Question: We have a 4-year-old child in our preschool who has been with us for four months.  He acts like a 2-year-old.  When he doesn't get his way, he gets hysterical.  He jumps up and down screaming. He has great difficulty focusing on any project, and keeps the class in a constant state of uproar. The teacher has been consistent, trying to get him to use his words.  She has given him words to use, but we seem to make no progress.  What should we do?

Polly Greenberg: Do you have a school counselor, psychologist, psychiatric social worker, or child psychiatrist? Or a short list of available specialists of this sort? Probably an assessment by such a professional is in order.

You may want to start by meeting with the child’s parent(s). You can explain that you always like to meet with parents to share your observations about their child and learn what they’ve noticed at home. Point out that you’re a team and the more you share, the more you all can help the child develop optimally.  After making the parents comfortable and talking about neutral matters pertaining to the little boy, describe the behavior that concerns you and ask the parents if they’ve seen this at home.

If they seem surprised or defensive and claim never to have seen anything out of the way with their son, agree with them that all of these behaviors are normal in a young child, but that their frequency and severity concerns you. Let them know that in your experience, this child’s lack of focus, inability to tolerate frustration, and regular hysterical rages are unusual. If, on the other hand, the child’s parents get upset because this behavior is all too familiar to them, be soothing. Either way, tell them you think it’s always important to consult whatever kind of specialist might be helpful in a given situation, whether it’s an orthopedist or a psychiatrist, because part of your job when working with young children is to try to see that possible future problems are nipped in the bud, and because you yourself would appreciate expert guidance.

For more advice by Polly, check out the Setting Limits column.