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Mental disorders diagnosed in childhood
| Field | Value |
|---|---|
| name | Mental disorders diagnosed in childhood |
| field | Psychiatry |
Mental disorders diagnosed in childhood can be neurodevelopmental, emotional, or behavioral disorders. These disorders negatively impact the mental and social wellbeing of a child, and children with these disorders require support from their families and schools. Childhood mental disorders often persist into adulthood. These disorders are usually first diagnosed in infancy, childhood, or adolescence, as laid out in the DSM-5-TR and in the ICD-11.
Intellectual disability
DSM-5-TR
The diagnostic criteria necessary in order to diagnose intellectual disability consists of: :A. Deficits in intellectual functions, such as reasoning, problem solving, planning, abstract thinking, and learning from experience. These deficits are confirmed through clinical assessments and individualized standardized tests. :B. Deficits in adaptive functioning that cause failure to perform sociocultural and developmental standards for independence and social responsibility. Without support, these deficits can lead to limited functioning in areas of daily life, such as in communication and independent living. :C. These symptoms must have onset during the developmental period. Intellectual disability is specified by severity, with the varying severities being mild, moderate, severe, and profound. These severity levels are determined by how well one is able to function intellectually, socially, and independently.
Cause
Intellectual disability in children can be caused by genetic or environmental factors. The individual could have a natural brain malformation or pre or postnatal damage done to the brain caused by drowning or a traumatic brain injury, for example. Nearly 30 to 50% of individuals with intellectual disability will never know the cause of their diagnosis even after thorough investigation.
Prenatal causes of intellectual disability include:
- Congenital infections such as cytomegalovirus, toxoplasmosis, herpes, syphilis, rubella and human immunodeficiency virus
- Prolonged maternal fever in the first trimester
- Exposure to anticonvulsants or alcohol
- Untreated maternal phenylketonuria (PKU)
- Complications of prematurity, especially in extremely low-birth-weight infants
- Postnatal exposure to lead Single-gene disorders that result in intellectual disability include:
- Fragile X syndrome
- Neurofibromatosis
- Tuberous sclerosis
- Noonan's syndrome
- Cornelia de Lange's syndrome These single-gene disorders are usually associated with atypical physical characteristics. About 1/4 of individuals with intellectual disability have a detectable chromosomal abnormality. Others may have small amounts of deletion or duplication of chromosomes, which may go unnoticed and therefore, undetermined.
Symptoms
As an infant, the individual with intellectual disability might sit up, crawl, or walk later than what is developmentally appropriate. They may have trouble talking or learn to talk late. The infants with intellectual disability will probably have trouble learning to potty train, feeding themselves, remembering things, with problem-solving, and may have recurrent explosive tantrums.
Some symptoms that a child with intellectual disability might show are continued infant-like behavior, a lack of curiosity, the inability to meet educational demands, learning ability that is below average, and the failure to meet developmentally appropriate intellectual goals. Some children with severe intellectual disability may have seizures, mobility problems, vision problem, or hearing problems.
Treatment
There is no treatment for intellectual disability but there are plenty of services offered for those diagnosed to help them function in their everyday lives. Professionals will sometimes work out an Individualized Family Service Plan (IFSP), which documents the child's needs, as well as the services that would best help them specifically. Speech, physical, and occupational therapy may be offered. Intellectually disabled children can be placed in special education classes through the public school system, where the school and parents will map out an Individualized Education Program (IEP). This program lays out all of the services and classes the child will become involved in during their time in school.
Learning disorders
DSM-5
The DSM-5 has the diagnosis of Specific Learning Disorder, which is a disorder where one has difficulties in being able to learn and use academic skills. Specific learning disorder has specifiers for the areas that one faces difficulties in, with those specifiers being impairment in reading, impairment in writing, and impairment in mathematics.
Cause
Learning disorders are believed to be caused by a nervous system abnormality. The abnormality could either be in the structure of the brain or in the functioning of chemicals in the brain. Because of this, individual has problems receiving, processing or communicating information normally. Some causes of the nervous system abnormality include problems during pregnancy, birth or early infancy, brain trauma at a young age, exposure to toxins, and prematurity.
Symptoms
Children with a learning disorder may display the following traits:
- Difficulties reading words, such as reading slowly, having difficulty sounding out words, and reading words incorrectly.
- Difficulty understanding what they have read.
- Difficulties with accurately spelling words.
- Difficulties with writing, such as grammatical errors and issues with origination and clarity of writing.
- Difficulties with number sense, number facts, calculations, or mathematical reasoning.
