Tantrum or Trauma? When to Seek Help for Children

This article first appeared in the Vail Daily on October 27, 2020.

During the past six months, there has been a substantial focus on the behavioral health impact of COVID-19. We, as a community, a nation, and a world, are experiencing a collective trauma.

As a result, there has been an increased focus on behavioral health, a greater interest in knowing how to support others, how to support ourselves, and, in many ways, our community has shown greater collective compassion for those struggling with addiction, anxiety, depression, or other behavioral health diagnoses.

However, in these discussions, we often overlook our youngest and most influenceable population … the 0-5 population. Historically, the presence and severity of behavioral health and mental health concerns within the preschool population have been substantially underestimated.

Young children are often viewed as “worry-free” and seen as incapable of having serious emotional concerns. However, the presence of clinical levels of depression and anxiety amongst the preschool population has been well researched and documented for over three decades.

Because the moods of young children can change rapidly and are often tied with extreme levels of emotion, as a parent it can be extremely difficult to determine what is typical “terrible 2” behavior and when this behavior is a sign of greater concern. Here are some tips that can help.

Typical or Concerning?

Behavioral health disorders manifest in many different ways in our adult population. Similarly, in children, it is important to look at patterns of behavior over a period of time.

Pervasive sadness or anger that is not tied to a specific event: Most humans experience a range of emotions throughout a day and some days include more happy moments than others. In our youth population, we often see a greater range of emotions and more rapid shifting between emotions.

However, in some young children, there is a predominant emotion, such as sadness, that is more predominant than all others. If you begin to see chronic signs of sadness or anger, rather than situational responses, it may be useful to consult with a behavioral health provider.

Persistent emotions that impact a child’s ability to do activities that they enjoy: Anxiety is a very normal experience in children. As humans, we are evolutionarily programmed to be cautious of new stimuli and experiences. By nature, children have more new experiences than adults. As such, they will likely have a higher level of anxiety and fear. However, when this fear is persistent and prevents a child from engaging in activities that they enjoy, there may be a reason for concern.

What To Do If You Are Concerned

Research has shown that therapy is incredibly effective on even our youngest population. Children as young as 3 have shown tremendous benefits from developing behavior-based coping skills like deep breathing, relaxation, and physical regulation.

Therapy with our youngest population also often includes caregivers. As caregivers, we have a unique ability to influence a child’s ability to effectively emotionally regulate. Through mirror neurons, our emotions and our coping skills can be contagious. Therapy can be incredibly useful to identify family system strategies that can help support change.

Play Therapy

Colorado Mountain Medical recently hired two behavioral health providers with clinical speciality in pediatric and families and have begun seeing patients 2 and up. Play therapy and parent consults can offer patients and children the opportunity to process challenging events and emotions.

This is effective via a dynamic interpersonal relationship with the therapist which promotes building coping skills, emotional regulation, and emotion identification. Dr. Gary Landreth, who is the creator of child-centered play therapy, suggests, “In play therapy, toys are like the child’s words, and play is the child’s language.”

Remember, the past six months have challenged all of us. In order to effectively respond to COVID-19, we have needed great flexibility, patience, frustration tolerance, and compassion.

It is important to remember that behavioral health, like most medical care, is most effective when initiated prior to crisis. Don’t wait to seek help until there is a crisis.

Olivia’s Fund is available for anyone in our community who identifies a financial barrier to seeking services. See eaglevalleybh.org for more information and to apply.

Dr. Casey Wolfington is a licensed psychologist and the community behavioral health director with Eagle Valley Behavioral Health.