It’s a question every parent asks themselves, at one point or another: is my child normal? From health to behavior, every kid is different, which makes it hard to know if yours is on track.
Dr. Keri Herrmann is a child and adolescent psychiatrist. She breaks down common behaviors, identifying what is typical and what might be considered troublesome.
Parents naturally concerned about the health and welfare of their children.
It’s important to understand what are normal behaviors, feelings, and thoughts at different developmental stages. Age/stage is very important—what normal for 4 yo would not be normal for 8 yo or 12 yo. Frequency important—if it happens once a month it is very different than every day or several times a day. Degree that the behavior interferes with the child’s ability to function is important—nuisance versus keeping them from learning or making friends. Can go to teachers, pediatrician, someone who has experience with lots of children.
Bottom line—trust your instincts, your gut feelings and thoughts. As parent you know your child best.
Typical vs. Troublesome:
1. Sleep Problems
Typical—Young children don’t want to go to bed, need one more drink or story, get up often to be with parent. Going to sleep is a time of separation which causes anxiety in children, very normal. Occasional nightmares very common, problem comes if they are very frequent and interfere with the ability to sleep.
Troublesome—Child who screams uncontrollably and appears to be awake but is confused and can’t communicate—called night terrors, or a child who sleep walks appears to be awake as they move around but they are actually asleep and in danger of hurting themselves—part of parasomnias. Occurs 4-12 yo, boys, run in families. Usually single or occasional episodes but if every night or several times a night for weeks at a time or interferes with daytime behavior then troublesome.
2. Bedwetting
Typical—most children start to stay dry through the night at around 3 years old. 15 % of children wet the bed after 3, more common in boys, runs in families, stops by puberty and most do not have emotional problems or kidney or bladder problems. Usually bladder control is just slower than normal. After a period of being dry at night when there is bedwetting it often happens when child is ill, big changes like a move, divorce, arrival of new baby. Rarely do children wet on purpose and most feel ashamed.
Troublesome—If after behavioral treatment for bedwetting—like limiting liquids before bed, waking a child to go to the bathroom, pads with buzzers to wake the child, then explore more possibilities of a physical or an emotional problem if it is associated with sadness, irritability, change in eating or sleeping habits.
3.Anxiety
Typical—Young children show intense distress when separated from their parents, they can be afraid of the dark, storms, animals, strangers and seek a lot of reassurance. Important to listen to and not dismiss a child’s fears—especially for quiet, eager to please children.
Troublesome—Refusing to go to school, frequent stomach and headaches, panic or tantrums at times of separation, avoidance of social situations or few friends, many worries or constant worries, repetitive, unwanted thoughts, severe fears that interfere with child’s ability to function.
4. Tantrums
Typical—2-3 year olds having a tantrum because you don’t buy them candy at the grocery check out, or because you have to leave MacDonald’s playland or a 12 or 13 yo may argue, talk back, disobey, or defy parents. All children are oppositional occasionally especially when tired, hungry, stressed, or upset.
Troublesome—Frequent and consistent tantrums, affecting child’s family, social or academic life. Or if it is part of a pattern of excessive arguing with adults, frequent anger and resentment, active defiance to comply with requests and rules, deliberately annoying others, excessive blaming, being spiteful and revenge seeking. Even more worrisome if cruel to animals or people, steals, uses weapons, starts fires.
5. Lack of Communication
Typical—infants and children smile, cuddle, laugh, play games like “peek-a-boo” or “hide and seek”. Some children are shy or less verbal but point, use hand gestures, wave, look you in the eye, share pictures they’ve drawn, go to a parent for comfort.
Troublesome—no single words by 16 months, no 2 word phrases by 24 months, loss of previously obtained speech, child who is withdrawn and fails to respond to others. Language is made up or an echo of the ends of words, can’t engage in make believe play, inflexible, persistent preoccupations with an abnormal intensity or focus.
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