Our therapy sessions are 30-60 minutes per session, depending on each child's individual needs. We will see them once a week unless we have discussed more frequently.

We do respect our clients' confidentiality, so we will not share what they say verbatim. We will share themes and progress with you to help you understand what they're expressing, showing, and how they're growing.

You are welcome to sit in on family therapy sessions, and if you do, we ask that you participate rather than just observe!

Yes, the child's teacher will know we are picking them up for therapy services. We will coordinate a pickup time with the teacher. If you'd like your teacher to know more information, please fill out a Release of Information so we can talk with them.

Progress is measured across multiple sessions. We assess the themes in your child's play and how they develop over time. Progress is evident when children shift their play themes toward more adaptable, holistic solutions.

We will never force your child to play. If they come to therapy and do not want to play multiple times, we will pause services, and, if requested by the family, we will try again. We never want to cause more mistrust in therapy services.

We do not work with CPS or give CPS all of the information from our sessions. If there is an open placement/plan, we will confirm services. We will not share themes, progress, or opinions about your child's care. However, we are mandated reporters, so if there is abuse or neglect disclosed to us, we are required by law to report that information to CPS at 1-800-ENDHARM (1-800-363-4276).

• Tulalip Crisis Line: 360-502-3365
• 988 lifeline: press 4 for Native Hotline 988
• Trevor Project Lifeline: LGBTQIA 866-488-7386 or -text 678-678
• Trans Lifeline: 877-565-8860
• Veterans Affairs Responder: text 838-255
• 24-hr help for SUD, Gambling, MH: 866-789-1511
• Native Youth Crisis Hotline: 877-209-1266
• Crisis Text Line (24/7 nationwide): Text HOME to 741741
• Suicide Prevention Lifeline: 1-800-TALK(8255) Spanish: 1-888-628-9454
• Crisis Connections (available 24/7 in Seattle area): 1-866-427-4747

Biting in children aged 1 to 3 is a normal and common developmental behavior, usually driven by strong feelings, teething, or a lack of communication skills rather than bad behavior.

Why Toddlers Bite:

• Limited language skills: Children cannot yet use words to express big emotions like anger, frustration, excitement, or fear.
• Overstimulation: Too much noise, bright lights, or a busy environment can overwhelm them.
• Teething pain: Sore gums can cause a physical urge to bite down on objects or people.
• Impulse control: Toddlers have developing brains and act on impulse before they can think about consequences.
• Seeking control or attention: They may bite to see what happens or to get an immediate reaction.

How to Prevent Biting:

• Notice triggers: Learn if biting happens when your child is tired, hungry, crowded, or frustrated, and adjust their schedule.
• Teach words: Help your child name their feelings, such as saying "You are mad" or "You want that toy".
• Offer alternatives: Give a teething ring or a cold washcloth if your child needs oral stimulation or is teething.
• Consult a doctor: Talk to your pediatrician if biting continues past age 3, becomes excessive, or happens with other concerning behaviors.

Hitting is a common behavior during the early years. Babies, toddlers, and preschoolers are still learning how to communicate, manage strong feelings, solve problems, and understand how their actions affect others. When those skills are still developing, hitting can sometimes become a way of communicating.

Hitting does not mean your child is aggressive, bad, or destined to become aggressive. It is often a sign that something is too difficult in that moment.

Why might young children hit?

Children may hit when they are:

• Frustrated or angry
• Overwhelmed by noise, activity, or emotions
• Tired, hungry, or overstimulated
• Having difficulty communicating what they want or need
• Struggling with sharing, waiting, or taking turns
• Trying to get someone's attention
• Excited or having difficulty controlling their body
• Wanting to create space or stop something that feels uncomfortable
• Experiencing a change in routine or environment

Sometimes the reason for hitting is obvious, and sometimes it takes some detective work to figure out what happened before and after the behavior.

What can you do when your child hits?

Stay calm and keep everyone safe.
Young children borrow our calm when they are having a hard time regulating themselves. Use a calm voice and gentle, firm boundaries.

Set a clear boundary.
Keep your words simple: "I won't let you hit." "Hitting hurts. I will keep your body safe."

Help them with what they are trying to communicate.
If you know what they need, give them the words: "You wanted the truck. You can say, 'My turn.'" "You don't want your brother that close. You can say, 'Move please.'"

Keep the teaching brief in the moment.
When a child is very upset, they may not be ready for a long explanation or lesson. Focus first on safety and connection. Talk about what happened later, when their body is calm.

