Category: 1. GradeSchool children

​Part of taking a sitting job seriously is protecting yourself as well as the children for whom you will be caring. Know the people you are sitting for before you take the job. Check references if this will be the first time working for this person.

Tips

• Get the parent’s or guardian’s name, address, and both home and cell phone numbers. Your parents or guardians may want to meet the people you are sitting for if they are not already acquainted.
• Get specific instructions about the number and ages of the children you will be sitting, their bed times, food allergies, medicines, and other information about their personal habits, and what is expected of you.
• Parents and guardians typically feel confident with a sitter who asks questions and is concerned about the care of their children. Discuss the information with your parents or guardians before accepting the job.
• Use the Sitter’s Checklist (see below).

Safety Cautions  

You may find enough jobs simply by letting friends and neighbors know that you are available to babysit. It is not a good idea to post flyers on supermarket bulletin boards or on the street, to place a classified ad in newspapers, or to have a website. You may receive some unwelcomed responses, and it may not be safe. Although most people are nice, do not make it easy for a stranger to find out your age, where you live, or your email address.

Accept jobs only from people you already know or from those who are recommended to you. Accepting jobs from strangers is not as safe as sitting for a neighbor or a neighbor’s friend. If you do not know the person calling, ask who recommended you, and tell the caller that you will call him or her back. If you do not know the people you plan to sit for, bring a trusted adult (parent or guardians, adult friend, etc.) along for the interview. The adult is there for support and safety. You should answer any questions and be prepared to ask questions. If you have any doubt or feel uneasy or fearful about the person or situation, refuse the job. Other jobs will become available.

A Few Important Points

Let your parents or guardians know where and when you are sitting. Always leave the following information with them:

• Name, address, and phone number of the people for whom you are sitting.
• Time you will be brought home or need your parent, guardian, or other family member to pick you up from the sitting job.
  • Arrange your own transportation to get to the location and to return home. If a family member is not picking you up, call home to let someone know that you are on your way.
• Never accept rides from people who have been drinking alcohol or using drugs.
• Consider creating an agreed-on code word with your family so that if you say, for example, “giggles,” they know to come get you right away.
• Be sure you have an escort home. This should be either a parent, guardian, or family member. Never go home alone from a night job.
• Learn how to use the electronic security system if the home has one.
• Let the parents or guardians for whom you are sitting know if you have a curfew. Ask them to call if they are running late.
• Call the child’s parents or guardians about a problem such as the following:
  • If a child has been crying for longer than 20 minutes and you can’t figure out what’s wrong.
  • If a child develops a fever, vomits, or is injured (more than a superficial scrape).
  • Anytime a situation develops that you feel you can’t handle without help.
  • Have a backup plan if you are unable to reach the child’s parent. You should also call your own parents or guardians for advice and assistance if something arises.

What can be done about a chronically disobedient child?

From time to time most children defy the wishes of their parents. This is a part of growing up and testing adult guidelines and expectations. It is one way for children to learn about and discover their own selves, express their individuality, and achieve a sense of autonomy. As they stretch their independent wings and engage in minor conflicts with their parents, they discover the boundaries of their parents’ rules and of their own self-control.

Sometimes, however, these conflicts are more than occasional disturbances and become a pattern for how parents and children interact. Disobedience can have a variety of causes. At times, it is due to unreasonable parental expectations. Or it might be related to the child’s temperament, or to school problems, family stress, or conflicts between his parents.

What parents can do

When you have a chronically disobedient child, examine the possible sources of his inner turmoil and rebelliousness. If this has been a persistent pattern that has continued into middle childhood, closely evaluate your own family situation:

• How much respect do your family members show for one another?
• Do they respect one another’s privacy, ideas, and personal values?
• How does the family work out its conflicts?
• Are disagreements resolved through rational discussion, or do people regularly argue or resort to violence?
• What is your usual style of relating to your child, and what forms does discipline usually take?
• How much spanking and yelling is there?
• Do you and your child have very different personalities and ways of getting along in the world that cause friction between you?
• Is your child having trouble succeeding at school or developing friendships?
• Is the family undergoing some especially stressful times?

If your child has only recently started to demonstrate disrespect and disobedience, tell him that you have noticed a difference in his behavior and that you sense he is unhappy or struggling. With his help, try to determine the specific cause of his frustration or upset. This is the first step toward helping him change his behavior.

