Houston Chronicle

If Beth Steele could have bestowed one quality on her daughter, it would have been self-esteem. So she hugged Megan and kissed her and read to her and told her she was pretty and special.

But none of this nurturing was insurance enough when kids in the nursery school class wouldn't play with Megan.

Telling the story still raises a lump in her mother's throat.

Too much biting. Too many fights. Her behavior was frantically active. A year ago, when Megan was 2, she was expelled from nursery school.

Megan's story is not unique.

In child care settings through out the country, children are being expelled at tender ages for behaviors that look very much the same as Megan's: hyperactivity, temper tantrums, and sometimes aggression that is frighteningly intense.

The causes are many: the stress of family woes, the ache of abuse, the gnawing hole of needs unmet. The outside world exacts its toll. But so can the child's inherent biologic vulnerability to depression, attention deficit hyperactivity disorder (ADHD) or even major mental illness.

As many as one in five children from birth through 17years suffer from a diagnosable mental, emotional or behavioral disorder, according to a Substance Abuse and Mental Health Services Administration estimate. Yet only an estimated one child in three receives mental health services.

Early childhood educators and mental health professionals preach intervention with behavior modification, therapy, medication or all of the above, to steady a child as early as possible. When children reach school age, they say, the same problems get only more involved.

If successful intervention doesn't take place in the early years, often it is the public schools that must cope with the troubled behavior– while the child's education usually suffers. By the time a child reaches the turbulence of adolescence, mental health issues may have escalated, further complicated by drug abuse, criminal activity or ruptured family ties.

In a six-month investigation, the Chronicle talked to families, educators, mental health professionals, researchers and the children themselves to document the breadth and gravity of children's mental health issues.

Part I of the resulting three-part series, running today in the Lifestyle section, looks at the problems of the very young child that are surfacing in child care settings. Subsequent installments, to run in June and August, will look at how the public schools cope with children who have mental health issues and how adolescents and their families fare when mental health problems even more complex.

Getting help can make all the difference in a child's life. But it isn't always easy for parents to do.

When Megan was asked to leave her day care, Steele tried a series of nannies. When they couldn't deal with Megan's behavior either, Steele realized she was seeing a destructive pattern. She sought help, first consulting a pediatric neurologist and then a psychiatrist.

At 3, on medication for ADHD, Megan is no longer so frantic. She's still very active.

Copyright 2003. Used with permission from the Houston Chronicle.