Question: How young is too young to have a child evaluated? I have a 4 year old. He is very wild and hyper, and he has never slept through the night. Now he is starting to have terrible tantrums. Our family is paralyzed. We can’t take him anywhere, because he has a fit whenever he knows something is about to change.
Anne Fenton, MD: Without exaggeration, no one is too young or too old for an evaluation. Of course, the younger the child, the more his or her parents are integrally involved. Much of what we do, therefore, is parent guidance. However, we are also learning that many psychiatric disorders we formerly thought affected only adults actually are identifiable in early childhood. Such conditions as autism, bipolar disorder, and anxiety manifest in various ways in infancy which are predictive of certain symptom trends in later childhood and adolescence. Obviously, early detection and intervention can help a good deal to prevent complications later on. For example, mood dysregulation (inability of the child’s nervous system to regulate mood and respond with resilience to various stimuli) in early childhood seems to adversely affect learning in school later on. One mechanism may be due to the interference of mood in the child’s ability to focus in the classroom. An ounce of prevention is worth a pound of cure.