Teach what they CAN do.
Children need alternatives that are realistic for their developmental level. Practice skills such as saying "stop," asking for help, stomping feet, squeezing a pillow, moving away, or getting an adult.

Look for patterns.
Notice what tends to happen before the hitting. Is it usually during transitions? When sharing toys? When your child tired? When there is a lot of noise? Understanding the pattern can help you prevent situations from becoming overwhelming.

Remember

Young children are still learning to manage their bodies and emotions. A boundary and empathy can exist at the same time.

You can say: "I won't let you hit. You're really angry. I'm going to help you."

The goal is not to shame a child for having a big feeling. The goal is to keep everyone safe while helping the child gradually learn safer ways to communicate and cope.

If hitting is happening frequently, causing injuries, becoming more intense, or making it difficult for your child to participate in everyday activities, talking with your child's pediatrician or a child mental health professional can be helpful.

How can I help my child with separation anxiety at school?
Establish a routine, communicate openly, and practice gradual separations to help them feel more secure.

What if my child refuses to go to school due to separation anxiety?
Talk to the school staff, visit the school together beforehand, and work on slow separations to ease their fears.

How can I help my kindergartener with separation anxiety?
Routines are especially important for young children. Additionally, offering comfort objects and quick, positive goodbyes can help them adjust.

Managing Parents' Back-to-School Separation Anxiety

Parents can also experience separation anxiety when their child returns to school. Managing your own stress is crucial to supporting your child effectively. Here are some tips to manage your anxiety:

• Plan Ahead: Get organized early to avoid the chaos of the first school day.
• Take Care of Yourself: Prioritize self-care and relaxation to stay calm.
• Talk to Other Parents: Sharing your concerns can provide reassurance and new strategies.

By managing your own emotions, you'll be better equipped to help your child through the transition.

Picky eating is very common in early childhood. As children grow, it is normal for their appetite, food preferences, and willingness to try new foods to change. A child who happily ate something last week may suddenly refuse it today!

Eating is about more than hunger. Children are also learning about new tastes, textures, smells, and temperatures, as well as how food feels in their mouths. For some children, these experiences can feel overwhelming.

Why might a child be a picky eater?

Children may avoid foods because of:

• Strong preferences for certain tastes, textures, smells, or temperatures
• Sensory sensitivities
• A desire for predictability or familiar foods
• Difficulty sitting at the table or staying focused during meals
• Changes in appetite as they grow
• Previous experiences such as choking, gagging, or feeling sick
• Difficulty chewing or swallowing
• Being tired, overstimulated, or not hungry
• Wanting more independence and control

How can you help?

Take the pressure off.
Try to avoid forcing, bribing, or making a child eat a certain food. Pressure can make mealtimes feel stressful and may make a child more hesitant to explore food.

Offer familiar foods alongside new foods.
Including at least one food your child usually enjoys can help them feel safe as they learn something new.

Let your child decide what and how much to eat from the foods you provide.
Adults are responsible for offering food. Children can learn to listen to their own hunger and fullness cues.

Give children opportunities to explore food.
Eating isn't the only way children can become comfortable with a new food. Looking at it, touching it, smelling it, licking it, or having it on their plate can all be steps toward trying it.

Keep mealtimes predictable.
Regular meals and snacks can help children know when food will be available and give them opportunities to practice eating when they are hungry.

Eat together when you can.
Children learn a lot by watching the people around them. Seeing adults and siblings enjoy a variety of foods can make new foods feel more familiar.

Try not to make food a battle.
It is okay if your child does not eat everything you offer. You can calmly remove the food and offer it again another time.

Remember

Learning to eat is a process. A child may need to encounter a food many times before they feel comfortable eating it-and sometimes they may never like a particular food. That's okay.

The goal is not to make a child eat a certain food. The goal is to help children develop a comfortable, positive relationship with food while ensuring their nutritional needs are met.

When to seek additional support

Talk with your child's pediatrician or another qualified professional if you notice things such as frequent choking or coughing while eating, difficulty chewing or swallowing, significant distress around eating, a very limited range of foods, avoidance of entire food groups, poor growth, or concerns about whether your child is getting enough nutrition.

For children with significant feeding difficulties, a pediatric feeding or occupational therapy evaluation may be helpful.

Transitions are a big part of childhood. Getting dressed, leaving the house, cleaning up toys, going to school, getting in the car, going to bed, and moving from one activity to another all require children to stop what they are doing and shift their attention and body to something new.

For young children, this can be surprisingly difficult. Their brains are still developing the skills needed for flexibility, impulse control, emotional regulation, and understanding what comes next.

