Kid's Health topics

The role of your PAEDIATRICIAN in managing undesirable behaviours

Today I wanted to write a quick article about the work-up of disordered behaviour in children and why it is important to see your GP or paediatrician around this.

I attended a lovely lunch last weekend where parents (and some educators) attended to listen to parenting experts talk about different approaches to behaviour management.  It was fabulous to be a part of, and reminded me of several things.

  1. Not all “parenting experts” will have the same approach
  2. It is unrealistic and naïve to think that there will be a “one size fits all” for ALL children and ALL carers in terms of behavioural management strategies. There are approaches that are well backed by strong bodies of evidence to show that they work when applied in the right way, but there will always be children and situations that are exceptions to the rule.

Different members of the parenting management community have different things to offer and different opinions on what might work for your child, and all of these contributions are important.  Some therapists will use play/art or music therapy, some will use talk based therapy and “zones of regulation,” and some might try reward based strategies to encourage positive behaviours.  These all have their place.  Similarly, doctors (particularly your child-friendly GP and/or paediatrician) have an important role to play in helping you to understand where your child’s undesirable behaviours might be coming from and hence work out how to deal with them effectively.

Children’s behaviour is influenced by a great many things.  You may have read my blog article on “angry kids” (and if you haven’t, here is a link:  http://www.kids-health.guru/angry-kids/ ) which alluded to this.  When I see a child who is having behavioural problems, I take a holistic view of the child and try look at everything that is going on in their life.  I do this by taking a long and detailed history from their parents that includes (but is not limited to):

  • The presenting complaint (how, what, why, where)
  • What has been going on in the child’s life since the behaviour emerged
  • What is going on at home?  What is going on at school?
  • Medical issues (eg asthma, diabetes, epilepsy etc)
  • Medications or supplements the child might be on
  • Allergies
  • Developmental milestones (speech, motor, social etc)
  • Social and academic history
  • A detailed family history – both medical and social

Importantly, the thing that your paediatrician will think about that other therapists may not be able to define are possible MEDICAL reasons why your child might be misbehaving.  Your doctor might need to order some further investigations to find out if any of these medical problems are an issue for your child and will make a decision on this based on the information gathered in the history and clues/signs found on clinical examination.

Some medical conditions that can affect a child’s behaviour can include (but are not limited to):

  • Hearing or vision impairment
  • Obstructive sleep apnoea or other sleep disorder
  • Thyroid problems
  • Constipation
  • Poor diet and iron deficiency, with or without accompanying anaemia
  • Anxiety or mood disturbance

Why is it important to investigate for these causes?

– because many of them are treatable, and by treating the trigger it is possible to resolve the undesirable behaviour!

Take home message:

It is important to seek the advice of your paediatrician when trying to manage undesirable behaviour in children.  There are medical reasons that need to be ruled out as to why your child might be misbehaving, and many of these are entirely treatable.  Behaviour Management Therapists have excellent techniques and strategies to use in managing behaviour in children, but only your DOCTOR is able to investigate MEDICAL reasons that could be influencing your child’s behaviour.

 

Catch you next week!

xxDr Megs

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