November 2026 Stony Brook CARE Newsletter

Posted Date: 11/10/26 (02:12 PM)
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A banner for the Stony Brook Children's CARE Initiative features colorful human figures sheltered by cupped hands.

CARE November 2026 Newsletter

Supporting Healthy Minds And Bodies, A Monthly Resource for Families

🍁 What's Inside This Month?

💻 Virtual Parent Workshop – November 17: How to Help Your Child Thrive: Understanding Impulsivity and Building Self-Control
🧠 Are Kids With ADHD “Bad”? Helping Your Child Navigate Impulsivity 
🩺 GI Symptoms in Kids: Is It Stress or Something Else?
🧸 Extra! Teddy Bear Clinic – November 14: Join Stony Brook Children’s Hospital for a fun, hands-on lesson in injury prevention!

FREE Virtual Parent Workshop: November 17

How to Cope with Impulsive Behavior

Beyond Behavior: Understanding ADHD

Join Gina Holzapfel, NP, a pediatric neurology nurse practitioner at Stony Brook Children's Hospital, for a practical discussion of ADHD impulsivity, why children may struggle with self-control and emotional regulation, and how parents can help children manage challenging behaviors with understanding and effective strategies.

Workshop Details
🗓 Tuesday, November 17
🕡 6:15 pm
💻 Virtual (Microsoft Teams)
⏱ 45 minutes + Q&A

What You’ll Learn
  • Why impulsivity can affect children’s behavior, emotions and friendships
  • Practical strategies to encourage positive behavior and strengthen self-control
  • How routines, visual aids, meaningful activities and positive reinforcement can help
  • When to seek additional support for your child

Meet the Expert
Gina Holzapfel, NP, is a pediatric neurology nurse practitioner at Stony Brook Children’s Hospital. She has a special interest in ADHD and pediatric headache management. Born and raised on Long Island, she takes pride in providing top pediatric care in her own backyard.

Join Workshop on Microsoft Teams

Meeting ID: 288 440 389 759 680 9
Passcode: zV7j5we7

Dial in by phone
+1 347-630-9468,,918731491# United States, New York City
Phone conference ID: 918 731 491#

BEHAVIORAL HEALTH

Are Kids with ADHD "Bad"?

Children who struggle to sit still, interrupt others or have difficulty focusing may sometimes be labeled as “bad” or misbehaved. But these behaviors may be symptoms of attention-deficit/hyperactivity disorder (ADHD) — and they’re not necessarily within a child’s control.

“ADHD is characterized by a persistent pattern of inattention, hyperactivity, and/or impulsivity. Sometimes these behaviors — like running around the room or interrupting others can be misinterpreted as a behavioral problem,” says Gina Holzapfel, NP, a pediatric neurology nurse practitioner at Stony Brook Children's Hospital.

ADHD can affect more than attention and activity levels. It can also make it difficult for children to regulate their emotions, manage transitions and navigate social situations.

“Many of these behaviors stem from impulsivity," Holzapfel explains. "These are children who do or say things without taking time to think first." As a result, ADHD can cause emotional dysregulation and difficulty with self-control, she says. 

Some children may have outbursts or struggle to control their reactions. These behaviors aren’t necessarily intentional or malicious. Many feel remorse afterward, creating a cycle of impulsive behavior and guilt that can undermine their self-esteem. 

The idea of being seen as a 'bad' kid can impact a child not only emotionally, but socially — the effects can extend to friendships, too. 

"Other children in the classroom become aware of this," says Holzapfel. "As a result, kids with ADHD can become isolated because their peers feel uncomfortable around these behaviors."

Understanding ADHD
It's important to note that these behaviors may not affect academic performance. A child may earn good grades while still struggling emotionally, socially or with self-esteem. Looking beyond schoolwork is important when considering whether a child needs support.

