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Awaiting Child Assessment in Northern Ireland

Background

As a parent, you want your child to reach their full potential. Sometimes children need specialist support and this can require an assessment. This can be a difficult time for parents with so much uncertainty, and can be the cause of increased anxiety for the whole family. It is important that you seek support and understand what you can do to help your child.

Research

In Northern Ireland, the waiting list for assessment for suspected autism in huge. According to the Northern Ireland Audit Office, more than 5,000 children with suspected autism are waiting for an assessment.[1] This is an increase of 148% from 2016.[2] Furthermore, the waiting lists vary depending on what health trust you live in. A total of 180 children in the Southern Trust will wait less than 13 weeks to be seen by a specialist, while there is a 10-week wait for a first appointment in the South Eastern Trust, where 63 patients face delays. The Northern Trust has the biggest backlog, with 1,883 children on waiting lists – which Trust officials partly attributed to it having the highest school age population. The longest delay is 490 days. In Belfast, there are 1,714 children waiting for autism assessments, with the longest wait at 846 days. The Western Trust confirmed it has 1,099 children waiting on appointments, with the longest wait at 720 days.[3]

Awaiting assessment for your child can exacerbate mental health and anxiety among parents. Parenting NI know, from our own studies, that just over a third of parents (37%) have reported high levels of emotional and mental health at the moment. While 44% reported a medium level of emotional and mental health and just under a fifth (19%) of parents reported a low level of emotional and mental health at the moment. This is likely higher if you are a parent waiting for an assessment for your child. Children’s education was the top area that parents felt has caused concern or affected their emotional health and wellbeing over the past six months with 50% choosing this option.  If you are in this situation, it can help to know you are not alone.  Many parents in a similar situation also feel stressed and anxious, this is to be expected and it is important that you seek support for yourself, during this challenging time.  Support can come in many guises – it can be from family, friends, a faith group or a community group or charity –online or in person, with specific experience of supporting parents.

[1] https://www.niauditoffice.gov.uk/sites/niao/files/media-files/242135%20NIAO%20Special%20Education%20

[2] https://www.niccy.org/media/3976/more-than-a-number-child-health-waiting-lists-in-ni-final-19-october-2021.pdf

[3] https://www.irishnews.com/news/healthcarenews/2021/04/19/news/-desperate-parents-opting-to-pay-up-to-1-400-for-private-autism-assessments-2293075/

Top tips

Below are some top tips and ideas to help you manage the time you are waiting for your child’s assessment:

Visual Supports

If your child struggles with communication, make some visual supports such as photographs of everyday things. Use the visual support while also naming the object or task. Think about how you give your child instructions and consider if this could be clearer e.g. break down into a step-by-step plan.

Thinking about time differently

If your child struggles with the concept of time, try using a sand timer to help your child. Your child may also understand much better if you say, “Two more goes before we put your toys away” rather than “five minutes until we tidy up.”

Play

Play helps to develop skills such as sharing, patience and increase attention span. It is also a great way to strengthen your relationship with your child while having fun. Encourage your child to lead the play activity using their imagination.

Focus

Focus on what your child can do rather than on what they cannot. Use lots of praise and encouragement when they accomplish a new task or behave well. All children are unique and you as their parent have the greatest knowledge of your child. Keeping a notebook on what behaviours you notice can help with the assessment.

Learn

Learn the art of keeping calm. Reacting to your child with a calm assertive approach will work best when things do not go so well. Speaking to other parents can reduce feelings of isolation and increase your knowledge of autism, which may help your child.

Practise self-care

Parents need to look after their own mental and physical health so they can parent effectively and advocate for their child. Talking through your concerns and frustrations can help reduce your worry and anxiety. Seek support from other parents, a support group or organisations such as Parenting NI.

Support available

Parenting NI encourage parents in Northern Ireland to use our Information and Support Line/web chat to speak to a Parent Support Officer who will provide a supportive listening ear and help guide parents to the services that may be most appropriate to them depending on their own unique circumstances.

Additionally Parenting NI have some resources online for all parents that provide advice and signposting for parents including an articles and podcasts that can be found on Parenting Family.

Further information including top tips and contact details can be found at www.parentingni.org.

Parents Guide to Facebook

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Keeping Children Safe Online

Many children in today’s society have easy access to the internet, whether it be using their smartphone, computers, tablets, at home, in school or with friends. UNICEF reported ‘’globally, one in three internet users is a child’’[1]. Therefore, as parents are not always in control of what their children see online, it is important that parents are educated on how to keep their children safe online. This article will focus on defining the types of online risks children maybe be subjected to, help parent to recognize the signs that their children may be at risk and provide some top tips on ‘how to keep children safe online’. 

