Feeling sad is normal but how can you know if your child’s sadness is indicative of a disorder? The following article discusses what childhood depression is, how it is diagnosed, and what to look out for if you have concerns for your child.
What is Childhood Depression?
Just as in adulthood, children experience a full range of emotions; from happiness and excitement to anger and sadness. According to a recent Australian government survey, 2.8% of children between 4-17 years met criteria for a major depressive disorder (Lawrence et al., 2015). Prevalence rates were higher in the 12-17 years age group, affecting more females than males (5.8% and 4.3% respectively; Lawrence et al., 2015).
Depression is a mood disorder characterised by periods of low mood for most of the day, most days for a period of two weeks (American Psychiatric Association [APA], 2013). How it presents and the severity in which it is experienced varies from individual to individual. In children, depression can present itself more like irritability than typical sadness (Australian Government, 2018).
There is no exact way to predict who is more at risk of developing a depressive disorder. It is a likely combination of biological predisposition (i.e. the child tends to focus on the negatives of a situation) and life circumstances. In children, key social stressors focus on pivotal times of change, including family conflict, friendship trouble and difficulties at school (Siu, 2016).
How is Depression diagnosed?
Diagnoses can be made by psychologists and psychiatrists using clinical interviews and observations in context to the Diagnostic Statistical Manual of Mental Disorders or the International Classification of Diseases (DSM-5 and ICD-11 respectively; APA, 2013; World Health Organisation, 2018). Screening questionnaires like the Depression, Anxiety and Stress Scale (DASS; Lovibond & Lovibond, 1995), may be a useful tool to help discern whether an individual is experiencing clinical depression.
To be diagnosed, at least five of the following symptoms need to be observed over a minimum two week period. At least one of the symptoms is either depressed mood or loss of interest/pleasure (APA, 2013). Other symptoms include significant weight changes, sleeping difficulties, psychomotor agitation or slowing, fatigue, feeling worthless or guilty unnecessarily, reduced concentration, and/or thoughts of suicide. These symptoms need to be having a significant impact on different areas of your child’s life (e.g. socially, at school, at home).
Presentations will vary and an initial consultation between the child and psychologist and the parent would best determine whether they are expected to meet the criteria.
Early Signs to look out for
Identifying characteristics of depression in a child can be difficult. Concerns may arise due to the ‘absence’ of behaviours considered to be ‘normal’ development and the ‘presence’ of behaviours considered to be ‘abnormal’ development.Consider seeking help if your child is demonstrating the following behaviours (Australian Government, 2018):
Weight gain or loss
Difficulty sleeping (too much or little), nightmares
Saying negative comments about themselves or the world around them
e.g “I am not good at anything”
Feeling tired, lethargic. Hard to get your child motivated. E.g. ‘dragging their feet’
Trouble at school; with friendship groups or concentrating in class/grades slipping
Gives up easily, hopelessness e.g. “what is the point in trying, I won’t be able to do it”
Deliberate harm to self
No longer enjoying games or activities e.g. wanting to drop out of the soccer team. Avoids social interaction
Changes to eating
Sensitive to rejection or being told no
Poor memory forgets details or doesn’t seem to listen
Jumpy, cannot settle
Risk-taking behaviours particularly in adolescence e.g. drug taking
Following diagnosis, recommendations for treatment are provided and they are tailored to each unique needs. Typically, the most common treatment for depression involves a cognitive behavioural approach (Australian Psychological Society, 2018). In addition to working directly with the child, treatment considerations may include working with the parents/carers and family systems to provide strategies to assist at home.
Remember that your child will experience good days and bad days. If you are concerned your child may be depressed, talk to them, and check in on anything that may be troubling them. This can be difficult as they may not know how to verbally communicate the issue. Be supportive and remember, what you might be able to cope with, your child may be finding difficult.
Strategies for Parents
Whether you are worried about your child exhibiting some of the aforementioned childhood depression symptoms, or you are looking to help prevent the onset of childhood depressions symptoms, the following strategies may be used to support your child:
Keep your child active. Research indicates that children that participate in regular physical activity are more likely to exhibit fewer depressive symptoms in later years (Zahl, Steinsbekk, & Wichstrom, 2017).