Helping Children Manage Impulsivity
Rather than labeling a child as 'bad,' Holzapfel recommends strategies that provide structure, encourage positive behavior and help children manage their impulses. Here, some suggestions:

  • Provide meaningful tasks. Children who finish schoolwork quickly may become disruptive when bored. A classroom job, such as helping the teacher or putting away supplies, can provide a productive focus. At home, non-screen activities can help children stay engaged.
  • Use timers thoughtfully. Timers can ease  transitions and break tasks into manageable intervals. Please note, for some children alarms increase anxiety.
  • Praise positive behavior. Recognize good choices to encourage children to repeat them.
  • Establish predictable routines. When children know what is expected, it can eliminate the element of surprise that might feel overwhelming. Providing structure daily also helps support overall independence.
  • Use visual aids. Simple instructions and checklists reduce the need for reminders.
 

When to Seek Help

Occasional fidgeting or interruptions are a normal part of childhood. However, when these behaviors persist and interfere with a child’s daily life, relationships or classroom experience, additional support may be helpful.

It bears repeating that a child doesn’t have to be struggling academically to need help. ADHD can affect children differently at school and at home, and difficulties with emotional regulation, social interactions or self-esteem deserve attention, too.

Treatment is individualized and may include behavioral interventions, counseling and — when appropriate — medication. Parents and teachers can work together with healthcare professionals to identify strategies that meet a child’s needs.

Just as important, progress may not be consistent from day to day. Understanding that inconsistency can help adults respond with patience rather than punishment.

What Parents Should Remember
“Reprimanding a child in the classroom or at home doesn’t work,” says Holzapfel. “Since the behavior is not in a child’s control, yelling won’t help. They aren’t ‘bad’ or misbehaved kids; they’re having difficulty with self-control.”

Consider reaching out to your child's healthcare provider when:
  • Impulsivity, inattention or hyperactivity repeatedly disrupts everyday life.
  • Your child struggles with friendships, emotional regulation or self-esteem.
  • Difficulties arise at school, at home or in other settings — even when grades are good.
  • You’re unsure whether your child’s behavior is typical for their age or may need further evaluation.

The takeaway: Children with ADHD need understanding, appropriate support and strategies that help them build self-control — not labels that damage their confidence.

KIDS WELLNESS

Gastrointestinal (GI) Symptoms in Kids: Is It Stress or Something Else?

If your child frequently experiences stomach pain, nausea or diarrhea before school, it may be more than ordinary morning jitters. In some cases, a cluster of stress-related gastrointestinal (GI) symptoms, known as DGBIs, disorders of gut-brain interaction may be the problem. 

“These symptoms may involve changes in how the gut and brain communicate. Although they cause significant physical discomfort, routine medical testing may not reveal an underlying problem,” explains Lesley Small-Harary, MD, a pediatric gastroenterologist at Stony Brook Children's Hospital. “Stress can play a role, particularly when school or other aspects of a child's life become overwhelming.” 

Common symptoms of DGBIs include abdominal pain, diarrhea and nausea. Separately, stress can also cause headaches, dizziness, lightheadedness or heart palpitations in some children. 

“While the exact etiology of DGBIs is not fully understood, we know there is a significant overlap in physical symptoms that manifest in children when they're very stressed,” says Dr. Small-Harary. “For various reasons, school is a common stressor for kids.” Stress-related symptoms can begin in early childhood but are most commonly found in teenagers.

Clues that Stress May Be Playing a Role
Because stress-related GI symptoms are real and can be just as distressing as those caused by other medical conditions, it isn't always easy for parents to know what's behind them. The following patterns may offer clues that stress is contributing.

Symptoms appear in the morning 
Symptoms can occur at any time but those related to school stress tend to pop up at the start of the day. "A lot of kids feel the need to go to the bathroom and can have diarrhea and/or stool urgency from stress when they wake up” says Dr. Small-Harary. 

Symptoms improve as the day progresses
Whether a child stays home or pushes through and goes to school, symptoms  gradually improve.

