Commentary: Avoid pathologizing your young child's behavior

We are a nation in love with a good diagnosis. Whether it's a vitamin deficiency, a personality disorder or a behavioral variation, we want to label it and treat it. It gives us a wonderful sense of control. And there are many very real issues kids face, which can be vastly improved by recognition and intervention. For example, the importance of access to early intervention in autism spectrum disorders is huge. But, there are also many crazy, annoying, troubling, disruptive, stressful and often worrying behaviors kids engage in that are simply normal. In our culture, parents, family and childcare institutions can become inclined to read pathology into these challenging behaviors. This can be especially true if a child's normal development puts them in conflict with the structure and bureaucracy of school, childcare or a family's scheduling needs. Remember that for most of human evolution, children were raised in hunter-gatherer societies. In that kind of culture, children roamed in multi-age groups. They would live and learn in an environment that allowed tremendous behavioral latitude. They were free to grow at their individual pace. Now, we expect all kids to conform to the rules of childcare, school and structured society. Then, when a child doesn't fit into these constructs, we may be inclined to pathologize them as opposed to asking what is wrong with a culture that can't give them the time and space to be young and immature. Perhaps sometimes the flaw is in a system that is unable to flex enough to embrace the needs and talents of these children. Perhaps the flaw is in the childcare or school. Perhaps the society we are expecting our kid to function in is antithetical to their strengths. If your kid is kicked out of preschool because he's "too disruptive" or "too aggressive" or "too upset," it doesn't necessarily mean your kid has a "disorder." This is no small issue for some parents. You may really, really need your child to go to preschool so you can go to work. And if other kids can do it, why can't yours? Right? There must be something wrong. And your child's preschool teachers may encourage your concern by implying some sort of pathology for your kid. Just be aware this can happen. Then seek help from a good specialist in child development. Your kid has no impulse control at age 5? Guess what. That's well within the normal developmental spectrum. I'm a medical practitioner. I know the power of a good diagnosis. Still, misdiagnosis and over diagnosis can also be very damaging. Get some good, knowledgeable advice before you give your kid a diagnosis that will follow them through their school years. A label that will shape the picture you have of him in your mind. A diagnosis that will shape the picture he has of himself within his mind. You may need to look around for good resources in your community. Remember that most pre-school caregivers have little to no education in the growth and development of a child's brain. Some young children don't do well in a preschool environment. Perhaps they are 3 years old and have all the skills they need to run wild through the woods with older kids. They could do it for hours on end and come home hungry, happy and ready for more. But, they don't have good "sit in a circle for story time" skills or good emotional-social skills. They are very, very young! They may just not have developed these skills yet. So, which is broken? The child or the environment? Do we try to force the child to fit the pre-school or do we find a way to provide the environment this child needs at this stage of their development? Personally, I believe the U.S. needs to make major changes in early childcare programs. One size does not fit all when it comes to young children. In some countries, there are options for "outdoor preschools" or "forest kindergartens." Rain, snow or sunshine, the kids spend most of the day outside in nature with an adult who facilitates their individually motivated explorations and activities. These are teachers specializing in child development who are focused on the emotional, social and language skills of their young students. For some kids, this outdoor freedom to learn is truly critical. It is what will allow them to grow without the constant condemnation and criticism by adults who want them to be developmentally ready for circle time. Kathleen Cawley is a physician assistant and author. She is a regular guest columnist for the Auburn Journal, where she writes on parenting and childhood. Her book, "Navigating the Shock of Parenthood: Warty Truths and Modern Practicalities – from a mom with twins," will be available in winter of 2022. You can find her on Facebook at The Shock of Parenthood and on Medium.