Developmental disorders

DR.K.V.S.SAI PRASADM.B.B.S.D.CH.,PGCCA.

DEVELOPMENTAL DISORDERSADHD(attention deficit hyperactive disorder)

2%-5.7%

ODD(opposition defiant disorder) 4%-16%

CONDUCT DISORDER 0-4%

DEPRESSION 0-2.1%

ANXIETY DISORDERS 0%-9.4%

MOST COMMON DISORDERS IN 0-3YRS

pica (2%),

behaviour disorder 1.8%

expressive speech disorder 1.4%

mental retardation 1.4%

attention deficit hyperactivity disorder (2%-5.7%),

Opposition defiant disorder (4%-16.8%),

conduct disorder (0%-4.6%),

depression (0%-2.1%),

anxiety disorders (0.3%-9.4%).

NORMAL BEHAVIOUR

ABNORMAL BEHAVOIUR

NORMAL BEHAVIOUR BEHAVIOUR THAT CAUSES CONCERN

Normal Teen Behavior Teen Behavior that Causes Concern

Wanting to spend more time with peers and less time with family Not wanting to spend time with either family or friends, i.e. shunning all social activity

Reluctance to get up early for school Absolute refusal to attend school—especially if this behavior happens suddenly and accompanies other signs of distress or depression

Needing more sleep or developing a larger appetite during growth spurts

Sudden changes in energy levels, i.e. sleeping abnormally long or not being able to sleep at all; sudden changes in appetite, i.e. consistent overeating or undereating accompanied by quick fluctuations in weight

Sadness and anxiety following fights with friends or a breakup with a boy/girlfriend

Sadness and anxiety that doesn’t correct itself or decrease in intensity after a few days to a couple weeks.

Some light risk-taking or experimenting with sex, alcohol, drugs, or self-harming behaviors such as cutting

Extremely risky behavior and/or delinquent behavior, including disregard for house rules, parents’ concerns, or laws of society; turning to cutting as a form of emotional and physical release

Turning to a beloved pet for comfort instead of a parent or friend Deliberately harming family pets or torturing or killing any animal

Worrying about physical appearance and trying to fit in Sudden and significant changes in eating behaviors, over-exercising, and other indications of eating disorders

ssssssWanting to spend more time with peers and less time with familyReluctance to get up early for school

Needing more sleep or developing a larger appetite during growth spurts

Sadness and anxiety following fights with friends or a breakup with a boy/girlfriend

Some light risk-taking or experimenting with sex, alcohol, drugs, or self-harming behaviors such as cutting

Turning to a beloved pet for comfort instead of a parent or friend

Worrying about physical appearance and trying to fit in

Not wanting to spend time with either family or friends, i.e. shunning all social activityAbsolute refusal to attend school—especially if this behavior happens suddenly and accompanies other signs of distress or depressionSudden changes in energy levels, i.e. sleeping abnormally long or not being able to sleep at all; sudden changes in appetite, i.e. consistent overeating or under eating accompanied by quick fluctuations in weightSadness and anxiety that doesn’t correct itself or decrease in intensity after a few days to a couple weeks.Extremely risky behavior and/or delinquent behavior, including disregard for house rules, parents’ concerns, or laws of society; turning to cutting as a form of emotional and physical release.Deliberately harming family pets or torturing or killing any animal.

Sudden and significant changes in eating behaviors, over-exercising, and other indications of eating disorders

Behavioral and Emotional Disorders• Rarely will a child under 5 years old receive a diagnosis

of a serious behavioral disorder. However, they may begin displaying symptoms of a disorder that could be diagnosed later in childhood. These may include:

• attention deficit hyperactivity disorder (ADHD)• oppositional defiant disorder (ODD)• anxiety disorder• learning disorders• conduct disorders• autism spectrum disorder (ASD)• depression• bipolar disorder

ADHD

ADHD• Based on the presenting symptom ADHD can be divided into three subtypes:• A) predominantly inattentive,• B) predominantly hyperactive-impulsive• C) and combined type• An individual with inattention may have some or all of the following symptoms• Be easily distracted, miss details, forget things, and frequently switch from one activity

to another• Have difficulty maintaining focus on one task• Become bored with a task after only a few minutes, unless doing something enjoyable• Have difficulty focusing attention on organizing and completing a task or learning

something new• Have trouble completing or turning in homework assignments, often losing things (e.g.,

pencils, toys, assignments) needed to complete tasks or activities• Not seem to listen when spoken to• Daydream, become easily confused, and move slowly• Have difficulty processing information as quickly and accurately as others• Struggle to follow instructions

An individual with hyperactivity

may have some or all of the following symptoms-• Fidget and squirm in their seats• Talk nonstop Dash around, touching or playing

with anything and everything in sight• Have trouble sitting still during dinner, school,

doing homework, and story time• Be constantly in motion• Have difficulty doing quiet tasks or activities

An individual with impulsivity

• may have some or all of the following symptoms:

• Be very impatient• Blurt out inappropriate comments, show their

emotions without restraint, and act without regard for consequences

• Have difficulty waiting for things they want or waiting their turns in games

• Often interrupt conversations or others' activities

Temper tantrumsTemper tantrums are a normal part of growing up• Why do tantrums happen?