Your reaction matters

If you react to your child’s talking back by exploding or losing your temper, he will respond with disobedience and disrespect. By contrast, he will become more obedient when you remain calm, cooperative, and consistent. He will learn to be respectful if you are respectful toward him and others in the family. If he becomes disobedient and out of control, impose a timeout until he calms down and regains self-control.

When your child is obedient and respectful, compliment him for that behavior. Reward the behavior you are seeking, including cooperation and resolution of disagreements. These positive efforts will always be much more successful than punishment.

When to seek additional help

For some disobedient children, you may need to obtain professional mental health treatment. Here are some situations where outside counseling may be necessary:

• If there is a persistent, long-standing pattern of disrespect of authority both at school and at home.
• If the patterns of disobedience continue in spite of your best efforts to encourage your child to communicate his negative feelings
• If a child’s disobedience and/or disrespect is accompanied by aggressiveness and destructiveness
• If a child shows signs of generalized unhappiness — perhaps talking of feeling blue, unliked, friendless, or even suicidal
• If your family has developed a pattern of responding to disagreements with physical or emotional abuse
• If you or your spouse or child use alcohol or other drugs to feel better or cope with stress

If relationships within your family show signs of difficulty and lack of cooperation, then family therapy may be indicated. By dealing with and resolving these problems at a young age, you can minimize and even prevent more serious struggles that may emerge as your children reach adolescence. The key is early identification and treatment.

Having a gender diverse child can be very stressful for parents and caregivers, as they deal with uncertainty and navigate schools, extended families, sibling relationships, and the world around them. There are several national and international organizations that support families with gender diverse children, as well as excellent books. Many parents and siblings also find it helpful to meet with a mental health care professional or other families in a support group setting.

Resources for Parents:

• Gender Diverse & Transgender Children
• Parenting a Gender Diverse Child: Hard Questions Answered
• PFLAG
• Family Acceptance Project
• Gender Spectrum
• Trans Youth Family Allies
• Explore: Parenting (Human Rights Campaign)
• The Transgender Child: A Handbook for Families and Professionals by Stephanie A. Brill and Rachel Pepper (Cleis Press, 2008)
• The Transgender Teen: A Handbook for Parents and Professionals Supporting Transgender and Non-Binary Teens by Stephanie A. Brill and Rachel Pepper (Cleis Press, 2008) 

Resources for Teachers & Schools:

• Gender Spectrum
• GLSEN
• Schools in Transitions (Gender Spectrum)
• LGBT Youth Resourses (American Physchological Association)
• Welcoming Schools (a project of the Human Rights Campaign Foundation)
• LQBTQ Resources for Professionals (Advocates for Youth) 
• The Transgender Child: A Handbook for Families and Professionals by Stephanie A. Brill and Rachel Pepper (Cleis Press, 2008)
• The Transgender Teen: A Handbook for Parents and Professionals Supporting Transgender and Non-Binary Teens by Stephanie A. Brill and Rachel Pepper (Cleis Press, 2008) 

Resources for Youth:  

• Trevor Project
• Trans Student Educational Resources
• Youth Pride
• The Gender Book
• Living Openly: Coming Out Guides and Resources (Human Rights Campaign)
• The Gender Quest Workbook: A Guide for Teens and Young Adults Exploring Gender Identity by Rylan Jay Testa (Instant Help, 2015)

Advocacy Organizations:  

• The Human Rights Campaign
• National Center for Transgender Equality
• Trans Youth Equality Foundation  
• GLAD 
• The Transgender Law and Policy Institute 
• Lambda Legal

For more information or help finding a support group for yourself or your child, please talk with your child’s pediatrician. 

What is the best way to handle a “difficult” child?