Treatment
There is no treatment that can cure a learning disorder, but intervention and accommodations can help those with learning disorders cope with the difficulties they may face. Special education programs in schools are able to give children with learning disorders an environment that is more appropriate for them and minimizes the issues they may face in a standard classroom. Individual education programs (IEPs) are also used in order to give children specific accommodations for their personal difficulties.
Motor disorders
DSM-5
The motor disorders described in the DSM-5 are Developmental Coordination Disorder and Stereotypic Movement Disorder. Developmental Coordination Disorder is a disorder where one's acquisition and ability to perform motor skills is below the level that is normal for someone their age. These difficulties with motor skills may include clumsiness, slowness, or inability to correctly perform motor tasks. Stereotypic Movement Disorder is characterized by repetitive motions that are seemingly driven and purposeless. These repetitive movements lead to disruptions in daily life, and may possibly be self-injurious.
Cause
The cause behind motor disorders is not exact, but the cause is usually genetic or environmental. Motor skills disorders are often associated with physiological or developmental abnormalities including ADHD, learning disorders, developmental disabilities and prematurity.
Symptoms
In infants, some babies may be hypotonia, a loose and floppy baby, or hypertonia, a stiff and rigid baby. Toddlers may have trouble feeding themselves or may stand, sit or walk later than what is developmentally normal. Other signs of motor skills disorders may be children that are clumsy or have excessive accidents, such as knocking things over. Children who have trouble with complex physical activities such as dancing, swimming, catching or throwing a ball, or drawing may avoid these activities completely.
Treatment
Different therapies are offered to children with motor skills disorders to help them improve their motor effectiveness. Many children work with an occupational and physical therapist, as well as educational professionals. This helpful combination is beneficial to the child. Cognitive therapy, sensory integration therapy, and kinesthetic training are often favorable treatment for the child.
Communication disorders
DSM-5
Communication disorders inhibit one's abilities in various areas of communication, such as language, speech, and non-verbal communication. Those with language disorder have deficits in using language, whether it be verbally, written, or signed. These deficits include a limited vocabulary, struggles with sentence structure and forming sentences, and limited ability to be able to describe topics or hold a conversation. Speech sound disorder is a disorder that impairs one's ability to produce sounds correctly and leads to limited speech intelligibility. Childhood-onset fluency disorder, more commonly known as stuttering, disturbs the normal flow and timing of speech. These disturbances may be sound and syllable repetitions, sound prolongations, pauses in the middle of words or speech, excess physical tension when pronouncing words, or the repetitions of one syllable words. Social Communication Disorder is marked by difficulties in being able to communicate appropriately, following rules for conversation (such as taking turns talking), understanding things that are not explicitly said, and understanding non-literal language. All of these disorders disturb one's ability to communicate with others significantly and can interfere with social participation, relationships, or the ability to meet academic and occupational standards.
Cause
The cause of communication disorders in children are usually biological, developmental or environmental. These causes include abnormalities in brain development, exposure to certain toxins during pregnancy, or genetic factors.
Treatment
Speech and language therapists are often very reliable for helping children with communication disorders. Remedial techniques are often used to help the child communicate more and work on their existing problems. Another technique is to help push the child to work on their strengths to improve their communication skills.
Pervasive developmental disorders
DSM-IV-TR
- 299.00 Autistic disorder
- 299.80 Rett's disorder
- 299.10 Childhood disintegrative disorder
- 299.80 Asperger syndrome
- 299.80 Pervasive developmental disorder NOS
Cause
Pervasive developmental disorders have no known cause yet, but researchers are interested in finding a connection between the disorders and problems in the nervous system. Studies are being done on the brain and spinal cord in children with PDDs to try to find a link.
Symptoms
Children with pervasive developmental disorders may exhibit the following symptoms:
- Have trouble expressing or understanding ideas
- Have trouble understanding nonverbal communication
- Difficulty in social interactions
- Temper tantrums
- Aggressive behavior
- May play differently with toys than other children
- May have difficulty adjusting to new places or people
- Anxious behavior"Pervasive Developmental Disorders (PDDs) Symptoms." MedicineNet.com. April 17, 2013, from http://www.medicinenet.com/pervasive_development_disorders/article.htm
Treatment
A specific treatment plan is usually laid out for the child because of the wide range of behaviors and abilities in each child. Treatment often involves promoting better communication and socializing, and reducing behaviors that can be disruptive. Children with pervasive developmental disorders may be placed in special education classes, receive behavior modification training, speech, physical or occupational therapy, or medication.
Attention-deficit and disruptive behavior disorders
DSM-IV-TR
- Attention deficit hyperactivity disorder (ADHD)
- 314.01 Combined subtype: If both Criteria A1 and A2 are met for the past 6 months.