• A tantrum is the expression of a young child's frustration with the challenges of the moment.

• Perhaps the child is having trouble figuring something out or completing a specific task.

• Maybe the child doesn't have the vocabulary or can't find the words to express his or her feelings. Frustration might trigger anger — resulting in a temper tantrum.

• If the child is thirsty, hungry or tired, his or her threshold for frustration is likely to be lower — and a tantrum more likely.

Can tantrums be prevented?• Be consistent. • Plan ahead. .• Encourage the child to

use words. • Praise good behavior. • Avoid situations likely

to trigger tantrums.

Temper tantrumsWhat about tantrums in public?

• If the child has a tantrum in public, ignore the behavior if possible. If the child becomes too disruptive, take him or her to a private spot for a timeout. After the timeout return to the activity — or else the child will learn that a tantrum is an effective way to escape a given situation.

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When is professional help needed?

• As the child's self-control improves, tantrums should become less common.

• Most children begin to have fewer tantrums by age 3 and a half.

• If the child is having trouble-speaking at an age-appropriate level,

• is causing harm to himself or herself or others,

• holds his or her breath during tantrums to the point of fainting

• if tantrums get worse after age of4 years

oppositional defiant disorder

ODD ODD

oppositional defiant disorder

• ODD, for instance, includes angry outbursts, typically directed at people in authority.

• But a diagnosis is dependent on the behaviors lasting continuously for more than six months and disrupting a child’s functioning.

• Conduct disorder is a far more serious diagnosis and involves behavior one would consider cruel, to both other people as well as to animals. This can include physical violence and even criminal activity — behaviors that are very uncommon in preschool-age children.

Behavior and Emotional Problems

• Behavior and Emotional Problems• Far more likely than one of the above clinical disorders

is that an young child is experiencing a temporary behavioral and/or emotional problem. Many of these pass with time, and require a parent’s patience and understanding.

• In some cases, outside counseling is warranted and may be effective in helping children cope with stressors effectively. A professional could help the child learn how to control their anger, how to work through their emotions, and how to communicate their needs more effectively.

• medicating children at this age is controversial.

Tension-reducing habit disorders

Thumb sucking Repetitive vocalisations Tics

Nail biting Hair pulling Breath holding

Air swallowing Head bangingManipulating parts of the body

Body rocking Hitting or biting themselves

A short list of famous people  who have learning disabilities

• Leonardo da Vinci• Pablo Picasso.• Muhammad Ali, World

Heavyweight Champion Boxer

• Alexander Graham Bell

• Thomas Edison• Albert Einstein• George Washington

LEARNING DISORDERSREADINGWRITNG

MATHS

Types of Learning Disorders

most common types: • Dyslexia affects reading

ability. • Dysgraphia affects writing ability. • Dyscalculia affects math ability.

Learning disorders• What Causes Learning Disorders?• cannot always be identified. • Structural differences in the brain may cause some of them in• some cases seem to be inherited (NICHD). • Drug and alcohol use during pregnancy can affect a fetus and lead to

learning disorders. • Poor nutrition in early childhood may cause. • Being exposed to certain chemicals or substances, such as lead,. • Cancer treatment (for instance, for leukemia) may also increase risk. • A traumatic brain injury may lead

• Who Is at Risk for a Learning Disorder?• The most common risk factor is a family history of learning disorders (

Cleveland Clinic).

What Are the Symptoms of a Learning Disorder?

• many possible symptoms. • Typical symptoms in a school-age child

1.include difficulty following directions, 2.reversing numbers or letters in writing,3. poor social skills.4.Trouble reading, 5.understanding speech, or speaking at an age-appropriate level is also a sign.

• Having an average or above-average IQ but nonetheless having problems with schoolwork may be a sign of a learning disorder.

How Is a Learning Disorder Diagnosed?

• Problems are frequently noticed in early childhood.

• An evaluation for a learning disorder often includes a medical exam to rule out problems such as hearing, vision, or developmental disabilities.

