Does My Child Have an Emotional or Behavioral Disorder?

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Perhaps the most important question of all for parents of school age children to consider is, "How much distress is your child's problems causing you, the child, or other members of the family?" If a child's aggressive or argumentative behaviors, or sad or withdrawn behaviors are seen as a problem for a child or members of his or her family, then the child' s behaviors are a problem that should be looked at, regardless of their severity.

While there is no substitute for parental knowledge, certain guidelines are also available to help families make the decision to seek an evaluation. In Help for Your Child, A Parents Guide to Mental Health Services, Sharon Brehm suggests three criteria to help in deciding whether a child's behavior is normal or a sign that the youngster needs help:

• The Duration of a Troublesome Behavior - Does it just go on and on with no sign that the child is going to outgrow it and progress to a new stage?

• The Intensity of a Behavior - For instance, while temper tantrums are normal in almost all children, some tantrums could be so extreme that they are frightening to parents and suggest that some specific intervention might be necessary. Parents should pay particular attention to behaviors such as feelings of despair or hopelessness; lack of interest in family, friends, school or other activities once considered enjoyable; or behaviors which are dangerous to the child or to others.

• The Age of the Child - While some behavior might be quite normal for a child of two, observation of other children of the youngster's age may lead to the conclusion that the behavior in question is not quite right for a five year old. Not all children reach the same emotional milestones at the same age, but extreme deviations from age-appropriate behaviors may well be cause for concern.

Attempts at self-injury or threats of suicide, violent behaviors, or severe withdrawal that creates an inability to carry on normal routines must be regarded as emergencies for which parents should seek immediate attention, through a mental health or medical clinic, mental health hotline, or crisis center.

Parents will also want to consider whether their child's behavior could be influenced by other factors:

• whether a specific physical condition (allergies, hearing problems, change in medication, etc.) could be affecting the behavior;

• whether school problems (relationships, learning problems) are creating additional stress;

• whether the adolescent or older teen might be experimenting with drug use or alcohol; or

• whether changes in the family (divorce, new child, death) have occurred which may be causing concern for the child.

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