face.

“Today has been a day I’ll never forget,” she said.

Miles away at Seattle Children’s Autism Center, Dr. Mendy Minjarez, director of the Applied Behavior Analysis Early Intervention Program and interim executive director of Seattle Children’s Autism Center at Seattle Children’s, celebrated as well. Cuzcueta had captured the moment on her camera and had sent a note of gratitude to Minjarez and her care team.

“It was monumental for our whole team,” Minjarez said. “I remember getting the email and running down the hall excitedly to tell our team. It’s been a long time coming.”

Today, Cuzcueta says the team at Seattle Children’s Autism Center is like a second family. Her twin daughters have come a long way since they first started receiving treatment more than 2 years ago. Read full post »

Microaggression may not be a term that most are familiar with.

Without knowing it, you may have been the recipient of a microaggression, or may have committed a microaggression.

That’s precisely why it’s important to understand what microaggressions are, so we can address and challenge our own biases, be aware that disparities exist, and assess the significant impact it has on our society.

On the Pulse sat down for a Q&A with Dr. Roberto Montenegro, a psychiatrist from Seattle Children’s Psychiatry and Behavioral Medicine clinic, who studies microaggressions.

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Seattle Children’s Zero Suicide Initiative helps identify and treat children ages 10 and up who are at risk for suicide.

A teenage boy arrives at Seattle Children’s Emergency Department (ED) with an increased heart rate. His parents are scared and unsure of what could be causing their son’s pulse to spike. While the nurse takes the patient’s vitals, she asks him a series of questions about suicide — prompting the patient to share that he tried to overdose on prescription medication the night before. The nurse informs the provider, and an immediate plan is set in motion to further assess not only the patient’s physical health, but his mental health, as well.

A 10-year-old girl enters the ED with a sprained elbow after taking a tumble on the soccer field. Her parents have been taking her to therapy to help with her anxiety, and the therapist communicates his findings with them often. Because she is so young, the therapist has never directly asked the patient if she’s ever had suicidal thoughts. After the ED nurse initiates suicide-screening questions, the girl admits that she has had thoughts about harming herself in the past. Prior to discharging the patient, a mental health evaluator shares resources and information about suicide with the family, and the provider contacts the patient’s therapist and asks the girl’s suicidal thoughts be addressed in their next appointment.

These are just two stories of the more than 500 children who have screened positive for suicide risk in Seattle Children’s ED and inpatient settings over the past six months who presented for concerns unrelated to their mental health. These crucial “catches” were made with help from a new clinical pathway known as Seattle Children’s Zero Suicide Initiative (ZSI), a universal screening method to help identify and treat youth at risk of suicide.

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When Sam Duenwald, 18, was in seventh grade, he got sick and had to miss a couple of weeks of school.

However, a couple of weeks of missed school turned into three, then four, then five.

“It became a vicious cycle,” Sam said. “I was getting really anxious about going back to school because I knew I had missed a ton of homework and that was causing my grades to drop, so I decided to avoid going to school altogether. This of course spiraled into missing even more homework, making my grades suffer further.”

Naturally, the situation caused tension between Sam and his parents.

“There was a lot of stress at home, and I was fighting with my parents all the time,” Sam said. “They knew I needed help.”

Sam’s anxiety became so severe that his parents took him to see a psychiatrist at Seattle Children’s midway through seventh grade. He was prescribed anxiety medication, which helped Sam finish up the school year.

“Over the summer, I kept telling myself, ‘I need to go back to school regularly; I’m going to be in eighth grade and everything is going to be great,’” Sam said.

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In an episode of the popular TV show Big Little Lies, a character’s young daughter has an anxiety attack, prompted by worries about climate change. Though this may seem drastic, Dr. Kendra Read, attending psychologist and director of anxiety programs with Seattle Children’s Psychiatry and Behavioral Medicine team, is having many conversations with families about how to cope with distressing news, such as mass shootings, crime, global politics and natural disasters.

“It’s common for kids to be worried about events that might potentially harm them or their loved ones,” Read said. “Worrying is normal and a typical part of life, but I tend to talk to children whose anxiety over current events impacts their daily functioning. They exaggerate the likelihood of bad things happening and underestimate their ability to cope with things.”

The key is helping kids cope with the worry about these events happening, even though the likelihood is small. With school back in session, Read offers advice to families whose children might experience heightened anxiety after a frightening news event.

“We want to bolster kids’ coping abilities and teach them how they can help themselves,” Read said. Read full post »

Grace Blanchard was just three weeks away from graduating from college when she began feeling like something was off.

“It started with my handwriting,” Blanchard said. “I had always felt like I had good handwriting, so it was strange that it all of a sudden became messy, slanted and unreadable.”

Then there was the slurred speech and dizziness.

“At first I thought I had vertigo,” she said, “so I decided to see a neurologist to get an MRI.”

Once the results of the MRI scan were in, Blanchard received a call.

“They asked me to come into the clinic as quickly as possible, and that I should bring support,” she said. “They knew that after hearing, ‘you have a brain tumor the size of a golf ball on your cerebellum,’ I wouldn’t be able to listen to anything else.”

The following day, Blanchard flew from California, where she had been going to school, to Seattle, her hometown, for surgery to remove the tumor.

“I decided Seattle would be the best option, not only because I wanted to be with my family,” she said, “but also because of the fact that Seattle has the best hospitals for cancer treatment.”

Within 24 hours of flying into Seattle, Blanchard went to Seattle Children’s to get her tumor surgically removed.

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The phrase ‘boys will be boys,’ is often used to describe what some consider are normal masculine tendencies boys might have, such as being rough and reckless.

Dr. Tyler Sasser, a psychologist in Seattle Children’s Psychiatry and Behavioral Medicine clinic believes these characteristics of what society deems as masculine can often reflect unhealthy and sometimes risky behaviors.

“In Western culture, boys and men are expected to be competitive, tough and dominant,” Sasser said. “The term, traditional masculinity, labels these expectations. Meaning, boys and men need to be stoic and suppress emotions they experience, other than anger.”

Recent research shows that these beliefs associated with traditional masculinity often lead to harmful behaviors toward themselves and others.

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I was in middle school when my mental health started deteriorating. Every day I would hide under tables, cover my ears, or hit my head. I would lash out at anyone who tried to help me. I was anxious 24/7. But I kept denying what was happening. I told myself that I was fine, that I was just going through a rough couple of days. Then days turned into weeks, and weeks into months.

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