As many as 25 percent of children will experience emotional or behavioral problems at some point that require mental health treatment. Unfortunately, less than 20 percent of these children will actually receive the treatment they require.

Reasons for this vary. Very often, it is quite difficult to admit that your child may be in need of something more than parental advice or discipline. Some parents may rationalize that the problem will get better on its own or go away with time. Others may even think that seeking mental health treatment would mean "my child is crazy" or even make matters worse. And some may think that the younger a child is, the less likely he of she is to have "real" problems.

However, emotional and behavioral problems do not discriminate with age. In fact, I have seen children as young as 18 months and 2 years of age who required treatment.

Dr. Bryan Gros is a child and pediatric psychologist with the Capital Area Human Services District and serves on its Early Intervention, Diagnosis and Prevention Committee.

One of the most prominent reasons the majority of children are left untreated is that parents often do not fully recognize symptoms and signs that would indicate the need for professional help. Furthermore, since it is uncommon for a child to recognize that he or she may be experiencing emotional problems, he or she does not seek help on his or her own. Thus, this often difficult task is left up to the parents.

While some psychological problems are resolved by themselves in children, this is generally not the case. In fact, if not properly addressed, many emotional or behavioral problems will actually worsen. The earlier the child receives treatment, the better the prognosis for significant improvement. Thus, it is very important to seek consultation with a mental health professional when the first signs of abnormal behavior or emotional problems are seen.

So, when is a child's behavior or emotional functioning so abnormal or severe that professional help is needed? Parents have struggled with this question for quite some time. Fortunately, there are certain signs to look for which indicate your child may be experiencing even early psychological difficulties. Among the signals are:

� excessive hyperactivity (difficulty keeping still or extremely fidgety) and/or difficulty with attention and concentration; impulsivity (your child often does not seem to think before he or she acts);

� rapid mood swings or signs of depression, such as a persistent depressed or irritable mood, excessive crying or sensitivity, withdrawal from school, friends or social activities, growing apathy or poor motivation;

� persistent or prolonged anxiety or nervousness, such as constantly worrying about trivial matters or excessive apprehension in certain situations; fears which are not proportionate to the situation or reality; excessive difficulty going to school or separating from others; or panic attacks;

� an abrupt change in mood or behavior (for example, a normally very responsible, polite and outgoing child who suddenly becomes very irresponsible, aggressive or hostile or extremely withdrawn);

� difficulty regulating or controlling emotions, a developmental task which involves self-soothing and is mastered by most young children at a very young age;

� sleep disturbances or changes, such as sleeping too much or too little, difficulty getting to sleep or chronic nightmares; this is often accompanied by symptoms of anxiety or depression;

� appetite disturbances or changes in eating habits, such as loss of appetite, excessive and sudden weight gain or loss without trying to do so and in the absence of an underlying medical explanation;

� problems associated with school, such as learning problems, a sudden decrease in grades or academic performance, frequent calls from teachers regarding misbehavior, frequent suspensions or expulsions;

� frequent and persistent oppositional and defiant behavior that you, as a parent, consider much more severe than what you would expect from someone your child's age; conduct problems such as stealing, frequent fighting, fire-setting, cruelty to animals and delinquency;

� odd or bizarre behavior, such as hearing voices or seeing things, excessive and unusual preoccupation with certain objects, frequent pulling out of his or her own hair; compulsive behavior, such as checking and rechecking again and again, or overly excessive hand washing;

� feelings of hopelessness or helplessness or self-injurious behavior (banging one's head against the wall) or thoughts of suicide. If a child makes reference to suicide with statements such as, "I feel like dying or killing myself," or "I wish I could die," immediate consultation with a mental health professional is recommended.

All children, at one time or another, display some of these symptoms. However, the more often a problem or behavior occurs, the longer the duration, the less age appropriate and the more resistant the child is to change, then the greater the need for mental health assistance. In other words, if any of these symptoms are severe or persistent, seek professional help for your child.

Getting help in the early stages is of the utmost importance in maintaining the emotional health of your child and family. This serves not only as intervention, but as prevention for the development of more serious psychological problems, as well.

Mental health assistance can be found in many forms and places. Since each child and family are unique, treatment is tailored to meet an individual's needs. Play therapy, individual, group or family therapy/counseling, parent training and medication, when needed, are some of the options available to children and families.

If you suspect your child has an emotional problem, help can be found through local mental health centers or mental health associations, your city or state department of health, school counselors, social workers, counselors, child psychologists and child psychiatrists.