- 314.01 Predominantly hyperactive-impulsive subtype
- 314.00 Predominantly inattentive subtype
- 314.9 Attention-Deficit Hyperactivity Disorder NOS: This category is used for individuals that have pronounced symptoms of inattention or hyperactivity-impulsivity, yet do not meet the criteria for Attention-Deficit/Hyperactivity Disorder. These individuals may include: ::1. Individuals who meet the criteria for ADHD, Predominantly Inattentive Type, but their age of onset is later than 7 years old. ::2. Individuals who present inattentive symptoms and meet the full criteria for the disorder but also have a behavioral pattern that is defined by having low energy, daydreaming, and laziness.
- Conduct disorder
- 312.81 Childhood onset: At least one of the Diagnostic Criteria needs to be met for Conduct Disorder before age 10.
- 312.82 Adolescent onset: The absence of any criteria characteristic of Conduct Disorder before the age of 10.
- 312.89 Unspecified onset: The age of onset is unknown.
- 313.81 Oppositional Defiant Disorder
- 312.9 Disruptive Behavior Disorder NOS: This category includes disorders similar to conduct or oppositional defiant behaviors but do not meet the diagnostic criteria for either disorder, yet the impairment is clinically significant and causes significant impairment in the individual's life.
Cause
With ADHD being one of the most common disorders diagnosed in childhood, the causes are often studied, yet still inconclusive. Many researchers say ADHD is caused by genetic factors, yet other studies are being done to expand on the cause. One research study showed that children who carry a certain gene associated with ADHD had a thinner layer of tissue in the areas of the brain associated with attention. As the children grew older, the brain tissue thickened and their ADHD symptoms improved. Environmental factors, such as the mother smoking or drinking during pregnancy is connected to children with ADHD. Children exposed to lead at a young age will also have an increased chance of developing ADHD. Brain injuries could cause ADHD, yet only a small number of children diagnosed fit into this category. Researchers have looked into sugar intake as the cause of ADHD, but have found little to support that theory.
Symptoms
Children with attention deficit and disruptive behavior disorders may show the following symptoms:
- Impulsivity or distractibility
- Difficulty socializing
- Aggressive behavior
- Difficulty following rules or directions or completing a task
- Problems at school
- Frustration
- Alcohol or drug use
Treatment
Medication is often used to treat children with attention-deficit and disruptive behavior disorders. Individualized programs are available for children with these disorders in order to help them function in and complete school. It is the common belief that many of these disorders will disappear as the children get older, but recent research shows that it can carry on into adulthood.
Feeding and eating disorders of infancy or early childhood
DSM-5-TR
Eating disorders that may be diagnosed in childhood include Pica, which is the persistent eating of nonfood substances that is severe enough to require clinical attention, and Rumination Disorder, which is the repeated regurgitation of food.
Cause
There are a number of factors that could potentially contribute to the development of feeding and eating disorders of infancy or early childhood. These factors include:
- Physiological – a chemical imbalance effecting the child's appetite could cause a feeding or eating disorder.
- Developmental – developmental abnormalities in oral-sensory, oral-motor, and swallowing can impact the child's eating ability and elicit a feeding or eating disorder.
- Environmental – simple issues such as inconsistent meal times can cause a feeding or eating disorder. Giving the child food that they are not developmentally acquired for can also cause these disorders. Family dysfunction and sociocultural issues could also play a role in feeding or eating disorders.
- Relational – when the child is not securely attached to the mother, it can cause feeding interactions to become disturbed or unnatural. Other factors, such as parental emotional unavailability and parental eating disorders, can cause feeding and eating disorders in their children.
- Psychological and behavioral – these factors include one involving the child's temperament. Characteristics such as being anxious, impulsive, distracted, or strong-willed personality types are ones that could affect the child's eating and cause a disorder. The individual could have learned to reject food due to a traumatic experience such as choking or being force fed.
Symptoms
Physical and emotional changes are often the most indicative symptoms of feeding and eating disorders of infancy or early childhood. The child's growth and development may be delayed due to the lack of necessary nutrients. The child will usually weigh much less than other children. Withdrawal and irritability are often associated with children that are malnourished.
Treatment
Since feeding and eating disorders in children can cause dangerous risks to the child, it is important to seek treatment as soon as possible. Cognitive behavioral therapy can be incredibly beneficial to children with feeding or eating disorders. Family therapy is usually encouraged in order to keep all members involved in nourishing the child.
Tic disorders
DSM-IV-TR
- 307.23 Tourette's disorder
- 307.22 Chronic motor or vocal tic disorder
- 307.21 Transient tic disorder: Must meet the following criteria in order to be diagnosed:
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