Can very young children be perceived to have mental health problems? Under fives cry a lot, hardly sleep, are incredibly active, oppositional and have food fads. Surely we are not suggesting they all have a mental illness!

Campbell (1995) suggested that the definition of a disorder in young children should include several components:

• the presence of a pattern of symptoms that goes beyond a transient adjustment to stress or change

• a cluster of symptoms which is evident in several settings and with people other than the parents

• that it is relatively severe

• that it interferes with the child’s ability to negotiate developmental challenges, thereby reflecting some impairment in functioning. 

Behaviour-extreme symptoms presenting in young children must therefore be viewed within a developmental context and medical conditions must be excluded or at least factored in. The social situation of the family is important as well as establishing the parents’ view of what is 'normal behaviour'.

In this module, the first of three, we look at the epidemiology and aetiology of behavioural problems in the under fives, developmental stages, assessment and attachment theory.

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