Symptoms follow the school calendar
If you’re dealing with a DGBI, symptoms may be less severe and improve over weekends, evenings, school breaks and during the summer. 

Medical Warning Signs Not to Ignore
Blood in the stool, waking overnight to have a bowel movement, unexplained weight loss, fever or significant abdominal bloating warrant further evaluation. “Bring these symptoms to your pediatrician's attention promptly,” says Dr. Small-Harary.

“When the red flag symptoms [listed above] are absent, testing often doesn't identify a cause, suggesting a possible DGBI," she explains. 

When to Seek Medical Advice
If your child experiences recurring abdominal pain, nausea, diarrhea or other GI symptoms, Dr. Small-Harary suggests consulting your pediatrician. “Your child's doctor can help determine whether further testing is needed and refer you to a pediatric gastroenterologist when appropriate."
 

Balancing Support with School Attendance

It's important to help children maintain regular school attendance when medically appropriate, according to Dr. Small-Harary. Working with the school and the child's healthcare providers to establish a supportive plan can help them manage their symptoms while staying connected to daily routines. 

"In some cases, accommodations may be helpful, but an ongoing pattern of missed school or late arrivals may unintentionally make it harder for children to return to their regular schedules," the doctor explains.

When students come to Dr. Small-Harary’s office, she validates what they’re feeling. “It's true they are experiencing significant GI distress and these symptoms may be due to academic and/or social stressors in school and/or at home,” she says. “Issues like not having friends in school, being bullied, even a change in or stressful family dynamics can all be contributors.”

If the physical symptoms are due to DGBIs, Dr. Small-Harary encourages families to meet with the school guidance counselor or an outside therapist/psychologist. “Involving a psychologist who can teach breathing and relaxation techniques can be very helpful,” she says. 

Dr. Small-Harary offers some reassurance. “These symptoms can be uncomfortable but there are also medicines, herbal remedies and other measures we can try to help alleviate the discomfort.”
 
Partnering with Your Child’s School 
The importance of consistent school attendance, can't be overstated, says Dr. Small-Harary. Although certain accommodations may be helpful, routinely modifying a child’s school day in response to stress-related symptoms can unintentionally reinforce school avoidance.

For students who need extra time in the morning, she suggests waking up earlier. Children experiencing diarrhea may also benefit from access to the school nurse's bathroom, where they can have added privacy. Dr. Small-Harary recommends incorporating accommodations like these into a broader care plan that may include behavioral health services. “Psychological guidance can help prevent a pattern of repeated bathroom visits and school absences.”

If there are concerns that your child has GI symptoms leading to school avoidance, first consult with your pediatrician. They can refer you to a pediatric gastroenterologist for further testing, if needed. 

"Rest assured, there are a several treatment options to help your child remain in school and succeed which, of course, is the ultimate goal," Dr. Small-Harary explains.

LEARN TO STAY SAFE THROUGH PLAY

🧸 Bring Your Own Bear to The Teddy Bear Clinic on November 14!

Celebrate National Injury Prevention Day (November 18) a little early! 

Saturday, November 14 | Noon to 2 pm
Build-A-Bear Workshop
Smith Haven Mall

Hosted by the Stony Brook Children’s Hospital Pediatric Trauma Team, this playful experience helps kids learn how to care for their “injured” teddy bears while building real-life safety skills.

HOW TO JOIN THE FUN

  • Bring your own bear (BYOB). Bring a favorite teddy bear or stuffed animal to the clinic.
  • Play doctor. Use fun injury-prevention accessories and supplies provided during the event to care for your bear.
  • Learn to stay safe while playing. Discover simple ways to prevent injuries.

Bonus: Registered Teddy Bear Clinic guests will receive $10 off furry friends available for purchase at Build-A-Bear Workshop, in-store only.

Event Details
📅 Saturday, November 14
🕛 Noon to 2 pm
📍 Build-A-Bear Workshop, Smith Haven Mall

Advanced Registration Encouraged
Visit stonybrook.info/buildabear or scan the QR code.