Ensure a good diet. Changes to eating patterns is a key sign of depression (APA, 2013). Ensuring your child is well nourished with a balanced diet with limited refined sugar has been shown to foster better mental health in children (O’Neil et al., 2014).
Develop a good parent-child relationship. Parent rejection has been shown to have a strong relationship with childhood depression (McLeod, Weisz, & Wood, 2007). A parent that is actively involved in presents as interested and encouraging will help your child develop a healthy sense of self.
Social and emotional learning. Teaching your child to recognise different emotions and label them as they are being experienced can help them to better manage experiences of overwhelming emotion (Durlak, Weissberg, Dymnicki, Taylor, & Schellinger, 2008). It can also help your child to develop better social connections.
Whether your child has a formal diagnosis or not, you know your child best. Start intervention as soon as you suspect that your child’s mood is detrimentally affecting their daily functioning.
Here at The Quirky Kid Clinic, our experienced team of Psychologists are more than happy to meet with you to discuss any concerns you have in relation to your child’s development and behaviour.
We always start with a parent only consultation to ensure that we get a thorough understanding of your child’s developmental history and a sense of your families identity, history and cultural dynamics. From here we provide an individualised case plan dependent on your child and families needs.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Australian Government. (2018) Depression. Retrieved September 3rd, 2018, from https://www.kidsmatter.edu.au/mental-health-matters/mental-health-difficulties/depression
Australian Psychological Society. (2018). Evidence-based interventions in the treatment of mental disorder: A review of the literature. Retrieved from https://www.psychology.org.au/About-Us/What-we-do/advocacy/Position-Papers-Discussion-Papers-and-Reviews/psychological-interventions-mental-disorders
Durlak, J. A., Weissberg, R. P., Dymnicki, A. B., Taylor R. D., & Schellinger, K. B. (2011). The impact of enhancing student’s social and emotional learning: a meta-analysis of school-based universal interventions. Child Development, 82(1), 405-432. doi: 10.1111/j.1467-8624.2010.01564.x.
Lawrence D., Johnson S., Hafekost J., Boterhoven De Haan K., Sawyer M., Ainley J., & Zubrick S. R. (2015). The Mental Health of Children and Adolescents. Report on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Canberra, Australia: Department of Health.
Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales. Sydney: Psychology Foundation.
McLeod, B. D., Weisz, J. R., & Wood, J. J. (2007). Examining the association between parenting and childhood depression: A meta-analysis. Clinical Psychology Review, 27(8), 986-1003. doi: 10.1016/j.cpr.2007.03.001
O’Neil, A., Quirk, S. E., Housden, S., Brennan, S., L., Williams, L. J., Pasco, J. A., … Jacka, F. N. (2014). Relationship between diet and mental health in children and adolescents: A systematic review. American Journal of Public Health, 104(10), 31-42. doi: 10.2105/AJPH.2014.302110
Parenting Strategies (2018). Preventing depression and anxiety. Retrieved from https://www.parentingstrategies.net/depression/
Siu A. (2016). Screening for Depression in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine, 164(5), 360-366. doi: 10.7326/M15-2957
World Health Organisation (2018). International Classification of Diseases, 11th Revision (ICD-11). Retrieved 21 August, 2018, from https://icd.who.int/browse11/l-m/en
Zahl, T., Steinsbekk, S., & Wichstrom, L. (2017). Physical activity, sedentary behaviour, and symptoms of major depression in middle childhood. American Academy of Pediatrics, 139(2). doi: 10.1542/peds.2016-1711
[00:00:00-00:00:32]Dr. Kimberley O’Brien introduces strategies for parents to help kids cope with traumatic news.
Hello Bonnie. It’s Dr. Kimberley O’Brien here. I’m auto-recording in Japan, so I hope there won’t be any background distractions. I’ll talk for five minutes on strategies to help kids cope when they’ve seen a tragedy, or had some sort of unfortunate event. I’ll have some tips for parents as well – I’ll fill you in on that towards the end of the interview.
[00:00:33-00:02:27] Parents shouldn’t shield children from all forms of adversity. Instead, teach them coping strategies for stressful events, since those are an inevitable part of life.
The first thing you said was about helping kids to deal constructively with bad news, rather than sweeping it under the carpet. I agree that it’s a healthier approach, because it’s really setting them up for life. It’s giving them the skills to overcome adversity, without feeling like a parent is required to shield them from something that’s not appropriate for kids to hear.