Online Usage for Children and its Risks

Ofcom noted the number of children having an increased access to the internet[1], their figures state:

  • Children aged nine and 10 using as smartphone has almost doubled from 23% in 2018, to 50% in 2020, and by the age of 15 almost all children have one 94%
  • WhatsApp is used by almost two thirds of older children, which has increased from 43% in 2018 to 62% in 2020, Facebook 62%, Snapchat 68% and Instagram 66%
  • One in seven older children in the UK use TikTok, an app that allows users to create a 15-second video, an increase from 8% in 2018 to 13% in 2020

UNICEF[2] has interviewed more than 10,000 teenagers across 25 countries on experiences of harassment, bullying or unwanted sexual comments online. They found that more than half of participants stated their friends participated in risky behaviors. They found that eight out of 10 18 year olds worldwide believe young people are in danger online. Interestingly, most teenagers agreed that meeting new people online was important to them, and 36% stated they could strongly tell in someone was lying about their identity online and more than 80% said they could deal with sexual comments online.

UNICEF have stated that governments have a duty to coordinate responses between law enforcement, schools, and internet providers to provide better protection for children online. They have found that 94% of UK and US teenagers believed they could protect themselves on social media, perhaps showing the benefits of being educated in online safety.

Additionally, The Belfast Telegraph published an article in 2020[3], stating that two-thirds of children in NI claim to have witnessed hateful content online. In support of this, Ofcom released a study in 2019[4], on children’s media and online life, they found that 43% are increasingly concerned about the content their children view online, with Ofcom’s study focused on children’s use of well-known apps and the possibility of being bullied. The study was based on 3,500 interviews of parent and children in the UK, they found that, 51% of 12-15 years olds saw hateful content online last year and this has jumped to 62%. Therefore showing the importance of a parents need to increase their knowledge and awareness and of online safety. Ofcom’s study supports this as they found that 85% of parents interviewed stated that they were likely to speak to their children about staying safe on the internet.

This research shows the increase in the number of children having access to the internet and their increased exposure to risk.

Online Risks

The internet can be dangerous for everyone, but children in particular are more vulnerable. An online risk is the likelihood of a person being exposed to a danger or adverse situation, during their time online. Children can be at risk on the internet from people that they know or strangers.

Online risks can take place through electronic devices with access to the internet, such as:

  • Smartphones
  • Apps, for example, TikTok, Snapchat, Instagram, etc.
  • Social networking sites, for example, Twitter, Facebook, WhatsApp, etc.

There are specific types of risks that your children may be exposed to such as:

Cyber Bullying: this refers to bullying through sharing communication and information on the internet. Bullying itself is when a person(s) repeatedly and intentionally verbally or physically abuses another person causing them psychological or physical harm, and can be conducted by an independent or a group of people. Examples of cyber bullying include; sending hurtful messages, setting up fake profiles, sharing embarrassing stories or pictures of someone and posting hurtful material on social media. The Department of Education in 2011[1] found that 15.5% of children in Year 6 and 17% of children in Year 9 were subjected to cyber bullying in the two previous months.  In reality we know the figures are likely to be much higher as many children and young people do not disclose their experiences for fear of being ‘in trouble’ with their parents or schools.

Online Scams: this is when a person makes a dishonest or illegal plan, which often involves tricking people in order to obtain something, for example, make money or steal personal information. A person can be scammed via text message, email, fake websites, social media, etc. A Scammer may often try to sell you something, send you an urgent or alarming message, threaten, providing links to click on etc. Children and young people tend to be inexperienced and more trusting when it comes to interactions online which makes them vulnerable to online scammers.

Privacy: this refers to the risk of private information such as, personal details, location, accessing your accounts, stealing cookies. For example, your information may be given to other websites; you may be subject to identity theft or online tracking (allowing a third party to build up a profile on you based on your private information). Children may be more vulnerable to privacy online threats as result of their lack of awareness or digital skills.

