Disorders Diagnosed in Childhood

Aspergers

Aspergers Disorder is a severe impairment in social interaction and repetitive patterns of behavior, interests and activities during school and/or occupation. Eye to eye gaze, facial expressions, body postures, and gestures are all marked impairments. Some children fail to develop peer relationships that are appropriate at their developmental level. There is also a lack in social and emotional responses. Restricted repetitive behavioral patterns, interests and activities can be characterized by a child being inflexible with non functioning routines or rituals; repetitive motor mannerisms (e.g. twisting of fingers or complex body movements); and a persistant preoccupation with part of objects. Generally, there is no significant delay in language in the first 3 years. In fact, just the opposite may occur. Some parents describe their child as having an “adult” vocabulary or even talking before walking.

Attention-Deficit/Hyperactivity Disorder (ADHD)

ADHD is persistent pattern of inattention and/or hyperactivity-impulsivity. These symptoms are present before age 7 and sometimes carry through adulthood affecting work or school. Inattention can be characterized as failing to pay close attention to details or making careless mistakes; not being able to keep attention focused on a task or activity usually resulting in not following through on the task; not listening when spoken to directly; has difficulty organizing; usually avoids tasks that require full attention such as homework; and is often forgetful in daily activities resulting in lost items like pencils, books, school assignments or toys. Hyperactivity-impulsivity can be described as fidgeting with hands or feet or squirming; leaving his/her assigned seat in the classroom; running or climbing excessively where it may be inappropriate; difficulty participating in activities quietly or blurting out answers before questions have been completed; has difficulty waiting their turn or interrupts or intrudes on others. Signs of the disorder are more likely to occur in group situations but may be minimal or even absent when the individual is receiving frequent awards for good behavior, is under close supervision, is engaged in especially interesting activities or is in a one on one situation.

Conduct Disorder

Conduct Disorder is persistent behavior in which the rights of others or major age-appropriate societal norms or rules are violated and can be described in four categories: Aggression to people and animals, Destruction of property, Deceitfulness of theft and Serious violation of rules. Aggression to people and animals includes bullying, threatening or intimidation others; initiating physical fights; or using a weapon that can cause serious physical harm to others. Deliberately engaging in fire setting with intention to cause serious damage and deliberately destroying other peoples property are characteristics of Destruction of property. Deceitfulness or theft can be described as breaking into someone house or car, lying to obtain goods or favors or to avoid obligations, shoplifting or forgery. Staying out late at night despite parental rules, running away from home or not showing up for school are all Serious violations of rules. Individuals with the disorder may have little empathy and concern for the feelings, wishes, and well-being of others.

Oppositional Defiant Disorder (ODD)

ODD is a hostile and defiant behavior that lasts about 6 months. Symptoms include easily and often loosing one’s temper, arguing with adults, refuses to comply with adults’ rules, deliberately annoys people, blames others for his or her mistakes or misbehavior, is easily annoyed by others, angry, resentful, spiteful and vindictive. Usually, individuals with this disorder do not regard themselves as defiant, but will justify their behavior as a response to unreasonable demands or circumstances.

Disruptive Behavior Disorder Not Otherwise Specified

Disruptive Behavior Disorder Not Otherwise Specified includes clinical presentations that do not meet the full criteria of either Oppositional Defiant Disorder or Conduct Disorder, but there is clinically significant impairment.

PICA

Persistent eating of substances that have no nutritional value for a period of at least one month is described as Pica. The typical substances vary with age and include paint, plaster, string or hair in younger children and animal droppings, sand, insects, leaves, or pebbles in older children. Adolescence and adults may consume clay, chalk or soil. Pica is frequently associated with Mental Retardation and Pervasive Developmental Disorder. It only comes to clinical attention after the person suffers from general medical condition (e.g. lead poisoning, bowel problems, intestinal obstruction or perforation or infections).

TIC DISORDER

A tic is a sudden, rapid, recurrent, nonrhythmic motor movement or vocalization. Motor and vocal tics may be simple (eye blinking, nose wrinkling, neck jerking, shoulder shrugging and abdominal tensing) or complex (hand gestures, jumping, touching, stomping, squatting, deep knee bends, and twirling when walking). Simple vocal tics can be meaningless sounds like throat clearing, grunting, sniffing, snorting and chirping. Complex vocal ticscan include sudden, spontaneous words or phrases, speech blocking, change in pitch, emphasis or volume in speech. Palilalia (repeating ones own words)and Echolalia (repeating the last heard sound, word or phrase) are a couple more examples of complex vocal tics as well as Coprolalia ( the sudden inappropriate expression of words or phrases). Tics are often described as irresistible but can be suppressed for varying lengths of time. An individual may feel the need to perform a complex tic in a specific way repeatedly until the person feel that the tic has been performed “just right” reducing any anxiety or tension in the part of the body where the motor or vocal tic occurs.