From a young age kids are learning how to overcome physical injuries. Like toddlers grazing knees – they hop up and brush themselves off, and then life goes on. They can cope with those sorts of little incidents. And if we do shield the kids from all adversity, then they don’t learn the coping skills they need in certain situations, like if they are not good enough for a sports team, or if they’re excluded from a game at school. Teaching them coping skills is like teaching them life skills that help them to be more resilient. And it gives them confidence to be able to overcome issues moving forward. That’s part of healthy psychological development.
Imagine adults that haven’t learned to overcome adversity. They’re more likely to react negatively, perhaps need a lot more support, and need to take time off work if they haven’t learnt to cope with life’s issues that will come our way. That’s just part of life, isn’t it? Kids will have to change schools, or they may lose a pet or loved one. That stress is a part of living, so it’s something that kids need to learn to cope with.
[00:02:27-00:04:08] Encourage children to express their feelings in words, rather than through actions. Praise them for expressing themselves clearly, and empathise with them verbally. When something bad happens, let kids write down questions in a booklet, so you can answer those questions when you feel prepared to remain calm during the discussion. It’s a way to model good coping skills.
The best way to do this, for parents, is to prepare for question time if it’s something that’s happened for a young person, like the loss of a pet. Have a question booklet that kids can record some questions in. And then make sure you feel prepared emotionally to answer each one of those questions. When I say prepared emotionally, I mean that children often take their cues from their parents. If parents are very emotional, kids will often follow suit and become quite emotional. So being prepared to model good coping skills as a parent is important. Say “these things happen but we will get through it”. Use words to explain those feelings.
Sometimes kids will use actions or behaviour to express their emotions. For example, they may feel disappointed, or upset that they didn’t make the sports team, and they may throw their sports bag across the room. But what we want kids to do is to use their words, and say “I feel so disappointed, I’m so jealous that my best friend was selected and I wasn’t”. Parents should then use verbal praise to say “I’m so glad to hear you express yourself so clearly, now I understand how you feel”. Parents can empathise with young people: “I’ve felt that way before, this must be hard”. Empathising is also part of helping kids to express their feelings in words, rather than in actions.
[00:04:08-00:05:01] When it comes to family trauma, such as a separation or a tragedy, it’s better to get professional help because they can remain objective and provide the family with support.
Just a final point now, for parents on how to help kids through family separation. It’s good to encourage them to see a psychologist, such as someone at the Quirky Kid Clinic or a school counselor, to help them normalize those feelings. Often if parents are involved in situations, like if there’s been a tragedy or trauma within the family, it’s better to get professional help. A professional can remain objective and provide kids and parents with stats on how often these things occur, how long it may take kids to recover, and what the phases of grief and loss may be. It’s good to have an expert when dealing with family separation or similar situations.
[00:05:01-00:05:58] When a tragedy happens, stick to the basic facts when relaying the news to the child. Avoid delving into the causes, or exposing them to distressing images, to avoid more of an emotional response.
And finally, a tip about how to relay the news to a child. Say it was something that happened in the world, like a tsunami. We often get rising referrals when there’s been a trauma, like a tsunami, and kids have seen it on TV. It’s best to switch off the news when there’s lots of visual, distressing images for kids to catch. Parents have more control when they’re giving the news to the young person. Stick with the facts: what happened, how it happened, when it happened. Avoid going into the whys, because that’s often going to trigger more of an emotional response.
[00:05:58-00:06:50] Apart from verbally expressing themselves, it can also be useful for kids to use art or visual props to talk about how they felt before, during, and after an incident.
I’m going to wrap up now. To help kids deal and process emotions, help them to use their words to understand those feelings, or to seek help from a professional. Sometimes kids will express their feelings using art, so give them an opportunity to draw what happened. Or, they can select images, such as from our “Face It” cards, which are feelings cards with a whole bunch of different facial expressions. Children can use them to talk about what they felt before, during, and after an incident. Visual props can be very helpful.
Bonnie, it’s been a pleasure to answer your questions today, and I look forward to talking to you again in the future. I’m Dr. Kimberley O’Brien from the Quirky Kid Clinic. That’s www.quirkykid.com.au. And keep in touch. Thank you.
