Disorders Diagnosed in Childhood

Asperger’s Disorder

Asperger’s 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 all suggest marked impairments. Some children fail to develop peer relationships that are appropriate at their developmental level. There is also a lack in normal social and emotional responses. Restricted repetitive behavioral patterns, interests, and activities can be characterized by a child’s being inflexible with non-functioning routines or rituals; repetitive motor mannerisms (twisting of fingers or complex body movements); and a preoccupation with parts 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 children as talking before walking and having “adult” vocabularies.

Attention-Deficit/Hyperactivity Disorder (ADHD)

ADHD is a 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; having difficulty organizing; avoiding tasks that require full attention, such as homework; and being forgetful in daily activities, resulting in the loss of items like pencils, books, school assignments, or toys. Hyperactivity-impulsivity can be described as fidgeting with hands or feet or squirming; leaving an 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; and having difficulty waiting one’s turn, or interrupting or intruding on others. Signs of the disorder are more likely to occur in group situations, but they 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 one-on-one situations.

Conduct Disorder

Conduct Disorder is persistent behavior in which the rights of others are violated, along with societal norms or rules. Four categories comprise these behaviors: aggression to people and animals, destruction of property, deceitfulness or theft, and serious violation of rules. Aggression to people and animals includes bullying, threatening, or intimidation others; initiating physical fights; or using weapons that can cause serious physical harm to others. Destruction of property generally refers to property belonging to other people and can included deliberately setting fires with to cause serious damage. Deceitfulness or theft can include breaking into houses or cars; lying to obtain goods or favors, or to avoid obligations; shoplifting; and forgery. Serious rules violations can include staying out late at night despite parental curfews, running away from home, or not showing up for school. 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 six months. Symptoms include losing one’s temper easily and often, arguing with adults, refusing to comply with adults’ rules, deliberately annoying people, blaming others for one’s mistakes or misbehavior, being easily annoyed by others, as well as being angry, resentful, spiteful, and vindictive. Individuals with this disorder typically do not regard themselves as defiant; instead, they 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, even though 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. Adolescents and adults may consume clay, chalk, or soil. Pica is frequently associated with Mental Retardation and Pervasive Developmental Disorder. It usually comes to clinical attention only after a person suffers from general medical condition (lead poisoning, bowel problems, intestinal obstruction or perforation, or infections).

TIC DISORDER

A tic is a sudden, rapid, recurrent, non-rhythmic 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 tics can include sudden, spontaneous words or phrases, speech blocking, change in pitch, or emphasis or volume in speech. Other examples of complex vocal tics are Palilalia (repeating one’s own words), Echolalia (repeating the last heard sound, word, or phrase), and Coprolalia (the sudden, inappropriate expression of words or phrases). Tics can be suppressed for varying lengths of time, but often appear to be irresistible sooner or later. An individual may feel the need to perform a complex tic in a specific way repeatedly, until the person feels that the tic has been performed “just right,” thus reducing anxiety or tension in the part of the body where the motor or vocal tic occurs.

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