Clinical Reference Systems: Pediatric Advisor 10.0

Parents are naturally concerned about the health and welfare of their children. Many parents correctly see their youngster as normal. However, some other parents worry about whether their infant, child, or teenager has a psychological problem. These worries may be about various things, for example:

• how the child is developing
• the emotional well-being of the child
• what the child says and thinks
• how the child acts (for example, eating and sleeping patterns, behavior at school, and the ability to get along with family and friends).

Physicians and mental health professionals can help parents determine whether their child is normal. These experts usually examine the child and ask the parents about the child's previous health and behavior. They may also ask about how the family gets along together. It is likely that infants, children, and teenagers are normal when, at the appropriate age, they enjoy their:

• learning, school, or work
• relationships within the family
• relationships with friends
• play.

Many parents first discuss their concerns about their child's normality with a family member or friend, the child's physician, a school counselor, or a member of the clergy. The family may then be referred to a child and adolescent psychiatrist or other specialist. A physician or mental health professional will listen carefully to the parents and child and sort out:

• the long-term factors that tend to lead to, or protect against, the development of problems
• the short-term factors that set off the child's problems
• the factors causing these problems to persist
• the role of medical conditions
• the combined effect of school learning with social and emotional growth.

Based on the evaluation, the physician or mental health professional may:

• reassure the parents, explaining how they can enhance normal development and be more effective in parenting
• suggest activities or an educational program for the child and/or education for the parents, which will support normal development
• provide or arrange for brief counseling to help the child and parents with minor developmental problems, stressful life situations, or difficulties with the child's temperament.

If the evaluation reveals a psychiatric illness, a specific treatment program will be recommended by a mental health professional.

Parents know their child better than anyone else and know what behavior is usual for their child. If there appears to be a problem, seeking professional help may be difficult but is very important. It is the first step in knowing for sure whether there is a problem and if so, what measures will best help the child.