It seems that few of us are immune to the occasional family spat and many of us will experience even long term ongoing tension within our family. At no time is this more apparent than at Christmas and often when the decorations go up the gloves come off! You only have to ask around to hear stories about board games gone bad and disagreements about where to eat Christmas lunch ending in a grumpy family eating ham and cheese sandwiches at home.
Arguments may start over everything from when exactly decorations should be allowed out of storage to whether or not a hot lunch is appropriate in Sydney on a 40 degree day. Add to this the “factions” that can develop within larger families along with a good dose of general family angst and you have a recipe for disaster. Why is it that at Christmas we can experience such excitement and yet such distress all at the same time? More importantly, how can you ease the tension in the hope of little more comfort and joy?
Christmas tends to be a time of heightened expectations. That added pressure means that we are all on edge trying a little too hard to make things just right (and we all have a different idea about what “just right” means). There also tends to be the slight feeling of going stir crazy when you are spending long periods of time with a group of people that you usually only see all together once or twice a year. Also, it doesn’t help that Christmas in general is a stressful time with calendars full of events and budgets at breaking point. Many of us are so stressed that it is no wonder that tensions arise.
Family involves a lot of emotion and even a lot of history. Most of your family know which buttons to press (or not press) and you know the same about them. Family members often feel the need to give advice without being asked and parents often have trouble seeing adult children as “grown ups”. In addition to this, we don’t tend to be very polite with our family so manners go out the window and honesty steps in. Remember that when you have an emotional response that your body is likely going into fight-flight-freeze mode which means that systems throughout your body are kicking into action. Many years ago this would have helped you flee from danger and hunt down your dinner but it doesn’t help you to carve a roast or have a civil conversation with a sibling so you may just need some time out to cool down so you can deal with the situation in a level headed way. If you are in a situation of ongoing tension with your family your body may be going through this response many times throughout the day so it may not just be the brandy on the pudding and the tryptophan in the turkey that leaves you desperate for a Christmas afternoon nap.
Once your head is level, or even to prevent it becoming off kilter in the first place, here are some more tips to help minimize the family tension:
Be a good guest. Respect the rules, values and routines of the house you are in even if you feel things are not going the way you would have them go in your own home.
Choose your battles. Ask yourself, is it worth it? How big a deal is this really? If other family members are being negative you can make the decision to step back and not let yourself be affected by this. If its not worth mentioning or getting into a fight about, let it go.
Listen more than you talk. You don’t have to agree with the person you are talking to but you also do not need to prove that you are right about everything. On boxing day, would you rather be looking back at the fun you had as a family, or reflecting on your victory over Uncle Max’s political views? A little “Mmhmmm”, “Oh?” and “I can see how you feel” goes a long way.
Take a break and offer breaks to others if it seems like they need it. If someone is getting on your nerves, take a quick drive to pick up some more ice. If a Mum in the family is looking overwhelmed, offer to take the little ones outside for a game.
Remember that Christmas is meant to be a fun time and that it is not just about pleasing others. At the same time, it is important not to put too much pressure on yourself to be feeling hunky dory all day long. Its ok to feel annoyed, frustrated or upset by how family members are behaving but making them feel the same way will probably only make matters worse. Just take a deep breath and enjoy the slightly humid but still festively pine scented air.
“Use organisation and time management to keep your stress levels down in the lead up to the big day. If you are already stressed up to your eyeballs you will be more likely to blow your top when someone makes an unwelcome comment” – Lisa (Psychologist)
“Breaking up the routine with a lot of different and new activities to keep things fun and interesting for all invoice. Ask grown ups to introduce and play they old games with everyone” – Leo Rocker (Practice Manager)
“Make Xmas structured and predictable by asking family members to help with setting up or cooking different dishes. Having a plan for the day with timeframes for dinner and presents so that everyone is prepared and relaxed. Create separate areas for mingling is also helpful in avoiding tension and that plenty of music and fun activities for the kids but not too much alcohol is advisable – Kimberly O’Brien (Child Psychologist).
This article as initially published by National Association of School Psychologists (USA)
Whenever a national tragedy occurs, such as terrorist attacks or natural disasters, children, like many people, may be confused or frightened. Most likely they will look to adults for information and guidance on how to react. Parents and school personnel can help children cope first and foremost by establishing a sense of safety and security. As more information becomes available, adults can continue to help children work through their emotions and perhaps even use the process as a learning experience.
