Childhood Disorders Classification

Classification and Diagnosis of Childhood Disorders

• Some disorders are unique to children, e.g., separation anxiety disorder.
• Some disorders are primarily childhood disorders but may continue into adulthood, e.g., attention-deficit/hyperactivity disorder.
• Some disorders are present in both children and adults, e.g., depression.

Treatment of Conduct Disorder

• Family interventions, including multisystemic therapy, are used to deliver intensive community-based services.
• Family check-ups (FCU) are associated with less disruptive behavior.
• Parental management training (PMT) teaches parents to reward prosocial behavior.

Depression in Children and Adolescents

• Symptoms common to children, adolescents, and adults include depressed mood, inability to experience pleasure, early morning awakening, fatigue, loss of appetite, problems concentrating, weight loss, and suicidal ideation.
• Symptoms specific to children and adolescents include higher rates of suicide attempts and guilt.
• Etiology of depression in children and adolescents includes genetic factors, less warmth, and more hostility.
• Prevalence of depression is 1% of preschoolers, 2-3% of school-age children, and 6% of girls and 4% of boys during adolescence.

Treatment of Depression in Children and Adolescents

• Medications: SSRIs are more effective than tricyclics.
• Psychotherapy: interpersonal psychotherapy (IPT) and CBT are generally only modestly effective with children and adolescents.

Anxiety in Children and Adolescents

• Fears and worries are common in childhood.
• Anxiety disorder: 3-5% of children and adolescents are diagnosed with anxiety disorder, which must interfere with functioning.
• OCD: prevalence is 1 to 4%, symptoms are similar to those in adults, and most common obsessions include contamination from dirt and germs.
• OCD is more common in boys than girls.

Etiology of Anxiety Disorders

• Genetics play a stronger role in separation anxiety in the context of more negative life events.
• Parenting plays a small role in anxiety disorders.

Treatment of Anxiety Disorders in Childhood and Adolescence

• Exposure to feared object, reward approach behavior, and CBT are used.
• Psychoeducation is also used.

Learning Disability

• Evidence of inadequate development in a specific area of academic, language, speech, or motor skills, e.g., arithmetic or reading.
• Not due to mental retardation, autism, physical disorder, or lack of educational opportunity.
• Individual usually of average or above-average intelligence.
• Often identified and treated in school.
• Reading disorders are more common in boys.

Specific Learning Disorder DSM-5 Criteria

• Difficulties in learning basic academic skills (reading, mathematics, or writing) inconsistent with person's age, schooling, and intelligence.
• Significant interference with academic achievement or activities of daily living.

Etiology of Learning Disabilities

• Impairment in reading (formerly dyslexia): genetic factors, speech perception, and analysis of sounds and their relationship to printed words.
• Evidence from family and twin studies shows genes are associated with typical reading abilities (generalist genes).
• Problems in language processing.

Treatment of Learning Disabilities

• Reading and writing specifiers: multisensory instruction in listening, speaking, and writing skills.
• Readiness skills in younger children as preparation for learning to read.
• Phonics instruction is used.