Vim & Vigor - Summer 2017 - Community Healthcare - 43
Q
Your toddler is becoming that
kid on the playground. He throws
sand, bites when he doesn't
get his way and has hit children. He
seems angry, but he can't tell you why.
IS IT: Stress or a developmental
disorder?
LIKELY STRESS. Little kids don't
have a complex vocabulary, so acting
out is one way of expressing emotions,
Hartselle says.
"If the child isn't responding the
same way that the other kids are or
is becoming incredibly enraged when
other kids are handling things, you
should check with a pediatrician,"
Hartselle says. "In toddlers, anxiety
can come out as anger."
Q
Your otherwise happy-go-lucky
kiddo has been having major meltdowns at day care. She sobs and has
become unusually clingy when it's time
to go your separate ways for the day but
seems fine when you pick her up later.
IS IT: Separation anxiety or a sign of
mistreatment at day care?
PROBABLY SEPARATION ANXIETY.
Separation anxiety waxes and wanes
from as early as age 6 months all the
way through the elementary school
years, Hartselle says. Talk to the day
care provider to see what's happening
once you leave your daughter behind:
Is she joining the other kids? Is she
playing? If so, those are good signs
that the earlier meltdown was a
typical bout of anxiety.
Of course, it's natural to worry about
your children when you entrust them
to someone else's care. Cases of mistreatment or abuse of children at day
care do happen. It's important to pay
close attention to our children's emotional well-being.
"The real warning signs [of something
more serious] are if the child also at
home is having outbursts or is not sleeping well, having many more nightmares
or having general behavior changes," she
says. See your child's pediatrician right
away-and take a break from day care
until you know what's going on.
Q
You and your teenage daughter
have had a standing Saturday
morning pancake date since she
was old enough to say "short stack."
But all of a sudden she wants to ditch
the tradition. In fact, she flatly refuses
to spend time with you and instead
retreats to her room.
IS IT: Normal teenage behavior
or depression?
PERHAPS DEPRESSION. It's normal
for teens to push for space and prefer
being with friends over parents. But if
your teen is spending vast amounts of
time alone, and not with friends, and
having frequent (very) angry outbursts,
take note.
"This can happen, but it shouldn't
be often, and it shouldn't be extreme.
Teenagers shouldn't be talking about 'I
wish I wasn't here,' 'I wish I wasn't alive' or
saying 'I could be dead,'" Hartselle says.
She recommends checking in with
teachers to gauge how your teen is
behaving at school (is she social?) and
connecting with a pediatrician or mental
health provider for guidance.
Q
It came out of nowhere-your child
abruptly started behaving strangely.
In addition to major changes in her
behavior, she began making odd body
movements, such as repeatedly blinking,
and strange noises, such as grunts or
repeating words.
IS IT: Mental illness or a complication
of strep throat?
IT MIGHT BE STREP. This one is rare,
but it happens. There's a known tie
between streptococcal infections and
something called PANDAS (pediatric
autoimmune neuropsychiatric disorders
associated with streptococcal infections). Symptoms include obsessive
behaviors, odd movements or tics, and
an overall alarming departure from a kid
who doesn't have anxiety or obsessivecompulsive disorder issues to one who
appears to have them.
"Does it mean every time your kid
gets strep throat and is grumpy, you
need to bring her into the pediatrician?
No. But if it's a really amazing, abrupt
change, bring them in right away and ask
if we can do a strep test," Hartselle says.
If a strep test is positive and PANDAS
seems likely, doctors typically will use
antibiotics to treat the strep infection
and the PANDAS symptoms subside. n
WEBSITE
Giving Relief to an Anxious Kid
If you're concerned your child might have a problem with anxiety,
check out the Anxiety and Depression Association of America's
screening form. Visit adaa.org and search for "screening children."
SU MM E R 2017
43
http://www.adaa.org
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