All Adults Should:
Model calm and control. Children take their emotional cues from the significant adults in their lives. Avoid appearing anxious or frightened.
Reassure children that they are safe and (if true) so are the other important adults in their lives. Depending on the situation, point out factors that help insure their immediate safety and that of their community.
Remind them that trustworthy people are in charge. Explain that the government emergency workers, police, firefighters, doctors, and the military are helping people who are hurt and are working to ensure that no further tragedies occur.
Let children know that it is okay to feel upset. Explain that all feelings are okay when a tragedy like this occurs. Let children talk about their feelings and help put them into perspective. Even anger is okay, but children may need help and patience from adults to assist them in expressing these feelings appropriately.
Observe children’s emotional state. Depending on their age, children may not express their concerns verbally. Changes in behavior, appetite, and sleep patterns can also indicate a child’s level of grief, anxiety or discomfort. Children will express their emotions differently. There is no right or wrong way to feel or express grief.
Look for children at greater risk. Children who have had a past traumatic experience or personal loss, suffer from depression or other mental illness, or with special needs may be at greater risk for severe reactions than others. Be particularly observant for those who may be at risk of suicide. Seek the help of mental health professional if you are at all concerned.
Tell children the truth. Don’t try to pretend the event has not occurred or that it is not serious. Children are smart. They will be more worried if they think you are too afraid to tell them what is happening.
Stick to the facts. Don’t embellish or speculate about what has happened and what might happen. Don’t dwell on the scale or scope of the tragedy, particularly with young children.
Keep your explanations developmentally appropriate. Early elementary school children need brief, simple information that should be balanced with reassurances that the daily structures of their lives will not change. Upper elementary and early middle school children will be more vocal in asking questions about whether they truly are safe and what is being done at their school. They may need assistance separating reality from fantasy. Upper middle school and high school students will have strong and varying opinions about the causes of violence and threats to safety in schools and society. They will share concrete suggestions about how to make school safer and how to prevent tragedies in society. They will be more committed to doing something to help the victims and affected community. For all children, encourage them to verbalize their thoughts and feelings. Be a good listener!
Monitor your own stress level. Don’t ignore your own feelings of anxiety, grief, and anger. Talking to friends, family members, religious leaders, and mental health counselors can help. It is okay to let your children know that you are sad, but that you believe things will get better. You will be better able to support your children if you can express your own emotions in a productive manner. Get appropriate sleep, nutrition, and exercise.
What Parents Can Do:
Focus on your children over the week following the tragedy. Tell them you love them and everything will be okay. Try to help them understand what has happened, keeping in mind their developmental level.
Make time to talk with your children. Remember if you do not talk to your children about this incident someone else will. Take some time and determine what you wish to say.
Stay close to your children. Your physical presence will reassure them and give you the opportunity to monitor their reaction. Many children will want actual physical contact. Give plenty of hugs. Let them sit close to you, and make sure to take extra time at bedtime to cuddle and to reassure them that they are loved and safe.
Limit your child’s television viewing of these events. If they must watch, watch with them for a brief time; then turn the set off. Don’t sit mesmerized re-watching the same events over and over again.
Maintain a “normal” routine. To the extent possible stick to your family’s normal routine for dinner, homework, chores, bedtime, etc., but don’t be inflexible. Children may have a hard time concentrating on schoolwork or falling asleep at night.
Spend extra time reading or playing quiet games with your children before bed. These activities are calming, foster a sense of closeness and security, and reinforce a sense of normalcy. Spend more time tucking them in. Let them sleep with a light on if they ask for it.
Safeguard your children’s physical health. Stress can take a physical toll on children as well as adults. Make sure your children get appropriate sleep, exercise, and nutrition.
Consider praying or thinking hopeful thoughts for the victims and their families. It may be a good time to take your children to your place of worship, write a poem, or draw a picture to help your child express their feelings and feel that they are somehow supporting the victims and their families.
Find out what resources your school has in place to help children cope. Most schools are likely to be open and often are a good place for children to regain a sense of normalcy. Being with their friends and teachers can help. Schools should also have a plan for making counseling available to children and adults who need it.
