Disorders More Common in

Children

By Salina Chan, R32013

Autism Spectrum Disorder

Autism Spectrum Disorder

Combined Autism +: Asperger’s disorder Childhood disintegrative disorder Atypical autism High-functioning autism Pervasive developmental disorder NOS Etc.

Autism Spectrum Disorder

A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history

Difficulties in social-emotional reciprocity Deficits in nonverbal communicative

behaviors used for social interactions Deficits in developing, maintaining and

understanding relationships

Autism Spectrum Disorder

B. Restrictive repetitive patterns of behavior, interests or activities as manifested by at least 2 of the following, currently or by history

1. Stereotype or repetitive motor movements, use of objects or speech

2. Insistence on sameness, inflexible adherence to routines or ritualized patterns of verbal/nonverbal beh

3. Highly restrictive, fixated interests that are abnormal in intensity or focus

4. Hyper- or hyporeactivity to sensory input or unusual interest in sensory asepcts of the environment

Autism Spectrum Disorder

Severity = Level 1-3 Refers to degree of support

Based on Social communication impairments Restricted, repetitive patterns of behavior

Attention-Deficit/Hyperactivity Disorder

Attention-Deficit/Hyperactivity Disorder (ADHD)

Either/and Inattention Hyperactivity/Impulsivity

At least 6 months & Not typical for normal developmental level

Several symptoms present before age 12

Several symptoms in 2 or more settings

Clear evidence of interference with or reduce the quality of social, academic or occupational functioning

Inattention (6/9) (FAIL TOO LOAD)

Forgetful in daily activities

Attention not sustained in tasks or play activities

Instructions and work not finished

Listens poorly when spoken to directly

TOO many details missed or makes careless mistakes in work

Loses things necessary for tasks or activities

Organizing tasks and activities is difficult

Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort

Distracted easily by extraneous stimuli

Hyperactivity/Impulsivity (6/9)

Loud playing

Fidgets with hands or feet or squirms in seat 

Leaves seat when remaining seated is expected

Always "on the go" or often acts as if "driven by a motor" 

Runs about or climbs excessively in situations in which it is inappropriate 

Excessive talking

Blurts out answers before questions have been completed 

Interrupts or intrudes on others

Difficulty awaiting turn 

Hyperactivity (Loud FLARE)

Impulsivity (BIDs)

Intellectual Disability

Deficits in general mental abilities and impairment in everyday adaptive functioning, in comparison to an individual’s age, gender and socioculturally matched peers

Mild, Moderate, Severe, Profound

Based on impairments to domains of Conceptual Social practical

Developmental Coordination d/o

acquisition and execution of coordinated motor skills is substantially below that expected given the individual’s chronological age and opportunity for skill learning and use

Difficulties are manifested as clumsiness, and, slowness and inaccuracy of performance of motor skills dropping or bumping into object using scissors or cutlery handwriting riding a bike participating in sports

Communication Disorders

Language Disorder

Speech sound disorder

Childhood-onset fluency disorder (stuttering)

Social Communication Disorder

**Causes function limitations in effective communication, social participation, academic achievement or occupational performance, individually or in any combination

Language Disorder

Persistent difficulties in acquisition and use of language across modalities i.e. spoken, written, other, due to deficits in

comprehension or production include

Reduced vocabulary Limited sentence structure Impairments in discourse

Other Communication

Disorders Speech Sound Disorder

Persistent difficulty with speech sound production

interferes with speech intelligibility or prevents verbal communication of messages

Childhood-onset fluency disorder (stuttering)

Social Communication Disorder

Specific Learning Disorders

Reading Word reading accuracy Reading rate or fluency Reading compreehnsion E.g. dyslexia

Written expression Spelling accuracy Grammar and punctuation

accuracy

Mathematics Number sense Memorization of

arithmetic facts Accurate math reasoning

1 symptoms for at least 6 months

Mild-mod-severe

Motor Disorders Developmental Coordination disorder

Stereotypical Movement Disorder

Tourette’s Disorder

Tic Disorders

Motor Disorders Developmental Coordination disorder

Acquisition and execution of coordinated motor skills substantially below expected

= clumsiness, and, slowness and inaccuracy of performance of motor skills dropping or bumping into object using scissors or cutlery handwriting riding a bike participating in sports

Stereotypical Movement Disorder Repetitive, seemingly driven, and apparently

purposeless motor behaviour

Tic Disorders A tic is a sudden, rapid, recurrent,

nonrhythmic, motor movement or vocalization  Tourettes

both multiple motor & at least one vocal tic, > 1 year, < 18 yo

Persistent Motor or Vocal Tic Disorder Either or, single or multiple, > 1 year, < 18 yo

Tics occur many times a day nearly every day or intermittently

Onset typically in prepubertal

Disruptive Mood Dysregulation Disorder Severe recurrent temper outbursts

manifested verbally and/or behaviorally grossly out of proportion in intensity or duration to the

situation or provocation

Inconsistent with developmental level

> 3x/week

Mood between outbursts persistently irritable or angry most of day, nearly every day

