how does one go about getting a mental health evaluation for a 6-year old?

[Anonymous]

I've been concerned about my 6- year old's social anxiety (at least, that's what I am calling it) for a couple years now. My husband seems to think she's totally fine, and since I tend to toward anxiety myself it may be that I am being overly vigilant. But I also wonder if he may just be in denial... I would say almost literally that I have never seen her speak to an adult the first time she meets one (well, at least in the past 3 years or so), and/or even look them in the eye.

So my question is, how do I got about getting a mental health evaluation for a 6-year old who refuses, in general, to talk to adults? I'm particularly concerned about social anxiety. Others on this board have suggested selective mutism, but it's not my sense that she CAN'T speak... she just freaks out about it.

We have MDIPA if that makes a difference.

[Anonymous]

Location?

[Anonymous]

Anonymous wrote:how do I got about getting a mental health evaluation for a 6-year old who refuses, in general, to talk to adults?

Therapists have all kinds of tricks for helping kids open up and feel comfortable, as well as for evaluating non-verbal communication. I don't think you have to worry about that part. Just go ahead and do your due diligence for finding a therapist to meet with your daughter and give an opinion.

Sources for referral include this forum, your adult therapist, your pediatrician, your daughter's school counselor, friends who have kids in therapy, and your insurance provider. I put your insurance provider last on the list as it seems that the good therapists don't take insurance, and there have been multiple threads here of people's calling their insurance company's approved providers only to find no openings. You can self-pay with other therapists and file for reimbursement, though.

It will probably take several sessions. The therapist will meet with the parents first for a thorough interview, then meet several times with your daughter. You can tell him/her up front that you're just looking for an evaluation and advice at this point, not necessarily requesting ongoing therapy.

Good luck!

[Anonymous]

We have MDIPA and live in Reston. Thank you for the response.

Not sure if anyone can provide some perspective on my being worried and my husband being completely unconcerned? I know an internet forum can't provide enough context, but I wonder if others have stories...

[Anonymous]

If she speaks to adults a little once she knows them, and is okay with teachers, then I think that sounds pretty normal. My DD (7 now) recently told me that she can't speak to teachers when she is the only one in the room - she can speak when there are other kids, but she feels shy when she's the only one. I think it is normal and they will get more confident as they get older. Can you talk it through with her? FWIW, I didn't speak to adults when I was younger and I am very sociable now (since hitting adolescence).

[Anonymous]

Actually selective mutism isn't about not being "able" to speak. It's about choosing when/where to speak. Children with selective mutism will chat up a storm at home, and then say nothing at school.

What does your ped say? Again, what does her kindergarten teacher say? If she's an experienced teacher, then she's seen a wide range of kids over the years and should be able to discern whether dc is one who shows behavior that is atypical.

[Anonymous]

There's the Ross Center for Anxiety Disorders

[Anonymous]

BTW, OP, this isn't about mental health. People with anxiety are (for the most part) perfectly mentally healthy. It's not a sign of mental illness.

[Anonymous]

OP, I answered on your other thread as well. My son has generalized anxiety. We see Dr. Alison Gardner at Family Compass in Reston. She specializes in anxiety and selective mutism and is absolutely wonderful. She is great with our extremely socially anxious child. I trust her judgment and advice completely and recommend her in the highest possible terms.

It is extremely common for one parent (typically the mom) to be more concerned than the other parent. I am sure this is common with all children but it is something that comes up all the time in the special needs board. I think in our case, my husband a) didn't see our child as many hours per day as I did b) didn't see other kids and couldn't compare c) has a very special relationship with our child and always gets the best of him d) is a generally very optimistic, upbeat person who tends to assume the best in people and that the best will happen...etc. I on the other hand spend more time with our kids and other kids, am more of a worrier... I could go on. It is a lonely place you are in, I remember it well, and even though it is hard to feel like I pushed my family to recognize my child's challenges, it was a necessary thing for us to do.

And I am not assuming that you'll end up with any diagnosis. Maybe you'll actually be reassured after talking to a professional that your child is totally fine and within the normal range. I think the point is that you feel that your child needs a little support or perhaps that you, as parents, need a little extra instruction on how to teach your child certain life skills. These are very legitimate reasons to talk to a child psych. You don't have to assume that there is a diagnosable issue. At this age, even if there is a diagnosis, the therapist will largely be working with the parents on how to manage/support/challenge a child anyway.

[Anonymous]

Anonymous wrote:BTW, OP, this isn't about mental health. People with anxiety are (for the most part) perfectly mentally healthy. It's not a sign of mental illness.

Huh? Anxiety is a mood disorder. I've been treated for it, my DC has been treated for it. It is absolutely a mental health issue. Denying that just perpetuates the stigma of mental health issues. Anxiety is closely related to depression, though obviously not the same thing. Its in the DSM. It may not be the most serious form of mental illness, but as someone who has had it, it can make life pretty miserable.

You might try finding a cognitive-behavioral therapist who works with children, like at Alford Baker (some of their therapists are fabulous, some are not so much, so be careful there). CBT is short term, highly directed therapy -- cured one of my DC of an intense phobia in a short period of time.

But you should take this seriously. We waited until my DC who has anxiety was well into his teens before finally choosing medication and he feels like it changed his life, and there was a cloud hanging over him for all those previous years. It does not sound like a situation that calls for medication in your case, but CBT might be a direct, simple fix.

[Anonymous]

BTW, OP, this isn't about mental health. People with anxiety are (for the most part) perfectly mentally healthy. It's not a sign of mental illness.

What?

[Anonymous]

Is shyness a mental health disorder?

[Anonymous]

Anxiety can be just as debilitating and disabling as depression which is commonly comorbid. Mentally healthy?!? Don't think so.

[Anonymous]

Anonymous wrote:Is shyness a mental health disorder?

Of course not, and if this post is meant as some kind of judgment of OP, please go back to General Parenting. She is only raising a concern and the fact is she won't know if this is just shyness or an anxiety issue unless she has a professional examine her DD. The Special needs Forum is not a place to pass judgment on other parents. Many of us missed out on early detection for a variety of isses with our DC and wish we had raised concerns earlier.

[Anonymous]

Anonymous wrote:Is shyness a mental health disorder?

No, it isn't. Neither is introversion. But anxiety is! It may be hard to tell the difference in any one given situation but there are diagnostic criteria to do just that.