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Unit 14 Disorders of Childhood and Adolescence — Developmental, Behavioural and Emotional

1. What are the criteria that are commonly adopted for identifying that the child is suffering from some developmental, behavioural or emotional problem?

Following are the criteria to identify that the child is suffering from some developmental, behavioural or emotional problem:

1. Age: Certain behaviours are normal for a particular age. For example thumb sucking or enuresis in a two year old child is normal but abnormal for a ten year old;
2. Frequency: If a particular behaviour occurs once in a while it is normal, but if it occurs very often it is a matter of concern. For example, a child having abdominal pain every morning before going to school;
3. Severity: Even a single episode of high intensity or severity requires professional attention. Examples are violent behaviour, fainting, muteness etc.; and
4. Effect on development: Some behaviours are persistent and have a negative impact on the growth and development of the child. For example, poor concentration or hyperactivity causes decline in academic performance.

2. Define mental retardation.

Mental retardation refers to sub average intellectual functioning, which originates in the developmental period and is associated with deficit in cognition, language, motor, social abilities and adaptive behaviour. A person is said to suffer from mental retardation if:

(i) The IQ attained is below 70 on standard psychological tests of intelligence, and

(ii) His or her adaptive skills are inadequate to cope up with the daily routines.

7. Fill in the blanks:

• ADHD is a disorder characterised by poor ability to concentrate, hyperactivity and impulsivity.
• While evaluating a child for conduct disorder, one must consider whether the reported behaviour is appropriate for the age of presentation.

8. Define ‘conduct disorders’.

Conduct disorder is defined as persistent antisocial behaviour of children and adolescents that significantly impairs their ability to function in the social or academic area.

9. List the psychosocial factors which lead to substance abuse

Psychosocial factors which lead to substance abuse are change in life style, low frustration tolerance, easy availability of drugs and peer pressure.

10. List the major anxiety disorders.

Following are the major anxiety disorders:

(i) Separation anxiety disorder,

(ii) Overanxious disorder, and

(iii) Examination anxiety.

11. Write short note on:

i) Somatoform disorder: Somatoform disorder is the disturbance of voluntary motor or sensory system. Often the symptoms are means to get primary and secondary gains. These patients commonly seek first consultation with the pediatrician as the symptoms are primarily physical, viz, seizures, aches and pains, hyperventilation, vomiting and paralysis.

ii) Obsessive-compulsive disorder: Obsessive-Compulsive disorder (OCD) presents with repetitive thoughts (obsessions) or repetitive rituals or movements (compulsions). Obsessions have been defined as intrusive thoughts, fears or images which become imposed on the conscious mind repeatedly and which cause anxiety. Typically, the thoughts or fears are perceived as senseless and the individual tries to resist them but is unsuccessful.

12. Define schizophrenia in childhood.

Schizophrenia in childhood refers to the development of mood-incongruent delusions, hallucinations, disorganised speech plus a deterioration in functioning (in academic performance, peer relationships etc.) under 15 years of age.

13. List the distinct features of child with manic depressive disorder.

The distinct features of a child with manic depressive disorder are:

• Associated medical or neurological problems are common.
• Unpleasant mood is found as frequently as elevated mood in mania.
• Convincing entrenched delusions are rarely seen in pre-pubertal children.

14. List the major family factors that may cause behavioural and emotional problems in children.

The major family factors that may cause behavioural and emotional problems in children are given below:

• Attitudes of parents,
• Over protection,
• Rejection,
• Child abuse,
• Discipline,
• Anxiety,
• Role model,
• Expectation,
• Time spent with the child,
• Conflict with parents and family members, and
• Alcoholism.

15. List down the steps to assess the behaviour problem in a child.

The steps to assess the behaviour problem in a child are given below:

i) Case history and mental status examination,

ii) Cognitive assessment,

iii) Projective techniques, and

iv) Rating scales and questionnaires

16. List the criteria to label a particular behaviour as abnormal.

The criteria to label a particular behaviour as abnormal are:

• The behaviour is inappropriate for the child’s age.
• The behaviour deviates significantly from the expected behaviour of the child's peer group.
• The behaviour causes significant distress in the child or the family.
• The behaviour is long lasting, and does not spontaneously resolve or improve over time.
• The behaviour causes significant impairment in day-to-day functioning.

17. What are developmental disorders?

Developmental disorders are a group of conditions that manifest during childhood and are characterised by delays or abnormalities in the acquisition of skills and milestones. They include mental retardation, specific learning disability, pervasive developmental disorders, specific developmental disorders, and habit disorders.

18. How will you differentiate between autism and mental retardation?

Autism and mental retardation are distinct disorders, although they can co-occur:

• Autism is a pervasive developmental disorder characterised by difficulties in social interaction and communication, and by repetitive behaviours.
• Mental retardation (intellectual disability) is characterised by deficits in intellectual and adaptive functioning.

19. Define the term ‘somatoform disorder’ and describe a case you have seen with this disorder.

Somatoform disorders are characterised by the presence of multiple physical symptoms that cannot be fully explained by a general medical condition. The symptoms cause distress and impairment in the individual's functioning.