An Ounce of Prevention is Worth a Successful School Year

posted in: Mental Health Tips | 0

By Theresa Shank, Ph.D.

The first day of the school year has come and gone. Back to school supply lists have all been checked off. Medical forms have been filled out and the sports physicals have been performed. Peer group parents have been consulted on the appropriateness of smart phones, tablets, and social media use. Within the next few weeks, parents will also be able meet their children’s teachers at Back to School events. All in all, parents will have had the chance to connect with their children’s medical and education experts, as well as other parents in the community, and measure their development, behavior, and general well-being. As an experienced child and adolescent psychologist, I think back-to-school is also an ideal time for parents to evaluate their children’s mental health as they transition into the challenges and changes of a new school year.

You’ve heard the saying, “An ounce of prevention is worth a pound of cure.” Fully 50% of all lifetime mental health disorders start by the age of 14. However, early signs of mental illness – anxiety, depression, mood disorders, learning disorders, attention deficit disorders, etc – are often missed, or are dismissed as passing phases in the child’s or teen’s development. The U.S. Surgeon General estimates that about 21% of children and teens in the United States have a diagnosable mental health disorder, but that 80% of them are not identified and do not receive help. Over time, untreated symptoms increase in scope and prevalence and often become entrenched in the individual’s personality, making it much more difficult for the late teen or young adult to separate himself or herself from them, instead experiencing the symptoms as “This is just how I am,” and, even worse, “there is nothing that can be done about my situation.”
As sobering as these facts can be, there is also a tremendous amount of hope. One of the best things you can do as a parent is to identify any mental health disorder early in your child’s development. Treatment in early stages of disorders can often be easier, more successful, and less reliant on medication. Identifying and treating symptoms of anxiety, mood disorders, learning disorders, and attention deficit disorders when they first appear results in better treatment outcome, lower costs to families, and overall better quality of life for the child and family.
As a mental health professional, I encourage you to think about how your child or teen is doing in the following areas:

  • Mood – watch for chronic low moods and negativity, periods of intense sadness lasting two or more weeks, rapid changes in mood, and/or thoughts of suicide
  • Fears and Anxieties – watch for frequent concerns about school performance, excessive sensitivity to world events/extreme weather, problems separating from parents, worries about being judged negatively by peers, social isolation, persistent unwillingness to try new activities, fears that are excessive (such as of germs, vomiting, or doing things incorrectly) or atypical fears such as a fear of becoming like someone else just by touching a person or breathing the air near him/her, or being responsible for the safety and well-being of others.
  • Friendships – Watch for problems making or keeping friends, peer rejection, and difficulty reading social cues.
  • Behavior – watch for social withdrawal, aggression, anger outbursts, excessive clinginess, reluctance to touch objects, repeated hand washing/use of hand sanitizer, checking, arranging, and body movements.
  • Attention/Concentration – listen for complaints by the child that he/she cannot pay attention in school, note teacher comments on report cards regarding a tendency to daydream, or to be off task, unable to complete work in a timely manner, or disruptive to peers.
  • Activity level – watch for underactivity, over activity, or extreme variability in activity level (i.e., problems getting out of bed alternating with difficulties sleeping and excessive talking).
  • Weight – watch for restricted or excessive eating and unexplained weight loss or weight gain
  • Sleep – watch for problems falling asleep or staying asleep during the night, a tendency to wake much earlier than usual, or difficulties sleeping alone.
  • Frustration tolerance – watch for a short-fuse that does not improve as the child gets older, or a decrease in frustration tolerance due to anxiety or mood problems
  • School performance – watch for drop in grades, problems adjusting to the new school year, missing or lost assignments, problems finishing tasks and tests within the time allotted, organizational and time-management difficulties, and problems learning how to read, write, or do math.
  • Skin, Fingernails, and Hair – watch for signs of hair pulling (may present as excessive “raking” of hair), skin and nail picking.
  • Non-suicidal self-harm – watch for unexplained cuts or burn marks on the skin and/or a tendency to wear inappropriately warm attire to hide the skin.
  • Substance use – watch for signs of use of marijuana, alcohol, or other substances
  • Motor skills – watch for difficulties with eye-hand and gross-motor coordination and handwriting,

What to do if you have concerns about your child or teen:
Most commonly, the first step parents take in finding help for their children is to talk to their pediatrician. Mental health professional referrals can come from pediatricians, friends, neighbors, or school guidance counselors. Websites, such as,, and, and state and national psychology associations such as and, include lists of therapists, the age of clients with whom they work, and their areas of specialization.
A good mental health professional can diagnose a potential problem with a thorough clinical evaluation that includes input from both the client and the parents. If treatment is suggested, it can range from cognitive behavior therapy, psycho-educational evaluations, additional consultation with the pediatrician or a child and adolescent psychiatrist regarding possible medication use, or referral to a different professional such as a speech and language pathologist or an occupational therapist.
Having worked with children in private practice for almost 15 years now, I receive updates from the families of the children with whom I worked as they have progressed through elementary, middle school, and high school. These young people are successfully heading off to college after having learned the skills to perform better in school, having built a number of satisfying personal relationships, and having experience in the therapeutic skills that effectively manage residual symptoms of anxiety, attention problems, and depression.
If you are a parent and your child is beginning to show signs of problems in any of the areas listed above, I strongly encourage you to have a consultation with a mental health professional trained in working with children. Highly skilled therapists can help children in a relatively few number of sessions and arm them with strategies not only to manage their current symptoms, but also to face any additional challenges they encounter along the way, with confidence and a concrete plan of action.

Theresa P. Shank, Ph.D. lives with her family in Howard County. She practices in Howard County, Baltimore City, and Anne Arundel County. Her expertise is in treating anxiety disorders and attention deficit disorders in children, adolescents and adults. In addition to treating those conditions, she performs testing to evaluate learning disorders and other developmental disabilities to help. She can be reached via email at