Does My Child Need Therapy?


    Psychologists find that the earlier we begin treatment, the greater the likelihood of success with any client.  But until the 1980s, this applied only to adults and teens — because there wasn't enough information available to offer treatment that addressed distress and psychological disorders in early childhood. 

   After 25 years of research and practice, child psychology has now exploded with advances in diagnosis and treatment of early childhood troubles. And this information has begun to diffuse into the general population, as parents, teachers, and the lay public are increasingly aware of just how much the earliest part of life influences everything that comes after. 

   There are two main reasons for parents to consider psychotherapy for young children.  The first concerns psychological disorders often seen first seen in childhood. The second reason is about parent/infant bonding, or what professionals call attachment

Disorders first seen in infancy and childhood

   Many serious psychological disorders can now be diagnosed and treated during infancy and early childhood.  Autism, for example, can often be identified before a child's first birthday; anxiety disorders can appear within the first two years of life.  Schizophrenia has now been diagnosed in children as young as 5.

   These are extreme examples, but they illustrate the wealth of information mental health professionals now have.  Treatment for many disorders can also begin very early.  Because problems can look very different in young children than for older kids and adults, we recommend that parents be aware of developmental milestones appropriate to their children's ages.  While some children talk at younger ages and others walk at younger ages, lags do not always even out.  Sometimes parents have to make a judgment call and to talk to a professional  — because the earlier you get help for your child, the better the likelihood of success.  When in doubt, consult a professional, if only to find out that the worry is unnecessary.  Psychologists will not undertake unnecessary treatment.  We have busy enough lives doing the necessary work.

Parent-child bonding

   Infants come into the world with identifiable temperaments that may or may not be a comfortable fit with those of their parents.  Quiet, shy babies are born into loud, boisterous families who have high expectations for early social interaction.  Fussy, demanding babies are born into quiet, non-demonstrative families.  These "goodness of fit" issues often resolve themselves naturally. 

   But sometimes, a difficult fit continues to have a serious impact on family life.  Parent frustration and infant vulnerability feed off each other, and this can throw an otherwise stable family off-kilter, as well as do long-lasting harm to the child. 

   We suggest that parents who experience any kind of continuing difficulties bonding with their babies, accepting their babies or getting comfortable with their babies' behavior or demands, should consult a licensed psychologist.  When in doubt, it's always a good idea to consult, even if it's just a phone call. 

   Psychologists are trained to observe family dynamics and work with parents to bond more fully and comfortably with their child.  Playing with the baby, soothing the baby, face-to-face contact, turn-taking, and vocal imitation are all areas that parents can improve.  Likewise, parents can learn to make more adaptive and soothing responses to infant fussiness, ineffective communication, and sleep disturbances.  In these cases, psychologists usually interact with the parents and child together for treatments of up to several months' duration. 

   Sometimes we may work with the parents separately to come up with effective interventions that address sibling rivalry, difficulty with in-laws, setting boundaries, and unfulfilled parental expectations about the baby.  By the time infants become toddlers, we can also work with the child separately to improve communication and interpersonal skills, independence, and self-esteem.  Here, too, we advise parents: If you've noticed problems, and you feel worried, it's best to ask a professional.  That's what we're here for.

MICHAEL C. SINGER, Ph.D., is a clinical psychologist in private practice in Manhattan, where he works with parents, children, and infants.  He also leads a federally-funded postpartum and perinatal depression program, Healthy Start Brooklyn, located in Bedford Stuyvesant.  He can be reached at 917-689-1746 or