Parents /guardians typically know their kids best. They know their day-to-day routines and personality and can likely sense when something is off with their child. But when there are too many changes (not for the better) for too long and too intense and negative consequences start adding up  it might be  time for a clinical intervention before they get too far off a healthy developmental path.

 

Clinical signs and  symptoms are negative  presentations that interfere in a child’s life in a persistent way, lowering their level of functioning and impacting healthy development. This is typically why children are brought into therapy.

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Problematic Signs & Symptoms May Include:

• Difficulty sleeping, recurrent nightmares, or chronic bed-wetting

• Problems with eating (loss of appetite or binging), elimination, toileting

• Excessive worry, sadness, anger, or fear

• General anxiety, separation anxiety, persistent fears, panic, phobias 

• Excessive shyness, social withdrawal, isolation

• Behavioural/developmental regression

• Adjustment problems

• Aggressive behaviour, rage (hurting self or others)

• Pre-occupation with sexual behaviour

• Compulsive behaviour

• Depression and extreme fatigue

• Self-harm, suicidal ideation

• Drug and alcohol use/abuse

• Risk-taking behaviours

• Defiance to authority figures and mistrust in adults

• Tummy and head aches

• Persistent lying

• Zoned out most of the time 

• Chronic low self-confidence/self-esteem

• Always in fight, flight or freeze mode

• Diagnosis of behavioural, emotional, or developmental disorder

• Social and relational challenges, withdrawal from normal play

• Self-regulation challenges, low affect tolerance

• School challenges: confusion, trouble concentrating, decline in academic functioning

• Attachment challenges with important people in their life

 

 

Potentially Traumatic Experiences That May Lead to Clinical Symptoms:

• ​Parental conflict, separation, or divorce: perceived loss of family unit, caught in the middle, experiencing hostility, moving from one place to another, getting to know new family, new roles, parent instability etc

• General loss: relationship, hope, core beliefs etc

• Adjustment to adoption, or foster care

• Illness or hospitalization of self, loved one, or pet

• Experiencing a car accident, getting in an accident in which they were really hurt

• Witnessing something scary

• Certain aspects of cultural and or negative community-based experience

• Child abuse (Sexual, physical, emotional, spiritual and neglect)

• Natural disasters: war, earthquakes, volcanoes, floods, hurricanes, tornadoes, tsunami, avalanche, fires, pandemic etc

• Relational trauma: bullying, peer rejection, physical, sexual, emotional, spiritual abuse and/or neglect and abandonment, racism, sexism, homophobia, witnessing domestic violence, persistent abuse of power by adults

• Death & Loss: death of a loved one or pet, witnessing death

• Miscellaneous traumas:  a single scary incident, accident, personal failures, social problems, animal nips, and nightmares etc

• Medical/Dental: waking up during surgery with out parents, ongoing medical problems, diagnosis, frightening experience in general

• Transitions: moving into a new grade, moving from childhood to adolescence, moving homes, living in new neighbourhood, getting to know a new family, new immigrants or refugees (Eg: culture shock, fleeing war or unpleasant circumstance in home country), new sibling

• Discrimination, racism, hate crime, homophobia

 

A Note On Ongoing Environmental Distress :

Children and youth who are in environments that contribute to clinical symptoms and unhealthy development are likely in an active state of fight, flight, freeze or shut down. These children can  be treated to manage symptoms but cannot be expected to recover from experiences that are ongoing.  Parents/guardians must manage therapeutic expectations in these cases and must be prepared to make interventions if possible in  the environments which are contributing to the child’s clinical symptoms for significant progress to occur. Therapists can help with this too.