Does My Child Need Help?

We all worry about our kids. Sometimes our worries are about whether they are developing in a healthy way. (Should he be talking by now?) Or about whether they are happy—we don’t like to see them sad or suffering. And sometimes we worry because a child’s behavior is causing problems for him—or for the whole family.

One of the challenges of parenting is knowing when a worry should prompt action. How do you know when to get help for a child who is struggling? Keep in mind that there is a lot of variation in how kids develop, and a broad range of behavior that’s typical and healthy (if sometimes troublesome) as children grow up. So you don’t want to overreact. But when the behaviors you worry about are seriously interfering with your child’s ability to do things that are age-appropriate, or your family’s ability to be comfortable and nurturing, it’s important to get help.

Here are some things mental health practitioners recommend you consider in deciding whether a child needs professional help.

  1. What are the behaviors that are worrying you? To evaluate your situation clearly, it’s important to observe and record specifically the things you are concerned about. Try to avoid generalizations like “He’s acting up all the time!” or “She’s uncooperative.” Think about specific behaviors, like “His teacher complains that he can’t wait for his turn to speak,” or “He gets upset when asked to stop one activity and start another,” or “She cries and is inconsolable when her mother leaves the room.”
  2. How often does it happen? If your child seems sad or despondent, is that occurring once a week, or most of the time? If he is having tantrums, when do they occur? How long do they last? Since many problematic behaviors—fears, impulsiveness, irritability, defiance, angst—are behaviors that all children occasionally exhibit, duration and intensity are often key to identifying a disorder.
  3. Are these behaviors outside the typical range for his age? Since children and teenagers exhibit a wide range of behaviors, it can be challenging to separate normal acting up, or normal anxiety, from a serious problem. It’s often useful to share your observations with a professional who sees a lot of children—a teacher, school psychologist, or pediatrician, for instance—to get a perspective on whether your child’s behaviors fall outside of the typical range for his age group. Is he more fearful, more disobedient, more prone to tantrums, than many other children? (See our Parents Guide to Developmental Milestones for children five and under.)  
  4. How long has it been going on? Problematic behavior that’s been happening for a few days or even a few weeks is often a response to a stressful event, and something that will disappear over time. Part of diagnosing a child is eliminating things that are short-term responses, and probably don’t require intervention.
  5. How much are they interfering with his life? Perhaps the biggest determinant of whether your child needs help is whether his symptoms and behaviors are getting in the way of his doing age-appropriate things. Is it disrupting the family and causing conflict at home? Is it causing him difficulty at school, or difficulty getting along with friends? If a child is unable to do things he wants to do, or take pleasure in many things his peers enjoy, or get along with teachers, family members and friends, he may need help.