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What do you think of the baby's mental health?
If I take my 2-year-old baby to consult, why? Why do babies need psychological counseling?
Babies' early brain develops rapidly, so it is necessary to provide a good environment for babies to explore and learn, because babies are not single babies, but babies in the environment.
The physical environment of the family, community and city where the baby lives, the psychological environment such as family culture, values, family relationship and even traditional culture will all affect the baby's mental health.
Culture is an important factor to judge whether a person's behavior is morbid. If the baby is considered normal by the family in the family environment, even if it is exaggerated in the eyes of others, it will not be considered as an obstacle.
Don't just treat the baby as an individual, but treat the baby in the environment. Family, house, friends' house, relatives' house, community and country will make babies feel the atmosphere of their environment.
Therefore, in addition to the detailed diagnostic evaluation manual for children, specific standards can also be obtained.
When evaluating the psychological state of infants, we need to do interdisciplinary work according to the age stage.
Not only in the studio, but also with pediatricians, kindergartens, speech therapists and their families.
In the evaluation, we should pay attention to the relationship field, not only to understand the baby itself, but also to understand the family environment. There are no singletons, only babies at home.
We need to know the feelings, thoughts and relationships between 0-3-year-old babies and their families.
However, the mental health development of 0-3 years old is easily overlooked, and 0-3 years old is actually the most easily overlooked and abused group.
Many parents have a misconception that the younger their children are, the less likely they are to suffer from mental illness. But the opposite is true. The younger you are, the more vulnerable you are to stress.
Many therapists, when working at the age of 0-3, have a great impulse to work hard and want to intervene in various ways. But don't forget to step back first. Because although parents themselves have misunderstandings and many wrong ideas, parents are experts who know their children best, so we should listen to them.
We need to know the special behavior of children, what it means and what impact it has on the family. What is the experience of parents in parenting? What is the child's experience in the family? What are the experiences, feelings and thoughts of the therapist during the interview? How to understand the story of this family? As a background role, the therapist leaves room to observe the interaction between the baby and his family and connect parents and children.
Parents' commitment, emotional input and adaptability (keeping in harmony with the baby) are very important for the baby.
It is a process for parents to tolerate ambivalence towards their children. Whether children have the ability to engage in social interests, whether parents have the ability to be interested in children, and whether parents have the ability to sit comfortably but quietly.
When a child shows a pathological state, can parents tolerate the feelings of pain and self-blame and help the child understand his emotional experience?
If infants and young children have pathological manifestations, it is difficult for parents to accept them, and they will feel guilty and don't know if their care for their children is correct.
We see that parents are under pressure. How can we tolerate parents' emotions and help parents better tolerate this uncomfortable experience? At the same time, parents are not incompetent babies, they can clean up their emotions to help their children better.
First of all, we must identify the typical development stages of infants and children, and we must know these typical contents in order to identify the pathological behavior of obstacles. Only by making an accurate diagnosis can we adopt appropriate methods, which requires better communication with interdisciplinary experts.
Excessive stress can make a person's behavior abnormal.
If younger children have behavioral disorders, their level of disorders will be higher than that of older children, especially their language ability is not perfect enough to describe to the therapist in words.
Typical behavior patterns are also morbid. For example, some children with ADHD have experienced trauma and some have not.
Boys are more likely to be diagnosed as aggressive behavior, but in fact some behaviors are normal.
Promoting the brain development of 0-3 years old requires a certain amount of pressure, and children will also experience various normal pressures, and positive pressure (tolerable pressure) is needed to promote brain development.
If this stressor is unbearable, repeated exposure to high-intensity pressure for a long time will cause harm. For example, babies keep crying and are left unattended for a long time.
Although infants have strong adaptability, excessive stimulation will affect their healthy development and the growth and connection of brain nerves.
And the beliefs that were not internalized correctly in the early days, such as "I don't like this world", "Nobody helps me" and "Nobody stands on my side" and so on.
Some babies look very good and never cry or make trouble. Adults will boast that the baby is "so good and never cries", but this may actually be a danger signal.
Because babies want to cry, crying is a way for babies to communicate with the outside world. If they don't cry, there is a problem. Let's listen to the baby's situation. If it doesn't conform to the typical development state, we need to pay attention.
If found, you can consider referral or cross-disciplinary consultation to see if there are more abnormalities and whether they are different from typical behaviors.
At the same time, we also observe whether the baby has experienced stress, behavior and dysfunction. Whether it affects both, if so, is a signal and clue, which needs further evaluation and family counseling.
On the other hand, it is necessary to observe the baby's behavior to see whether it has cultural adaptability, such as whether it is normal in some ethnic groups. We need to be careful about misdiagnosis and mistakenly regard culture-specific behavior as abnormal.
If babies experience more adverse events, they will have a greater chance of getting sick and having psychological problems, leading to mental illness, suicide and physical diseases, such as hypertension, diabetes and heart attack.
20 17 the United States has expanded its research on the influence of children's bad experiences. Witnessing violence and being discriminated against can affect brain development.
