Childhood Disorders

1
Childhood Disorders

• Disorders usually diagnosed in infancy, childhood
  and adolescence

2
Mental Retardation

• IQ and deficits in adaptive functioning in at
  least 2 areas
• Onset prior to 18
• Many causes possible
• Mild 50-55 to 70
• Moderate 35-40 to 50-55
• Severe 20-25 to 35-40
• Profound below 20-25
• Severity Unspecified

3
TX MR

• Diagnose early to treat and prevent
• Many can be prediagnosed inutero to prevent MR
  PKU, hypothyroidism, hydrocephalus, allergy to
  milk enzymes
• Educate parents about tetrogens
• Educational interventions
• Family interventions
• Medications

4
Learning Disabilities- Public Law 94-142

• Reading Disorder
• Inaccurate reading, slow reading, poor reading
  comprehensions, along with spelling problems,
  poor writing, speech delay and dyspraxia
• Switch from phonetic to holistic instruction, or
  the reverse
• Tutoring and small group instruction
• Mutisensory instruction long-term, patience with
  slow progress
• Teacher plus comuter assisted instruction with
  repetition and practice

5

• Mathematics Disorder
• Difficulties with learning number names, rote
  counting, learning printed numerals, committing
  basic fact to memory, difficulties with concepts
  of combining and separating are just some of the
  initial symptoms
• Tx Drill and practice programs, determine
  strengths and weaknesses (concrete, semiconcrete,
  abstract), activities to help generalize
  concepts, clear teaching of math vocabulary,
  use of calculators when problems involve math
  reasoning, use of acronyms to remember math facts

6

• Disorder of Written Expression (does not require
  testing due to lack of availability of tests to
  measure this-WoodCock Johnston can be helpful)
• Handwriting problems
• Spelling problems
• Error in grammar and syntax
• Learning Disorder NOS

7
How to test for an LD

• Testing for LD (Achievement is gt2 SDs below
  IQ-Woodcock Johnston and WISC. If IQ scores are
  compromised by LD or other issue, then a smaller
  discrepancy can be justified)

8
Motor Skills Disorder

• Developmental Coordination Disorder
• Fine or gross motor skill development is delayed,
  causing significant impairment in academics or
  daily activities
• Remember that all children develop strengths and
  weaknesses while developing and this must be a
  MARKED delay

9
Communication Disorders

• Expressive Language Disorder
• Mixed Receptive-Expressive Language Disorder
• Phonological Disorder-articulation
• Stuttering
• Communication Disorder NOS
• Early dx and intervention can help

10
Pervasive Developmental Disorders

• Autistic Disorder- impairments in social
  interactions soon after birth and persist thru
  out life (often MR)
• Retts Disorder-Girl Disorder- Normal development
  for 6 months, then develop autistic like
  symptoms, language impairments, poor
  coordination, psychomotor retardation, and small
  head
• Childhood Disintegrative Disorder- Two years
  normal, then become impaired in two major areas
  of functioning
• Aspergers Disorder- The Nerd- partial autism
  w/out cognitive and language delays
• Pervasive Developmental Disorder Not Otherwise
  Specified (Including Atypical Autism)

11
Attention-Deficit and Disruptive Behavior
Disorders

• Attention-Deficit/Hyperactivity Disorder
• Symptoms before age 7
• Test for using WMS, WISC, Digit Vigilance Test,
  Trails AB
• Medication and reduction of stimuli, small
  groups, and transitional cues
• Family therapy, use cognitive therapy to teach to
  think before acting
• No ADD dx in DSM
• Biological underpinnings
• ADHD NOS

12
A continuum of disorders

• Oppositional Defiant Disorder- May have had ADHD.
  Angry child who ignores the rules, is spiteful
  and vindictive- but does not seriously violate
  the rights of others. Behavior may occur in one
  envir. but not another. Tends to begin prior to
  early adolescence. Outcome of Tx usually poor,
  may try parent training and paradoxal approaches.
• Conduct Disorder- violate norms and the rights of
  others. Often have difficulties with abstract
  reasoningmay have been ADHD, ODD leading to
  missing cognitive skills development. Behavioral
  treatments are used, help develop empathy if
  possible to avoid Antisocial personality as
  adult. No proven Tx
• Disruptive Behavior NOS

13
Feeding and Eating Disorders of Infancy or Early
Childhood

• Pica- At least one month eating nonfood items
  that is developmentally and culturally
  inappropriate. Not due to another disorder
• Rumination Disorder- At least 1 month of
  regurgitating and rechewing food
• Feeding Disorder of Infancy or Early Childhood- 1
  month of failure to eat properly resulting in
  weight loss or lack of appropriate weight gain
  before age 6.

14
Tic Disorders

• Stress makes them worse, sleep and absorbing
  activities-better
• All may be variants of the same disorders
• Tourettes Disorder
• Chronic Motor or Vocal Tic Disorder
• Transient Tic Disorder
• Tic Disorder NOS

15
Elimination Disorders

• Encopresis- can dx at 4 yrs
• Anxious vs defiant
• May occur after life stress
• Regular toilet times, muscle training, diet w/
  high fiber to reduce constipation, medication
  (stool softeners, laxatives), stress management
• Enuresis- can dx at 5 yrs, tends to be biological
• Delay urination after large intake of liquid
• Conditioning devices
• Medication- imipraimine

16
Other Childhood Disorders

• Separation Anxiety Disorder-
• Fear harm to, or separation from major attachment
  figures.
• Usually after a life stress. May turn into
  Dependent PD.
• Use transitional objects and gradually increase
  length of separations, increase choices and
  autonomy behaviors, work with parents on their
  anxiety
• Selective Mutism- Speaks in some E, but not
  others- usually lasts a few weeks

17
Other Childhood Disorders

• Reactive Attachment Disorder of Infancy or Early
  Childhood- No/little attachment (orphanages) may
  form ODD, CD, APD. Controversial Tx
• Stereotypic Movement Disorder-self-stimulate
  intentionally to increase stimulation
• Disorders of Infancy, Childhood, or Adolescence
  NOS