When to Worry: Balance, Patterns, and Progress

The books I have found to be among the most useful as both a child psychologist and a parent are a series of books by a developmental psychologist, Louise Bates Ames, and a pediatrician, Frances L. Ilg. Each book highlights the stages that typical children progress through fairly predictably. The authors are careful to remind parents that, although child development generally follows a predictable path, each child develops on their own timetable. Perhaps the most valuable message for me is that typical kids will create challenges and discomfort for those around them. We can (and should) expect that. If you’re not sure if you should be worried about your child’s development, consider the following.



I operate under the assumption that my kids will mess up. Socially, I know that my kids will get their feelings hurt and that my kids will hurt feelings. With those expectations, it’s easier for me to hear my children when they tell me about an interaction with a friend that made them feel bad. It’s also easier for me to respond to a complaint from one of their friends. For example, when I hear “Charlie won’t let me take a turn” from a neighbor, I can easily respond, “sometimes that happens when friends play together – I think you guys can work out a good plan.” I truly believe my response and I don’t feel like I need to apologize for my kid, make an excuse for him, or punish him. On the other hand, if Charlie says to me, “Henry won’t let me in the treehouse,” I can respond similarly, “yeah, sometimes that happens. I bet you guys can sort it out.”


The key here is to step back and reflect every now and then. Are you hearing both complaints from and complaints about your child? Do you notice that sometimes your child teases and is sometimes teased? If your child’s social interactions seem lopsided, then you will want to pay attention and look for skills that may need to be taught or developed. For example, if your child’s friends routinely protest about his tendency to quit a game he’s losing and you’re not noticing or hearing about other kids quitting on your son, that’s a good sign that there is work to be done. 



When we accept that our kids are learning all sorts of things about how to behave, process and manage their emotions, control their reactions, get along in a group, and operate independently from us, we recognize that they will do better some days than others. When stress is manageable, when conditions are right, you should expect that your child can do much of these things fairly well. On little sleep, when hungry, and after a long hard day, it’s easy to anticipate more struggles. That’s typical. For example, “no, you can’t have ice cream right now. We’re about to have dinner,” might be met with an eye roll or sigh on a good day. On a rough day, there might be some version of a tantrum (for a toddler, falling on the floor; for a preschooler, stomping and protesting; for an older kid debating and arguing).


If you start to recognize other patterns of problem behaviors, think about what makes it a pattern. Is it your child’s level of energy/rest/hunger as described above? Is it pretty common for your child to melt down anytime they hear the word, “no?” Can your child manage herself pretty well most of the time but flies off the handle when asked to try new things or when she makes a mistake? Does your child do really well one on one but struggle with siblings around? 


Once you have some more information about what makes the problem behavior more or less likely to occur and under which conditions, you can think about what (if anything) needs to be put in place or what (if anything) needs to be taken away. For example, if you find that your child can be pretty easy going most of the time, but becomes frustrated, angry, and out of control when asked to try something new or when he makes a mistake, you might start to hypothesize that he has trouble working through a task or activity that he doesn’t feel he has mastered.



Once you have a pretty good idea of the underlying skill deficit contributing to the pattern of problems, you can put a plan in place to help your child develop those lagging skills. As in the example above, if frustration tolerance is something your child struggles with, you might work on helping your child develop a growth mindset or learn tools to manage her emotions. 


Usually the skill deficits underlying a pattern of problems (like frustration tolerance and emotion control/self-regulation) are slow to change. Kids and their parents usually understand and recognize the lagging skills quickly. In theory, the tools we teach seem like they would be easy to implement. In practice, it is often a challenge and it probably won’t be a quick fix.


It can be easy to feel frustrated when your child knows what she should do to calm down but just won’t do it. Try thinking about it from this perspective: your kid has identified and labeled the skill deficit. You now have a common language for talking about the challenge and you have a plan and tools for developing skills and preventing the problem. It will take lots of practice to master the new skill and what you’re looking for now is progress


Look for ways you know your kid gets it. It’s progress when your child makes a connection with the behavior in question and the world around him. The other night, when I was reading to my son, a character was saying something pretty rude to another character. Charlie acted horrified and gasped, “I would never do that, Mom!” Instead of me pointing out, “actually…you would. And you did earlier today…,” I thought about how this is on his mind. He doesn’t often interrupt the story to make comments like that, so I figure it held some importance to him. I said, “yeah, I guess that’s a little harsh and I think he was pretty upset. What could he have done instead?” Because he’s not in the moment, he can quickly come up with an alternative. That moment won’t prevent Charlie from ever losing his temper with his friends, but I know he’s thinking about it, recognizing that it’s not a good thing to do, and he can come up with some alternatives. Eventually, that transfers to real life, in the moment interactions. Sometimes, progress is hard to see because we don’t always realize when our child has bit their tongue and walked away. Progress means the problem episodes are getting shorter, less intense, and less frequent. 

Remembering that children develop all of these skills on their own timetables, some progress will come with maturity. Monitoring your child’s progress is really about noting if your child is trending in the direction you want to see. Think back to where your child was 6 months to a year ago and where she is now. Are you closer to where you eventually want to be or does it seem the challenges are more intense and creating more of a problem for all of you? With some support and guidance, are there signs that she is getting it? If so, you can probably rest assured that your child is learning and developing. If not, you can seek guidance from your child’s pediatrician, teacher, or a behavioral health clinician.

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