How do you know when your child needs therapy? Is it just a phase? Or is this odd, annoying, confusing (fill in the blank) behavior actually "normal"?
Step One: How Bothered Are You By The Behavior?
The first thing to think about when deciding if your child needs therapy is to check in with yourself, your spouse, your family: How bothersome is the child's behavior? Does the behavior get in the way of the family's daily routines? Is learning or school participation affected? Are family members prevented from doing what they want or need to do? For example, does the child's difficulty organizing himself keep you from getting out the door on time? Is your child having such a hard time with social situations that you need to limit important family functions? Does the child's mood swings mean that you need to "walk on eggshells" around her? If you find that your family life consistently revolves around the needs or demands of one family member, at the expense of everyone else's goals, then now might be the time.
Step Two: How Bothered Is Your Child?
So OK, you and maybe the rest of the family are pretty bugged by your child's moods, quirks, or behavior. But what about your child? Does it get in the way of her happiness? Is she asking for help? My 6 year-old recently lamented to me that her clothes feel so terrible, that she can only wear one dress and one pair of shoes. We have known for a while that she had some sensory issues, where clothing, textures, and sounds can be irritating to her. It has been manageable, up to now, by helping her make choices, distracting her, and using the ubiquitous sticker chart to reward her for trying new pants in the winter. Yet it has quickly become very difficult for her, and today a) she felt terrible that "my skin wasn't letting me try," and b) she was sad she was going to be late for school, which she loves. Time to call an Occupational Therapist to deal with sensory processing issues. If your child isn't bothered, and the issue is manageable by other means, then perhaps a wait and see approach is appropriate.
Step Three: Should You or Your Child Be Bothered?
Here is the reality check. Maybe your child isn't bothered, and maybe you aren't either. But should you be? Maybe your spouse thinks your child's tantrums in the grocery store are out of control, but you think they're no big deal. Or maybe your child's teacher has told you (again) that your son really should be "tested for ADHD," or that there are possible "learning issues." Even if you disagree, you owe it to your child and the rest of your family to make sure that you are not sweeping a big issue under the rug. First stop: the pediatrician's office. Come armed with questions, and take notes. And your child's teacher? Schedule a longer meeting and ask for details of her concerns. Talk to your child's coach, scout leader, or church youth group leader if the concerning behavior happens during those activities. You can also request a consultation with a child psychologist to determine if further evaluation or treatment might be warranted. A psychologist can hear both parents' viewpoints if you disagree, and help you decide the best course of action.
Step Four: So Is This "Normal Kid Stuff"or something bigger?
In all things, there is a wide range of "normal." So to find out if your child's behavior is actually within the typical range for his age, check in with his pediatrician, teacher, daycare provider, and trusted websites (for a comprehensive list, see the Links on my website at www.LaurieFergusonPsyD.com). Weigh all the information and advice, and make a plan from there.
Step Five: Weigh The Consequences Of Not Acting.
So you've done your research, weighed your options, but you're still not convinced you need to do something "right now." For example, you might not think that your child's reading difficulties are anything to worry about, "since he's only in second grade, he'll catch up." But your son's teacher is recommending testing. Or maybe your pediatrician says, "I don't think your daughter has autism," but you still wonder if she is on the spectrum. Keep in mind that early intervention has the best chance of success, particularly in the areas of developmental disorders (such as autism and asperger's disorder), learning, anxiety and depression management, social skills, behavioral problems, and sensory processing, such as my daughter has. By not acting early, particularly in these key areas, your child could have a significantly more difficult time later.
Step Six: Ok, We Need An Assessment Or Therapy Now.
First, call your insurance company and ask what your benefits are, including what your out-of-pocket costs would be. Ask for a list of providers in your area who specialize in working with children with, say, depression or autism. Ask for referrals from your pediatrician, and ask your child's teachers if they have recommendations. There are also community groups that can refer you to the proper specialist (see the Links on my website www.LaurieFergusonPsyD.com for many national organizations that offer referrals). Call the providers that are recommended and ask if they have experience working with the issues that your child is struggling with. Schedule a one-time consultation with the provider to see if their services are a good fit for your child. Some providers (including myself) offer a brief, complimentary consultation over the phone.
Step Seven: Ask, Ask, and Ask Some More!
Ask everyone you speak with (psychologist, pediatrician, teacher) a lot of questions and don't be afraid to ask for resources, referrals, and information! Everyone who has a child's interests at heart is more than willing to provide this. Good luck!
