In my years as a teacher and school counselor, one of the most common questions I would get asked is, “Does my child need therapy?”. Parents would ask me this question: whether their child was in trouble for the very first time or if it was the 10th time. They would ask it after the loss of the family dog or when a grandparent was sick. It came up all the time. Parents would ask about their child needing therapy in hopes to support their child as best as they could as well as to stop any undesired behavior their child was exhibiting. If this is a question you have ever asked, then here are the signs you can look for to determine if your child needs therapy.
According to the CDC, 9.8% of children ages 3-17 have been diagnosed with ADHD, 9.4% have been diagnosed with anxiety, 8.9% have behavioral problems, and 4.4% have been diagnosed with depression. It is also notable that about 3 in 4 children diagnosed with depression also had anxiety, and almost 1 in 2 children diagnosed with depression had behavior problems. More than 1 in 3 children diagnosed with anxiety also had behavior problems. The statistics show us that enough children have these diagnoses that parents, teachers, and doctors should be more aware of the signs a child needs therapy.
Before you can recognize the signs that your child needs therapy, it is essential to know what typical emotional and behavioral development looks like in children. Emotional and behavioral development for children can be seen through the lens of these social-emotional developmental stages.
- Infancy: In their first year of life, infants learn about social cues from their parents and others who interact with them. They respond to smiles and regulate themselves with gentle, calming voices. As they age, they learn turn-taking in conversations (vocalizations) and how to communicate how they are feeling to their caregivers. For example, the baby cries when you take his toy away or is happy when you hold him.
- 12-18 Months Old: At this time, the child really begins to explore their environment with support from their caregivers. The child begins to engage more in play and learn how to interact with others. They may even begin to learn the art of sharing their toys and actively involve themselves in simple household tasks.
- 2-4 Years Old: As the child grows into a toddler, they develop their impulse control and friendship skills. During these years, the child tests the limits of their behaviors and sees what they can and cannot get away with. They can play appropriately with 3-4 peers at a time and are beginning to be able to control some of their emotions.
- 5-6 Years Old: By the time a child is 5, they are able to follow simple rules and directions. They can reflect on their actions and emotions as they play with their friends and learn in school. Children at this age are learning adult social skills, such as giving praise and apologizing when they make a mistake.
- 7-8 Years Old: At this age, children fully understand the different rules around them. They take on more responsibilities, and their morals begin to develop more fully. As they continue to grow, they develop more complex coping skills (e.g., taking a break, deep breathing) and explore their own ideas.
- 9-10 Years Old: Once a child reaches this age, they start to prioritize their friendships over their families. They become more independent and engage in more risky behaviors to explore the boundaries placed by the adults in their lives. This is the age when they learn how to navigate disagreements and express their emotions effectively.
Recognizing Signs of Distress
Young children do not always have the ability to express how they are feeling, and there are not always obvious reasons why they are in distress. Because of this, knowing when they are distressed and in need of help can be difficult. Three of the most common signs of distress for children are emotional indicators, behavioral changes, and academic performance.
- Emotional indicators refer to your child’s emotional expression. Children can be very expressive in their emotions. They may go through several emotions throughout the day, just like we do as adults. That being said, persistent sadness or anxiety, frequent mood swings, and low self-esteem can all be signs your child may be in distress. This could look like frequent crying spells or emotional outbursts over little things. These emotional changes will stand out as they will be disruptive to your daily life, not just small bumps in the road like most emotional changes can be.
- Behavioral changes may be slow to notice, and they can be a key signal your child is in distress. Some common behavioral changes you may see include isolation, withdrawal from friends, and lack of desire to engage in their usual activities. Maybe they no longer want to play with their friends or ask not to have to go to baseball practice anymore. Behavioral changes can also include changes in sleep (insomnia or nightmares) and appetite (increase or decrease). If you notice any significant or long-term changes like these, your child may be in distress and in need of therapy.
- Declining academic performance can be a significant sign that your child is not doing well. You may see sudden drops in their grades, difficulty concentrating, or lack of desire to go to school. This lack of interest or ability to perform at school can stem from your child’s mind being overwhelmed with other events going on in their life. While declining academic performance may take time for you to notice, once you do, seeking help for your child can be most beneficial.
Specific Situations That May Warrant Therapy
For some children, there are specific situations they may face that warrant some time in therapy to help them cope. These specific situations include major life changes, traumatic experiences, and chronic health issues.
- Major life changes for a child could include a divorce, relocation, or the loss of a loved one. These situations could also include going from elementary school to middle school, middle school to high school, or the loss of a family pet. Keep in mind that the size of the life change is not what is important here; it is the simple fact that the life change feels major to your child.
- Traumatic experiences can include exposure to violence, abuse, or significant stress at home or school. Many of our kids are being exposed to violence at much younger ages than ever before due to school shootings and practicing school safety. These events leave children feeling anxious and overwhelmed that they, too, may be harmed one day.
- Chronic health issues are ongoing medical conditions that impact a child’s well-being. These health issues may be ones the child is facing or a close family member who lives in their home. The longer the chronic health issue is around for the child, the more likely they are to be impacted by it.
The Role of Parents and Caregivers
Awareness of the signs your child is in distress and specific situations that could warrant therapy is the first step in helping your child. As parents and caregivers, your role is vital in getting your child the help that they need. It is encouraged that you open up lines of communication with your child and help them learn that talking about their feelings and behaviors is ok. Listening to your child when they do share shows your child you care and want to help them. Here are a few ways you can initiate conversations about feelings and behaviors with your child.
- Have daily check-ins. Each day after your child comes home from school, ask them how their day was. Show them a feelings chart and have them check in with you each evening on how they are feeling.
- The High/Low Game. At the dinner table or before bed, have each family member go around and share their high point and low point of the day. This allows you, as parents, to model for your child that you have tough days and how you overcame hard challenges.
- Have a shared journal. Grab a blank journal from the store and start writing about your thoughts, feelings, and behaviors and then give it to your child to read and share back with you. This journal can be a safe way for your child to communicate with you what is going on when they have difficulty talking to others.
When and How to Seek Help
If you notice your child is displaying any of the above signs or is going through any of the specific situations listed, it is a good time to start looking for professional help. You can begin by talking to your child’s school counselor or researching child therapists local to you. Once you find someone you think would be a good fit, reach out and get scheduled.
If you and your child are in the Tampa Bay/ St. Petersburg area, please reach out to us at Integrated Care Clinic. Several of our clinicians specialize in working with children with a variety of presentations. Allow us to walk alongside you and your family and help you find the help you need.
