When Should Daycares Get Involved with Behavioral Health

When Should Daycares Get Involved with Behavioral Health

Susie, a three-year-old girl, has been in daycare for 3 months. She is struggling with social interaction with her peers, and cannot seem to keep her hands to herself. When she gets mad, she throws things, and sometimes hits other children. During outside time, she prefers to play alone, and gets upset when others come near her. She struggles with transitioning from one activity to another, and most of her teachers dread telling her it is time to clean up. The daycare workers have done everything they can to encourage Susie to give daycare a chance, and have started to become discouraged. Susie’s parents are considering pulling her out of daycare because they are not sure what to do to meet the needs of their child. Susie wishes she had someone to help her feel better, and learn skills to enjoy her time at daycare.

As we can see with Susie, there are certain behaviors that are red flags to look for when considering a referral to Behavioral Health. It can be difficult to differentiate between negative behaviors and what is developmentally appropriate. Sometimes, negative behaviors are developmentally appropriate, and there are ways to manage those behaviors. Other times, negative behaviors are more concerning, as the behaviors do not seem to be normal for the child’s developmental stage. Daycare teachers are often the first to identify negative behaviors exhibited by children. Children spend large amounts of time in daycare settings and children become comfortable with their teachers. Because of this, daycare teachers can bridge the gap for families by referring children to Behavioral Health services.We are going to break down some warning signs in daycare settings that might indicate a child and their family would benefit from engaging with a Behavioral Health therapist.

Difficulty Separating from Parents
At a young age, it is developmentally appropriate for children to be nervous or skeptical in separating from parents for the first time. When children first start daycare, it can be an unfamiliar and scary experience. Over time, children become comfortable at daycare, and even like going to daycare to spend time with peers and engage in fun activities that promote learning. However, a referral to Behavioral Health may be necessary if a child struggles to separate from parents for extended periods of time, even after the child is familiar with teachers, peers, and other staff members. Another warning to look for would be if a child spends a large amount of their day crying and asking for their parent.

Aggressive Behaviors
Some child care professionals will see aggressive behaviors on a daily basis. It can be difficult to determine when aggressive behaviors are past developmental appropriateness and have reached a maladaptive form of coping. Some behaviors you might notice are kicking, hitting, spitting, biting, or otherwise injuring another child on a regular basis. When methods of redirection and limit setting are not effective, it may be time to seek professional help from a Behavioral Health therapist.

Potty Training
All children will grow and change at different speeds, even when on target for developmental milestones. If a child continues to struggle with potty training as they grow further away from infancy and pass the toddler stages, additional help may be needed. Children may benefit from behavioral health services if they struggle with holding urges to go to the bathroom during the school day, or do not inform teachers of an accident when developmentally appropriate. Behavioral Health specialists can assist parents with identifying reward systems, positive communication strategies regarding potty training, and any barriers that may contribute to difficulties with potty training.

Social Withdrawal
Typically, each child interact with their peers in daycare on different levels. It is common to see parallel play between children, joint play, and play in small or large groups. If you notice a child in your class prefers to play independently, regularly disengages in group play, or becomes easily dysregulated when play is interrupted by others, you may consider discussing with the parent the benefits of Behavioral Health services. This would allow the child an opportunity to work on communication skills, social skills, and positive peer interactions.

Overt Non-Compliance
Many children love to use the word “no” when they discover the power the word can have. Children may also push limits to see how far their answer “no” will go with an adult. Some refusal is developmentally appropriate, such as when asked to stop a preferred task, or to start a task that is not preferred. When children refuse to do anything asked of them, including preferred tasks, Behavioral Health services may be beneficial.

Difficulty Transitioning
For children who are new to the school setting, some level of adjustment is necessary. Children will typically settle into their new routine at school after a few consistent weeks. When a child continues to struggle with transitions after a consistent routine has been followed at school, the child may need support around managing transitions. Signs to look for when determining if a child struggles with transitions are tantrum behaviors at transition times, aggressive behaviors, or self-injurious behaviors for children who struggle with self-regulation. When a child continues to struggle with transitions, even after they become familiar with the school routine, the child may benefit from a Behavioral Health referral.

Tantrum Behaviors
Tantrums are a normal part of childhood. Most children will have multiple tantrums before they start kindergarten. Tantrum behaviors become concerning when the child’s tantrum seems more intense and lasts for excessively long periods of time as compared to their peers. Another indication that additional support may be needed is if a child’s tantrum behaviors increase, even when consistent consequences are implemented, or if the child begins engaging in self-injurious behaviors during tantrums.

Other behaviors to watch for when considering a referral to Behavioral Health services include the following:

Persistent Worry
Worry becomes a barrier when the experience of worry begins to interfere with everyday life. This can include difficulty concentrating, avoiding activities, fidgeting, irritability, or seeking excessive reassurance from others.

Self-Injurious Behaviors
If you frequently notice that a child is hitting their head against the wall or the floor, or regularly bites themselves when feeling any type of elevated emotion, that child may benefit from additional supports.

Hyperactivity and Inattention
Examples may include children who struggle to stay on task, are more easily distracted, or have far more energy than his or her peers.

Somatic Symptoms
Anxiety can trigger physical symptoms of sickness for some children. This can include frequent headaches, stomach aches, and even vomiting.

Sudden Changes in Behavior
Any drastic behavioral change could indicate some concern for overall mental wellness. This could include aggression, withdrawing behaviors, personality changes, or sudden disregard for safety skills.

Children, like Susie, do not always know how to tell adults that something doesn’t feel right. Recognizing behaviors that can indicate the need for additional services is the first step to getting support for children. This is why daycare centers play such an important role in the mental health of children. To begin supporting your child on the journey back to Behavioral Health wellness, discuss the concerning behaviors you with the child’s parents. With parental approval, you can refer a child to Behavioral Health services at Carolina Pediatric Therapy by contacting our office at 828.398.0043. You can also click here to review additional information regarding the Behavioral Health services provided at our clinics across Western North Carolina.

When Should Daycares Get Involved with Behavioral Health
Amber Gulley, LPCA

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