Childhood Mental Health: Toddler and Preschooler Red Flags

by Kevin B. Doyle

Depressed boyHow people, even little kids, think, feel and act as they encounter life's ups and downs affects our mental health. When all is functioning as it should, good mental health allows children to think clearly, develop socially and learn new skills.

According to the CDC, in 2005–2006, 15 percent of U.S. children ages 4 to 17 years had parents who talked to a healthcare provider or school staff member about their child's emotional or behavioral difficulties. About five percent of those children received medication and another five percent also received treatment other than medication for challenges.

Toddler and Preschooler Mental Health

Can you imagine the panic that would ensue if we saw adults behaving like ordinary kids? Getting angry easily, failing to pay attention to what's going on, pestering other people, repeating what's said to them, taking off their clothes in public or asking embarrassing questions in loud voices?

These activities are all things that might cause concern regarding an adult's mental health, but they are regular, commonplace, developmentally-appropriate events in the lives of toddlers and preschoolers. However, there are other, less desirable behaviors your child could display that signal a potential mental health problem.

Most kids act "sad" if they don't get their way, have a short attention span at times or defy a request. As long as these feelings or behaviors don't last or interfere too much in their day to day activities, there's probably nothing to worry about.

If your child seems to be experiencing severe or long-lasting distress, it's an indicator of a mental health problem. Here are some of the signs your child might be having troubles:

Always Unhappy

All children will be sad at times. They might not feel well, someone was mean to them, or the family pet might have died. For some, the sadness doesn't go away. You might want to get help if, for two weeks or more, your child:
• Rarely laughs or smiles,
• Lacks usual energy
• Begins doing poorly at preschool
• Is very irritable, moody, or grumpy
• Becomes overactive, destructive, or overly sensitive,
• Gets into fights constantly

If your child says they want to die or resorts to self-harm, please seek immediate professional help.

Extremely Anxious

Healthy kids have periods of anxiety. They're afraid of things like loud noises or separation from their parents. They might develop patterns of doing things like washing their hands excessively or
lining up their toys. It's time to consider help when your child:

• Maintains patterns of repetitive activity for a long time • These begin to interfere with sleep, appetite, or normal activities
• Complains of frequent headaches or stomach aches
• Starts to worry all the time
• Frequently worries about death

Lacks Friends

Kids need friends. Some children prefer a small group to a large group. It's time to get help if your child:

• Has difficulty relating to other children his age
• Has trouble making friends because of overly aggressive or frightening behavior
• Has trouble making friends because habits or behavior seem strange to other kids
• is constantly teased or socially isolated

Short Attention Span

At times, all children have a short attention span, but you might want to get help when a child stands out as inattentive. Signals of a problem include:

• Can't focus on an activity as long as other kids of the same age
• Frequently fails to listen to instructions
• Is often overactive
• Regularly acts without thinking first
• Is easily distracted
• Is constantly being scolded or corrected
• Endangers self or others

Defiant and Aggressive

Every child has times when they don't behave. During the toddler years, defiance appeared to be a positive development. You might ask for help when your child:

• Has frequent temper outbursts or more than other children
• Has constantly battles for control with adults
• Seems spiteful and openly defiant
• Is disrespectful and tries to hurt adults or other children
• Can't stay in child care or preschool because of defiant behavior

Inappropriate Behaviors

Mental health problems show up in other ways, too. You might consider talking with a professional when your child:

• Displays behavior which should have been outgrown long ago, such as clingy behavior or toilet accidents
• Displays sexual behavior that exceeds normal childhood curiosity
• Repeatedly plays with fire or is cruel to animals
• Hears voices or sees things that aren't there except when involved in imaginary play

The signs of mental illness in children vary by age and type of condition. However, two warning signs tend to cross over into all categories and signal that you should consult with an emotional health professional experienced in kids' psychology.

Extreme or peculiar behavior for the age and gender of the child, such as being significantly more hyper, aggressive, or withdrawn
Sudden, hard-to-explain negative changes in behavior, such as a steep decline in school performance

Finding Help

Many parents choose to talk to their family doctor or pediatrician first about their concerns. If more help is needed, the doctor can suggest names of counselors, social workers, psychologists, and psychiatrists who specialize in treating children with mental health issues.

Parents also reach out and touch base with other families in the community, family network organizations, crisis outreach teams, family resource centers and support groups.

If your child's hurting, don't be ashamed to ask for assistance. Appropriate treatment can help your child learn to cope with trauma. Adults who understand a child's abilities can help the child develop necessary skills.

Have you dealt with this situation? What worked for you?