Mental Disorders in Infancy, Childhood, and Adolescence

1. Mental Disorders in Infancy, Childhood, and Adolescence Psychiatric disorders are not diagnosed as easily in children as they are in adults. Children usually lack the abstract cognitive abilities and verbal skills to describe what is happening. Because they constantly are changing and developing children have no sense of a stable, normal self to allow them to discriminate unusual or unwanted symptoms from normal feelings and sensations

2. Children and adolescents experience some of the same mental health problems as adults, such as moodand anxiety disorders, and are diagnosed with these disorders using the same criteria as for adults. • Eating disorders, especially anorexia , usually begin in adolescence and continue into adulthood..

3. ➤ DISORDERS FIRST DIAGNOSED IN INFANCY, CHILDHOOD, AND ADOLESCENCE MENTAL RETARDATION • Mild • Moderate • Severe • Profound LEARNING DISORDERS • Reading disorder • Mathematics disorder • Disorder of written expression MOTOR SKILLS DISORDER • Developmental coordination disorder COMMUNICATION DISORDERS • Expressive language disorder • Mixed receptive and expressive language disorder • Phonologic disorder • Stuttering

4. PERVASIVE DEVELOPMENTAL DISORDERS • • Autistic disorder • (also called autism); more recently described as "mindblindedness“ • is a neurological and developmental disorder that usually appears during the first three years of life. • A child with autism appears to live in their own world, showing little interest in others and a lack of social awareness. • The focus of an autistic child is a consistent routine and includes an interest in repeating odd and peculiar behaviors. • Autistic children often have problems in communication, avoid eye contact and show limited attachment to others.

5. PERVASIVE DEVELOPMENTAL DISORDERS • • Rett’s disorder: • Rettsyndrome is a neurodevelopmenal disorder that affects girls almost exclusively. • It is characterized by normal early growth and development followed by a slowing of development, loss of purposeful use of the hands, distinctive hand movements, slowed brain and head growth, problems with walking, seizures, and intellectual disability • DEFICIT AND DISRUPTIVE BEHAVIOR DISORDERS • • Attention deficit hyperactivity disorder • • Conduct disorder • FEEDING AND EATING DISORDERS • • Pica (is characterized by an appetite for substances that are largely non-nutritive) • • Rumination disorder (Rumination disorder is a condition in which a person keeps bringing up food from the stomach into the mouth (regurgitation) and re chewing the food.)

6. PERVASIVE DEVELOPMENTAL DISORDERS ELIMINATION DISORDERS • Encopresis (is voluntary or involuntary fecal soiling in children who have usually already been toilet trained.) • Enuresis (is a repeated inability to control urination) OTHER DISORDERS OF INFANCY, CHILDHOOD, OR ADOLESCENCE • Separation anxiety disorder (is a psychological condition in which an individual experiences excessive anxiety regarding separation from home or from people to whom the individual has a strong emotional attachment (e.g. a parent, caregiver, significant other or siblings)

7. MENTAL RETARDATION The essential feature of mental retardation is below average intellectual functioning (IQ less than 70) accompanied by significant limitations in areas of adaptive functioning such as communication skills, self-care, home living, social or interpersonal skills, use of community resources, self-direction, academic skills, work, leisure, and health and safety. The degree of retardation is based on IQ and greatly affects the person’s ability to function: • Mild retardation: IQ 50 to 70 • Moderate retardation: IQ 35 to 50 • Severe retardation: IQ 20 to 35 • Profound retardation: IQ less than 20

8. LEARNING DISORDERS • A learning disorder is diagnosed when a child’s achievement in reading, mathematics, or written expression is below that expected for age, formal education, and intelligence. • Learning problems interfere with academic achievement and life activities requiring • Reading and written expression disorders usually are identified in the first grade; math disorder may go undetected until the child reaches fifth grade. About 5% of children in U.S. public schools are diagnosed with a learning disorder. • The school dropout rate for students with learning disorders is 1.5 times higher than the average rate for all students reading, math, or writing

9. Low self-esteem and poor social skills are common in children with learning disorders. As adults, some have problems with employment or social adjustment; others have minimal difficulties. • Early identification of the learning disorder, effective intervention, and no coexisting problems are associated with better outcomes. • Children with learning disorders are assisted with academic achievement through special education classes in public schools.

10. MOTOR SKILLS DISORDER • The essential feature of developmental coordination disorder is impaired coordination severe enough to interfere with academic achievement or activities of daily living (ADLs) (APA, 2000). • This diagnosis is not made if the problem with motor coordination is part of a general medical condition such as cerebral palsy or muscular dystrophy. This disorder becomes evident as a child attempts to crawl or walk or as an older child tries to dress independently or manipulate toys such as building blocks. • Developmental coordination disorder often coexists with a communication disorder.

11. ◗ COMMUNICATION DISORDERS • A communication disorder is diagnosed when a communication deficit is severe enough to hinder development, academic achievement, or ADLs including socialization. • Expressive language disorder involves an impaired ability to communicate through verbal and sign language. The child has difficulty learning new words and speaking in complete and correct sentences; his or her speech is limited. Mixed receptive expressive language disorder includes the problems of expressive language disorder along with difficulty understanding (receiving) and determining the meaning of words and sentences. Both disorders can be present at birth (developmental) or they may be acquired as a result of neurologic injury or insult to the brain. • Phonologic disorder involves problems with articulation (forming sounds that are part of speech). • Stuttering is a disturbance of the normal fluency and time patterning of speech. Phonologic disorder and stuttering run in families and occur more frequently in boys than in girls.

12. ◗ ELIMINATION DISORDERS • Encopresis is the repeated passage of feces into inappropriate places, such as clothing or the floor, by a child who is at least 4 years of age either chronologically or developmentally. It is often involuntary, but it can be intentional. Involuntary encopresis usually is associated with constipation that occurs for psychological, not medical, reasons. Intentional encopresis often is associated with oppositional defiant disorder or conduct disorder. • Enuresis is the repeated voiding of urine during the day or at night into clothing or bed by a child at least 5 years of age either chronologically or developmentally. • Most often enuresis is involuntary; when intentional, it is associated with a disruptive behavior disorder. Seventy-five percent of children with enuresis have a first-degree relative who had the disorder. • Most children with enuresis do not have a coexisting mental disorder. • Both encopresis and enuresis are more common in boys than in girls; 1% of all 5 year olds have encopresis and 5% of all 5 year olds have enuresis.

13. ◗ OTHER DISORDERS OF INFANCY, CHILDHOOD, OR ADOLESCENCE SEPARATION ANXIETY DISORDER • Separation anxiety disorder is characterized by anxiety exceeding that expected for developmental level related to separation from the home or those to whom the child is attached (APA, 2000). • When apart from attachment figures, the child insists on knowing their whereabouts and may need frequent contact with them such as phone calls. These children are miserable away from home and may fear never seeing their homes or loved ones again. • They often follow parents like a shadow, will not be in a room alone, and have trouble going to bed at night unless someone stays with them. • Fear of separation may lead to avoidance behaviors such as refusal to attend school or go on errands. • Separation anxiety disorder often is accompanied by nightmares and multiple physical complaints such as headaches, nausea, vomiting, and dizziness.