Children’s Mental Health

Children’s Behaviors and Emotions

According to the Children’s Mental Health and Emotional or Behavioral Disorders Project, among all the dilemmas facing a parent of a child with emotional or behavioral problems, the first question — whether the child’s behavior is sufficiently different to require a comprehensive evaluation by professionals — may be the most troublesome of all. Even when a child exhibits negative behaviors, members of a family may not all agree on whether the behaviors are serious. For instance, children who have frequent temper outbursts or who destroy toys may appear to have a serious problem for some parents, while others see the same behavior as asserting independence or showing leadership skills.

Every child faces emotional difficulties from time to time, as do adults. Feelings of sadness, loss, or emotional extremes are part of growing up. Conflicts between parents and children are also inevitable as children struggle from the “terrible twos” through adolescence to develop their own identities. These are normal changes in behavior due to growth and development. Such problems can be more common in times of change for the family, such as the death of a grandparent or family member, a new child, or a move. Generally, these kinds of problems tend to fade on their own or with limited visits to a counselor or other mental health professional as children adjust to the changes in their lives.

At times, however, some children may develop inappropriate emotional and behavioral responses to situations in their lives that persist over time. The realization that a child’s behavior requires professional attention can be painful or frightening to parents who have tried to support their child, or it may be accepted and internalized as a personal failure by the parent.

Sometimes parents fear that their child may be inappropriately labeled. They have concerns that the array of medicines and therapies suggested are not always agreed upon by all professionals. Still, others become alarmed after obtaining an evaluation for their child only to discover that the evaluator believed emotional disturbances originate in family dynamics and that “parenting skills” classes were the best way to address the problem.

While many parents will concede that they may need to learn new behavior management or communication techniques in order to provide a consistent and rewarding environment for their child, many also express deep anger about the blame that continues to be placed on families with children who behave differently.

Children’s Mental Health Assessment

Before seeking formal mental health evaluation, parents may have tried to help their child by talking to friends, relatives, or the child’s school. They may try to discover whether others see the same problems and to learn what others suggest. Parents may feel that they also need help in learning better ways of supporting the child through difficult times and may seek classes to help them sharpen behavior management or conflict resolution skills. Modifications in a child’s routine at home or school may help to establish whether some “fine-tuning” will improve performance or self-esteem.

If the problems a child is experiencing are seen as fairly severe and are unresponsive to interventions at school, in the community, or at home, a diagnostic evaluation by a competent mental health professional is probably in order. Evaluations provide information that, when combined with what parents know, may lead to a diagnosis of a mental health, emotional, or behavioral disorder.

So what is that magical moment when parents should recognize their child’s behavior has surpassed the boundary of what all children do and has become sufficiently alarming to warrant a formal evaluation? There probably isn’t one. It is often a gradual awareness that a child’s emotional or behavioral development just isn’t where it should be that sends most parents on a quest for answers.

Perhaps the most important question of all for parents of school-age children to consider is, “How much distress is your child’s problem causing you, the child, or other members of the family?” If a child’s aggressive or argumentative behaviors or sad or withdrawn behaviors are seen as a problem for a child, the school, or members of his or her family, then the child’s behaviors are a problem that should be looked at, regardless of their severity.

While there is no substitute for parental knowledge, certain guidelines are available to help families make the decision to seek an evaluation. In Help for Your Child: A Parent’s Guide to Mental Health Services, Sharon Brehm suggests three criteria to help in deciding whether a child’s behavior is normal or a sign that the youngster needs help:

  • Duration of troublesome behavior. Does it just go on and on with no sign that the child is going to outgrow it and progress to a new stage?
  • The intensity of behavior. While temper tantrums are normal in almost all children, some tantrums could be so extreme that they are frightening to parents and suggest that some specific intervention might be necessary. Parents should pay particular attention to their child’s feelings of despair or hopelessness; lack of interest in family, friends, school, or other activities once considered enjoyable; or behaviors that are dangerous to the child or to others.
  • Age of the child. Some behavior might be quite normal for a two-year-old, but observation of other children that age may lead to the conclusion that the behavior in question is not quite right for a five-year-old. Not all children reach the same emotional milestones at the same age, but extreme deviations from age-appropriate behaviors may well be cause for concern.

Attempts at self-injury or threats of suicide, violent behaviors, or severe withdrawal that creates an inability to carry on normal routines must be regarded as emergencies for which parents should seek immediate attention, through a mental health or medical clinic, mental health hotline, or crisis center.

Parents will also want to consider whether their child’s behavior could be influenced by other factors, such as:

  • a specific physical condition (allergies, hearing problems, change in medication, etc.) that could be affecting the behavior;
  • school problems (relationships or learning problems) that are creating additional stress;
  • experimenting with drug use or alcohol for an adolescent or older teen; or
  • changes in the family (divorce, new child, death) that may cause concern for the child.

Children's Mental Health