problem checklist

 1  2  3  4           Promote interactive learning and encourage the child's construction of knowledge   

1  2  3  4           Encourage development of positive feelings and dispositions toward    learning while leading to acquisition of knowledge and skills

1  2  3  4           Have expectations that are realistic and attainable at this time

1  2  3  4           Build and elaborate on children's current knowledge and abilities                                                            

1  2  3  4           Facilitate concept learning and skills development in an integrated and natural way

1  2  3  4            Foster children's exploration and inquiry, rather than focusing on "right" answers or "right"ways to complete a task

1  2  3  4           Insecurity sometimes can cause a child to withdraw or behave aggressively.

1  2  3  4           An environment that is sensitive to this need in children will provide interesting activities as well as a quiet place to get away from the action.

1  2  3  4          Children are inherently different in their tolerance to noise, activity, visual stimulation, or changes in the environment.

1  2  3  4         Provide experiences that promote feelings of success, competence, and enjoyment of learning 

1  2  3  4         Promote positive relationships with families

1  2  3  4         Some children think quietly through possible solutions to a problem others push in and try the first idea that occurs to them   

1  2  3  4        Other children need more quiet time or more rest.

1  2  3  4        Some children are interested in experimenting to find out how objects work others choose to ask friends or adults for help.

usual problems of eced child

Common Behavioural Problems in Children

These can be usefully classified into psychosocial disorders, habit disorders, anxiety disorders, disruptive behaviour and sleeping problems.

Psychosocial disorders These may manifest as disturbance in:

• Emotions e.g. anxiety or depression
• Behaviour e.g. aggression
• Physical function e.g. psychogenic disorders
• Mental performance e.g. problems at school

This range of disorders may be caused by a number of factors such as parenting style which is inconsistent or contradictory, family or marital problems, child abuse or neglect, overindulgence, injury or chronic illness, separation or bereavement.¹

The child's problems are often multi-factorial and the way in which they are expressed may be influenced by a range of factors including developmental stage, temperament , coping and adaptive abilities of family, the nature and the duration of stress. In general, chronic stressors are more difficult to deal with than isolated stressful events.

Children do not always display their reactions to events immediately although they may emerge later. Anticipatory guidance can be helpful to parents and children in that parents can attempt to prepare children, in advance, of any potentially traumatic events e.g. elective surgery or separation. Children should be allowed to express their true fears and anxieties about impending events.

Young children will tend to react to stressful situations with impaired physiological functions such as feeding and sleeping disturbances. Older children may exhibit relationship disturbances with friends and family, poor school performance, behavioural regression to an earlier developmental stage, development of specific psychological disorders such as phobia or psychosomatic illness.

It can be difficult to assess whether the behaviour of such children is normal or sufficiently problematical to require intervention. Judgement will need to take into account the frequency, range and intensity of symptoms and the extent to which they cause impairment.

Sleeping problemsSleep disorders can be defined as too much or too little sleep than is appropriate for the age of the child. By the age of 1-3 months the longest daily sleep should be between midnight and morning. Sleeping through the night is a developmental milestone but at the age of 1 year 30% of children may still be waking in the night. Stable sleep patterns may not be present until age 5 years but parental or environmental factors can encourage the development of circadian rhythm.

Sleep disturbance can have a deleterious affect on the cognitive development of children, as well as the functioning of the parents. One study of 2-3 year olds found a significant link between sleep disturbance and emotional and behavioural disorders.Other links include memory loss and obesity.
Regular bedtimes, quieter activities and the creation of marked differences between the sounds, activities and light levels associated with night time sleeping and daytime activities may help to encourage better sleep patterns. A solid evidence base now supports the use of behavioural treatments in infants and pre-school children (under 5).⁹ All of these are based on the objective of the parents gaining control of the bedtime routine. They include unmodified extinction (ignoring the child's cries but monitoring for illness or injury), modified extinction (ignoring the child for a specified period of time) and positive routines (doing some quiet pre-sleep activity and ensuring that falling asleep is associated with a positive parental-child interaction).¹⁰ One study found that parental interventions that encourage independence and self-soothing were associated with extended and more consolidated sleep compared to more active interactions that were associated with shorter and more fragmented sleep.

Hypnotherapy has been found to be of benefit in school-age children.

The BNF for Children states that the use of hypnotics, except for occasional short-term treatment of night terrors and sleep-walking, is never justified. However, it is recognised that the treatment of paediatric insomnia is an area that needs further research.

Melatonin is sometimes of benefit in sleep disorder associated with visual impairment, cerebral palsy, attention deficit hyperactivity disorder and autism. It is unlicensed for this indication and specialist supervision is recommended for initiation and monitoring.

Habit disorders 

All children will at some developmental stage display repetitive behaviours but whether they may be considered as disorders depends on their frequency and persistence and the effect they have on physical, emotional and social functioning. These habit behaviours may arise originally from intentional movements which become repeated and then become incorporated into the child's customary behaviour. Some habits arise in imitation of adult behaviour. Other habits such as hair pulling or head banging develop as a means of providing a form of sensory input and comfort when the child is alone.

• Thumb sucking - this is quite normal in early infancy. If it continues it may interfere with the alignment of developing teeth. It is a comfort behaviour and parents should try to ignore it while providing encouragement and reassurance about other aspects of the child's activities.
• Tics - these are repetitive movements of muscle groups that reduce tension arising from physical and emotional states, involving the head, the neck and hands most frequently. It is difficult for the child with a tic to inhibit it for more than a short period. Parental pressure may exacerbate it while ignoring the tic can reduce it. Tics can be differentiated from dystonias and dyskinetic movements by their absence during sleep.
• Stuttering - this is not a tension reducing habit. It arises in 5% of children as they learn to speak. About 20% of these retain the stuttering into adulthood. It is more prevalent in boys than girls. Initially it is better to ignore the problem since most cases will resolve spontaneously. If the dysfluent speech persists and is causing concern refer to a speech therapist.