Of all the questions I

receive from parents, by far the most frequent questions

refer to the normalcy of their children's behaviors.

Parents want to know if the

things their children can and cannot do, the way they

behave, and the difficulties they face are normal.

Generally speaking, there is a very broad range of what

is "normal."

There is a normal curve for

most behaviors and those of us that do developmental

analyses know what we should and should not see, on the

average, in a child at any given age. For example, a

child at 15 months of age should have lost most of her

neonatal reflexes, she should be walking, and she should

be forming at least a few words.

But there is variability in

when these skills develop. A child who exhibits a

behavior earlier than the average child is not

necessarily exceptional. Likewise, a child who is later

than average in exhibiting a certain behavior is not

necessarily dysfunctional. For example, one child might

talk at 13 months and another might not talk until 22

months and yet both could be seen as "normal."

Other issues in childhood

have equally evasive meanings. For example, I am often

questioned by parents who wonder if their children are

normal because they appear more aggressive than other

children, or because they seem to have disturbed sleep

patterns. This is especially true for parents who have

more than one child, with the child in question being the

youngest, because the younger child is so visibly

different from older siblings.

However, in children of any

age, there are three specific behaviors that are almost

never normal. I always ask about these three behaviors

when I am analyzing a child. These three behaviors are

called the "terrible triad."

Their presence in a child,

especially when the child exhibits all three behaviors

together, is almost always a troubling sign. The first of

these three behaviors is bed-wetting. All children, of

course, wet the bed and how long it takes to train

children to master nighttime bladder control varies.

However, once the child has fully mastered both day and

nighttime bladder control, a relapse several months, or

especially several years, later is a troubling symptom.

Even though there are many

reasons why a child might begin to wet the bed after

mastering the skill, those reasons include trauma such as

sexual abuse. I absolutely never draw any such conclusion

based on a single piece of evidence, but it is something

I would definitely investigate until I am satisfied that

something else is causing this relapse.

The second symptom of the

terrible triad is fire setting. Again, both children and

adults have some level of fascination with fire. Curious

children may occasionally seek to experiment with fire or

matches, but an obsession with fire and an apparent need

to burn things is highly abnormal. This need to destroy

is indicative of unresolved internal conflict.

The final symptom of the

triad is cruelty to animals. It is not unusual for

children to hurt animals by accident, but any harm to

animals that is deliberate and cruel is abnormal.

Children normally have compassion for animals and the

absence of such compassion is a sign of a problem.

I have always found

significant disturbances in children who torture or kill

pets, neighborhood animals, or wild animals that are

caught for the purpose of torturing. Like fire setting,

this is representative of a need to destroy and it also

is a sign of serious emotional distress.

Many years ago when I was

first beginning my practice, I worked with a child who

delighted in killing frogs. He repetedly would find frogs

and then throw them into trees or into the ground to kill

them. His parents were not sure if that was a problem. In

his case, it most definitely was a problem.

Many teenagers and young

adults who rape, assault, or kill began their careers by

torturing and/or killing animals. I recognize I am making

a sweeping generalization, but if there is no resolution

to the internal conflict that drives this behavior, he or

she will eventually graduate to harming people.

Because every child is

different, I am very careful in my developmental analyses

and I look for a normal progression in development as

much as I look for certain behaviors at a certain time. I

also consider the wide variety of backgrounds and

cultures that could contribute to behaviors that I see.

However, a parent, teacher or other concerned adult who

sees any or all of the terrible triad should pursue

clinical intervention for the child.

These behaviors are not

normal and the child should be referred to a psychologist

for evaluation.

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