Childhood Disorders

1. Childhood Disorders

2. Childhood Disorders • Disorders that are commonly first diagnosed in childhood or that can only be diagnosed in childhood • Variation in presentation of illnesses between children and adults • Behavior that would be seen as abnormal in an adult may occur in a “normal child” • Not studied at all until the 20th Century

3. Austism • A total of six (or more) items from 1, 2, and 3, with at least two from group 1, and at least one each from groups 2 and 3

4. Austism Group 1: Qualitative impairment in social interaction: • Marked impairment in the use of multiple nonverbal behaviors • Failure to develop peer relationships appropriate to developmental level • Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people • Lack or social or emotional reciprocity

5. Austism Group 2: Qualitative impairments in communication: • Delay in, or total lack of, the development of spoken language • In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others • Stereotyped and repetitive use of language • Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

6. Austism • Group 3: Restricted repetitive and stereotyped patterns of behavior, interests, and activities • Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus • Apparently inflexible adherence to specific, nonfunctional routines • Stereotyped and repetitive motor mannerisms • Persistent preoccupation with parts of objects

7. Autism • Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years • Social interaction • Language as used in social communication • Symbolic or imaginative play • The disturbance is not better accounted for by Rett’s Disorder or Childhood Disintegrative Disorder ***Essentially, the presence of markedly abnormal or impaired development in social interaction and communication and a markedly restricted repertoire of activity and interests

8. Autism • Appear to be unaware that other people think, feel, and have beliefs • Sometimes even unable to identify someone else’s age, gender, emotion • Can be difficult to diagnose: • Other medical conditions can produce similar behaviors • Autistic symptom profile has been found in kids with and without neurological impairments • Shares several characteristics with other disorders that involve social/communication impairment • Symptoms can vary widely

9. Asberger’s • Qualitative impairment in social interaction, manifested by at least two of the following: • Marked impairment in the use of multiple nonverbal behaviors • Failure to develop peer relationships appropriate to developmental level • Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people • Lack or social or emotional reciprocity

10. Asberger’s • Restricted repetitive and stereotyped patterns of behavior, interests, and activities, manifested by at least one of the following • Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus • Apparently inflexible adherence to specific, nonfunctional routines • Stereotyped and repetitive motor mannerisms • Persistent preoccupation with parts of objects

11. Asberger’s • The disturbance causes significant distress or impairment in functioning • There is no clinically signficant general delay in language (e.g. single word use by age 2, communicative phrases by age 3) • There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills and curiosity about the environment • Criteria are not met for another Pervasive Developmental Disorder or Schizophrenia

12. Attention-Deficit/Hyperactivity Disorder • Either 1 or 2 1. Six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level • Fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities • Has difficulty sustaining attention in tasks or play activities • Does not seem to listen when spoken to directly • Does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace • Has difficulty organizing tasks and activities • Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort • Loses things necessary for tasks or activities • Is easily distracted by extraneous stimuli • Is forgetful in daily activities

13. ADHD 2. Six (or more) of the following symptoms of hyperactivity-impulsivity has persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level: • Often fidgets with hands/feet or squirms in seat • Often leaves seat in classroom or in other situations in which remaining seated is expected • Often runs about or climbs excessively in situations in which it is inappropriate • Often has difficulty playing or engaging in leisure activities quietly • Is often “on the go” or often acts as if “driven by a motor” • Often talks excessively • Often blurts out answers before questions have been completed • Often has difficulty awaiting turn • Often interrupts or intrudes on others

14. ADHD • Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 • Some impairment from the symptoms is present in two or more settings • There must be clear evidence of clinically significant impairment in functioning • Symptoms are not between accounted for by another mental disorders

15. Conduct Disorder A. A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated (see next slides) B. The disturbance in behavior causes significant impairment in functioning C. If the individual is 18 years or older, criteria are not met for Antisocial Personality Disorder

16. Conduct Disorder A (continued). Three or more of the following criteria in the past 12 months and at least one in the past 6 months: Aggression to people and animals • Often bullies, threatens, or intimidates others • Often initiates physical fights • Has used a weapon that can cause serious physical harm to others • Has been physically cruel to people • Has been physically cruel to animals • Has stolen while confronting a victim • Has forced someone into sexual activity

17. Conduct Disorder Destruction of property • Has deliberately engaged in fire setting with the intention of causing serious damage • Has deliberately destroyed others’ property (other than arson) Deceitfulness or theft • Has broken into someone else’s house, building, or car • Often lies to obtain goods or favors or to avoid obligations • Has stolen items of nontrivial value without confronting a victim

18. Conduct Disorder Serious violation of rules • Often stays out at night despite parental prohibitions, beginning before age 13 • Has run away from home overnight at least twice while living in parental or parental surrogate home • Is often truant from school, beginning before age 13

19. Oppositional Defiant Disorder • A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, manifested by 4 or more of the following: • Often loses temper • Often argues with adults • Often actively defies or refuses to comply with adults’ requests or rules • Often deliberately annoys people • Often blames others for his or her mistakes or misbehaviors • Is often touchy or easily annoyed by others • Is often angry and resentful • Is often spiteful or vindictive **Consider a criterion met only if the behavior occurs more frequently than is typically observed in individuals of comparable age and developmental level

20. Separation Anxiety Disorder • Developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached, manifested by three or more of the following: • Recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated • Persistent and excessive worry about losing, or about possible harm befalling, major attachment figures • Persistent and excessive worry that an event will lead to separation from a major attachment figure

21. Separation Anxiety Disorder A (continued). Three or more of the following: • Persistent reluctance or refusal to go to school or elsewhere because of fear of separation • Persistently and excessively fearful or reluctant to be alone or without major attachment figures at home or in other settings • Persistent reluctance or refusal to go to sleep without being near a major attachment figure or to sleep away from home • Repeated nightmares involving the theme of separation • Repeated complaints of physical symptoms when separation occurs or is anticipated

22. Separation Anxiety Disorder • The duration of the disturbance is at least 4 weeks • The onset is before age 18 • The disturbance causes clinically significant distress or impairment in functioning • Is not better explained by another mental disorder