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Children & Adolescents

Child and Adolescent Concerns

Parents, do you need help managing depression/anxiety during the COVID-19 crisis?

There are many reasons why parents contact us to begin treatment for their children. Parents will often call us out of concern for their children because they are observing out of character behaviors and or emotions from them.

Sometimes the child themselves will ask to see a therapist and the parent is contacting us on behalf of their request.  Occasionally, parents are expecting an increase in stress in the child’s environment such as an upcoming family illness, death, blending of a family, or divorce, and the parents want to prepare the child to cope appropriately.  

Additionally, at times other service providers have made a recommendation to the parents, such as teachers, physicians, coaches, or other family members to seek out treatment for their child. Whatever the reason, we understand that this can be a difficult and anxiety-provoking process for the family and child.    

As providers, it is our duty to work as a team with the family to decrease this anxiety and develop an appropriate treatment plan that best fits the needs of the family and child.  There are various concerns that bring a family into treatment and we will identify some of the more common ones below.

A boy voicing his behavioral concerns to his therapist.

Behavioral Concerns

There are a variety of reasons why children behave in ways that are uncharacteristic.  These behaviors may be observed in school, at home, with their peers, or in other environments in which the child has contact. Parents may notice:

  • an increase in worry or fears
  • obsessional thinking or compulsive behaviors such as rituals or repetitive behaviors
  • isolating from family or friends
  • becoming more irritable or angry
  • becoming aggressive towards peers and family
  • losing interest in previously enjoyed activities
  • decrease in grades or motivation to complete tasks and homework
  • self-injury behaviors such as cutting
  • crying more often
  • becoming defiant at school or home
  • sleeping less or more
  • an increase or decrease in appetite
  • being disruptive at school
  • talking about suicide

The list goes on but these are just several examples.   These behaviors may occur as a result of anxiety, depression, ADHD, boredom, attention-seeking, an unidentified experienced trauma, learning disability, oppositional defiance, or even grief.   These behaviors are often scary for parents or caregivers because they can recognize the child’s behavioral change, yet lack understanding of why it may be occurring.  This is often when parents seek out help.

A child doing attention deficit hyperactivity disorder (ADHD) games with her therapist.

Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is a common disorder that most often develops during early developmental years.  While parents or other adults who have contact with the child, may see various behaviors in a young child, it is most often not diagnosed prior to entering elementary school.  Many practitioners will not diagnose before the age of six.  

Many parents or teachers will observe a lack of focus and concentration in the child.  Adults may have to ask the child several times to complete one task.  They may notice the child “daydreaming” or focusing on things that are irrelevant to the task at hand.  Parents will often describe impulsive behaviors such as saying or doing things without thinking about the consequences of their actions.  

Parents will also describe the child’s inability to sit still and is often in constant motion.  Parents may also report that they see their child exhibit behaviors that are representative of or be able to report feeling overwhelmed, anxious, or depressed.   There are three forms of ADHD, inattentive, hyperactive, and combined type.

A therapists plays with a child while also talking about school concerns.

School Concerns

Parents will often become worried when they start to learn about changes in school behaviors from their children.  There may be a change in grades, decrease in motivation to complete homework, difficulty understanding their homework and lessons learned in school, forgetting to turn in homework, refusing to attend school, reporting an increase in illness that prevents them from attending school, or increased peer conflict.  

These are just some of the concerns that we hear from parents.  Again, the reason for these school concerns may vary from anxiety, depression, a learning disability, bullying, ADHD, an unidentified trauma, and family discord, to substance abuse, peer pressure, and self-esteem issues.  Regardless of the reason, change in behavior for children and adolescents is often evidence that an underlying concern exists.

A therapist and a child with autism have a creative therapy session.

Autism Spectrum Disorders

Parents will often seek out mental health treatment for their child who has been given a previous diagnosis of what was formerly named Asperger’s Syndrome and is now diagnosed as Autism Spectrum Disorder.  Parents may also seek out treatment for their child who may be displaying characteristics of this diagnosis, however do not have the diagnosis or do not know what is going on with their child but suspect that something is not right.  

There are various treatment interventions for children on the spectrum.  These interventions are based on the severity of the disorder.  Applied Behavioral Analysis is an extremely effective intervention for those children with a more severe form of Autism.  Those children who are higher functioning can benefit from different forms of talk therapy.

Typical reasons for seeking out treatment may be to gain social skills when interacting with peers and adults, learning to cope with anxiety and possible depression, learning activities of daily living skills, coping with obsessions which are characteristic of the disorder, and often how to change patterns of thinking that may be more productive for the child.

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