A difficult transition does not necessarily mean a child is being defiant or "not listening." Sometimes their behavior tells us that the change feels hard.

Why might transitions be difficult?

Children may have a harder time transitioning when they are:

• Deeply engaged in something they enjoy
• Tired, hungry, or overstimulated
• Unsure about what is happening next
• Having difficulty shifting their attention
• Sensitive to changes in routine
• Wanting more control or independence
• Worried about what comes next
• Still developing their understanding of time
• Having a particularly difficult day

How can you help?

Give a heads-up.
Let your child know that a transition is coming: "Five more minutes, then it will be time to clean up."

For younger children, visual or concrete cues can be especially helpful.

Make the next step predictable.
Try to use the same language or routine whenever possible: "First shoes, then car."

"First pajamas, then books."

Give simple choices.
Small choices can give children a sense of control while keeping the transition moving:
"Do you want to put your shoes on first or your coat?"

Use visual cues.
Pictures, a simple visual schedule, timers, songs, or objects that represent what comes next can help children understand what to expect.

Connect before redirecting.
Acknowledge that stopping something can be hard:
"You really wanted to keep playing. It's hard to stop when you're having fun."

Understanding the feeling does not mean changing the boundary.

Make transitions playful when you can.
Try a cleanup song, race to the bathroom, pretend to be a train on the way to the car, or let your child carry something important. Play can make a difficult shift feel more manageable.

Allow extra time.
Young children often need more time than adults expect to shift from one activity to another. When possible, build transition time into the routine rather than expecting children to switch instantly.

When a transition becomes a meltdown

Sometimes, despite our best efforts, a child will have a very big reaction. When this happens, focus first on safety and regulation rather than teaching or reasoning.

Use fewer words, stay calm, and offer support. Once your child's body is calm, you can reconnect and move forward.

You do not have to prevent every big feeling. Children can experience disappointment, frustration, and anger while still being supported through them.

Remember

Transitions are a skill that develops over time. A child who struggles to leave the playground today may gradually learn to handle saying goodbye to something they enjoy.

Predictability, connection, and practice can make transitions easier-but they do not have to be perfect.

If transitions consistently cause significant distress, interfere with daily routines, or make it difficult for your child to participate at home, school, or in the community, talking with your child's pediatrician or a child development professional may be helpful.

Parenting can be complex and bring a unique mix of emotions and challenges.

Our ancestors raised children with the support of their entire families. Grandparents, aunts, uncles, great-grandparents, and cousins. Many of our people still have this support today, and many don't. Children are sacred, highly respected, and central to the family. This parenting and community style was forever altered after boarding schools forcefully took our children and tore our communities apart.

Our ancestors raised children with the support of their entire families. Grandparents, aunts, uncles, great-grandparents, and cousins. Many of our people still have this support today, and many don't. Children are sacred, highly respected, and central to the family. This parenting and community style was forever altered after boarding schools forcefully took our children and tore our communities apart.

Taking care of ourselves as Native people and Tulalip people has many different aspects.

Mentally: Signs that we need support mentally can range from feelings of isolation, feelings of anger, feeling short-tempered, forgetfulness, and feelings of sadness. Some things that can help our mental health include: talking to our elders and friends in our community, going to therapy, and doing something for ourselves every single day, even if it is small.

Physically: Signs that we need support physically include feeling exhausted, trouble eating or sleeping, or having physical pain in our bodies. Things that can help us physically: seeing specialists (massage therapist, acupuncturist, physical therapist), walking outside, going to the Y (using our free membership), or taking a long nap.

Emotionally: Signs that we need support emotionally can vary greatly, especially depending on our personal experiences. Some people may feel isolated, disconnected, unsure of who they are, misunderstood, numb, angry, and intensely sad. We have so many things we can do for our emotional health. We can go to community gatherings/jams, go to a sweat, sing one of our songs, go to the water, go into nature, weave cedar/wool/bead, join a BJTELA cultural event, or watch canoe journey videos on YouTube.

Spiritually: Signs that we need support spiritually include feeling disconnected, tired, unfulfilled, and detached. Some things we can do to help ourselves include going to jams or pow wows, practicing a cultural art, making a craft, visiting loved ones at our cemetery, going to a sweat lodge, singing, dancing, going into nature, and visiting with loved ones.

You are not alone in parenting. We are here to help and support you.

These are some of the songs we play with our kids in our music groups at BJTELA.

• These are the Colors lushootseed
• Happy and Loved
• Goodbye Song
• Nettle Song
• Goodnight Baby