> 12 months with w/o symptom-free > 3 months

2 of three possible settings: home, school, peers

Anxiety Disorders Separation Anxiety disorder

Selective mutism

Separation Anxiety

Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached by 3 of the following 8:1. Recurrent excessive distress when anticipating or

experiencing separating from home or from major attachment figures

2. Persistent and excessive worry about losing major attachment figures or about possible harm to them

3. Persistent and excessive worry about experiencing an untoward event that causes separation from major attachment figure

4. Persistent reluctance or refusal to go out, away from home, to school, to work, or elsewhere because of fear of separation

Separation Anxiety Cont’d

Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached by 3 of the following 8:5. Persistent and excessive fear of or reluctance about

being alone or w/o major attachment figures at home or in other settings

6. Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure

7. Repeated nightmares involving theme of separation8. Repeated complaints of physical symptoms when

separation from major attachment figure occurs or is anticipated

Separation Anxiety

> 4 weeks in children/adolescents, > 6 months in adults

Most prevalent anxiety d/o in children < 12

Children may be described as demanding, intrusive, in need of constant attention

Adults = dependent, overprotective

Selective Mutism Consistent failure to speak in social

situations in which there is an expectation for speaking

Interferes with educational/occupational achievement or social communication

> 1 month

http://www.youtube.com/watch?v=gmEJEfy5f50 (15:34 - 18:06)

Trauma- and Stressor-Related

Disorder Reactive Attachment Disorder

Disinhibited Social Engagement disorder

Both from having experienced pattern of extremes of insufficient care as evidence by social neglect repeated changes of primary caregivers; or rearing in unusual settings

Trauma- and Stressor-Related Disorder

Reactive Attachment Disorder Consistent pattern of inhibited, emotionally

withdrawn behavior toward adult caregivers, manifested by both of the following

Persistent social and emotional disturbance

Disinhibited social Engagement disorder Pattern of behavior in which a child actively

approaches and interacts with unfamiliar adult Overly familiar, little or not checking with

caregiver, no hesitation to go off with adult stranger

Feeding & Eating Disorders

Pica Persistent eating of nonnutrive, nonfood substances > 1 month, inappropriate for developmental level,

severe enough to warrant clinic attention

Rumination disorder Repeated regurgitation of food > 1 month, not d/t physical condition or eating d/o

Avoidant/Restrictive food intake disorder Eating/feeding disturbance with persistent failure to

meet appropriate nutritional &/or energy needs = sig wt loss, deficiency, need supplements or

interferes with psychosocial functioning

Elimination Disroders

Enuresis Repeated voiding of urine into bed/clothes Involuntary or intentional > 2x/week for 3 months; or Presence of clinically sig distress or impairment in

functioning > 5 years old

Encopresis Repeated passage of feces into inappropriate

palces > 1x/ month for 3 moths > 4 years old

Sleep-Wake Disorders

Non-REM sleep arousal disorder Recurrent episodes of incomplete awakening with

Sleepwalking; or Sleep terrors

No or little dream recalled Amnesia for episodes

Nightmare disorder Repeated occurrences of extended, extremely

dysphoric and well-remembered dreams Re: survival, security or physical integrity Acute, subacute, chronic Mild-mod-severe

Gender Dysphoria Marked incongruence between one’s

experience/expressed gender and assigned gender > 6 months 6/8 possible symptoms

Strong desire be other gender Strong Cross-dressing preference Strong preference for cross-gender roles in play Strong preference for cross-gender toys Strong preference for playmates of other gender Strong dislike for one’s sexual anatomy Strong desire for sex characteristics of other gender Strong rejection of their gender toys

Disruptive, Impulse-Control & Conduct D/O Oppositional defiant disorder

Conduct disorder

Oppositional-Defiant Disorder

A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness

> 6 months, > 4 symptoms: Blames others for his or her mistakes or misbehavior  Annoys people deliberately Spiteful or vindictive 2x/6 months Touchy or easily annoyed  Argues with adults   Resentful and Angry often Defies or refuses to comply with adults' requests or rules  Loses temper often 

How frequent symptoms dependent on age

Conduct Disorder Repetitive and persistent pattern of

behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated

> 3 criteria in the past 12 months, > 1 in the past 6 months Aggression to people and animals  Destruction of property  Deceitfulness or theft  Serious violations of rules 

Conduct Disorder Aggression to people and

animals (BASIC F-U) Bullies, threatens, or

intimidates others Animal cruelty Stolen while confronting a

victim Initiates fights Cruel to people  Forced someone into sexual

activity  Uses Weapon

Destruction of property Fire setting with the

intention of causing serious damage 

Destroyed others' property

Deceitfulness or theft (LOTS OF BS) LOTS OF Lies to obtain goods

or favors or to avoid obligations

Broken into someone else's house, building, or car 

Stolen items of nontrivial value without confronting a victim 

Serious violations of rules (RUNTS) RUNs away from home

overnight at least twice Truant from school, beginning

before age 13 years Stays out at night despite

parental prohibitions, beginning before age 13 years 

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