Working with Children: Emotional/Behavioral Disorders

Working with Children and Adolescents with Emotional/Behavioral Disorders

• Criteria for Diagnosis: Inability to learn unexplained by intellect, senses, or health; difficulty maintaining relationships; inappropriate behaviors; pervasive unhappiness or depression; physical symptoms or fears related to personal or school issues.

Disorders of Attention and Activity (ADHD)

• Type I (Predominantly Inattentive): Six or more symptoms of inattention for at least six months, including difficulty sustaining attention, easily distracted, forgetfulness.
• Type II (Predominantly Hyperactive-Impulsive): Six or more symptoms of hyperactivity-impulsivity for at least six months, including fidgeting, difficulty remaining seated, impulsivity.
• Type III (Combined): Meets criteria for both inattentive and hyperactive-impulsive types.
• Recommended Interventions: Behavioral therapy, parent training, classroom accommodations, stimulant medication.

Depression

• Criteria: Persistent sadness, loss of interest, significant weight/appetite change, fatigue, feelings of worthlessness.
• Recommended Interventions: Cognitive Behavioral Therapy (CBT), psychotherapy, antidepressants (e.g., SSRIs), school counseling.

Conduct Disorders

• Criteria: Repetitive behaviors violating societal norms, aggression, deceitfulness, serious rule violations.
• Recommended Interventions: Multisystemic therapy, parent management training, social skills training.

Schizophrenia

• Criteria: Delusions, hallucinations, disorganized speech/behavior, negative symptoms for at least six months.
• Recommended Interventions: Antipsychotics, family psychoeducation, individual therapy focusing on coping skills.

Anxiety Disorders

• Criteria: Excessive fear, worry, or behavioral disturbances affecting daily functioning.
• Recommended Interventions: CBT, exposure therapy, relaxation techniques, SSRIs.

OCD (Obsessive-Compulsive Disorder)

• Criteria: Presence of obsessions (intrusive thoughts) and/or compulsions (repetitive behaviors).
• Recommended Interventions: Exposure and Response Prevention (ERP), CBT, SSRIs.

Eating Disorders

• Types: Anorexia Nervosa (restrictive eating, fear of weight gain); Bulimia Nervosa (binge eating followed by purging); Binge Eating Disorder (recurrent overeating without purging).
• Recommended Interventions: Nutritional counseling, CBT, family-based therapy.

GAD (Generalized Anxiety Disorder)

• Criteria: Excessive, uncontrollable worry for at least six months, restlessness, muscle tension.
• Recommended Interventions: CBT, relaxation techniques, mindfulness training, SSRIs.

Social Phobias (Including School Phobia)

• Criteria: Intense fear of social situations leading to avoidance, impaired functioning.
• Recommended Interventions: CBT with exposure therapy, social skills training, family support.

PTSD (Posttraumatic Stress Disorder)

• Criteria: Intrusive memories, avoidance, negative mood, heightened arousal following trauma.
• Recommended Interventions: Trauma-focused CBT, Eye Movement Desensitization and Reprocessing (EMDR), SSRIs.

Assessment

• Functional Behavioral Assessment (FBA): Determining the function and factors maintaining a behavior to design interventions that teach new behaviors.
• Behavior Intervention Plan (BIP): Formal plan based on FBA, describing the problem behavior, hypothesized reasons, and intervention strategies.

Example Assessment Question:

• Bob, a 10-year-old boy, has persistent upsetting thoughts and rituals to control anxiety. These rituals involve repeatedly checking, touching things in a sequence, counting, and difficulty discarding things. The best representation of his condition is Obsessive Compulsive Disorder.