Parents worry about their children’s health. They go to well-checks, monitor their growth, try to provide good nutrition and a safe environment, and still, things go wrong. Sprains, cuts, rashes and fevers are all concrete warning signs that a child needs attention or medical care, but parents know not every condition that needs treatment comes with an obvious signal.
Sometimes the clue to a problem (like ADHD, childhood depression and a host of other possible issues) is more subtle. Usually it starts with an observation, such as “my child doesn’t notice when I am speaking to him,” or “my child’s activity seems a lot higher (or much less) than I expected,” or “my child is always angry.”
Dr. Bob Zajac, a pediatrician at New Kingdom Pediatrics with specialized training in child development, special education and holistic care, says what is considered “normal behavior” changes depending on the child’s age and that problems are not uncommon.
“We think that about 20-30 percent of kids in the first 18 years of life will have a diagnosed mental/behavioral condition,” Zajac says, “but up to 50 percent will experience symptoms that get really close to at least catching the attention of a professional. It might be for a three-month window when they are 13 or it might be for four years between the ages of 2 and 6 when we’re wondering when are these terrible 2’s going to end. That’s normal behavior for a 2-year- old, not a 5-year-old.”
When parents who are concerned about their child start asking questions, they may get a host of conflicting messages from family members, friends, teachers and doctors. Zajac says there are four key benchmarks a professional watches for:
- Is the child’s behavior dramatically different from other kids the same age?
- Can the symptoms be better described by a different condition? For instance, thyroid disease can look like ADHD or depression.
- Are the symptoms causing “functional impairment,” preventing the child from participating in activities usual for his/her age?
- Have the symptoms persisted longer than three to six months?
If this rings a bell, then a more focused assessment is called for, which a parent can coordinate through a pediatrician’s office, a psychologist, or the county public health system.
Marilyn Gitter, Early Childhood program coordinator with Eden Prairie Schools says, Early Childhood Family Education and Special Education are also a resource.
“Families may not be aware that [all school districts in Minnesota] offer parent education, assessment and support services for all families beginning at the birth of their child,” Gitter says. “Free parent consultations are available to answer questions about child growth and development, as well as respond to the needs of children born with extra challenges.”
Zajac emphasizes that a thorough assessment takes time.
“Making a diagnosis based on a nine-question questionnaire is not as comprehensive as a four-hour testing session,” he says. “Some kids are misdiagnosed and others go undiagnosed because [practitioners rely] on general ballpark info.”
Zajac recommends seeking out physicians with specialized training in child development, behavior and emotional health.