Recognising the signs that your child has been exposed to an online risk

It is important parents are able to recognise signs that their children may be experiencing abuse online, for example, your child may:

  • Becomes obsessive about being online
  • Spend an increased or decreased amount of time online
  • Show emotions of sadness, anger or irritability after being online
  • Keeps secrets about what they are doing online, for example, turning off their phone or laptop when you enter the room
  • Talk about new ‘friends / people’ they’ve met online
  • Be withdrawn from family activities after using the internet
  • Receives phone calls or texts from people or numbers you don’t recognise
  • Receives gifts of packages from an unknown person
  • Is looking at inappropriate content

Tips on How to Keep Children Safe Online:

  1. Report abuse: this is an important step to take when something goes wrong in order to keep your child safe online. You should explain to your child the importance of talking when something goes wrong online and if they are feeling scared. Reassure them everything will be okay and they are not in the wrong. In the case of abuse, firstly, you should report abuse to the website or app being used (there is often a section in setting which allows you to report abuse, sometimes it may be under the tab ‘help’). If you feel the abuse is more serious and requires immediate attention it is important that you contact the police and file a report. It is important you talk to someone you trust if you are feeling overwhelmed or stressed about your child’s online safety. You can also contact a local charity such as Parenting NI based in NI or NSPCC operating Nationally if you have concerns about your young persons online use.
  2. Teach your child the importance of keeping safe online: showing your child how to keep their profiles on private (refer to Parenting NI links for specific app guides). This option is often found in settings under the tab ‘privacy’. You should also stress the importance of setting passwords and not sharing personal information online.
  3. Encourage your child to speak openly about their online activity: this will allow you to build up a trust with your child and keep control of what they are doing online.

[1] http://www.endbullying.org.uk/what-is-bullying/online-bullying/

[1] https://syncni.com/article/3655/over-half-of-ni-kids-have-seen-hateful-content-online

[2] https://www.theguardian.com/technology/2016/jun/07/poll-reveals-teenagers-concerns-over-online-abuse

[3] https://www.belfasttelegraph.co.uk/news/northern-ireland/two-thirds-of-northern-ireland-children-have-seen-online-hate-content-report-reveals-38923950.html

[4] https://syncni.com/article/3655/over-half-of-ni-kids-have-seen-hateful-content-online

[1] Unicef (2016) https://www.theguardian.com/technology/2016/jun/07/poll-reveals-teenagers-concerns-over-online-abuse

The Importance of Self Care

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Dad’s Project on Overcoming Isolation

Father’s Day Special

Children and 5 stages of grief article

Children and the Five Stages of Grief

In an earlier article, available here we gave parents advice on helping children understand death and loss. This article will discuss the process of grieving and go through the five “stages of grief”. It will provide an overview of what the stages are, how they might present in children or young people and what you as a parent can do to help children through this.

Elisabeth Kübler-Ross presented the five stages of grief in her 1968 book ‘On Death and Dying’1. She suggested that people grieve in five distinct stages:

  • Denial
  • Anger
  • Depression
  • Bargaining
  • Acceptance

Kübler-Ross noted that these stages are not linear e.g People do not necessarily “exit” one stage and enter another. Nor is there a universal timeframe for how long someone might spend in one stage. As a parent, you might find your child switches between stages. They may change quickly, in hours – or stages may last for long periods of time. Additionally, people may have feelings associated with different stages all at one time. Do not think of the five stages as a roadmap towards acceptance. Instead, use it to think about what sort of support would be best for your child at any given time.

Stage 1: Denial

At this stage, children will usually deny the reality of what happened. They might cling to a false but preferable version of reality. If the lost loved one was particularly close to the child, they may refuse to accept that they are gone2. They might for example insist that they will soon walk through the door alive and well. As a parent, it is important not to indulge this fantasy. Nonetheless, remember that denial in children is a natural defence mechanism. 

They may not be able to cope with the shock of a loss and need time to process it. Parents should instead gently dispel any misconceptions and answer any questions. If you child needs more time to come to terms with the loss, it is reasonable to give them some time. If they seem unable to accept the loss even after a longer period of time it may be worth seeking further support.

Stage 2: Anger

Once children have accepted that someone they love is gone, they may express anger. Typically, they may attempt to blame someone they feel is responsible – the doctors or nurses or even God. They may be angry with the lost loved one for “abandoning” them. Often, they express anger at family members or other “safe” targets. Be aware that they may express anger at you3.

It is natural and important for them to express this anger. That does not mean you should allow them to get totally out of control. You can and should still set a limit on what is acceptable behaviour. Encourage them to talk about their feelings with a trusted person, maybe a friend or a loved one. Alternatively, a physical distraction such as exercise is a useful outlet. (Remember to follow government advice in these current circumstances with being outdoors).

