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Behavioral Issue or Mental Illness?

When your child can't pay attention, won't follow directions or has temper tantrums, it's hard to know what to do. Is it just a stage, like the "terrible 2s"? Or is it a real health issue? Should you work on it yourself or talk with a doctor?

"If these problems persist and get in the way of your child's daily activities, you should talk with your doctor," says Ann Davis, PhD, MPH, ABPP, pediatric psychologist at The University of Kansas Health System. "This topic should be part of any well-child checkup. Most primary care doctors and pediatricians do a really good job of picking these things up."

If it turns out your child does need professional help, Dr. Davis says, don't be dismayed. Most childhood mental health issues can be addressed with behavioral training for the parent and child. Medication can help some children, too.

Common mental health issues in children

  • All kids have some anxiety. But it gets in the way of daily life for 3-5% of them. Parents should notice when their child doesn't want to play with friends or go to school. Fixating on a topic and having frequent stomachaches or headaches are signs you need to check with a doctor.

    "Gentle reassurance from Mom or Dad is always helpful," says Dr. Davis. "If that's not enough, you might want to seek behavioral therapy or medicine."

  • Attention deficit hyperactive disorder (ADHD) is the most common mental health issue for children. It affects 7-9% of those ages 3-17. You may notice it earlier in boys. They may seem impulsive, move around quickly and can't sit still. Girls are often diagnosed later, when they start school and have trouble paying attention. The most common treatments for ADHD are behavioral parent training and medicines.

  • Autism affects just 1-2% of children. It's often spotted before age 3. A child with autism may seem to stay in his own world, avoid talking, restrict eating and have little social interaction.

    "A kid without autism will pick up a caterpillar and show it to you, or hear a loud sound and look to you for an explanation," says Dr. Davis. "One with autism might process the experience internally."

    It's important to recognize and treat autism early, she says, so be sure to bring it up with your doctor.

    "Intensive applied behavior analysis – as much as 30 hours a week – can make a big difference in the prognosis."

  • About 2% of all kids ages 3-17 have depression right now. It's expected that 3-6% will develop it at some time during childhood. Kids with depression are often sad and irritable, and they may have dramatic mood swings. Your doctor can give you a simple survey to see how your child compares with others. Behavioral parent training and medicine can be effective.

  • About 3-5% of kids in this age range have conduct problems. They often have temper tantrums and don't do what they're told. This can turn into oppositional defiant or conduct disorder later in life.

    "All kids defy their parents sometimes," says Dr. Davis. "But when the child never does what she's told, you may want to seek help."

    Dr. Davis suggests working with a behavioral health provider to learn new ways of working with your child.

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COVID-19 and your kid

For information on how COVID-19 affects kids, visit healthychildren.org. You can also use Our Behavior Checker® for help understanding your child's behavior during the pandemic.

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