Here are some general strategies and solutions to help you live with a youngster with bothersome temperament traits:

1. First, recognize that much of your child’s behavior reflects his temperament.
2. Establish a neutral or objective emotional climate in which to deal with your child. Try not to respond in an emotional and instinctive manner, which is unproductive.
3. Don’t take your child’s behavior personally. Temperament is innate, and your child probably is not purposely trying to be difficult or irritating. Don’t blame him or yourself.
4. Try to prioritize the issues and problems surrounding your child. Some are more important and deserve greater attention. Others are not as relevant and can be either ignored or put “way down the list.”
5. Focus on the issues of the moment. Do not project into the future.
6. Review your expectations of your child, your preferences and your values. Are they realistic and appropriate? When your youngster does something right, praise him and reinforce the specific behaviors that you like.
7. Consider your own temperament and behavior, and how they might also be difficult. Think how you might need to adjust yourself a bit to encourage a better fit with your child.
8. Anticipate impending high-risk situations, and try to avoid or minimize them. Accept the possibility that this may be a difficult day or circumstance, and be prepared to make the best of it.
9. Find a way to get some relief for yourself and your child by scheduling some time apart.
10. Seek professional help, when needed, from your pediatrician or another expert in child behavior.

What are the signs of low self-esteem?

To help you determine if your child has low self-esteem, watch for the following signals. They could be everyday responses to how your child relates to the world around him, or they might occur only occasionally in specific situations. When they become a repeated pattern of behavior, you need to become sensitive to the existence of a problem.

• Your child avoids a task or challenge without even trying. This often signals a fear of failure or a sense of helplessness.
• He quits soon after beginning a game or a task, giving up at the first sign of frustration.
• He cheats or lies when he believes he’s going to lose a game or do poorly.
• He shows signs of regression, acting babylike or very silly. These types of behavior invite teasing and name-calling from other youngsters, thus adding insult to injury.
• He becomes controlling, bossy, or inflexible as ways of hiding feelings of inadequacy, frustration, or powerlessness.
• He makes excuses (“The teacher is dumb”) or downplays the importance of events (“I don’t really like that game anyway”), uses this kind of rationalizing to place blame on others or external forces.
• His grades in school have declined, or he has lost interest in usual activities.
• He withdraws socially, losing or having less contact with friends.
• He experiences changing moods, exhibiting sadness, crying, angry outbursts, frustration, or quietness.
• He makes self-critical comments, such as “I never do anything right,” “Nobody likes me,” “I’m ugly,” “It’s my fault,” or “Everyone is smarter than I am.”
• He has difficulty accepting either praise or criticism.
• He becomes overly concerned or sensitive about other people’s opinions of him.
• He seems to be strongly affected by negative peer influence, adopting attitudes and behaviors like a disdain for school, cutting classes, acting disrespectfully, shoplifting, or experimenting with tobacco, alcohol, or drugs.
• He is either overly helpful or never helpful at home.

My child is shy and does not make friends easily. Should I be worried?

Although childhood shyness is commonplace, it concerns many parents, especially those who place great value on sociability. Some children become shy because of harsh life experiences, but most are born that way. For some middle-years children, social situations and interactions can be terrifying. When they come in contact with new children, they rarely feel at ease. Typically, they are unwilling or unable to make the first move, preferring to abandon a potential friendship rather than reach out to the unfamiliar. A few of these timid children may be emotionally distressed, but they are in the minority. In fact, some children are just naturally withdrawn and slow to warm up in new situations.

Severe shyness

In some cases, shyness can be disabling. Extremely shy children often do not adapt as well as most of their peers in the classroom and on the playground. The longer this pattern exists, the more difficult it is for children to change. Shyness can increasingly lead to purposeful avoidance of social settings and withdrawal, and ultimately create an inability to function effectively as a social adult. If your child’s shyness becomes debilitating, it may be caused by an anxiety disorder or a temperament pattern; then an evaluation by a child mental-health professional would be helpful.

Time to adjust

Most shy children, however, do well in relationships and in social settings once they are past an initial period of adjustment. Children who have difficulty establishing and maintaining relationships even after the ice-breaking period merit more concern and attention. Eventually, many (and perhaps most) children who are shy learn to conquer their tendency. They function in ways that are not obviously timid or reticent, although inside they may still feel shy. Parents can gently guide or direct their children into social situations in which they can learn to successfully interact.

Rejected children

Most children want to be liked, yet some are slow in learning how to make friends. Others may long for companionship but might be excluded from one group or another, perhaps picked on because of the way they dress, poor personal hygiene, obesity, or even a speech impediment. Youngsters are often rejected by peers if they exhibit disruptive or aggressive behavior. Still other children may hover on the fringes of one clique or another but never really get noticed. These neglected children spend most of their time alone.

