Bill Klaproth (Host): Along with physical well-being, a child's mental health encompassing behavioral, emotional, and social development is very important and here to talk with us about pediatric mental health is Dr. Michelle Steffen who is a practicing pediatrics physician. Dr. Steffen, thanks for being out with us. What does a parent need to know about pediatric mental health?

Dr. Michelle Steffen (Guest): I should say, first off, thank you for having me today. I think that pediatric mental health is extremely important for parents to be aware of and pediatricians will be talking with parents about their child's mental health, probably without them even realizing that they're doing that. You know, starting even with their babies when they're just in their newborn and infant years. When we think about pediatric mental health, we're not just thinking about older children who may have mental health disorders, but we're thinking about the child's well-being when it comes to their environment, when it comes to the appropriate stimulation to offer newborns and young babies. Healthy sleep patterns are very important for children when it comes to their mental health, healthy social relationships. So, it's important to understand as parents that all of these recommendations that they're hearing from their pediatricians about healthy lifestyles will impact their child's mental health for many years down the road.

Bill: So, it's starts early. You talked about as an infant, this starts. What should a parent know about talking to their child as an infant?

Dr. Steffen: There's been quite a bit of research done in the past decade, really, looking at brain development in the first three years of life, and what we're finding out is that the brain development during that period of time is exponential and, if not encouraged and supported in the way that it should be, those are years that we never get back and we can't make up for once the children are older. So, some of the things we talk to parents about that are very important in the first few years of life, is positive social interaction with babies, which typically will come in the form of lots of singing and talking with babies. There are certainly lots and lots of gadgets and toys on the market for young children to be exposed to, but nothing takes the place of positive social interaction with parents and caregivers and then also hearing the spoken word, both in song and just in voice.

Bill: So, that communication early on is vitally important, that talking or even singing. So, very important for parents to keep that line of verbal communication open and the love and nurturing, right? It all kind of goes together to build a healthy mental aspect in the child.

Dr. Steffen: It definitely does and another very important activity to share with even newborn babies and then develop the regular part of your schedule with children is going to be sharing books, as well. Books for newborn babies and for children all the way up through adulthood are extremely important for their development, but certainly we're finding that introducing books early and consistently makes a very significant difference for children when it comes to their development for speech and language and also their ability to perform well in school when they're to the age to enter kindergarten.

Bill: So, when should a parent feel that something is not right, or “Geeze, maybe something's not right with my child. They're not acting the way they should.” What are some of the more common mental health issues you see or should a parent be looking out for?

Dr. Steffen: That depends quite a bit upon the age of the child. We do see different mental health concerns related to children at different times and stages of development. Very early on, when it comes to abnormal development, particularly in children not developing healthy social interactions with their parents in being able to show affection, having good eye contact, enjoying their interaction with others around them, can certainly be a large red flag that there is a concern about their development and their mental health when it comes to potentially diagnosis of a pervasive developmental disorder or autism. There are children in toddler years who also can develop some significant behavioral problems that cause a lot of stress for both the parent and the child. I think those of us who are parents can remember the times that our toddlers have had tantrums, but if the tantrums are happening with such regularity that you're unable to even get out of your home or have a normal outing to a store or a restaurant, it is one of those situations where I think coming in and talking to your pediatrician can really help the family to find out if you have something we can help with parenting or parenting guidance or could there be something going on with the child that is causing them to have difficulty with their development and handling different types of environments. As the children get older and turn to school age, we do worry more about or see more anxiety that can pop up sometimes just with being away from the home and also with some of the expectations of performing well in school and also in other extracurricular activities. Then, as we move toward more of the teenage years, is when we do see higher rates of depression. So, certainly as the teenager who is having consistent, prolonged periods of a depressed mood, or having issues with withdrawing from activities or from children that they normally would be spending time with, difficulty sleeping, those types of things, that are a longer, sustained period of time--more than two weeks of these types of behaviors--it's certainly worthwhile to talk to your pediatrician. And, there are many screening tests that we can do, as well, to make the appropriate diagnosis.

Bill: So, it sounds like when the child's behavior, like you said, if it goes on for two weeks or really starts affecting normal, daily life, that's kind of the red flag parents should look out for?

Dr. Steffen: Absolutely. Absolutely. Everybody's going to have a bad day off and on, but it's the children who are exhibiting consistent, prolonged symptoms that are particularly getting in the way of their quality of life, those are the children that really should be evaluated and look at what diagnosis may be appropriate, if any, and then, certainly moving forward with a treatment plan.

Bill: Well, Dr. Steffen, there's so much to talk about when it comes to mental health. What is it that you'd like to say to parents right now? Is there a general overall message you want to say to parents right now about their child's mental health development?

Dr. Steffen: Absolutely. I think that, as parents, one of the most important things that we should try to do with our children is keep the lines of communication open. This starts with very young children with playing with your child. It is so important and developing a strong bond, and enjoyable relationship with your children, and then as they get older, paying attention to the small things that are going on so that when big things come along, they'll be more likely to confide in you that there's a concern. I think being a parent myself, too, I always tell parents to trust your instincts. If you get a sense that there's something going on with your child and you're concerned that it might be important or it could be detrimental to their health, I think that you really do need to trust that instinct and you need to call your pediatrician and bring your child in for an evaluation. Certainly, it may be a false alarm and everyone would be happy if that's the case, but if you ignore that sense that there's a problem and it ends up becoming more significant, it's that much more work to do to get the child back into a position where they're able to enjoy their lives to the fullest that they should.

Bill: Better safe than sorry, as they say. So, those are really good tips: playing with your child, paying attention to them, keeping the lines of communication open, talking to them as they're an infant, reading books as they get older, and then, make sure you're listening to your instincts as a parent. So, those are terrific tips to take away from this. Dr. Steffen, thank you so much for your time. Why should a parent choose Tidelands Health for their child's pediatric care?

Dr. Steffen: We have a wonderful community of medical professionals through Tidelands Health and in the Georgetown area and I think what I'm most proud of, over the past several years is how the pediatricians and the counselors in the area and also some of the psychologists are really all trying to come together to provide a comprehensive care for children who have particularly mental health or behavioral issues, among other things. I do think that's unique to our community, and unique to Tidelands Health and we're certainly very happy to be a part of that.

Bill: Dr. Steffan, thanks again. For more information about Tidelands Health Physician Services and facilities, visit www.tidelandshealth.org. That's www.tidelandshealth.org. This is Better Health Radio, I'm Bill Klaproth. Thanks for listening.