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Johns Hopkins Bayview News - More Than Just the “Terrible Twos”

Summer 2014

More Than Just the “Terrible Twos”

By: Meghan Rossbach
Date: June 2, 2014

Preschool Therapeutic Learning Center addresses needs of children with mental health and behavioral disorders

Noy Brown and Aisha Frisby with daughters Marley and Karter on playground
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Noy Brown and Aisha Frisby, pictured with daughters Marley (top) and Karter (bottom), have a lot to smile about these days.

Aisha Frisby noticed that her daughter Marley’s behavior was “different” when she was a little over a year old. She would cry, scream and throw herself on the floor when she didn’t get her way. She would take her clothes off when she got too hot or throw a tantrum if she was too cold. And, once she started school, sitting still and paying attention became more of a problem. Marley’s behavior got so bad that her preschool teachers suggested that she may need professional help.

“I had a feeling that this was more than the ‘terrible twos,’” says Frisby. “I just didn’t know what to do or where to go for help.”

Seeking Help

After meeting with her school’s behavior thera­pist, Marley, now 4, was referred to the Preschool Therapeutic Learning Center at Johns Hopkins Bayview (see more below). Johns Hopkins child psychi­atrist Vanessa Howells, M.D., and senior mental health thera­pist Darren Frisinger, LCPC, completed an initial evalua­tion of Marley and diagnosed her with speech and language delays, and sensory delays.

“A lot of Marley’s behavior stemmed from not being able to communicate with others,” says Dr. Howells. “She would get so frustrated that the only way to deal with those emotions was to lash out.”

Dr. Howells adds that Marley’s sensory issues contributed to her behavior. “Being around a lot of people where a lot of different things are going on at once can be overwhelming for someone with sensory disorders,” she says. “Their system goes into overload and they need to be removed from the situation. This is one of the reasons Marley didn’t do so well in the school setting.”

Modifying Behavior

The first step in helping Marley was to make sure her entire family was on board. Aisha and her part­ner, Noy Brown, brought Marley to the Preschool Therapeutic Learning Center several times a week. They even brought Marley’s younger sister, Karter, for additional support (see Karter’s story in sidebar).

While Frisinger worked with Marley on speech, language and socialization skills, Frisby and Brown attended a parenting group and learned how to reinforce good behaviors, commu­nicate effectively and strengthen their relationship with their daughter. After their respective sessions, the family was brought back together to practice and build upon the skills they learned in group therapy.

“I think the most important thing we learned was how to be patient,” says Frisby. “Once we learned that Marley’s behavior was caused by her own frustrations, we were able to take a step back and change the way we parented her.”

Some of those skills include different techniques for handling temper tantrums, encouraging Marley to slow down and use her words, and paying attention to social cues.

Continuing Treatment

Marley spent six weeks in the Preschool Therapeutic Learning Center before graduating to less frequent treatment in the outpatient clinic. There, she sees a therapist once a week to build on her speech and language skills, and work on her behavior.

While Frisby and Brown recognize that Marley’s treatment is an ongoing process, they couldn’t be happier with their daughter’s im­provement. “It’s amazing how much she has changed over the past year,” says Frisby. “Now that she can tell us what she wants or is feeling, everyone is a lot calmer.”

Frisinger gives a lot of credit to Frisby and Brown for Marley’s success. “They are very engaged parents and want the best for their child,” he says. “They are committed to improving not only Mar­ley’s well-being, but the well-being of the family.”

To make an appointment or for more information about the Preschool Therapeutic Learning Center, call 410-550-0104.

Karter’s Story

Not long after Marley started treatment in the Preschool Therapeutic Learning Center, Frisby recognized similarities in her younger daughter’s be­havior. Karter, now 2, was very aggressive and did not like being around other children—not even her sister. She would pinch, hit and bite. Sharing was a big problem. And, her speech was delayed, making it hard for her to communicate.

“I knew it was important for Karter to get the care she needed,” says Frisby. “I didn’t want to wait as long as I did with Marley.”

Karter started treatment in the Preschool Therapeutic Learning Center earlier this year. She was diagnosed with some language delays, but primarily needed treatment for her challenging behaviors. After intensive therapy sessions to help with socialization, Karter is now receiving treatment in the child psychiatry outpatient clinic. A few days a week, a therapist works with her on socialization—playing with friends, listening and using manners.

“My goal in life is to make sure my girls get everything they need,” says Frisby. “I truly believe that the care they have received will help them become productive citizens of this society and overall good people.”

Clinical Programs for Preschoolers

Preschool Clinical Programs at Johns Hopkins Bayview serve children from birth to age five who are experiencing:

  • Depression
  • Anxiety
  • Oppositional behavior
  • Aggression
  • Sleeping problems
  • Eating problems
  • Behavior problems
  • Autism spectrum disorder
  • Speech and language delays
  • Other developmental concerns

The Preschool Therapeutic Learning Center is an intensive outpatient program for children ages three to five who are experiencing developmental delays or mental health disorders. Each parent and child is assigned a primary therapist who oversees all services to the family, including:

  • individual therapy
  • family therapy
  • speech and language therapy
  • occupational therapy
  • behavior modification

Medication evaluation and management also is offered, if necessary.