What to Look For - FIRST

What to Look For

Each day many parents face a difficult family situation. Seemingly without warning, their child’s behavior takes a noticeable change for the worse. They become unusually sad or constantly disruptive. Their performance in school begins to decline, eating habits change, or they avoid their usual friends. How does a parent know if this is just a phase or truly a problem? The best way is to become familiar with the warning signs of emotional and behavioral problems, and to seek professional help if they persist.

It is especially important to pay attention to sudden changes in mood, thoughts and behaviors. Also keep in mind that the onset of several of the symptoms below, and not just any one change, indicates a problem that should be assessed.


  • Feels sad or lonely and these feelings don’t go away
  • Feels guilty more than others
  • Feels anxious or worries about many things.
  • Experiences prolonged grief
  • Has unexplained fears
  • Exhibits extreme mood swings
  • Is persistently unhappy
  • Has panic or anxiety attacks
  • Is persistently irritable
  • Is persistently fatigued, tired or has a loss of energy
  • Is restless, fidgety, or exhibits psychomotor agitation


  • Thinks they are worthless
  • Thinks they are controlled by others or by their minds
  • Is disorganized at school and at home
  • Day dreams and is unable to accomplish tasks
  • Thinks of suicide or that they would be better off dead
  • Hears voices that cannot be explained
  • Has poor concentration
  • Has difficulty making decisions
  • Has difficulty focusing
  • Has racing thoughts


  • Cries more than the usual child
  • Overacts more than others
  • Has behavior problems in school
  • Has academic problems
  • Is losing interest in things that were previously enjoyable
  • Changes in sleep
  • Changes in appetite
  • Isolates self from friends and family
  • Talks about suicide
  • Talks about harming others
  • Hurts or injures other people, or animals
  • Has difficulty sitting still
  • Must perform certain rituals or routines
  • Uses alcohol, drugs or other illicit substances
  • Destroys property
  • Breaks the law
  • Injures or hurts self
  • Overeats or restricts food intake
  • Excessively exercises, vomits or has diarrhea
  • Avoids going to school
  • Difficulty separating from caregivers
  • Difficulty following rules
  • Blames others
  • Has planned or attempted suicide
  • Persistent nightmares
  • Eating large amounts of food and then forcing vomiting, abusing laxatives, or taking enemas to avoid weight gain
  • Continuing to diet or exercise obsessively although bone-thin
  • Unexplained cuts and burns
  • Extreme moods

Next Steps

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Quality & Compliance

If you have a concern about patient care or quality of care, we would like to hear from you.

Any concerns about patient safety and quality of care can be directed either to the CGFS Director of Quality & Compliance, Dr. Timothy Bartlett, at 330-762-0591, or to our accrediting body, The Joint Commission. There are three ways to contact The Joint Commission:

  • At www.jointcommission.org, use the “Report a Patient Safety Event” link in the “Action Center” on the home page of the website
  • By fax to 330-792-5636
  • By mail to Office of Quality and Patient Safety, The Joint Commission, One Renaissance Boulevard, Oakbrook Terrace, IL 60181