Kids' behaviour: When to seek help

It’s our worst fear: There’s something wrong with our child. Like, really wrong. However, most of the childhood behaviours that parents fear are “abnormal” are, in fact, well within the realm of normal. Oh, we may not like them much, but that doesn’t make them disordered. Sure, having to coax your six-your-old onto the stage for her ballet recital is exhausting, but her stage fright needn’t earn her a diagnosis of anxiety disorder.

We worry too much. That’s our job as moms and dads. But when is that worry truly warranted? When should we ride out an on-cue developmental phase and when should we pull the chute and ask for professional help?

Read more: Kids health: What's in a label?>

It’s probably time to look for help when…

• The behaviour interferes with the normal conduct of life. Your child is crippled by his problem. His world is getting smaller, not bigger. He is unable to participate in the activities you would consider appropriate for his age. He is not going to school, or birthday parties, or participating in sports. (I had a young client whose fear of vomiting not only led to avoidance of the school lunchroom, but also to any event at which food might be served.)
• The problem is protracted and a normal “phase” persists longer than it should. Grief over the death of the family dog has turned into a depressed mood that is lasting months. A disappointment or setback at school seems unrecoverable. One of my clients was bullied, once, in the playground, but despite mediation, was unable to move past the event. His self-esteem remained stuck in “victim” mode.
• The problem is persistent. All your attempts to intervene have failed. This may be a signal that there’s more going on than meets the eye. There may be deeply entrenched beliefs that require a complete re-setting of the internal GPS. A first-born child who staunchly refuses to believe that she is loved as much as her sibling, despite the mounting evidence to the contrary, is just one example. And here’s another: your daughter insists she’s fat no matter what you, the doctor and the scale tell her.
• The problem is affecting other family members. You’re starting to doubt yourself (and you find solace, nightly, at the bottom of a bottle chilled Sauvignon Blanc). Siblings are starting to react negatively, or, worse, even compensate for their sib’s “issue.” They anticipate their reclusive sister’s anti-social behaviour and work harder to smooth troubled waters, or hide the behaviour. In some instances, angelic siblings become invested in keeping the “trouble” child troublesome so that their own halo stays shiny.
• The problem is aberrant. Your gut says the behaviour is uncharacteristic of your child. Your free spirit all of a sudden becomes conformist. Your social butterfly turns wallflower. Miss Independent gets clingy. When a child’s very temperament changes, there may be some cause for concern. (Caveat: in the teen years it’s normal to experiment with guises, before, typically, settling comfortably back into the self we were before adolescence. Bottom line: trust your gut. Most therapists see clients when they’re in crisis mode. Don’t wait that long.