Ask Dr. Nikki
Question: What are some signs that my young child's mental health is suffering, and what can I do to help?
Answer: Mental health concerns in children can be primarily seen in their behaviour. Watch your child’s behaviour, has it changed? If so, how? Some children may be less engaged with things they normally enjoyed, like colouring, playing with blocks or even video games. Perhaps, they seem more worried, more isolated, crying when you go out of sight, changes in eating habits or getting angry, throwing things, hitting you or their siblings, you might notice they don’t focus as well or are having trouble remembering things. If you are noticing a change in your child’s behaviour that concerns you, it is best to get help. The challenge with infant and child mental health is it hard to know what it causing the behavioural changes, it is best to bring the child to see their doctor and share your observations and concerns. The doctor is the best place to start to make sure it is not something physiological, which can look similar and have a different treatment. The doctor will tell you if they think some form of therapy or talking with a mental health professional will help.
Children express their thoughts and feelings through play and art as adults do by talking. So watch what they are playing. For instance, it would be typical for a child to comfort their “baby” doll and what they say and how they care for their doll will provide you some insight into what they are feeling, hearing or experiencing. Use your empathy to wonder about what your child is sharing in their play. Being open and emotionally available to your children during difficult times is especially important as infant and child mental health is often related to the parents and families wellbeing. Think about what they may be experiencing or feeling in their home without the benefit of understanding the adult world. Is there something that you can do to share more loving interactions with them so they feel emotionally safe, like reading books, or riding bikes, something fun and connected you can do together, which also may distract from the stressful feelings. Nature and physical activity have powerful affects on mental health and coping with stress, get outside and find some awe and wonder while moving your body. Children respond more quickly then adults to changes in their environment, you will likely see changes through the providing of boundaries, physical activity, interest and engagement and loving support. If you continue to be concerned listen to yourself, you know your children the best, go to their doctor and share your concerns. Also make sure that you are taking care of yourself. Parents are the most important people in a child’s life. Your children need you to feel safe and cared for too, make sure you are creating and safe environment of care and love for the whole family.
Question: My 5-year-old's potty training has regressed the past few months. How can I help get them back on track?
Answer: Regression in children’s behaviour like toilet training is to be expected when there is change in the home such as the birth of a sibling, parental conflict or life changes from the pandemic. This can feel disappointing for a parent who perhaps saw freedom from diapers and pride in their child learning a new skill and developing into a self-sufficient little one. All is not lost, you can take comfort in the accomplishments your child has already achieved, wherever they are in the process.
Try to identify the reason they regressed. Talk to them about it and help them understand and express their feelings. It is important to try not to push your child into toilet training if they aren’t ready, or create additional stress and a need to perform. The child has complete control over their urination and bowel movements — they can hold it if they want too and that is not good for them physiologically. We want to create a positive and supportive environment to celebrate this great achievement in a child’s life. If you feel the time is right, both in your home environment and the child’s emotional life, then encouragement can be helpful.
You may also choose to stop using the diapers during the day. Talk to your child about this and explain they are growing up and can wear underwear. It could help to let them pick out their own so they can be excited to wear them. There will be accidents, so make sure your family is home and prepared for them (if there does not seem to be any change in about a week it is best to go to the doctor to check out medical reasons). The feeling of being wet can be helpful for some children to “feel” the urine to help them make the association with the internal feeling and learn to hold it. Try not to resort to using diapers again (during the day), as this can be confusing and can feel like defeat for the child. It is also helpful to try and be aware of your feelings and attitudes towards the accidents. Your child might feel embarrassment, shame or guilt and these are not feelings that should be reinforced.
Understand and validate their feelings, and build their confidence, autonomy and resilience by highlighting their strengths, achievements and capabilities. Everyone has accidents and makes mistakes, especially when we are learning something new. This is a great achievement in a child’s life, a time to learn to make mistakes and try again, to succeed and to be proud. Provide lots of praise and encouragement for both of you and celebrate this milestone.
Question: Do you think behavioural issues associated with this time will change once life goes back to normal?
Answer: Behavioural issues will change when the stress in our life is reduced, but it will be different for every child. The pandemic has changed the way we do everything, so naturally there will be feelings of grief over what we have lost. For children, that means playing with friends, on the jungle gym or missing child care/school. Let’s be honest, even having their parents home all day is a big change!
Some behavioural issues might be your child has become more clingy or whiny, started sucking their thumb again, is showing baby characteristics you had thought were gone. These behaviours may be ways for your child to express their need to feel safe and cared for like a baby — natural stress reactions due to the increased fear and anxiety in the world. Perhaps your child is having more tantrums, getting upset frequently or talking back. If you think this is related to the pandemic, it is a natural response when you are unable to do what you want or would normally do.
While these are normal and natural responses, that does not mean the behaviour has to be okay for you in your home. Children feel safe with loving boundaries, understanding the rules and what is expected of them. They thrive with routine. They need to learn how to self-regulate, manage their emotions and behaviour so they learn what is appropriate and what is not at home. The best thing to do is to talk, draw or play with your children. Listen to them and try to imagine what they are feeling or experiencing. Children need to feel heard, understood and cared for, just as adults do.
When you listen to them, ask yourself, what are you hearing is bugging them? Try to talk and react to that feeling, not the behaviour. If you feel overwhelmed by a behaviour and yell, try to take a breath, apologize for the outburst and explain to them how the behaviour makes you feel and that you love them even if you don’t always love their behaviours.
Listening, talking, sharing and loving will help everyone get through this difficult time and teach kids valuable lessons like empathy and compassion along the way.
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Disclaimer of Liability
The content, including information and or advice provided on this site or by Dr. Nikki Martyn is intended for informational purposes only and are the views of Dr. Nikki Martyn to be used generally as guidance. If you have concerns about your child or parenting please see your doctor or health care provider for specific health and or wellbeing concerns they can assess and provide a referral if necessary. If you think you have a medical emergency please call 911 or the emergency services in your area.