"With the level of someone like Miley, it can all be overwhelming," says manager Susie Mains, co-owner of kids boutique Trilogy Talent.

And then there's the fact that child stars at age 9 can be completely different people at age 12.

"Publicists have to approach dealing with kids very differently," Mains says. "Kids change, grow older and have to keep proving themselves. It's not like an adult who continues to build on who they are."