Most children start going to school by the time they turn six. At this stage, they begin to understand their surroundings and the role they play in it. They also start asserting their independence and individuality, which is critical for their development.
However, this is also the time when some children start showing signs of behavioural problems. According to a study titled, ‘Age of onset of mental disorders: A review of recent literature,’ by Ronald Kessler et al published in Current Opinion in Psychiatry in 2007, about half of all lifetime mental disorders in children begin before 14 years of age. Ironically, although effective management strategies exist, particularly in developing countries, most children do not receive treatment for behavioural problems. Often due to a lack of awareness, parents feel that behavioural problems are an inevitable part of childhood and children will outgrow them. They try to deal with the problem on their own, not realising that these are signs of treatable behavioural conditions. A recent review of epidemiological studies in India (published in Child and Adolescent Psychiatry and Mental Health, 2014) looked at the prevalence of childhood psychiatric disorders and found that the prevalence in community studies was reported to be around 6.5%, whereas it was a staggering 23.3% in school-based studies. This wide difference in figures shows that most children with behavioural problems remain undiagnosed and do not get professional help.
In addition to lack of awareness amongst parents, there are also other reasons for children not receiving treatment for behavioural problems. These include - limited number of professionals, inadequate treatment facilities and the existence of multiple misconceptions about mental illness.
It is essential that children receive treatment for such problems. Therefore, parents should watch for signs of problematic behaviour in their children and seek professional help at the earliest.
Here are five common behavioural problems to watch for:
- Refusing to go to school: Most children occasionally refuse to go to school. However, if a child makes excuses frequently, it could be a sign of school refusal. For example, a child may regularly complain of feeling sick but may get better as soon as he is told that he can stay back at home. This behaviour could be a sign of separation anxiety, which causes a child to think that bad things may happen to him or his parents when the family is not together. Children suffering from separation anxiety are reluctant to stay away from their parents for a long period.
- Sudden episodes of being unable to speak: When a child freezes and is unable to speak when required, it could be a sign of selective mutism, social anxiety or panic. Often, a child with this problem is talkative at home but her teachers may complain about contrary behaviour at school. Selective mutism can cause a lot of embarrassment to the child. If left unattended, it can negatively impact the child’s confidence and can hinder his/her social development.
- Social withdrawal and difficulty in making friends: It is expected that by the time children start going to school, they would have learned to interact in a socially appropriate manner and make friends. This is a crucial sign of development. Some children may take time to develop this skill. But, if a child always remains withdrawn, it is possible that he may be autistic. Although this disorder begins in early childhood, many cases remain undiagnosed until social demands increase. Common symptoms of autism include avoidance of eye contact, and difficulty in understanding other people’s emotions and communicating.
- Inability to sit quietly and pay attention: Most children tend to be inattentive and hyperactive at times, driving parents to frustration. However, once they enter school, it is important that they develop the ability to sit attentively in the classroom. If a child is inattentive and hyperactive both at home and school, it is possible that she has attention deficit hyperactivity disorder (ADHD). A child suffering from ADHD is easily distracted, keeps fidgeting, appears not to listen and forgets instructions frequently.
- Difficulty in keeping up with studies: Every child learns at a different pace and some are slow at grasping things. However, if your child struggles to read or write, she could be suffering from learning disorders such as dyslexia or dysgraphia. One symptom to look out for is, repeatedly making the same mistakes despite your efforts to teach and correct her.
Now that you have read about some common behavioural problems in children, pay attention to your child’s behaviour. If you spot any of these in your child, understand that such behaviour is not always within her control. Also, it may need prompt intervention. Take her to a mental health professional at the earliest, as a delay in doing so can worsen the problem and have a long-term impact on the child’s development.
The author is a Senior Research Fellow at Public Health Foundation of India (PHFI).
Related video: Venkata Suresh Lolla, Principal, Global City International School dispels the misconceptions about mental health.