Rejected youngsters are overtly disliked by their peers and are constantly made to feel unwelcome. They often tend to be aggressive or disruptive and very sensitive to teasing. They may be bullies and rule-violators, or they may be so unsure of themselves that they invite the rejection of others. They might also be rejected because of their impulsive and disruptive behavior. Some of them may have attention deficits or hyperactivity.

Neglected children

Neglected children, on the other hand, are not overtly rejected and teased but are often just ignored, forgotten, not invited to parties, and are the last ones picked for a team. These youngsters may be perceived as loners but might be passive and detest their isolation. Others may actually prefer to be alone. This latter group might be respected and admired by others but simply feel more comfortable in solitary pursuits or in spending time with parents, siblings other adults, or even pets. They may also lack the social skills and self-confidence necessary for them to enter social arenas, often because of limited social experiences. Or they may be more shy, quiet and reserved than most of their peers.

How parents can help

Successful peer interactions require a variety of skills and special ways of interacting. Parents should look for these skills in their children and help develop and model them.

• Coping with failure and frustration
• Coping with success
• Coping with change and transitions
• Coping with rejection and teasing
• Managing anger
• Using humor
• Forgiving
• Apologizing
• Refusing to accept a dare
• Thinking up fun things to do
• Expressing affection
• Avoiding dangerous situations
• Defending himself
• Comforting someone
• Sharing
• Making requests
• Self-disclosure
• Giving a compliment
• Expressing appreciation
• Coping with loss
• Sticking up for a friend
• Doing favors
• Asking for help
• Helping others
• Keeping secrets

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Did you know that injuries are the greatest threat to the life and health of your child? Injuries are the cause of death of school-aged children. Yet you can prevent most injuries!

At age 8, children are now taking off on their own. They look to friends for approval. They try to do daring things. They may not want to obey grown-up rules. But your child can learn safety rules with your help and reminders. Your child now goes out more without you and could drown, be hurt on a bike, or be hit by a car. And your child still can be hurt or killed while riding in a car if he is not buckled by a seat belt.

Sports Safety

Ask your doctor which sports are right for your child. Be sure your child wears all the protective equipment made for the sport, such as shin pads, mouth guards, wrist guards, eye protection, or helmets. Your child’s coach also should be able to help you select protective equipment.

Water Safety

At this age, your child is not safe alone in water, even if he or she knows how to swim. Do not let your child play around any water (lake, stream, pool, or ocean) unless an adult is watching. Never let your child swim in canals or any fast-moving water. Teach your child to always enter the water feet first.

And Remember Bike Safety

Make sure your child always wears a helmet while riding a bike. Now is the time to teach your child “Rules of the Road.” Be sure he or she knows the rules and can use them. Watch your child ride. See if he or she is in control of the bike. See if your child uses good judgment. Your 8-year-old is not old enough to ride at dusk or after dark. Make sure your child brings the bike in when the sun starts to set.

Car Safety

NEVER start the car until you’ve checked to be sure that your child is properly restrained in a booster seat. Your child should use a booster seat until the lap belt can be worn low and flat on the hips and the shoulder belt can be worn across the shoulder rather than the face or neck (usually at about 80 pounds and about 4 feet 9 inches tall). Be sure that you and all others in the car are buckled up, too. Install shoulder belts in the back seat of your car if they are not already there. Serious injuries can occur with lap belts alone. The safest place for all children to ride is in the back seat.

Firearm Hazards

It is best to keep all guns out of your home. If you choose to keep a gun, store it unloaded and in a locked place, separate from ammunition. Ask if the homes where your child visits or is cared for have guns and how they are stored. Your child is at greater risk of being shot by himself, his friends, or a family member than of being injured by an intruder.​

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Did you know that injuries are the greatest threat to the life and health of your child? Injuries are the leading cause of death of school-aged children. Yet you can prevent most major injuries!

At age 6, your child will become more independent. He or she will be able to do more things that are dangerous. Your child will try to prove that he or she is grown up. But children still aren’t good at judging sound, distance, or the speed of a moving car at this age. Your child can learn a few simple things to do for protection, but you must still be in charge of his or her safety.

Fire Safety

Make an escape plan in case of fire in your home. Your fire department can tell you how. Teach your child what to do when the smoke alarm rings. Practice what you and your child would do if you had a fire.

Do not smoke in your home. Most home fires are caused by a lit cigarette that has not been put out completely.