• It will include a discussion of family history.• A psychological assessment and academic

testing are also part of an accurate diagnosis.• A specialist may also give the child an IQ test.

How Is a Learning Disorder Treated?

• Treatment for learning disorders involves education. ensures that schools offer specialized instruction to children with learning disorders.

• students may videotape lectures instead of taking notes.

• special memorization techniques.• more time to complete work. • Learning disorders are not treated with medication.

If additional issues exist, such as attention-deficit hyperactivity disorder (ADHD), medication may be recommended. Therapy may include counseling for related issues, such as low self-esteem.

OUT LOOK& PREVENTION• What Is the Outlook for Learning Disorders?• People do not outgrow learning disorders. But specialized

learning techniques and strategies can help a child overcome obstacles and frustration with schoolwork. Early intervention is best, so educational plans can be put in place. With these tools, children can overcome learning disorders and have successful academic and social lives.

• Can Learning Orders Be Prevented?• The cause of learning disorders is often unknown, so

prevention is not always possible. Avoiding drugs and alcohol during pregnancy may reduce the risk of learning disorders in children.

Anxiety disorders

• Anxiety and fearfulness are part of normal development; however, when they persist and become generalised they can develop into socially disabling conditions and require intervention.

• Approximately 6-7% of children may develop anxiety disorders and, of these, 1/3 may be over-anxious while 1/3 may have some phobia.

• [Generalised anxiety disorder, childhood-onset social phobia, separation anxiety disorder, obsessive-compulsive disorder and phobia are demonstrated by a diffuse or specific anxiety predictably caused by certain situations.

School phobia• occurs in 1-5% of children and there is a strong

association with anxiety and depression.• Management is by treating the underlying psychiatric

condition, family therapy, parental training and liaison with the school in order to investigate possible reasons for refusal and negotiate re-entry.

• Behavioural and cognitive treatments show promise, although most evidence-based trials involve children with mental health problems rather than the general population of school refusers per se.

• More research needs to be done in this area.

Disruptive behaviour

• Many behaviours, which are probably undesirable but a normal occurrence at an early stage of development, can be considered pathological when they present at a later age.

• In the young child, many behaviours such as breath holding or temper tantrums are probably the result of anger and frustration at their inability to control their own environment.

• For some of these situations it is wise for parents to avoid a punitive response and, if possible, to remove themselves from the room.

• It is quite likely that the child will be frightened by the intensity of their own behaviour and will need comfort and reassurance.

• While some isolated incidents of stealing or lying are normal occurrences of early development, they may warrant intervention if they persist.

• Truancy, arson, antisocial behaviour and aggression should not be considered as normal developmental features.

ANXIETY• Anxiety is body’s natural response to stress. It

is a feeling of fear and apprehension about what’s to come. We all feel it at times; the first day of school, going to a job interview, or giving a speech cause most people to feel fearful and nervous.

• But if the feelings of anxiety are extreme, last for longer than six months, and are interfering with life, you may have an anxiety disorder...

Who Gets Anxiety Disorders?

• Anxiety disorders can affect anyone at any age.• Anxiety disorders are the most common form of emotional

disorder. • (APA) Approximately 40 million American adults (18 percent

of the population) are affected by an anxiety disorder in any given year. (NIMH)

• If you have an anxiety disorder, you may also be depressed. Some people with anxiety disorders abuse alcohol or other drugs in an effort to feel better.

• This may provide temporary relief, but can ultimately make the condition worse. It may be necessary to treat an alcohol or drug problem before the anxiety can be addressed.

What Does Anxiety Feel Like?

• Anxiety is hard to describe. You might feel like you’re standing in the middle of a crumbling building with nothing but an umbrella to protect you.

• Or you might feel like you’re holding onto a merry-go-round going 65 mph and can’t do anything to slow it down.

• You might feel butterflies in your stomach, or your heart might be racing.

• You could experience nightmares, panic, or painful thoughts or memories that you can’t control.

• You may have a general feeling of fear and worry, or you may fear a specific place or event.

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What Is the Difference Between Anxiety and an Anxiety Disorder

Anxiety• It is a feeling of fear you have

when you must do something stressful.

• It’s normal to feel anxious about moving to a new place, starting a new job, or taking a test.

• Normal anxiety is unpleasant, but it may motivate you to work harder and do a better job.

• Normal anxiety is a feeling that comes and goes, but does not interfere with your everyday life.

anxiety disorder• In the case of an anxiety

disorder, the feeling of fear may be with you all the time.

• It is intense and sometimes debilitating.

• This type of anxiety may cause you to stop doing things you enjoy.

