What Are Symptoms of Mental Problems in a 4-Year-Old Boy?

At age 4, boys and girls may like the same toys and cartoons, but their emotional and mental development can be very different. Boys are more likely than girls to develop attention deficit hyperactivity disorder, or ADHD, as well as other behavioral issues and autism, according to the Centers for Disease Control and Prevention. No one knows your child better than you, so if your instincts tells you something's unusual in your 4-year-old's behavior, listen.

  1. Typical Development

    • Before you can gauge whether your child has mental health issues, you have to know what's developmentally normal. At age 4, the typical boy is a social butterfly who loves playing with friends and running around getting messy, but who still likes to snuggle and wind down with his caregivers. He speaks in sentences of more than five words, according to HealthyChildren.org, and he displays a wide range of emotions. A boy this age can typically sit still for 10 minutes or so and should demonstrate his burgeoning imagination through storytelling and creative activities such as acting or arts and crafts.

    Signs of ADHD

    • Diagnosing ADHD in a 4-year-old can be challenging, as kids this age are naturally rambunctious. However, "children with ADHD are much more extreme than the average 3-year-old,̶1; Dr. Alan Rosenblatt tells ADDitude, a magazine for people affected by ADHD. A 4-year-old child with this disorder may be unable to concentrate on any activity, even one he enjoys, for more than a few minutes. He may also seem constantly restless, take a lot of physical risks like jumping off high surfaces, behave aggressively and be unable to hop on one foot, according to the Kennedy Krieger Institute.

    Signs of Autism Spectrum Disorders

    • Autism spectrum disorder, or ASD, is the diagnosis that includes several disorders including autism and Asperger̵7;s syndrome. As many as 90 percent of parents of children with ASD notice signs by the time the child is 24 months old, according to the CDC, so it's unlikely your child will suddenly demonstrate an ASD at age 4. A child with an ASD typically prefers to play alone, avoids eye contact and has a generally flat affect; for instance, he may consistently have neutral facial expressions instead of showing joy or sadness and may speak in a flat, robotic voice. The CDC says he may show obsessive tendencies, have delayed language skills and make repeated physical gestures such as hand flapping or rocking back and forth.

    Signs of Other Issues

    • It's normal for a 4-year-old to display unusual behavior, like anxiety or aggression, for short periods after a big event such as moving to a new house, but troubling behaviors that last for more than a few weeks may signal a larger issue. For instance, refusing to go to school or becoming frightened and withdrawn around other children could be a sign of an anxiety disorder. Oppositional defiant disorder (ODD) is characterized by hostile behavior, frequent temper tantrums ̵1; which should be infrequent by age 4 in most children ̵1; and spiteful attitude, according to the American Academy of Child and Adolescent Psychiatry. Children as young as 3 can even show signs of depression, such as listlessness and low self-esteem, according to the National Institute of Mental Health.

    What to Do

    • Every disorder requires different treatment, and every child requires personalized care. The first step is to contact your pediatrician. She can connect you with adolescent psychiatric experts who can perform a full assessment of your son's needs. Certain disorders, such as ADHD, can be helped with medication. Working with therapists specializing in areas including speech and occupational therapy can also help some children, and a therapist can also give you tools and routines to use at home with your 4-year-old.

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