Does Your Child Need a Mental Health Evaluation?

By Michael Oberschneider, Psy.D., author of Ollie Outside: Screen-Free Fun

Does Your Child Need a Mental Health Evaluation?Young children achieve their developmental milestones through engaging in life—moving, acting, speaking, learning, and playing—and while development isn’t perfectly linear, developmental milestones are expected to occur within a certain range. When delays do occur outside of that range, the appropriate professionals are then typically engaged. For example, a five-year-old child with significant speech articulation struggles should be evaluated by a speech and language pathologist. A four-year-old child with significant gross motor delays should be evaluated by an occupational therapist.

Insofar as there are distinct moments in development when a child should be crawling, walking, talking, smiling, and so on, there’s typically an evaluation and a treatment to help the child get back on track when she has a delay or problem.

Although research has shown that early intervention for neurodevelopmental conditions (e.g., autism or ADHD) and emotional and behavioral conditions is extremely important for symptom reduction and improvements in well-being, parents don’t always know exactly when a mental health problem lies outside the norm or the normal range for their young children. Moreover, accepting that there’s a mental health problem is also challenging for parents for a variety of reasons—parents may not want their child to be “labeled,” they may feel ashamed or responsible for the problem, they may want to protect their child (and themselves) from the problem, or they may not be ready to deal with the news of a real or perceived negative diagnosis.

Here are four tips to help parents decide if a mental health evaluation is warranted for a young child.

In my opinion, parents are the best first responders and diagnosticians for their children; when children have social, emotional, developmental, learning, or behavioral problems, nine times out of ten, moms and dads are aware of the issue or issues before anyone else. So, use your paternal and maternal instincts and love to identify your child’s struggles when they occur in your presence. Parental observations across several different settings (structured and unstructured) and with different individuals is helpful in determining the seriousness of a possible problem. It’s one thing for your child to become overly sensitive or upset with himself in one setting or with specific individuals (e.g., when his soccer team loses), but it’s an entirely different thing for your child to experience more pervasive symptoms of anxiety or depression.

Listen to others.
Being open to what others say is important when it comes to accepting that your child may have mental health problems. Teachers, family friends, and grandparents, among others, may have very important information about your child for you, even if what they say is difficult to hear. I recently diagnosed a four-year-old boy with autism, and although that diagnosis was upsetting for the boy’s parents, they weren’t surprised—the boy’s grandparents and speech therapist had already expressed concerns regarding notable communication, social, and self-regulation struggles for the boy.

Address your feelings.
As parents, we all want to do what’s best for our children, but we also want to avoid upsetting our children in the process whenever possible. Parents often turn to me for help after the social, emotional, or behavioral problem(s) has become very serious. In these cases, the delay to have the child evaluated and treated doesn’t happen because the parents don’t love their child; rather, it’s because they do. Whether a child is experiencing anxiety, depression, behavioral problems, or developmental delays, coming to terms with the notion that professional help may be needed can take time. Speaking openly with your partner about your concerns is a good starting place toward working together to get your child evaluated and treated.

See a child specialist.
If you’re concerned about your child’s mental health, your child’s pediatrician, in my opinion, is the best professional to speak to initially. Pediatricians typically don’t treat mental health conditions, but they will educate you regarding your concerns as well as provide you with support and guidance and referrals to specialists in your child’s area of need. Board-certified child psychologists and child psychiatrists are trained to evaluate and treat mental health conditions in younger children.

Author Michael OberschneiderMichael Oberschneider, Psy.D., is a clinical psychologist and the founder and director of Ashburn Psychological and Psychiatric Services, a private mental health practice located in Northern Virginia. He has been featured as a mental health expert on CNN, Good Morning America, and other popular media outlets, and he has written articles for several news agencies, including The Washington Post. Dr. Oberschneider has also received Washingtonian Magazine’s “Top Therapist” honor for his work with children and adolescents. He lives in Leesburg, Virginia, with his wife Liz and two children, Ava and Otto.

Ollie Outside: Screen-Free FunMichael Oberschneider is the author of Ollie Outside: Screen-Free Fun.

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