Stage 3: Bargaining 

Bargaining is a complicated form of grief. Before the loss of a loved one, children and young people may bargain to save them. They may pray, make outlandish promises or other changes. This is an attempt to feel in control and is often paired with guilt. A child may feel that if they had acted differently, or had (in their thinking) behaved better this would not be happening. Bargaining can serve as a distraction from the pain of the situation they find themselves in.

Parents should gently and calmly explain that no promise or deal can reverse the loss. They should reassure them that it was not caused by their own ‘bad behaviour’, and that they have no blame for the loss4. Understand that some children will need to do this, and that It should pass as they accept the loss.

Stage 4: Depression

Once this has passed, children will likely feel depressed. They may feel powerless, or lose interest in things that made them happy before and be more lethargic. Physical displays of emotion like crying are also common. This stage is often challenging for parents, because it is difficult for them to see their children experience this. However, a period of depression after a loss is normal and natural5. To not feel depressed after losing a loved one would be uncommon. 

Parents should note that the depression experienced after a loss is not like clinical depression. While it can be a trigger for more serious issues, there is no reason to be immediately concerned. Instead, make efforts to allow children to express their feelings. Talk to them regularly, and ensure that they get enough sleep, food and water as well as physical activity. Kübler-Ross invited patients to see depression as a visitor – an unwelcome one, but one who would eventually leave. Depression forces us to slow down and process the feeling of loss which in turn helps us to move past it.

Stage 5: Acceptance

The final stage of grief is acceptance. In this stage, emotions have become more calm and stable. If the loved one is not yet gone, children may focus on the time they have left. Alternatively, if they have already passed away they may focus on positive memories and stories6.

The ‘support’ parents provide in this final stage is more nuanced. As your child is more emotionally stable, it can be productive to talk about the experience of grief with them. They will have learned a lot about themselves, and as a parent you can support them to ensure that in future the process of grieving is easier or more manageable.

Conclusion

Death is a natural part of life, and every person will eventually have to learn to deal with grief.

Remember that grief is not a straight line. Each experience and individual will be different. Rather than trying to “plan” for dealing with grief in children, parents should be aware of what is or is not normal.

1 – https://books.google.co.uk/books/about/On_death_and_dying.html?id=OeB-AAAAMAAJ&redir_esc=y

2- https://globalteletherapy.com/helping-children-cope/

3 – https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Children-and-Disasters/Documents/After-a-Loved-One-Dies-English.pdf 

4 – https://www.cruse.org.uk/get-help/for-parents/children-and-young-peoples-emotional-responses

5 – https://books.google.co.uk/books?id=d5fgzAEACAAJ&dq=Kubler-Ross:+Stages+of+Grief&hl=en&sa=X&ved=0ahUKEwiym_nU6snoAhVHe8AKHZJRAwoQ6AEIOzAC

6- https://www.ncbi.nlm.nih.gov/books/NBK507885/

Separation

Separation is not an isolated event but a process that unfolds over time. The longer a relationship has lasted, the longer it may take to be able to move on. Reaching out for support will empower you to take the first steps, help you focus on how to put your children at the centre of your decisions and give you the space for self-care and
compassion.

Don’t be hard
on yourself

New ways of parenting take
time to become the new normal.
Successful co-parenting, where
two parents work together to
ensure the child is the centre of
decisions, can take a lot of work.
Remember it is the quality of
time spent with your child after
separation rather than the amount
of time that has the most
positive impact.

Allow Time & Space

If children display signs of
feeling depressed or are angry
acknowledge that these are normal
feelings. Show them healthy ways to
deal with sadness & ways to express
anger. Support them to build on
their self-confidence & support
their personal growth. What
children need most is time,
love & attention.

Managing Conflict

Learn to listen. The most important
skill in reducing parental conflict is
listening. Keep communication focused
on the children. Focus on the present
& what is best for your children. Work
on what is right for the children & not
who is right.

Life after Separation

Give yourself time to adjust & practice
self-care. Try to minimise changes
for your children such as living in a
different house, moving away to a
new area, changing schools, losing
contact with friends or extended
family members. Try to respect the
other parent’s independence to lead a
separate life & a separate home.

Communication

Try to make use of FaceTime, phone
calls & keeping in touch by texts when
your child is with their other parent.
Write regularly using letters, nice
stationary/cards or by email & try
recording yourself doing things or
making a special message.
Always remember special occasions
& birthdays.

Game on: Parenting and Video Games

Impact of World News

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