Common Problems in Children

There are five questions parents commonly ask about child management:

  1. How do I handle a temper tantrum?
  2. What do I do if my child is rebellious?
  3. What if my child is bedwetting?
  4. Is my child developing normally?
  5. How can I help my child adjust to school?

Every parent can recognise a temper tantrum. It usually results when parents have to deny a child a request. The child becomes extremely angry and shows dissatisfaction by screaming, crying, kicking, spitting, biting, pulling – anything that will hurt others and sometimes themself. A temper tantrum can go on for a long time and is very effective in driving parents crazy! The quickest way to stop a temper tantrum is to give the child what they want but that is the surest way of setting a habit of the child throwing a temper tantrum whenever they want something. They soon learn that temper tantrums work!!

What can parents do? It is not going to be easy, but parents should remain calm and ignore the temper tantrum. The child will not come to any harm. If they are very aggressive, they may need physical restraint or put into a secure time-out place. The time-out place can be a room or even a corner of the house where the child is put for a short time during which they can quieten down. Be firm and do not be tempted into a shouting match. Punishing the child by beating or threats may stop the temper tantrum but it tends to result in more anger and bad feelings. It is also not helpful to try and reason with a child that is screaming and crying. Do so when they have cooled down. They will eventually quieten down when they become aware that a temper tantrum is not going to get them what they want.

Disobedience starts at about two years old and becomes more and more of a problem as the child grows older. Little children can learn that they can get more attention when they are naughty than when they are good. Parents should make it a point to recognise, reward and praise good behaviour in addition to checking bad behaviour.

Set fair and consistent rules. A child will disobey if they feel that they are being punished unjustly or if they think that the rules will change at different times. Remember also that too many rules make life difficult and restrictive. Both parents must present a united front when it comes to making rules and enforcing them. It is easier to disobey and get away with it if the child knows that Mum will support him against Dad or the other way round.

Disobedience should not be seen as a personal attack on the parent. It should not stand in the way of building a close relationship with your children, which is probably the best way to elicit their obedience and respect. Disobedience can sometimes escalate into conduct problems and professional help should be sought when this happens.

Bedwetting becomes a problem if it persists beyond the age of five years. Parents expect night dryness to happen naturally and this is usually the case. However, it is still a good habit to teach a three-year-old to empty their bladder before bedtime, restrict excessive intake of fluids towards bedtime and also avoid spicy, salty foods as they might stimulate fluid intake. If bedwetting continues even with these simple measures and beyond the age of five years, it might be useful to see a medical practitioner to exclude urinary infection and other abnormalities. After this, a referral can be made to the psychiatrist who can plan a behavioural programme to obtain bladder control. Bedwetting in a child can also reflect emotional problems within the family and family work will be necessary.

Parents frequently worry about their child’s mental development: “How come my child cannot say the alphabet yet?”, “When should my child start reading?”, etc. Worries like these are easily clarified and parents should not worry unnecessarily. Development occurs at a different pace for every child but the pattern of development does not change, e.g. the child will sit before he can stand and then walk, or the child will scribble and draw lines before he can write legible letters. The time at which each developmental stage is reached varies within a time frame and if a child’s development tends to fall outside this time frame, then parents should seek professional advice. Advice on development is easily available at Child Health Clinics and Paediatric Clinics while more specific assessments are available at Specialist Clinics dealing with Child Growth and Development.

School adjustment is one of the major worries parents have once their child is old enough to start school. Going to school is usually the child’s first experience away from home for a length of time. The child is subject to the authority of strangers. He has to compete and also learn to get along with others of his age. He may fail his test! He is apprehensive and may refuse to go to school!!

School refusal is a complex problem with more than one cause. The child may be afraid of the new environment of the school, or he may be afraid to be apart form his parents.

Parents who are overly anxious about their children leaving their sides, may convey this anxiety to the child, who may then refuse to go to school. Children who are worried about their parents for whatever reason may also refuse to go to school. Solving the problem involves working with the parents, the child and the school. Both parents have to work together to help their child confront fears about school. They have to be firm and consistent about the child going to school. Sometimes, parents may need to deal with their own anxieties at the same time. Support from the school teacher should be enlisted to facilitate an early return.

As parents, we can help our child adjust to school by preparing them for the change. The idea of going to school should be discussed by the family and presented positively as an interesting event. The advantages of having friends, learning things and the possibility of successful achievements should be highlighted. Practicalities like registering for school, buying uniforms and textbooks should involve the child and can be treated as an outing for the whole family. Acknowledge the child’s anxieties if there are any. Be reassuring and give the child the opportunity to express their anxieties without criticism or argument.

Once the child is attending school, encourage them to discuss their experiences. Be careful not to become too involved and too ready to rescue your child from difficulties. Remember this is their opportunity to learn to cope with problems and they will feel a sense of achievement when they can handle them effectively. Do not be afraid to talk about failures. Keep an open mind – failure is not always due to laziness. Use this as an opportunity to share problems and to impart values.

Encourage your child to develop a range of interests both in and out of school. Children’s interests change quickly, so be prepared for your child to want to experiment with different things.

Get to know the teachers. Apart from mum and dad, the teacher is probably the third most important person in your child’s life. Be considerate of the teacher’s unique problem of having to deal with a roomful of active children, all demanding attention in their own way. By being supportive rather than critical, both of you can work together to bring out the best in the child.

Where To Get Help?
Bringing up children and managing the challenges they invariably present can be the most rewarding investments we can make in our lives. Yet it can be frustrating and parents can often feel that they are struggling all alone. In Singapore, the family doctor and the Child Health Clinics are well equipped to handle most day to day worries about bringing up children. More specialised services are provided by the Child Guidance Clinics which focus on helping families and parents deal with their children’s emotional and behavioural problems.