Install smoke alarms on every level in your house, especially in furnace and sleeping areas, and test the alarm every month. It is best to use smoke alarms that use long-life batteries, but if you do not, change the batteries once a year.

Firearm Hazards

Children in homes where guns are present are in more danger of being shot by themselves, their friends, or family members than of being injured by an intruder. Even if your child is taught never to touch a gun, if there is a gun in the house a child’s curiosity can lead to severe injury or deathIt is best to keep all guns out of the home. Handguns are especially dangerous. If you choose to keep a gun, keep it unloaded and in a locked place, with ammunition locked separately. Ask if the homes where your child visits or is cared for have guns and how they are stored.

Bike Safety

Protect your child from bad head injuries or even death. Make sure your child wears a properly fitted, approved helmet every time she rides a bike. Never let your child ride in the street. Your child is too young to ride in the street safely!

Street Safety

Never let your child play near the street. Your child may dart out into traffic without thinking. The park or playground is the best place to play. Begin to teach your child safe street habits. Teach your child to stop at the curb, then look to the left, to the right, and back to the left again. Teach your child never to cross the street without a grown-up.

And Remember Car Safety

Your child must now use a booster seat in the car. Always check to be sure that he or she is correctly restrained in the booster seat before you start the car. Your child should use a booster seat until the lap belt can be worn low and flat on the hips and shoulder belt can be worn across the shoulder rather than the face or neck (usually at about 4 feet 9 inches tall and between 8 and 12 years old). The safest place for all children, even through school age, is in the back seat of the car. Set a good example. ​Make sure you and other adults buckle up, too!

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Did you know that injuries are the greatest threat to the life and health of your child? Injuries are the leading cause of death of school-aged children. Yet you can prevent most major injuries if you and your child take a few simple steps.

At age 10, children will do more things away from home. They will spend more time on a bike or in a car and will not see the need for adults to watch over them. You must take charge; you must remind your child of safety! It takes only a few steps to prevent major, common injuries. 

Firearm Hazards

It is best to keep all guns out of your home. Handguns are especially dangerous. If you choose to keep a gun, store it unloaded and in a locked place, separate from ammunition. Your child is in more danger of being shot by himself, his friends, or a family member than of being injured by an intruder. 

• Ask if the homes where your child visits have a gun and how it is stored.
• Talk to your child about guns in school or on your streets.
• Find out if your child’s friends carry guns.  

Sports Safety

At this age your child may be playing baseball, soccer, or other sports. Ask your doctor which sports are right for his or her age.

Be sure your child wears the protective equipment made for that sport, such as:

• Shin pads
• Mouth guards
• Wrist guards
• Eye protection
• Helmets

Ask your child’s coach what is needed.  

And Remember Car Safety

Your child must buckle the seat belt EVERY TIME he or she rides in any car. Booster seats should be used until the lap belt can be worn low and flat on your child’s hips and the shoulder belt can be worn across the shoulder rather than the face or neck (usually at about 80 pounds and about 4 feet 9 inches tall). Remind your child to buckle up when riding with others. Ask your child to remind you to buckle up, too! Install shoulder belts in the back seat of your car if they are not already there. Serious injuries can happen to your child when a lap belt is used alone. The safest place for all children to ride is in the back seat. 

Bike Safety

Your child may want to ride his or her bike farther away from home. Teach your child the “Rules of the Road” and be sure your child knows them. You must watch your child to be sure he or she can handle a bike safely. Make sure your child always wears a helmet while riding a bike. It is still very dangerous for your child to ride at dusk or after dark. Make sure your child brings in the bike as soon as the sun starts to set.

Emergencies

Would you be able to help your child in case of an injury? Put emergency numbers by or on your phone today. Learn first aid and CPR. Be prepared…..for you child’s sake!  ​

Parenting a gender-diverse child can leave some parents with a lot of questions and concerns for their child’s wellbeing. Research suggests that gender is something we are born with; it can’t be changed by any interventions. So, rather than predicting or preventing who a child may become, it is better to value them for who they are now, even at a young age. This approach fosters secure attachment and resilience.This article is also available in other languages. See links to download at bottom.

The American Academy of Pediatrics recommends parents make their home a place where their child feels safe and loved unconditionally for who they are. Here are frequently asked questions from parents about topics related to gender identity.

Will my child grow up to be transgender?