The more adverse events children experience in their early years, the greater the possibility of death, and all the risk factors will affect them.
Such as brain trauma, trauma, fracture, burn, pregnancy complications, disease spread and other early adversity has a lasting impact.
If a single child experiences too much in the early stage, he will face more diseases.
Therefore, our intervention in infants aged 0-3 can promote the mental health of adults.
Therefore, the purpose of providing this information is to screen the host family as soon as possible and how the parents' experiences affect the intimate relationship with their children.
Not only depends on the child's behavior, but also how all aspects of the child's life affect the child. We need a systematic view to judge the development of babies.
Whether it meets the typical characteristics of each stage. Various physical health problems will also affect mental health, leading to the performance of some problem behaviors.
Assessing physical health should also consider from multiple dimensions, whether there are problems in perinatal period, whether there are premature births, whether there are allergies, whether there are operations, and record these physiological conditions. Parents' descriptions should also be recorded, such as "amniotic fluid entered the baby's brain", which is recorded in the parents' report.
And the time of each event.
So when we observe the psychological and social stressors, we should observe what the stressors are like. The more stressors we bear, the more likely we are to suffer from mental illness.
What is the relationship between the key nodes in a baby's life and the adults around him?
Why do we have to understand the relationship between baby caregivers? For example, one paramedic said so, and the other said the opposite. The contradiction between family members has caused great confusion among babies.
So we need to observe the parents' care for the baby. Are parents willing to cooperate and understand the baby's problems? How will it be solved? Whether we can work together to promote the baby's development and whether the baby's brothers and sisters are harmonious will affect the baby's life feelings.
What are the contributions of family members to taking care of children? What are their interests in children, whether they play games with children, and whether their expectations for children are in line with their age? Some parents' expectations for children are beyond their age, which is unrealistic.
Understand whether there are daily behavior norms and practices in the family. Every family has different family habits, so it is very important to have a unified, coherent and consistent family habit.
The second is to understand the influence of the baby's family environment. For example, some babies have a good temper and are calm under pressure. Moreover, some babies have strong personalities, which may make parents unprepared and unbearable.
Why do clinical problems come last? Because clinical problems may affect the baby's behavior.
We observe the clinical manifestations of children, first of all, to see if there are any neurodevelopmental disorders, such as autism, ADHD and so on.
Neurodevelopmental disorders are difficult to deal with because most of them are hereditary. Genetics is a mysterious subject with various variations. If there are developmental disorders in the meridians, it is difficult to completely cure them. It can only help children improve their functions and keep their daily lives unaffected.
Therapists can't diagnose autism, but they can find signs so that children can get better help or referral. Let children receive treatment as early as possible, prevent the development of derivative problems as early as possible, and intervene as early as possible, which will reduce the stress state and achieve better results.
Children who feel overreacted have sensory avoidance behaviors, such as being sensitive to loud sounds and feeling uncomfortable. And sensitive to touch, uncomfortable to touch.
Children with insufficient sensory response will have sensory craving behaviors, such as licking the wall or everything they see, in order to get stronger sensory stimulation.
Recent research shows that anxiety occurs in young babies, and it is easy to ignore the influence of anxiety on the functional expression of babies.
The younger the children, the stronger the reaction to the influence of anxiety, and stronger than the older children.
For example, infants can't bear the anxiety of separation. If you don't meet the age development stage, you will cry 1 hour and can't stop. This is always under pressure.
For example, infants are very afraid of new things, unable to accept new things, and even very anxious to see new toys. We need to see whether the level of anxiety affects children's development, their ability to establish contact with others and their relationship with their families. For example, I can't go out and stay at home all the time. This will affect mental health.
Now that we are in an epidemic situation, we will indeed reduce going out, but it also depends on the impact on the community, how these effects will affect the baby itself, and how we balance it.
Such as depression, and aggressive problems, such as a state of great anger.
One of the tasks of babies in their early years is to learn to adjust their emotional state, which needs to be adjusted through relationships. Some people can't adjust their emotions or relationships because there is no stable relationship to help them adjust their emotions in their early years.
Of course, we should look at the above situation from the perspective of whether it conforms to the age stage, and whether it will affect the development or daily life of children.
Observe whether the child has emotional disorder, and observe what the child's emotional disorder state is most of the time.
It is difficult for young children to make a differential diagnosis of obsessive-compulsive disorder because their children have repetitive characteristics, such as watching the same video 20 times.
Then it is necessary to evaluate obsessive-compulsive disorder and observe whether there are special behaviors, such as constantly pulling out hair and tearing your skin. For young people, it is difficult to observe, so it is necessary to carefully observe whether there are scars on the scalp.
For older children, tearing hair will be more obvious, such as eyelashes and eyebrows. However, for young children, if the fine movements are not well developed, they will not be displayed on eyelashes or eyebrows, but the skin picking will be more obvious, and scars and scratches can be seen through the skin.
