1: How do they compare to others?
There is a wide continuum in relation to what constitutes ‘normal’ for just about every aspect of any individual child. But it’s important to not get overly concerned about what is regular. Diversity in children is something we should appreciate, because as the saying goes ‘normal is just a setting on the dryer’. In saying that, at the extreme ends of the continuum there are functional problems for a variety of issues. However, there’s a big range within which we would consider a child is ‘normal’ or ‘typical’. For instance, in terms of activity levels, some children have loads of energy, and will need a lot of physical exercise, compared to other children of a similar age. At the extreme end of the continuum, hyperactivity may be suggestive of Attention Deficit Hyperactivity Disorder (ADHD), but a thorough formal assessment is required to diagnose this disorder. At the other end of the continuum there are children who have very little energy, and getting them to engage in physical activities can be a real challenge. Their lack of activity can also worry adults.
A practical tip: It can be helpful to get feedback from others if you are worried about an aspect of your child’s development. But this can be tough, because no one wants to hear negative comments about their child. However, some of the best people at helping you determine whether your child is similar or different to their peers, is an experienced teacher or childcare provider. A teacher that has taught children the same age as your child, for a number of years, will have a very good idea of what is within the regular range. Feedback from teachers can focus on the academic aspects of a child’s performance, so you may need to ask questions which shift the focus. For example – “how does my child compare to the other children in the class in terms of their emotional development?” If your child does struggle with things at school, it can also be handy to ask the teacher to focus on your child’s strengths, by asking something like “what have you noticed in terms of what my child does really well?” Because all children will have certain strengths and areas for development. For further information you can check out the NHS’s Child Health web pages and read up on things like ‘How much exercise should my child do?’ to give you an idea of what is to be expected.
2: Have you noticed any major changes?
We all have fluctuations in terms of our emotions and overall functioning, children are no different in that regard. But it can be hard for children and young people to communicate their thoughts and feelings, and why they might have behaved in a certain way. It can also be challenging to know when something is a problem, say if a child is eating much less than they would usually, and determining if this is just natural variation in appetite. I have previously worked in outpatient Child and Adolescent Mental Health Services (CAMHS), and one of the most useful ways in figuring out when a ‘problem was a real problem’ was by asking caregivers to compare their child’s behaviour to what is usual for them. There can be lots of changes in the teenage years, so it can be hard to tell if a certain change is a major concern. If you notice considerable changes in things like eating, sleeping, emotional regulation and/or physical health, it could be time to seek professional advice for your child from your General Practitioner (GP).
A practical tip: A good professional to see when you are worried about major changes in your child is your general practitioner (or practice nurse), as doctors are primary health care professionals, and they can diagnose and treat a range of conditions, and refer on when necessary. It isn’t always straightforward knowing when you should see a doctor, but trust your gut, you are the expert when it comes to your child. It can also help to write down your concerns, and take these with you into the consultation, that way you can be sure to get your key points across when discussing things. As a general rule, it is better to seek help even if things aren’t that serious, than to wait and have things get a lot worse.
3: Mental health matters
As a lecturer and researcher with an interest in child and adolescent mental health, I would encourage parents and caregivers to think about the psychological aspects of child development – and how we can have rather limited views on what constitutes ‘normal’ or healthy emotional and social development. For instance, in terms of gender role expectations, does it really matter if a girl dresses and acts in a way that is masculine? and maybe it can be okay that your child doesn’t want to go to any parties, because they prefer solitary activities. If a child is not distressed and their functioning is not impaired, then we probably don’t need to be concerned. During childhood we can encourage a high degree of conformity, sometimes inadvertently. This won’t bother many children, but for the child that ‘dances to a different beat’ it can be really tough. It can be helpful to consider, what might be a symptom of a bigger issue (such as depression or anxiety) versus societal expectations.
A practical tip: The Werry Centre for Infant, Child, and Adolescent Mental Health, from the University of Auckland in New Zealand, has developed some useful information sheets. These fact sheets are about various mental health topics, specifically written for family members to read e.g. on Alcohol & Drug Problems, Anxiety Disorders, Depression, Family Therapy, Obsessive Compulsive Disorder (OCD), Psychosis, and Mental Health Assessments.
4: A balanced view
It is important to be fair on people, children need this fairness too. From before a child starts school to beyond A-Levels, children and young people are expected to perform. Some children have very little ‘down time’, and they can be overwhelmed by all the activities they are expected to do outside of school. Then at school they are required to engage in everything from singing and dancing, to maths, hand-writing, physical education and more. As adults we can focus more on what we are good at (or enjoy), and we can fairly easily accept that most of us will never be an Olympian or the next Nobel Prize winner for Chemistry. However, children are expected to do a wide range of things, and can find ‘failure’ really hard, at school and outside of school. Your child may have terrible ‘ball handling skills’, may find making and maintaining friends really tough, and they may struggle with numeracy, but what are their strengths? Testing and formal feedback on your child’s performance can become deficit focused. It is useful when thinking about whether your child is normal to focus on their strengths. This can help ensure the ‘fullest possible picture’, because no one can be good at everything.
A practical tip: Try to list all the things your child does well, or qualities within them that you admire. It’s important for your child to know that you value things like kindness and thoughtfulness, just as much as other things, like academic ability. Sometimes parents can worry that providing too much in the way of positive feedback could make their child conceited, but this is rarely the case. It is helpful to acknowledge and praise things that children do well, especially the efforts that they put in. For example, your child may be almost last in a running event, but they tried, and didn’t give up, and that makes you proud, because your child has got grit, even when things are tough. For young children you can complete the ‘Childhood Health Assessment’ on the NHS Choices webpages. and check out your knowledge (and some expectations) you might have. Finally, you could ask yourself, ‘are my expectations too high?’ in relation to your child, considering their age, and current abilities.
5: Make time for your children
This last point is less about helping determine whether your child is normal, but more about valuing your child. It is important to spend quality time with your child (or children). You can do this by letting them select an activity or game, and engaging in what can be called ‘child- directed play’. Avoid critiques or asking too many questions about their play, let the child direct things. This one-on-one time can help you connect with your child around their interests, it can also enhance your relationship, and it is likely to improve their overall behaviour. This quality 1:1 time is important in the teen years too, even when it becomes less about play and more about engaging in an activity they enjoy.
Practical tips: It’s quality time that counts, so even if it is only 5-10 minutes a day that can make a huge difference. Child-led play is awkward at first, and it's hard to not guide the play and ask loads of questions, but it gets easier. The Incredible Years® programme (and the associated books) go into more detail about engaging in one-on-one time with a child. It is an evidence-based program, which aims to help young children in terms of their social, emotional, and academic competence. The program is used worldwide, and has been shown to work across nations and cultures.
To conclude, it is perfectly natural to think about the question – Is my child normal? But perhaps it isn’t the most helpful question to ask. Something better to consider is – are they happy and are they able to function in their world?
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