Early Detection: Spotting the Subtle Signs of Mental Health Issues in Children

As the school year kicks off, many children are navigating new routines, relationships, and expectations. While most adjust with time and support, others may be quietly struggling—often in ways that don’t match the traditional “red flag” behaviors we’re trained to spot. Early detection of mental health issues in children can make a critical difference, and sometimes, the signs are more subtle than we think. Here’s what to watch for and what to do when something doesn’t feel quite right.

Subtle Signs Worth Noticing

Mental health challenges in children don’t always look like withdrawal, aggression, or sadness. They might show up as:

• Frequent somatic complaints
  Headaches, stomachaches, or vague physical discomforts—especially when tied to certain situations (like math class or lunch period)—can be a child’s way of expressing emotional stress.

• Perfectionism and overcompliance
  Children who are overly eager to please or afraid to make mistakes might be masking high levels of internal anxiety. It can be easy to overlook these students because they seem like “model” learners.

• Fatigue or zoning out
  A child who’s consistently tired, slow to respond, or daydreaming might not just be bored or inattentive. Sleep disturbances, depression, or trauma-related hypervigilance could be underlying causes.

• Regressive behaviors
  Behaviors such as thumb-sucking, clinging to adults, or difficulty with toileting or separation (especially after breaks or transitions) may signal emotional distress.

• Shifts in social engagement
  A talkative child becoming quiet, a social child suddenly keeping to themselves, or a typically shy child acting out can all indicate that something is off.

The Role of Context

It’s important to consider the child’s developmental stage, cultural background, and context. For example:

• A child learning English might be quiet not because of social anxiety, but because they’re still building language confidence.

• A high-energy student may appear “defiant,” when in reality they’re overwhelmed by sensory input or internal worry.

Whenever possible, gather observations from multiple settings (e.g., classroom, recess, specials) and stakeholders (teachers, caregivers, after-school staff).

Opening the Door to Conversation

Early support doesn’t require a diagnosis. If you notice something, open a gentle line of communication:

• “I’ve noticed you’ve been holding your tummy a lot lately. How’s your body feeling today?”

• “It seems like mornings have been tough recently. Want to tell me about what that’s been like for you?”

These kinds of observations create opportunities for children to name what they’re feeling—sometimes for the first time.

When to Refer

You don’t need to be certain to take action. If a pattern of concern emerges, consider:

• Talking with the school counselor or school psychologist.

• Referring for a broader social-emotional screening or assessment.

• Partnering with caregivers to share concerns and collaborate on next steps.

Early intervention works best when it’s a team effort.

Final Thoughts

The most impactful supports often begin with someone simply paying attention. By tuning into the small shifts and unexpected behaviors, we can help ensure that no child slips through the cracks. Let’s be curious, not conclusive—and stay ready to listen.