You’ve just finished talking to your child’s doctor, paediatrician or psychologist and they have told you your child meets the criteria for a mental health, educational/learning or long term physical health diagnosis.  What do you say to your child/young person? 

10% of young people are diagnosed with a physical disability and up to 20% with a mental health diagnosis during their childhood and adolescence.  Many more young people don’t have a formal diagnosis per se but have tough struggles in a particular area (learning, social, mental health, physical health). 

It’s not surprising therefore that many parents have to grapple with these questions to “What should I say? And How should I say it?”.   

Working out how to talk to children about their challenges and diagnoses can be tough.  But doing this as well as we can is really important. 

When we talk helpfully to children and young people about their challenges we can potentially support them to better understand their challenges, feel less blame and isolation, help them understand the need for treatment/appointments/home activities (when this applies) and also empower them to ask them for what they need when we are not with them. 

In Australia, around 10% of children have a physical, cognitive or mental disability or disorder. Over the years I’ve had the privilege of working with a whole range of these children and adolescents, for example those who’ve been diagnosed with:

• a speech or language disorder or disability

• autism spectrum disorder

• a significant learning disorder or dyslexia,

• a hearing or visual impairment

• attention deficit/Hyperactivity Disorder

• a chronic health condition leading to physical disabilities

• and many others

For some of these children, their disability had a huge impact on nearly every area of their social, school and home life.  For other children, their disability was relatively mild, or affected only one area of their life.

Kids and teens have negative experiences with other children and young people very frequently.  From the age of 4 (when physical aggression starts to decrease) feeling hurt, frustrated, distressed and disappointed when interacting with friends and classmates becomes increasingly common. 

For example, one study found that children report having a conflict with one of their good friends approximately once per fortnight.  Another study found that approximately 60% of children and teens report having a “mutual enemy” (someone they dislike and who dislikes them) which presumably is associated with at least some negative interactions.  Other studies find that - depending on how you ask the question - 1 in 4 children/young people say they have experienced “bullying” during their primary or secondary years. 

A few months ago I was working with a 10 year old girl I’ll call Jennifer (as always, names and details changed). I was initially working with Jennifer on helping her reduce her anxiety about being around her peers.   However something else which was quite noticeable about Jennifer’s challenges was this:  she struggled to show almost any positive emotion.  Jennifer rarely smiled in sessions, and despite me doing a great deal of play, games and rapport building with her, found it almost impossible to talk positively or enthusiastically about any of her interests.   

When I asked Jennifer’s Mum about how she acted at home,  she told me that Jennifer frequently looked unhappy or anxious at school and around other children too – and had been like this for some time.   

Some children smile less frequently, and/or show less enjoyment, interest, excitement or happiness in their words or faces than other kids.  They have a “blank”, sad or worried expression on their face a lot of the time, often stay quiet when something positive happens to them, or talk much less enthusiastically or positively about their interests compared to other children.

Take a moment to remember a time in the last few days in which you felt stressed, frustrated or worried.   Reflect for a moment on your body in that moment.  Your heart rate had sped up a little, you were breathing a little quicker, your body temperature rose slightly and your muscles were more tense than usual.   You might not have noticed these things at the time because you were focused on whatever problem you were managing, but it was there in the background. 

This reaction is a deep seated physical response for humans, and happens for kids too.  Whenever they perceive some kind of danger, threat or problem, their bodies react by increasing what can be called their “physiological arousal”- either just slightly (eg they might say they have a headache because they’ve had tense shoulders for example at the end of the day) or a significantly (they might hyperventilate, experience heart racing, or rigid body which makes them scream/yell or stops them even being able to talk).