Child development problems: disorders in children aged 4-6 years

When to show your child to a child psychiatrist: behaviors and symptoms that should alert you

Delayed psychoverbal development

It often happens that with a delay in psycho-speech development, parents seek help at the age of 4 and later, when, for example, the kindergarten reports that the child is not coping with the mass preschool program. He still confuses colors and geometric shapes, and the question of the seasons is difficult for him.

At this age, the child already feels his “failure” and develops secondary neurotic traits: withdrawal, refusal to speak, anxiety, expectation of failure. He needs help, this will be done by a child psychiatrist, psychologist, speech therapist and defectologist. Sometimes parents are sure that the child speaks well, since he reproduces Chukovsky’s long poems by heart, but if, at the same time, his own active speech is underdeveloped, this is a reason to ask for help.   

Difficulties of adaptation in the social sphere

After 3 years, the child already correlates himself with the social environment. At this age, excessive shyness, avoidance of social situations (performances at matinees or simply the need to start communication) may appear. Sometimes the child completely refuses to speak in any situation outside the home – the so-called elective mutism. Most likely, we are talking about an increased level of anxiety, and specialists – psychologists and psychiatrists – will help the child .  


Fears are common in childhood. Their intensity should be alarming (for example, he is afraid of dogs so much that he does not go outside at all), the unusual plot of fear (afraid of a crack outside the door, a fire alarm, men with a mustache on the street). Some children are afraid of loud sounds, especially household appliances, while others run out of the room at the sight of a frightening cartoon character. The usual fear of the dark may indicate a violation if the child points to something that is not there (“there is a jellyfish on the ceiling”) or looks at a certain place as intently as if he was seeing something.  

Older children have very complex fears: germs, contamination-infection, while the child washes his hands for a long time, or poisoning (looking closely at food, refusing to eat). Of course, we judge the ordinary and unusualness of fear with a great deal of subjectivity. The doctor will help allay your anxiety and clarify the nature of the child’s feelings. A separate type of anxiety in childhood is the fear of separation from a loved one: the child does not let go of his mother, refuses to enter a kindergarten group or developmental activities without a mother, and does not calm down for a long time in her absence. At this age, the symbiosis is clearly delayed and maladjusted the child – seek advice.

Jealousy between siblings

The birth of a brother or sister is an ordeal for any child. If you notice that after being added to your family, an older child has become capricious, irritable, shows aggression towards the baby, or regresses himself to an infant state: asks to put on a diaper and feed him from a nipple, this indicates a strong mental discomfort for the child. See a psychologist.

Stuttering and tics

The most common disorders of this childhood period are psychomotor disorders, which include tics and stuttering. Tics are repetitive movements that at first carried a protective function (blinking, brushing off the bangs), and then they became entrenched and lost this function. The child can usually, by an effort of will, delay the repetition of these movements for a while, in order to resume them with renewed vigor. Small children are not capable of such an effort. In classic cases, the child is burdened with tics, but this may not be the case.

In the event that tics are multiple, including vocal (vocalizations, shouts, grunts), one can think of the so-called Gilles de la Tourette’s syndrome. Tics respond to therapy, in mild cases completely. Convulsive contraction of the speech motor muscles during speech is called stuttering. It can be caused psychogenically (stress) or indicate an organically defective soil in a child, for example, due to an unfavorable pregnancy or childbirth. Stuttering leads to a secondary fear of speech: the child is ashamed of his defect and is afraid to speak. Stuttering requires a whole range of therapeutic measures with the participation of a psychiatrist, psychologist, speech therapist.

Enuresis and encopresis

Urinary incontinence – enuresis – is nocturnal (more often) and daytime. Nocturnal enuresis is also psychogenic and organically determined, the psychiatrist decides what kind of enuresis a given child has . Nocturnal enuresis is usually difficult for the child himself, making it difficult for him to adapt in a team with round-the-clock stay. Daytime enuresis usually indicates either more serious mental disorders, developmental delay or pathology of the urinary system. Encopresis is a special condition when a child, enjoying the containment of feces, stains the laundry. Usually combined with aggressiveness, stubbornness, greed. You should not be shy and hide these violations, they are treatable. 


Aggressiveness and conflict in preschool age are usually a continuation of the same problems of an earlier period. Less often, they appear for the first time at 4-6 years old, can be a reaction to an unfavorable situation in the family, kindergarten, and can reflect stable characterological traits. Sometimes they can indicate the onset of a mental disorder. In order to avoid social maladjustment of the child, they require correction by specialists.


A common occurrence in children is attention deficit hyperactivity disorder. Such a child cannot sit still and concentrate on something for a long time. He is in constant motion, fussy, restless, too mobile. Even when he is sitting, he either dangles his legs, or fidgets, or makes movements with his hands, or turns his head in all directions. Complaints of carelessness and violations of discipline are constantly received from educators. The disorder will greatly interfere with the child at school age, do not delay the visit to the doctor! 


Along with active, noisy children, there are always opposite cases: children striving for loneliness, immersed in their inner world. Such immersion may reflect an excessive tendency to fantasize; sometimes a child has to be called out several times in order for him to emerge from the fantasy world. And it happens that the child insists on his fantasy game: he demands to call him Bobby and feed him from a bowl on the floor. If you can’t switch the child, this is a reason to ask for help.

Fantasizing can be normal and pathological, what it is in each case – the psychiatrist decides . In other cases, the child’s fencing off indicates a violation of communicative functions, in which case it is accompanied by unusual speech or its absence, strange movements, and insufficient interest in living objects. Intensive remedial work and treatment allows these children to do great positive dynamics, learn to use speech and other means of communication, and achieve good levels of adaptation. 

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