Ask Shelby: Assessing Children’s Needs for Treatment

Here is September’s installment of “Ask Shelby” from Chester County’s own Licensed Marriage and Family Therapist, Shelby Riley.

Dear Shelby,

I’m worried about my daughter. She’s seven and I think there is something going on. She seems sad and angry and throws massive tantrums at the drop of a hat. She can’t remember what I told her to do and spaces out a lot. And then there are the days where she’s really tired and wants to sleep all afternoon. I don’t know if this is normal kid behavior or if I should be worried. And I’m confused about who to talk to. Do I call her pediatrician? A therapist? A psychiatrist? Help!

Signed, Worried Momma

Dear Worried Momma,

I know how scary it can be to think there might be something going on with your child and not know how to handle it. It’s smart of you to be concerned. And I’ll guide you through the process:

1.)  The first step is to consult your pediatrician. Have a full physical done. You want to make sure there aren’t any medical reasons for her symptoms. Hopefully your pediatrician knows your child well, and can note if there are any medical or developmental concerns.

2.)  Check with your child’s teachers. Do they see these symptoms in the classroom? This helps determine the severity of the symptoms and helps professionals diagnose things properly. If ADHD is a concern, it will usually be seen at school. A child who has mild depression may be able to mask it at school and then loses it at home just from the exhaustion of coping at school all day, but a more severe depression will be noted at school as well as home.

3.)  If your pediatrician recommends any follow-ups, schedule them. A pediatric neurologist has specialized training to diagnosis complicated ADHD. A child psychiatrist is a medical doctor who has specialized training in diagnosing and prescribing medication for childhood mental health issues, like severe depression or anxiety disorders. A therapist can help provide treatment for her issues. For a child of seven, you want someone who is trained in play therapy.

Different therapists:

A child psychologist is trained in specific testing that might be helpful in determining what is going on with your daughter. They can often provide a psychological evaluation to help determine an appropriate diagnosis. Some are trained in providing therapy as well, but always ask about their experience and background to make sure.

A licensed clinical social worker (LCSW) is well trained to help you navigate the community support systems available to your daughter. They can help find programs and services that she may need and help you navigate that process. Some are trained in providing therapy as well, but always ask about their experience and background to make sure.

A licensed professional counselor (LPC) is trained to provide counseling to individuals and may have some training in providing therapy to families with young children, always ask about their experience and background to make sure.

A licensed marriage and family therapist (LMFT) is trained to work with the entire family system, as well as individuals, couples, and parts of families. They are well trained to help determine what family interactions are helpful for your daughter and what ones may be contributing to the problem. They can address how her issues are impacting your marriage and the larger family dynamic and work with your daughter and the rest of the family to develop healthy ways of dealing with emotions, expectations, and behaviors. Not all licensed marriage and family therapists are trained to work with children, so make sure you ask about their experience and background to make sure.

Again, any therapist working with your daughter should be trained in play therapy, as most seven-year-olds don’t respond to traditional “talk therapy” very well.

It may be that all of her behaviors fall in the range of “normal” behavior, as most children of seven exhibit what you describe to some degree or another at times. If her symptoms are significant, it may be all you need is some family work around parenting her through her tough moments, and some play therapy to help her learn individual coping skills, so she can better deal with difficult emotions. If it turns out her symptoms are quite severe, there are a lot of options and resources available to you to help her (and you!) better manage.

Yours, Shelby

Shelby Riley, LMFT is the owner of Shelby Riley, LMFT and Associates, LLC. Remember to check out Shelby’s website www.shelbyrileymft.com for useful information about therapy for individuals, couples, and families.

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