Is my child okay?
Since children develop in different ways and at different times, “normal” is often hard to define and assess. The American Academy of Pediatrics offers this list of seemingly “alarming behavior” as normal things we might see our children doing as they develop:
- A wide range of ages and times when children pick up big milestones, such as rolling over, sitting up, walking, and talking.
- Stuttering in preschool age children.
- Motor tics in preschool and younger school age children.
- Differences in personalities, e.g., some children are very shy and quiet while others are very outgoing.
- Occasional “strange” behaviors, like a 2-year-old who puts his hands in his diaper and smears his poop all over.
- Occasional “difficult” behaviors as your child tests his limits, e.g., lying, swearing, biting.
Does age make a difference?
The general age at which children exhibit the behaviors listed above plays an important role in whether the behavior is in fact appropriate or not. While it may be common for a 3-year-old to start having accidents if you bring home a new baby, it isn't common for an older child to soil himself. And while a preschooler may have trouble paying attention, your older child should usually be able to concentrate on things without getting easily distracted. But parental and cultural expectations, experience, and the child’s personality all influence behavior and development.
What should you do if your child exhibits some of those normal, but often frustrating behaviors?
If your 3-year-old starts stuttering, instead of correcting her or asking her to repeat herself, see your pediatrician, who will likely tell you that it is a normal developmental stage that your child will outgrow. This also applies to school age children who develop tics, involuntary muscular movements that often go away after a few months. In either of the above cases, if you overreact and tell your child to stop, the added stress may make things worse.
What is a developmental delay?
A developmental delay occurs when your child has delayed achievement of one or more of his milestones. This may affect your child's speech and language, his fine and gross motor skills, and/or his personal and social skills. Your pediatrician should screen for delays at your child's well-child visits. This may consist of simple questions to see what your child is able to do at different ages or it may include a formal screening test.
For example, one infant might start rolling over as early as 2 months and another might not roll over until they are 5 or 6 months old. Or an infant might not start walking until 10 months, 12 months, or 15 months, and would still be considered normal. In evaluating a child with a mild delay, you might also consider the timing of when he picked up other milestones. If he was late rolling over, sitting up, and pulling up, then it makes sense that he might be late walking, too.
Is there a time to worry?
Parents usually worry about their children. It comes with the territory. But pediatricians are usually only concerned about children who aren't catching up or who seem to be losing milestones. Older children can have delays too, although delays in later milestones are often harder to notice than developmental delays in younger children. Milestones in preschool age children might include more subtle things, like balancing on one foot, walking heel-to-toe, wiggling his thumb, or copying a square. In these children, parents are more likely to notice tasks that their children aren't able to do, like riding a tricycle, getting dressed, or brushing their teeth.
Again, the first step in alleviating your worries is to act on your concerns. Trust your instincts and ask your pediatrician. Here are some others ideas to help you understand if your child has a potential problem:
- Try not to rely only on comparisons to other children of the same age, especially for infants and toddlers.
- Consider how your child's “problem” is affecting her day-to-day life. For example, if your child is shy, it is less likely to be a problem if she has a few good friends, talks to her teacher when necessary, and is social with close friends and family. On the other hand, a shy or anxious child who won't go to school or talk to anyone likely does have a problem.
- Consider how long or how many times your child has done a behavior you are concerned about. Lying or swearing one or two times can be normal if your child stops after being told it is wrong. It may be a problem if it continues.
- Write down your observations and your questions. Ask your pediatrician or a developmental specialist for more help.
- Read a parenting book to get more help identifying what's normal.
Should you just wait and see if your child “outgrows” your concerns?
Always consult your pediatrician, but once you bring your concerns about your child's development to your doctor, you may in fact hear, “That’s normal. Just wait and see if she catches up.” That response, although often appropriate, can be frustrating for parents.
To alleviate some of your anxiety and help gain greater assurance, ask your doctor the following questions:
- Why do you think it’s normal?
- How long should we wait?
- What is the next step after the waiting time?
- Listen carefully and trust your instincts. Be persistent. This is especially important if you return after the waiting period and are told to wait some more. Sources for more help might include an Early Childhood Intervention program, a Pediatric Neurologist, or a Developmental Pediatrician.
Are you normal?
Parents run the gamut from worriers to laid-back optimists. If we are too far towards one end of the continuum, friends and family often help us achieve perspective. Many parents today tend to be prone to worry because there is so much parenting information surrounding us, often laced with the implicit message that perfection is possible and anything less than a total obsessive focus is slacking in your most important role. If you find yourself worrying too much and distrusting the opinions of professionals, step back and consider whether you have lost perspective. After all, most children develop fine at their own rate, and even thrive in all kinds of circumstances without any special intervention.
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