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According to a 2007 Columbia University study, about 1 in 70 preschoolers take psychiatric medications

Toddlers on Psychiatric Medications

According to a 2007 Columbia University study, about 1 in 70 preschoolers take psychiatric medications—including stimulants, antidepressants, mood stabilizers, antipsychotics, and antianxiety drugs. It is not possible to say—without knowing these children personally—if medications are appropriate. But we do know that psychiatric drugs are not approved by the FDA for children under 6. There is simply not enough information to know how very young brains and body will respond—over time—to these medications.

As a child psychologist, I have worked with hundreds of children on psychiatric medications. In many cases, medications were necessary for the children’s safety and well-being. Almost every parent I’ve worked with has agreed to their child’s taking medication because they really believed it was the best way to get back on track. Few parents are excited about medications, but look instead to outweigh the downsides of out-of-control behaviors, moods, and urges.

But, here’s the thing. Medication is not the only option. It should never be the first option. The fields of child psychiatry and child psychology have solid, evidence-based research that shows the effectiveness of non-invasive treatments—therapy, sensory integration, parent/teacher education, and coaching.

If you’re wondering if your toddler is “abnormal,” see a child psychologist. This doctor should spend time with your child, you, and get a detailed history of the problem. Child psychologists can conduct standardized measures that have been validated to use on very young children. Mental illness is hard to characterize in preschoolers. You need an expert. There’s a national shortage of child psychologists and child psychiatrists, but it is worth the wait to see one. There is nothing less at stake than the health and welfare of the one you love most—your child.

This CNN article by Kelley King Heyworth is a thorough dialogue about the dilemma of putting toddlers on psychiatric medications.

 

 

What is a Child and Adolescent Psychologist

What is a Child and Adolescent Psychologist?

What is a child and adolescent psychologist?

Clinical psychologists have doctoral-level training to provide therapy (including coaching) and consultation, and psychological testing. They are the only providers who can administer psychological tests to diagnose mental illness. Training at this level allows for expert knowledge in “psychopathology”–mental illness. Child and adolescent psychologists have advanced training and backgrounds in providing psychological services to young people.

Just as you take your child to a medical doctor who specializes in children (pediatrician), you should look to a child psychologist if your child needs help with emotions, thoughts, and behaviors. A child and adolescent psychologist is an expert in developmental psychology—so she knows what is normal and abnormal for children from birth to young adulthood. It also usually means that she is “good with” kids. In order to get better, your child should enjoy (even while working hard) spending time with the psychologist. The psychologist should see the many strengths in your child—since these are the building blocks for improvement. Feedback about parenting strategies is critical when working with young people, and this is part of a psychologists’ duty, too. A child and adolescent psychologist should have strong lines of communication with parents and caregivers.

Therapist, psychiatrist, psychologist…who does what?

• Clinical Psychologists provide psychological assessments and therapy to different types and ages of people. They usually advertise their specialty. They may also obtain advanced training in types of therapeutic interventions. They do not (in Illinois) provide medications. Clinical psychologists with a Psy.D. have more clinically-based training. This means their studies focused on how theories and therapies actually impact clients. Psychologists with a Ph.D. have more research-based training. Providers with doctoral-level training have typically spent between 5-7 years in graduate studies. No matter the degree, psychologists treating clients should be licensed. This means the state government has certified that the practitioner has met educational and knowledge requirements to provide mental health services.

• Therapists include a variety of folks, and most of them have at least a Bachelor’s Degree and some training in helping people. It is more common for therapists to have a Master’s Degree. Therapists are also called counselors, coaches, mentors, and advisors. They cannot conduct psychological testing or provide medications. They provide talk-based and activity-based therapy to a range of populations. They usually advertise a specific area of interest or specialty. Providers with master’s-level training have typically spent 2 years in graduate studies. However, they must attend regular trainings to keep their license active. Licensed therapists have been certified by the state to have met basic educational and knowledge requirements to provide mental health services.

• School psychologists usually obtain Master’s Degrees (though some have a doctorate), and have extensive training in schools and educational systems. They can conduct IQ testing, but particularly Illinois schools have done away with this. They provide counseling and advice to children and academic support teams as to how best to help children at school. They are part of the gatekeeping team that determines what (if any) school supports can be used to optimize a child’s learning. They cannot provide medications.

• Psychiatrists are medical doctors that have advanced training in mental illness. They are the only providers (in the mental health field) who can determine if/what medication may be helpful in addressing psychiatric issues. Psychiatrists are also able to provide in-depth mental health counseling, although they do so less often than psychologists and therapists.

• Child and Adolescent Psychiatrists have advanced training in working with young people. Although pediatricians can write prescriptions for psychiatric medication, they do not have the advanced training and licensure of a Child and Adolescent Psychiatrist. Since they are so specialized, it can be difficult to get a short-notice appointment with a Child and Adolescent Psychiatrist. However, the appointment should be well worth the wait.

Of all mental health providers, it’s good to know: no matter the training or title, there are excellent–and not so excellent–providers at every level. A mental health provider should be a good fit for your family. You should feel informed, motivated, and comfortable with them. The provider should be implementing evidence-based treatments, where goals and benchmarks are defined as early as possible in treatment. If, after 3 months of regular services, your child has not shown reasonable improvements, it may be time to find a new provider.