• By preschool, kids start to recognize gender differences, both physically and socially. They also start to develop feelings, thoughts, and fantasy play that allows them to explore their gender. It is important to recognize that cross-gender preferences and play is a normal part of this exploration process, regardless of their future gender identity. However, research suggests that children who assert a gender-diverse identity know their gender as clearly and consistently as other kids do and benefit from the same level of support, love, and social acceptance.

It used to be the case that for children, gender-diverse assertions were seen as “possibly true” and not acknowledged until they were considered old enough to know for sure. This does not serve the child, because it increases discomfort without offering critical support and understanding. The best approach for parents is to love and appreciate their child as they are in the moment.

What caused my child to identify with a different gender?

• While we do not understand why some children identify as gender-diverse or transgender, research suggests that gender identity involves biology, development, socialization and culture. There is no evidence that parenting is responsible for a child having a gender identity that is not in line with his or her gender assigned at birth. Childhood trauma does not cause a child to become gender-diverse, transgender, or impact their sexual orientation. Variations in gender identity and expression are normal aspects of human diversity.

If a mental health issue exists, it most often stems from other factors, such as bullying, discrimination, and other negative experiences. Being seen as “different” is not easy, especially in childhood, and may contribute to teasing or bullying. If this is happening, speak with the child’s teacher and the school to create a plan to prevent bullying. The most important thing to remember is to support, love, and accept your child as he or she is.

My gender-diverse child is still exploring their gender identity, but really distressed about puberty. What can we do?

• During puberty, hormone “blockers” can be used to delay physical development. This is reversable and gives an individual more time to explore their gender identity. Available data show that delaying puberty in transgender children generally leads to improved psychological functioning in adolescence and young adulthood. For those who were assigned female at birth, periods may be particularly distressing. Periods can be reduced or blocked with “blockers” or with certain contraceptive agents.

What treatments are available for children who identify as transgender? What does the process include?

• As gender-diverse individuals express their underlying gender identity, they engage in a gender affirmation process (sometimes referred to as “gender transition”). This process involves reflection, acceptance, and, for some, intervention. There is no prescribed path, sequence or endpoint, but the process may include any of the following components:
  
  • Social affirmation: This is a reversible intervention in which children and adolescents express their asserted gender identity by adapting hairstyle, clothing, pronouns, name, etc.
  • Legal affirmation: When elements of a social affirmation, such as name and gender marker, become official on legal documents (birth certificates, passports, school documents, etc.). The steps to doing this vary from state to state, and often specific documentation from the child’s health providers is required.
  • Medical affirmation: This is the process of using hormones to allow adolescents who have started puberty to develop characteristics of the opposite gender. Some changes are partially reversible if hormones are stopped, but others are not.
  • Surgical affirmation: Surgical approaches are used most often in adults, but occasionally on a case-by-case basis in older adolescents, to also modify certain characteristics, such as hair distribution, chest, or genitalia. These changes are not reversible.

The decision of whether and when to initiate gender-affirmative treatments is personal and involves careful consideration of the risks, benefits and other factors unique to each patient and family. The gender affirmation process is best when facilitated through collaboration between the patient, their family, their primary care provider, a mental health provider (preferably with expertise in caring for transgender and gender diverse youth), social supports, and a pediatric endocrinologist or adolescent medicine gender specialist, if available.

Ask your pediatrician if a telehealth visit by phone or video call is an option. Your child may feel more comfortable talking to their doctor from home. For teens, the telehealth visit should take place in as private of a place as possible so they can have a one-on-one conversation with the doctor. You can make a plan with the doctor about talking before or after they talk to your teen privately. If it’s a video call, and your child or teen would prefer to have the camera off, they can ask their doctor if that is okay. Telehealth visits can also be used for follow-up visits to check on your child’s progress.

If my child says they are “gender fluid” does that just mean they are confused?

• No. For some people gender identity can be fluid, shifting between more masculine, feminine, in between or something else, in different contexts or at different times. This may also be part of a person’s personal journey or exploration of gender.

Can my child become transgender because of their friends or things they see online? What if there were no earlier signs?

• Being transgender is not contagious. Some children and teens may not have confronted or feel they have to suppress gender-diverse traits until they find nonjudgmental and affirming peers or online communities. If this is discovered by parents, or the child discloses such suppressed feelings, it may seem sudden and unexpected.