We must pay attention to distinguish between compulsive behavior and normal development expression. For example, when a young friend learns to control his arm, he may accidentally scratch his face, which is different from forcibly scratching his scalp.
Finally, the impact on the function, whether it affects the normal interaction with children of the same age, and whether it affects the daily life of the family.
Of course, if you want to make a diagnosis, it depends on whether the child is over 36 months old and whether the compulsive behavior lasts for more than 3 months.
This is the most likely place to take children to the emergency room. For Xiao Baobao, sleeping, eating and crying are the most important tasks for the baby.
For Xiao Baobao, sleep, eating and crying disorders are very common, so it is not appropriate to make a diagnosis too early, depending on the patience of parents.
Some babies cry more and some cry less, but how do parents understand this crying behavior? The baby's behavior will affect the parents' attitude towards him, and the parents' attitude towards the baby will become a stimulating condition that affects the baby's mood. If parents can tolerate the baby's emotions, this cycle is positive, so it is not a problem.
Parents need to have expectations that match their children's age.
A mother asked, "I'm worried that children never sleep." What happened? Did I do something wrong? " "How old is your child?" "My child is just four weeks old." It is normal for a 4-week-old baby, so it is necessary to popularize knowledge for novice parents.
Sleeping is a private matter. Some families think that children should sleep independently as soon as possible, whether in the cradle or in their own bed, not in their parents' bed.
In some families, parents should protect their children's safety and pay attention to the location and place where their children sleep. We don't interfere with parents, just to see if children's sleep disorders affect normal development and daily life.
Similarly, when a child has an eating disorder, it depends on whether it is an eating disorder or a sensory problem.
The sensory system has visceral sensation, and visceral information is transmitted to the brain. For example, the internal organs feel hungry, but the brain does not know that it is hungry.
"The child didn't eat dinner yesterday, and he didn't know to eat breakfast when he got up in the morning." It is necessary to judge whether the child does not eat by himself or really does not know that he is hungry. You can do a physical examination and combine some physical indicators to judge.
PTSD, as well as the problem of avoidant attachment, it is difficult for children to make psychological evaluation, so be careful enough.
For example, a 9-month-old child visitor experienced a very serious domestic violence at home when he was 3 months old. Dad is often absent, and my brother and sister are often here.
Although the child performed well, he did not interact with his father and asked for a separate consultation with his father, which obviously caused a traumatic reaction. At that time, the children were invited to visit. As soon as they entered the consulting room, they obviously climbed out of the treatment room with their hands and feet.
Dad's voice, smell and height left a nervous system reaction to the 9-month-old baby. Obviously, this information left a strong fear reaction for children.
The relationship with caregivers at the age of 0-3 is a very important factor, and it is necessary to consider whether the child has a relationship disorder.
If the child does have clinical problems, neurodevelopmental disorders, etc. Clinical manifestations can be observed in any environment.
Only when you see another person in the relationship will you show it. For example, seeing grandma, dad, and teachers will not be a problem, but seeing mom alone will show symptoms of relationship disorder.
There are also behaviors in specific environments. Children can fall asleep at home and school, but they can't sleep at grandma's house, and they feel great pressure.
Relationship disorder is the only one that has no obvious symptoms, mainly depending on whether there are various problems in the specific relationship.
To evaluate a baby's development stage, you can choose a scale to evaluate it. No matter what kind of scale, we should look at those kinds to evaluate rough exercise, intensive exercise, language development and emotional experience.
At the same time, we should also evaluate the family, and we can use the familiar scale.
If it is a referral, you can get some psychological scales from the pediatrician. Of course, we are often more likely to be the first to receive families and the first to evaluate children's mental health.
First of all, we should communicate with the baby's caregivers, do detailed interviews with parents, investigate the historical background, the situation of each adult family member, the relationship with children, and the relationship with adults.
If it is unrealistic to interview all family members, at least one of them should be interviewed, and other members can quickly collect some information and understand some concerns by telephone.
I need to know the following information:
How do family members feel about pregnancy, planned or unplanned, and how do they feel about the baby?
Whether the child's emotional function is normal, what concerns parents have for help, at what age and node these behavioral problems are observed, and what parents think.
Understand children's development and skills, fine and rough movements, language and relationship development.
Do a screening for children with synaesthesia, and screen in detail what causes behavior expression.
Although restricted by various reasons, daily exercises can't be well observed. But there is still an ideal way to observe babies, which can be modified according to the actual situation.
First of all, ideally, observing the behavior of infants from free play can go to the treatment room to play freely, just like playing freely at home.
Secondly, we can conduct structured observation, introduce stressors, and observe how babies cooperate and behave under pressure.
Observe alone, observe the performance of the child when he is alone in the treatment room, and then let the parents enter the treatment room when the reaction is strong, and end the independent observation.
Home observation, kindergarten observation, it is best to choose one. Observe the performance of infants and young children at home or kindergarten, go to kindergarten to observe the performance of children, and then formally understand.
If the little guy knows the counselor, he will always say hello to the counselor, so observe him before he knows you, and you can see the real performance of the child.