It's a question that quietly lingers in many parents' and caregivers' minds perhaps your normally cheerful child has been unusually quiet. Or maybe your teenager, once outgoing and lively, appears more withdrawn or irritable by the day. You attribute it to growing pains, hormones, or school stress. But deep in your belly, a small voice whispers: Could this be something more ominous?Maybe at last mental health is finally receiving the attention it should receive. And yet with children, it's still simple to miss the early warning signs. After all, kids don't always know how they're feeling—and sometimes their distress manifests itself in seemingly random ways, like difficulty sleeping, tantrums, or even reports of a tummy ache.In the complex process of childhood development, mental health tends to take a backseat to worry about physical growth, vaccinations, and diet. But as there is growing awareness about emotional health worldwide, it's increasingly becoming apparent that children's mental health deserves as much concern and care as their physical health. In fact, pediatricians are now leading the way in detecting early warning signs that could indicate more serious psychological problems.We interviewed Dr. Kushal Agrawal, Department Head of Neonatology and Paediatrics, to learn how pediatricians recognize the early warning signs of mental health issues—and why parents must never second-guess their instincts. His observations shed light on what's normal, what's not, and how early intervention can be the difference-maker in a child's life.In keeping with the World Health Organization's findings, it is estimated that one in every six children in the 10-19 year age group suffer from a mental health condition. Experts point out that early detection and intervention are what can transform a child's life. Dr. Kushal, points out, "Being pediatricians, we are also the first stop when children exhibit slight changes in mood or behavior. While overall physical health still takes precedence, the increasing rates of mental disorders in children deserve equal priority.What Mental Health in Children Really Means?Child mental health is the emotional, psychological, and social well-being that determines how they think, feel, and behave. It is instrumental in enabling them to deal with stress, relate to others, and make proper choices. While physical illnesses are more apparent and can be diagnosed easily, mental health issues tend to present themselves subtly—sometimes not being noticed until they start impacting schoolwork, social interaction, or family dynamics.A child's mental health is not fixed but changes with age, environmental factors, and biological growth. Hence, it is important to have constant interaction and monitoring in identifying red flags early.Common Mental Health Disorders Identified in ChildrenChildren may exhibit a range of mental health disorders that appear during different phases of their lives. These include developmental and mood as well as behavioral disorders:Autism Spectrum Disorder (ASD): Marked by communication problems and repetitive activities, symptoms typically emerge in early childhood and greatly differ in intensity.Attention-Deficit/Hyperactivity Disorder (ADHD): ADHD is a very frequent neurodevelopmental disorder among children, commonly associated with inattention, impulsiveness, and restlessness.Post-Traumatic Stress Disorder (PTSD): This disorder might occur after the experience or witness of a traumatic event. PTSD children tend to have difficulty with flashbacks, sleep disturbances, and emotional unresponsiveness.Obsessive-Compulsive Disorder (OCD): Children who have OCD have uncontrollable, repetitive thoughts and acts they feel the need to repeat.Mood Disorders: Both depression and bipolar disorder may be seen in children, usually disguised as irritability or hostility.Developmental Disorders: These are a range of disorders involving language, behavior, and learning disorders, and usually require early treatment.Dr. Agrawal explains, "Mental health issues may manifest differently in children than in adults. One of the first signs is a clear change in behavior—avoidance of activities they previously enjoyed, sudden belligerence, or persistent unhappiness."Early Warning Signs Parents Shouldn't IgnoreGetting ahead of the game starts with paying attention. Kids might not have the words or emotional maturity to describe their suffering, so their pain tends to emerge through behavior.Behavioral Changes: Sudden moodiness, chronic irritability, or defiance can be more than a bad day. A reclusive extroverted child, or an aggressive child previously mild, warrants closer scrutiny.Sleep and Eating Changes: Sleep disruptions—insomnia, nightmares, or hyper-sleeping—and shifts in appetite are potential precursors of emotional stress or anxiety.Academic Struggles: A former high-achieving student might suddenly turn away from homework, face difficulty maintaining attention, or act out in class. "Decline academically is another significant signal," responds Dr. Agrawal. "A declining, previously attentive student may be quietly fighting anxiety or depression."Physical Complaints: Persistent, unexplained headaches or stomachaches—particularly coupled with stress-producing situations—are commonly associated with emotional pain.Regressive or Risky Behaviors: Young children can regress to previous behaviors like bedwetting or clinginess, whereas older children can indulge in risky behavior or show hopelessness.Supporting Mental Health at HomeThe home environment is a critical factor in a child's mental and emotional health. Dr. Agrawal believes in empowering parents with practical strategies that assist in creating a stable, supportive environment.Establish Open CommunicationCreate a space where your child feels safe discussing emotions. Avoid rushing to solutions—instead, listen actively and validate their feelings. This reassures them that they are not alone.Maintain Routine and PredictabilityChildren find comfort in structure. Regular mealtimes, bedtime routines, and household rules provide a sense of security, especially during stressful times.Encourage Healthy Lifestyle HabitsExercise, healthy eating, and sleep have a significant effect on mood and mental focus. Everyday family activities such as evening strolls or family meals can reinforce connections and enhance emotional well-being.Educate Yourself and Your ChildLearning about mental health dispels the stigma. With child-friendly materials, tell your child that mental health is as vital as physical health—and that asking for help is a strength.Use Positive ReinforcementAccepting your child's efforts and accomplishments, however minor, increases their self-esteem and resilience. Praise effort, not perfection.When to Seek Professional Help?Dr. Agrawal suggests that parents "trust their instincts—if something feels 'off,' it probably is." Regular pediatric check-ups are a good time to mention concerns. Pediatricians can offer initial evaluation and refer families to child psychologists or psychiatrists, as needed.It's crucial not to wait to seek professional help. Early intervention can lessen the severity of mental illness and provide children with coping skills that last a lifetime.Identifying and treating children's mental health is not just a parent's job—it takes a shared effort from educators, caregivers, and healthcare providers. As awareness increases in society, so must our dedication to listening, watching, and acting early.Dr Kushal Agrawal is HOD, Department of Neonatology and Paediatrics at KVR Hospital, Kashipur in India.