When babies see shrinks

Some conditions are being detected at much earlier ages than ever. Dr. Joan Luby, a child psychiatrist at Washington University in St. Louis, says thanks to the attention being focused on infant mental health, professionals are now more likely to diagnose certain problems such as autism spectrum disorders as early as 18 months.

And research in the past several years by Luby and colleagues, published in the Journal of the American Academy of Child and Adolescent Psychiatry and elsewhere, has helped scientifically validate that children as young as preschool age can suffer from depression, anxiety and other mood disorders.

Even with these disorders, though, doctors tend to be wary about medicating the pre-kindergarten set because most of the drugs used to treat the disorders haven’t been properly studied in children.

“Treatment for mood disorders really depends on the disorder but, in general, behavioral and psychotherapeutic modalities are still the first line,” says Luby. The more severe the impairment, she adds, the more likely the child will eventually need psychotherapy and medication.

“It sometimes helps to think about [mental illness] in terms of diabetes,” says Anders. “If a child was diabetic you wouldn’t like it but you’d get treatment. If it’s true that your child has a problem, you need to treat it.”

Teen problems can have early roots
Experts say that while many of us haven’t realized it, our children have often paid steep prices for not having their mental health taken into consideration. Dropout rates, drug abuse, suicide and eating disorders are all adolescent problems that could have roots in treatable early childhood mental-health issues.

Zero to Three’s Onunaku points out that we don’t even have to wait until adolescence to see the impact of ignoring early childhood mental wellness.

A Yale study last year looked at the problem of pre-kindergarten children being expelled. Led by Yale Child Study Center researcher Walter S. Gilliam, the study found that in classrooms where the teacher had no access to a psychologist or psychiatrist, preschool students were expelled about twice as frequently.

“We know for certain that kids this young can have significant problems. By catching the problems early and working with them we have a chance to positively influence how their lives progress,” says Onunaku.

Researchers point out that more than just influencing whether a child gets kicked out of a school or not, by identifying and treating certain mental and emotional problems extremely early there is a chance that the brain could even be altered positively.

“If we intervene early there is the issue of plasticity of the brain,” says Glass. The ability of the brain to change with learning is called neuroplasticity, or plasticity. “There are no absolutes and we know we can’t just fix everything that isn’t right.”

But, she says, there is reason to believe that if we help early on we may be able to help more and perhaps in a more permanent way.

There’s even hope, says Glass, that with early intervention we’ll have fewer teens and adults “on the couch” in the future.

Victoria Clayton is a freelance writer based in California and co-author of "Fearless Pregnancy: Wisdom and Reassurance from a Doctor, a Midwife and a Mom," published by Fair Winds Press.

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