Behavioural problems in preschool toddlers
Preschool children are particularly difficult to manage. They are very active and yet have not developed the sufficient insight and understanding to see them out of trouble. Although by this time the child would have started talking, it is unlikely that he/she will be able to communicate much in form of verbal cues. Most of the behaviour of children is still action based, and hence many such behavioural problems may be noticed in preschool toddlers. The following is a generic description of the common behavioural abnormalities seen in preschool children:-
Head banging or rocking in bed
A toddler who is fatigued or under stress may bang his head against the bed or rock it in rhythmic movements. Apparently this provides him with a pleasurable diversion. In these cases bed should be padded to prevent injury to the child.
Thumb sucking and nail biting
Thumb sucking and nail biting is another pleasurable sensation that diverts the child from his or her environment. These behaviours are generally a manifestation of deep insecurity. To some children, thumb sucking is a kind of security blanket. They feel secure and happy when sucking their thumb. Thumb sucking can cause problems with alignment of the teeth. Parents are advised not to show excessive anxiety about thumb sucking until the child is 4 years of age.
A child may obtain pleasure by genital stimulation, rubbing of thighs against each other or rhythmic swaying movements. This behaviour is usually harmless and is not going to cause any sexual perversions or deviant behaviour later on. Hence mothers can rest reassured about the benign nature of this behaviour.
Clarity of speech normally improves gradually during the first few years of life. It should become completely intelligible by 4 years of age. An unclear speech after this age often means that the child may be suffering from some major disorder in the language, cognitive development or hearing. Such children may develop language based learning difficulties later in school years. These children should be carefully examined by a doctor and speech therapist together. A speech therapist will be able to pin point the reason for the unclear speech and also provide a remedy for this problem.
Many children develop the habit of eating inedible things like sand and chalk. This is known as pica. Medical textbooks have traditionally described an association between pica and anaemia. However, other than anaemia pica is associated with various forms of neonatal insult. They are slow in motor and mental development and show neurologic defects and deviant behaviour. Children under 2 years of age usually put everything they can lay their hands on in their mouth. This is normal and is a kind of evolutionary training. The child tries to learn the taste of whatever suits his curiosity. But persistence of this habit beyond 2 years is worrisome. It can be a manifestation of parental neglect, poor supervision or lack of affection. It is commoner in children from lower socioeconomic strata and at times in the malnourished children. These children are prone to lead poisoning and often complain of chronic abdominal pain and pallor. Sleep disturbances The child may suddenly awaken after a frightening nightmare. Manifestations may include fear of dark, difficulty in falling asleep, night walking, sleep talking or night terrors. If children frequently suffer these sleep disturbances, a child psychiatrist or psychologist should be consulted.