• In extreme cases, it may prevent you from entering an elevator or crossing the street or even leaving your home.

• If left untreated, the anxiety will keep getting worse.

What Are the Types of Anxiety Disorders?

panic disorder: characterized by bouts of intense fear or terror that develop quickly and unexpectedlyphobia: excessive fear of a specific object, situation, or activitysocial anxiety disorder: extreme fear of being judged by others in social situationsobsessive-compulsive disorder: recurring irrational thoughts that lead you to perform specific, repeated behavior separation anxiety disorder: fear of being away from home or loved oneshypochondriasis: anxiety about your healthpost-traumatic stress disorder: anxiety following a traumatic event, such as the death of a loved one, war, or being the victim of a crime

What Is the Outlook for an Anxiety Disorder?

• Anxiety disorders can be treated with medication, psychotherapy, or a combination of the two.

• Some people who have a mild anxiety disorder or a fear of something they can easily avoid decide to live with the condition and to not seek treatment.

• It is important to understand that anxiety disorder is an illness and can be treated, even in severe cases.

• Treatment may not result in a complete cure, but in most cases, the symptoms can be controlled so to live a normal life.

CONDUCT DISORDERS

What Is Conduct Disorder?

• Conduct disorder is a group of behavioral and emotional problems that usually begins during childhood or adolescence.

• Children and adolescents with the disorder have a difficult time following rules and behaving in a socially acceptable way.

• They may display aggressive, destructive, and deceitful behaviors that can violate the rights of others.

• Adults and other children may perceive them as “bad” or delinquent, rather than as having a mental illness.

conduct disorder• they may appear tough and confident. • In reality, however, children who have

conduct disorder are often insecure and inaccurately believe that people are being aggressive or threatening toward them

Types of Conduct Disorder

• Childhood onset - signs of conduct disorder appear before age 10.

• Adolescent onset - signs of conduct disorder appear during the teenage years.

• Unspecified onset - the age at which conduct disorder first occurs is unknown.

Symptoms of conduct disorder

• often hard to control and unwilling to follow rules.

• They act impulsively without considering the consequences of their actions.

• They also don’t take other people’s feelings into consideration

child may persistently display one or more of the following behaviors:

• aggressive conduct• deceitful behavior• destructive behavior• violation of rules

Aggressive conduct&decietful behaviour

Aggressive conduct• intimidating or bullying

others• physically harming

people or animals on purpose

• committing rape• using a weapon

Deceitful behavior

• Lying• breaking and entering• stealing• forgery

DESTRUCTIVE BEHAVOIUR &VIOLATION OF RULES

• Destructive Behavior• Destructive conduct may include arson and

other intentional destruction of property.• Violation of Rules may include:• skipping school• running away from home• drug and alcohol use• sexual behavior at a very young age

What Causes Conduct Disorder? 

• Genetic and environmental factors may contribute

• The impairment of the frontal lobe may be genetic, or inherited, or it may be caused by brain damage due to an injury.

• A child may also inherit personality traits that are commonly seen in conduct disorder.

Environmental Factors

include:• child abuse• a dysfunctional family• parents who abuse drugs or alcohol• poverty

Restless leg syndrome• have uncomfortable sensation in their legs and

sometimes in arms & upper part of the body .• an irresistible urge to move the legs to relieve the

sensations .• The condition causes an un-comfortable,,”itchy,pin

& needles,creepy crawly feeling in the legs.• Sensations are usually worse at rest, especially

when lying/sitting.• Worse in the evening &night.• Causes sleep disturbances• Predominant in woman

Treatment of restless leg syndrome

• Stay away from :alcohol,caffeine,nicotine

• Treat underlying medical conditions: anemia,

diabetes,renal disease,thyroid disease, correction of nutritional deficiencies

Language delay(alalia)

• Delay in the development of language or use of knowledge.

• children diagnosed with speech delay are prone for emotional & social impairments.

• Causes: physical disruption in the mouth such deformed frenulum,lips,palate.

• Oral-motor dysfunction-lack of /delay in the area of the brain that speech is formed, created &communicated to the mouth & tongue

Auditory processing disorder

• Also known as• central auditory processing disorder.• Most of the tests of APD REQUIRE THE CHILD TO

BE 7-8 YRS OLD.

autism spectrum disorder (ASD)

• Autism, meanwhile, is actually a broad range of disorders that can affect children in a variety of ways, including behaviorally, socially, and cognitively. They are considered a neurological disorder and, unlike other behavioral disorders, the symptoms may begin as early as infanthood. According to the American Psychiatric Association, about one in 68 children are diagnosed with an autism spectrum disorder.

THANQ U Dr.sai prasad