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UoC Faculty of Medicine Senior Lecturer in Psychiatry and Consultant Child and Adolescent Psychiatrist Dr. Dulangi Dahanayake MBBS, MD (Psychiatry)[/caption]
We often turn a blind eye to the mental health needs of children as it’s expected of them to ‘bounce back’ if they’re feeling low. However, with the pandemic, it’s now evident that more and more young children are not bouncing back from their lows and this is affecting other aspects of their lives. The effects can be severe enough to impact their day-to-day life and if these are not tackled promptly it is likely to continue into adulthood. Compounded by the fact that normal childhood development is subjected to behavioural changes from time to time it is sometimes difficult for parents to identify when their child is suffering from a mental illness. Therefore, to address the relative paucity of information on mental health issues in children, we spoke to University of Colombo (UoC) Faculty of Medicine Senior Lecturer in Psychiatry and Consultant Child and Adolescent Psychiatrist Dr. Dulangi Dahanayake MBBS, MD (Psychiatry).
What are the common psychological issues you encounter in children?
Psychological issues among children can be broadly divided into developmental, emotional, and behavioural disorders. In the Sri Lankan context, we see children presenting with difficulties in all of these areas, with some children having more than one condition. Common presentations are school-related issues such as school refusal, poor academic performance, aggression, excessive usage of electronic screens/internet gaming, oppositional behaviours, excessive fears, and persistent sadness.
These children are usually brought in by concerned parents. Sometimes schoolteachers also facilitate their referral.
Are there any triggers?
The school closure due to the Covid pandemic has been difficult for a lot of children. Lack of routine, online education/interruption of education, inability to meet friends, inability to engage in sports and other activities, above average access to electronic devices have all led to a rise in problems.
In addition, the triggers contributing to difficulties in children include issues at school and home. At home, domestic violence/parental conflicts are major contributing factors. Lack of a close attachment or relationship with parents leads to an increase in vulnerability for these problems. Parents provide for the physical needs, but due to multiple reasons, they are unable to be emotionally available for the children. Being emotionally available means being able to understand the child’s emotions, validating them, and helping children manage difficult emotions without brushing them aside or being overprotective. Lack of stimulation during the early years can also impact development.
The competitive nature of education and even extracurricular activities create stress for children. High-performing students are stressed out as they try to maintain their performance and the others are stressed out because their achievements are less than that of their peers. The parents also inadvertently contribute by announcing their child’s achievements or putting them on social media or putting pressure on children to perform better. A significant number of children present to us close to the grade five scholarship examination as well as O/L and A/L examinations. These are usually due to heightened anxiety and worries and we see both high-performing and underperforming children having these issues. Additionally, peer relationship difficulties are also a common trigger for such presentations, stated Dr. Dahanayake.
As shown above, environmental factors are extremely important in triggering emotional and behavioural issues in children. Due to increased dependence on the adults around them, children are more vulnerable to these effects.
What signs and symptoms should parents look out for?
Any change in the child’s behaviour needs to be looked into. Especially if they appear sad, are irritable, engage in self-harm, are socially withdrawn and/or there is a reduction in school performance. Frequent anger outbursts, sleep and appetite disturbances, physical complaints such as recurrent stomach aches and headaches without any underlying cause are important features to be vigilant for. In younger children, failure to achieve age-appropriate developmental milestones is also a reason for concern.
When should they see a doctor or a child psychiatrist?
UoC Faculty of Medicine Senior Lecturer in Psychiatry and Consultant Child and Adolescent Psychiatrist Dr. Dulangi Dahanayake MBBS, MD (Psychiatry)[/caption]
We often turn a blind eye to the mental health needs of children as it’s expected of them to ‘bounce back’ if they’re feeling low. However, with the pandemic, it’s now evident that more and more young children are not bouncing back from their lows and this is affecting other aspects of their lives. The effects can be severe enough to impact their day-to-day life and if these are not tackled promptly it is likely to continue into adulthood. Compounded by the fact that normal childhood development is subjected to behavioural changes from time to time it is sometimes difficult for parents to identify when their child is suffering from a mental illness. Therefore, to address the relative paucity of information on mental health issues in children, we spoke to University of Colombo (UoC) Faculty of Medicine Senior Lecturer in Psychiatry and Consultant Child and Adolescent Psychiatrist Dr. Dulangi Dahanayake MBBS, MD (Psychiatry).
What are the common psychological issues you encounter in children?
Psychological issues among children can be broadly divided into developmental, emotional, and behavioural disorders. In the Sri Lankan context, we see children presenting with difficulties in all of these areas, with some children having more than one condition. Common presentations are school-related issues such as school refusal, poor academic performance, aggression, excessive usage of electronic screens/internet gaming, oppositional behaviours, excessive fears, and persistent sadness.
These children are usually brought in by concerned parents. Sometimes schoolteachers also facilitate their referral.
Are there any triggers?
The school closure due to the Covid pandemic has been difficult for a lot of children. Lack of routine, online education/interruption of education, inability to meet friends, inability to engage in sports and other activities, above average access to electronic devices have all led to a rise in problems.
In addition, the triggers contributing to difficulties in children include issues at school and home. At home, domestic violence/parental conflicts are major contributing factors. Lack of a close attachment or relationship with parents leads to an increase in vulnerability for these problems. Parents provide for the physical needs, but due to multiple reasons, they are unable to be emotionally available for the children. Being emotionally available means being able to understand the child’s emotions, validating them, and helping children manage difficult emotions without brushing them aside or being overprotective. Lack of stimulation during the early years can also impact development.
The competitive nature of education and even extracurricular activities create stress for children. High-performing students are stressed out as they try to maintain their performance and the others are stressed out because their achievements are less than that of their peers. The parents also inadvertently contribute by announcing their child’s achievements or putting them on social media or putting pressure on children to perform better. A significant number of children present to us close to the grade five scholarship examination as well as O/L and A/L examinations. These are usually due to heightened anxiety and worries and we see both high-performing and underperforming children having these issues. Additionally, peer relationship difficulties are also a common trigger for such presentations, stated Dr. Dahanayake.
As shown above, environmental factors are extremely important in triggering emotional and behavioural issues in children. Due to increased dependence on the adults around them, children are more vulnerable to these effects.
What signs and symptoms should parents look out for?
Any change in the child’s behaviour needs to be looked into. Especially if they appear sad, are irritable, engage in self-harm, are socially withdrawn and/or there is a reduction in school performance. Frequent anger outbursts, sleep and appetite disturbances, physical complaints such as recurrent stomach aches and headaches without any underlying cause are important features to be vigilant for. In younger children, failure to achieve age-appropriate developmental milestones is also a reason for concern.
When should they see a doctor or a child psychiatrist?
- Changes in behaviour and emotions as above which impacts on relationships, studies, and other activities of the child
- Delay in achieving developmental milestones