Talking with your child’s pediatrician about behavioral problems and medication
As a parent, if your child appears to have a behavioral or mood problem, you may worry about the best way to get help and treatment. It is important to feel comfortable and confident asking questions about your child’s health and expressing concerns you might have about your child’s moods, thinking or behavior.
Alarmingly, medication is being prescribed at a growing rate to children by pediatricians to treat behavioral or mood problems. Medication for an emotional or behavioral problem can be helpful, but research shows that for children psychological interventions are more successful than medication alone.
While a prescription may be one of the options given to you by your pediatrician, it’s important to consider all options before making a decision. Sometimes medication is necessary — especially if your child has extreme aggressive or even dangerous behavior, or is severely moody. Talk with your pediatrician about getting a good assessment of your child, and ask for a referral to a mental health professional such as a psychologist when these problems are severe.
A few startling numbers about children and medication:
- More than 500,000 children and adolescents in America are on antipsychotic drugs, according to a report (PDF, 183KB) by the Food and Drug Administration.
- Between 2001 and 2005, research shows that the number of children taking antipsychotic medications rose 73 percent (spending on medications to treat attention deficit disorder alone rose 183 percent).
- A Columbia University study found despite increasing rates of antipsychotic use by very young children, provision of formal mental health services remains sparse.
- Psychological interventions have a low rate of use and that rate is getting lower as more medications are used. Researchers found that less than one-half of antipsychotic-treated young children received a mental health assessment, a psychotherapy visit or a visit with a psychiatrist during the year of antipsychotic use.
Make sure to remember that with any medication there are risks, such as side effects and adverse reactions, as well as benefits. Children’s brains and bodies are still developing, and the safety of psychotropic medications cannot be inferred from adult data. Research has yet to comprehensively examine the effectiveness and long-term side effects of many of these drugs on children.
The most important thing to do with your pediatrician is to get information and to get your questions answered.
- Can my child receive a mental health assessment from a psychologist before we proceed?
- How is the medication going to help my child? Will I see changes in short-term or long-term behavior?
- What specific changes can I expect to see in my child’s thinking, moods or behavior as a result of the medication?
- What side effects might this medication have on my child?
- What other treatment do you recommend? Is medication really necessary for my child?
If the medication is not working, however, and your child either has side effects or you’re not seeing the expected mood or behavioral change with the medication, it is imperative to get back in touch with your pediatrician and talk with them about other treatment options.
How psychologists can help
Psychologists are trained to help children with behavioral or mood problems. If you need help, consult with a psychologist or other licensed mental health professional. Practicing psychologists use a variety of evidence-based treatments — most commonly psychotherapy — to help people improve their lives. Psychologists, who have doctoral degrees, receive one of the highest levels of education of any health care professional. Use APA's Psychologist Locator Service to find a psychologist specializing in children in your area.
This Help Center article was adapted from a September 2010 post by Katherine C. Nordal, PhD, on APA’s Your Mind Your Body Blog. Thanks also to Ron Palomares, PhD, who assisted with this article.
- Mehta, H. 2009. Drug Use Review. DHHS Public Health Service. FDA Center for Drug Evaluation and Research, (PDF, 183KB).
- Michael, K.D., & Crowley, S.L. 2002. How effective are treatments for child and adolescent depression? A meta-analytic review. Clinical Psychology Review,22 (2), 247-269.
- Olfson, M., Crystal, S., Huang, C., & Gerhard, T. 2010. Trends in antipsychotic drug use by very young, privately insured children. Journal of the American Academy of Child and Adolescent Psychiatry,49 (1), 13-23.
- Parens, E., & Johnston, J. Mental health in children and adolescents. From Birth to Death and Bench to Clinic: The Hastings Center Bioethics Briefing Book for Journalists, Policymakers, and Campaigns, ed. Mary Crowley (Garrison, NY: The Hastings Center, 2008), 101-106.