and Supporting Your Child's Psychological Needs in Preschool - Psychiatry

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Child Psychology


Hello Doctor: My child, a 4-year-old boy, is in a public kindergarten's middle class.
From infancy until preschool, he was cared for by his grandparents during the day and brought home by us at night.
He grew up without interaction with peers until he started school.
The kindergarten teacher is very concerned about his behavior; he is reluctant to learn new things and often says "no." Even during one-on-one instruction, he refuses to participate and seems unable to integrate with his classmates, often zoning out and only engaging with activities that interest him.
He does not talk about school when he comes home, and when asked, he responds with "I don't know." He is very sensitive to others' opinions; when I talk to the teacher, he feels it is about him, which leads to him crying and refusing to enter the classroom.
The teacher suggested we seek an evaluation, so we went to Taichung Chung Shan Hospital's Daqing branch, where Dr.
Tsai Cheng-Tao from the Pediatric Neurology department assessed him.
After inquiring about his situation, the doctor stated that the child is quite normal, but due to the teacher's recommendation, he referred us to the Rehabilitation department.
The rehabilitation doctor, after questioning, suspected some traits of autism and ordered four types of assessments.
We completed three (occupational, physical, and psychological), and the therapists indicated that the results were not ideal, as the child was unwilling to follow instructions during the sessions, even suggesting psychological therapy.
I would like to consult with you on how we can help our child.
I cannot ascertain the underlying issues as he does not provide clear answers.
I kindly ask for your guidance.
Thank you.

Bu zhi suo cuo de mama, 30~39 year old female. Ask Date: 2016/12/06

Dr. Liang Sunyuan reply Psychiatry


Hello: The child may have a more stubborn personality and might need extra time to adjust.
The child's anger and noncompliance can sometimes be a way of testing their surroundings.
When we remain patient, not getting frustrated, and continue to engage them with fun and interesting activities, over time, the child may feel valued and find enjoyment in the activities, which could help them gradually integrate into school activities.
Additionally, the child's behavior at home is an important reference point; if they are doing well at home, it is more likely that they are simply experiencing a transitional difficulty in adapting to the environment.
However, if there are many issues at home as well, the child may be experiencing some emotional distress, and it is advisable to seek an in-person evaluation from a pediatric mental health specialist.

Reply Date: 2016/12/06

More Info


Supporting a child's psychological needs, especially in preschool, is crucial for their emotional and social development. Based on your description, it seems your 4-year-old son is experiencing significant challenges in adapting to the preschool environment. Here are some strategies and insights that may help you understand and support your child's psychological needs.


Understanding the Situation
1. Separation Anxiety: It's common for children who have been primarily cared for by family members, like grandparents, to experience separation anxiety when they start school. This anxiety can manifest as reluctance to engage in learning or social interactions. Your child's fear of being judged or the feeling that others are talking about him can exacerbate this anxiety.

2. Social Skills Development: Since your child has had limited interaction with peers before starting school, he may not have developed the necessary social skills to engage with classmates. This can lead to feelings of isolation and frustration, making him less willing to participate in group activities.

3. Communication Barriers: Children at this age often struggle to articulate their feelings or concerns. When asked about school, your child's response of "I don't know" may indicate confusion or a desire to avoid discussing something that makes him uncomfortable.


Strategies for Support
1. Create a Safe Space for Communication: Encourage open dialogue at home. Let your child know that it's okay to express his feelings, whether they are positive or negative. Use simple language and ask open-ended questions to help him articulate his thoughts. For example, instead of asking, "Did you have fun at school?" try, "What was the best part of your day?"
2. Establish a Routine: Children thrive on routine. Establishing a consistent daily schedule can provide a sense of security. Include time for play, learning, and relaxation. This predictability can help reduce anxiety about what to expect at school.

3. Positive Reinforcement: Celebrate small achievements, whether it's participating in a class activity or simply entering the classroom without crying. Positive reinforcement can boost your child's confidence and encourage him to engage more with his peers and teachers.

4. Gradual Exposure: If possible, arrange playdates with classmates outside of school. This can help your child build friendships in a less structured environment, making him feel more comfortable in school.

5. Work with Educators: Maintain open communication with your child's teachers. Share your concerns and ask for their insights. They may have strategies that have worked for other children in similar situations. Collaborating with educators can create a supportive network for your child.

6. Professional Support: Since the therapists have suggested psychological treatment, consider following through with this recommendation. A child psychologist can provide tailored strategies to help your child cope with anxiety and develop social skills. Therapy can also help uncover any underlying issues that may not be immediately apparent.

7. Modeling Behavior: Children learn by observing adults. Show your child how to handle emotions and social interactions. Demonstrate calmness in stressful situations and discuss your feelings openly. This modeling can help him learn how to express himself appropriately.

8. Mindfulness and Relaxation Techniques: Introduce simple mindfulness exercises or relaxation techniques to help your child manage anxiety. Activities like deep breathing, yoga, or even simple stretching can be beneficial.


Conclusion
Supporting your child's psychological needs requires patience and understanding. It's essential to create an environment where he feels safe to express himself and explore new experiences. By fostering open communication, establishing routines, and working closely with educators and mental health professionals, you can help your child navigate his feelings and develop the skills necessary for a successful preschool experience. Remember, every child develops at their own pace, and with the right support, your child can thrive both socially and emotionally.

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