What Schools Can Do:
Assure children that they are safe and that schools are well prepared to take care of all children at all times.
Maintain structure and stability within the schools. It would be best, however, not to have tests or major projects within the next few days.
Have a plan for the first few days back at school. Include school psychologists, counselors, and crisis team members in planning the school’s response.
Provide teachers and parents with information about what to say and do for children in school and at home.
Have teachers provide information directly to their students, not during the public address announcements.
Have school psychologists and counselors available to talk to students and staff who may need or want extra support.
Be aware of students who may have recently experienced a personal tragedy or a have personal connection to victims or their families. Even a child who has merely visited the affected area or community may have a strong reaction. Provide these students extra support and leniency if necessary.
Know what community resources are available for children who may need extra counseling. School psychologists can be very helpful in directing families to the right community resources.
Allow time for age appropriate classroom discussion and activities. Do not expect teachers to provide all of the answers. They should ask questions and guide the discussion, but not dominate it. Other activities can include art and writing projects, play acting, and physical games.
Be careful not to stereotype people or countries that might be associated with the tragedy. Children can easily generalize negative statements and develop prejudice. Talk about tolerance and justice versus vengeance. Stop any bullying or teasing of students immediately.
Refer children who exhibit extreme anxiety, fear or anger to mental health counselors in the school. Inform their parents.
Provide an outlet for students’ desire to help. Consider making get well cards or sending letters to the families and survivors of the tragedy, or writing thank you letters to doctors, nurses, and other health care professionals as well as emergency rescue workers, firefighters and police.
Monitor or restrict viewing scenes of the event as well as the aftermath.
What’s in a label? Should I get a diagnosis for my child?
‘Labelling a child’ is the term used to describe the process where a psychologist or psychiatrist assesses a child, resulting in a diagnosis or ‘label’. The diagnosis is based on a set of criteria defined in the Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV).
About 10% of children and young people will have a mental health problem. The most common diagnoses for children include anxiety disorders; attention-deficit and disruptive behavior disorders; autism spectrum disorders; and eating disorders (for example, anorexia nervosa).
If you suspect your child may have a mental health condition, chances are you’ve wondered if it’s beneficial to obtain a professional opinion and perhaps a diagnosis. While professionals were traditionally hesitant to diagnose pre-adolescents with DSM-IV conditions, diagnoses have been on the rise since the 1980s, partly as a result of greater research into child mental health.
What is a diagnosis?
A reputable mental health professional will not give a diagnosis without a thorough evaluation of a person’s symptoms, behaviours, and developmental history. In the case of a child, specialists will usually consult with several other sources (for example, parents, teachers, and family doctors) before confirming a diagnosis.
What are the advantages of a diagnosis?
An accurate diagnosis will give parents and their child a clear and realistic sense of the limitations and challenges the child may face as a result of the disorder. Following a diagnosis, you should also have a good sense of what treatment plans are available, their pros and cons, and how effective they are. This knowledge can provide tremendous peace of mind for families who are struggling.
Other advantages of a diagnosis include:
An accurate understanding of your child’s strengths and how to best harness them.
Individual support from Specialists at your child’s school (for example, regular hours with a Learning Support teacher or funding for resources or appropriate training for teachers).
Subsidized help for the family (for example, home-based intervention such as ABA for children with autism spectrum disorders).
Effective collaboration between health professionals. For example, a Speech Pathologist, Occupational Therapist and Psychologist can work together to give your child comprehensive treatment.
What are the disadvantages of a diagnosis?
Most professionals agree: forming a diagnosis can be difficult. A child’s behaviour can change depending on their environment, their food intake and the people around them, which can impact the assessment process.
The disadvantages of a diagnosis may include:
Stigma from other parents or peers.
Difficulties reversing the diagnosis should behaviour change or improve.
Children need support when discussing a diagnosis.
Some families might find a thorough assessment and Diagnostic Report costly.
Finding more support:
Quirky Kid has offices in Sydney and Wollongong,
If you are concerned as to whether or not obtaining a diagnosis for your child is right for your family, you may find it helpful to talk through the decision with a professional yourself. Ask your health care provider about counselling or support services in your community orcontact Quirky Kid on +61 2 9362 9297.