Does My Child Need a Psychiatrist?

Parents are usually the first to recognize that their child has a problem with emotions or behavior. Still, the decision to seek professional help can be difficult and painful for a parent. The first step is to gently try to talk to the child. An honest open talk about feelings can often help. Parents may choose to consult with the child’s physicians, teachers, members of the clergy, or other adults who know the child well. These steps may resolve the problems for the child and family.

Following are a few signs which may indicate that a child and adolescent psychiatric evaluation will be useful.

YOUNGER CHILDREN

  • Marked fall in school performance
  • Poor grades in school despite trying very hard
  • Severe worry or anxiety, as shown by regular refusal to go to school, go to sleep or take part in activities that are normal for the child’s age
  • Frequent physical complaints
  • Hyperactivity; fidgeting; constant movement beyond regular playing with or without difficulty paying attention
  • Persistent nightmares
  • Persistent disobedience or aggression (longer than 6 months) and provocative opposition to authority figures
  • Frequent, unexplainable temper tantrums
  • Treats to harm or kill oneself

PRE-ADOLESCENTS AND ADOLESCENTS

  • Marked decline in school performance
  • Inability to cope with problems and daily activities
  • Marked changes in sleeping and/or eating habits
  • Extreme difficulties in concentrating that get in the way at school or at home
  • Sexual acting out
  • Depression shown by sustained, prolonged negative mood and attitude, often accompanied by poor appetite, difficulty sleeping or thoughts of death
  • Severe mood swings
  • Strong worries or anxieties that get in the way of daily life, such as at school or socializing
  • Repeated use of alcohol and/or drugs
  • Intense fear of becoming obese with no relationship to actual body weight, excessive dieting, throwing up or using laxatives to loose weight
  • Persistent nightmares
  • Threats of self-harm or harm to others
  • Self-injury or self destructive behavior
  • Frequent outbursts of anger, aggression
  • Repeated threats to run away
  • Aggressive or non-aggressive consistent violation of rights of others; opposition to authority, truancy, thefts, or vandalism
  • Strange thoughts, beliefs, feelings, or unusual behaviors

If problems persist over an extended period of time or if others involved in the child’s life are concerned, consider a consultation with a child and adolescent psychiatrist or a trained mental health professional.

You may wish to complete the pediatric symptom checklist for your child. Scoring:

never=0

Sometimes=1

Always=2.

scores greater than 24 suggest you should consult a clinician if your child is 4-5 years old

Scores greater than 28 suggest you should consult a clinician if your child is 6-16 years old