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Common disorder

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Navjyot Singh
Navjyot Singh

The document discusses several common behavioral disorders in children including repetitive behaviors, finger/thumb sucking, nail biting, temper tantrums, evening colic, stranger reaction/anxiety, pica, breath holding spasms, and stuttering/stammering. For each disorder, the document describes characteristics, potential causes, management strategies for parents/caregivers which generally involve reassurance, ignoring problematic behaviors, and positive reinforcement of acceptable behaviors.

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Presented By: Navjyot Singh M.Sc.(Nsg) 1st Year
INTRODUCTION Disruptive behaviors should be considered from both a developmental and a bio-psychosocial framework. A child who is not doing what adults want him to do at a particular time is considered as behavioral disorder.
DEFINITION A person is said to have a behavior disorder when he or she demonstrates behavior that is noticeably different from that expected in the school or community.
COMMON BEHAVIORAL DISORDERS  Repetitive Behaviors  Finger (thumb) sucking & Nail biting  Temper Tantrums  Evening Colic  Stranger Reaction / Anxiety  Pica  Breath holding spasms  Stuttering / Stammering
REPETITIVE BEHAVIORS  Benign & self-limiting  Begin between 6 – 10 years Example- Body rocking, Head banging  Head banging  In 5-20% of children during infancy & toddler years  Can result in callus formation, abrasions, contusions
MANAGEMENT Assurance Teach parents to ignore – as concern and punishment can reinforce it. Padding
FINGER (THUMB) SUCKING & NAIL BITING
 Sensory solace for child (“internal stroking”) to cope with stressful situation in infants and toddlers.  Reinforced by attention from parents.  Most give up by 2 years.  Predisposing factors: • Developmental delay • Neglect
ADVERSE EFFECTS  Malocclusion – open bite  Mastication difficulty  Speech difficulty (D and T)  Lisping  Paronychia and digital abnormalities
MANAGEMENT  Reassure parents that it’s transient.  Improve parental attention / nurturing.  Teach parent to ignore; and give more attention to positive aspects of child’s behavior.  Provide child praise / reward for substitute behaviors.  Bitter salves, thumb splints, gloves may be used to reduce thumb sucking.
TEMPER TANTRUMS
 In 18 months to 3 year olds due to development of sense of autonomy.  Child displays defiance, negativism / oppositionalism by having temper tantrums.  Normal part of child development.  Gets reinforced when parents respond to it by punitive anger.  Child wrongly learns that temper tantrums are a reasonable response to frustration
MANAGEMENT  In general, parents advised to:  Set a good example to child  Pay attention to child  Spend quality time  Have open communication with child  Have consistency in behavior
 During temper tantrum:  Parents to ignore child and once child is calm, tell child that such behavior is not acceptable  Verbal reprimand should not be abusive  Never beat or threaten child  Impose “Time Out” - if temper tantrum is disruptive, out of control and occurring in public place.
EVENING COLIC
Intermittent episodes of abdominal pain and severe crying in normal infants Begins at 1-2 weeks age and persists till 3-4 months. Crying usually in late afternoon or evening
CAUSE  Not known  More likely if the child is over active and parents are over anxious  Could be a manifestation of -hunger, -aerophagia, -immaturity of intestine, -overfeeding,
MANAGEMENT  During Episode  Hold the child erect or prone  Avoid drugs  Counseling - Coping with the parents  Reassure the parents that infant is not sick  They need to soothe more with repetitive sound and stimulate less with decrease in picking up and feeding with every cry.
STRANGER REACTION
 By 6-7 months age infant can differentiate from primary care givers and others  At this age they develop fear of others.  This may last for a few months to peak around 13-15 months  It might be an indication for later development of behavioral problem as separation anxiety.
MANAGEMENT  Teach relaxation technique such as slowly exposing them to stranger,  Initially from a distance  Asking them to greet and slowly advance  Reassure the parents that the behavior gradually declines  But if persists, refer to child psychiatrist
PICA
Repeated or chronic ingestion of non-nutritive substances. It’s an eating disorder. Normal in infants and toddlers. Examples: mud, paint, clay, plaster, charcoal, soil.
PREDISPOSING FACTORS  Parental neglect  Poor supervision  Mental retardation  Lack of affection Psychological neglect, orphans)  Family disorganization  Lower socioeconomic class  Autism
MANAGEMENT  Screening for:  Iron deficiency anemia  Worm infestations  Lead poisoning  Family dysfunction  Treat accordingly to cause.
BREATH HOLDING SPASMS
 Behavioral problem in infants and toddlers.  Child cries and then holds breath until limp.  Cyanosis may occur.  Sometimes, loss of consciousness or even seizure can occur.  It is child’s attempt to control environment: parents/caregivers.  Benign condition: no risk of epilepsy developing in later life.
MANAGEMENT  Referral to Child Guidance Clinic.  Referral to Child Psychologist – If BHS accompanied with head banging or highly aggressive behavior.
STUTTERING / STAMMERING
 Defect speech  Stumbling and spasmodic repetition of some syllables with pauses  Difficulty in pronouncing consonants  Caused by spasm of lingual and palatal muscles  Usually begins between 2 – 5 years  Reminding and ridiculing aggravate  Child loses self-confidence and become more hesitant  They can often sing or recite poems without stuttering
MANAGEMENT  Parents should be reassured  They should not show undue concern and accept his speech without pressurizing him to repeat  Children should be given emotional support  Older children with secondary stuttering should be referred to speech therapist
Common disorder

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Common disorder

  • 1. Presented By: Navjyot Singh M.Sc.(Nsg) 1st Year
  • 2. INTRODUCTION Disruptive behaviors should be considered from both a developmental and a bio-psychosocial framework. A child who is not doing what adults want him to do at a particular time is considered as behavioral disorder.
  • 3. DEFINITION A person is said to have a behavior disorder when he or she demonstrates behavior that is noticeably different from that expected in the school or community.
  • 4. COMMON BEHAVIORAL DISORDERS  Repetitive Behaviors  Finger (thumb) sucking & Nail biting  Temper Tantrums  Evening Colic  Stranger Reaction / Anxiety  Pica  Breath holding spasms  Stuttering / Stammering
  • 5. REPETITIVE BEHAVIORS  Benign & self-limiting  Begin between 6 – 10 years Example- Body rocking, Head banging  Head banging  In 5-20% of children during infancy & toddler years  Can result in callus formation, abrasions, contusions
  • 6. MANAGEMENT Assurance Teach parents to ignore – as concern and punishment can reinforce it. Padding
  • 8.  Sensory solace for child (“internal stroking”) to cope with stressful situation in infants and toddlers.  Reinforced by attention from parents.  Most give up by 2 years.  Predisposing factors: • Developmental delay • Neglect
  • 9. ADVERSE EFFECTS  Malocclusion – open bite  Mastication difficulty  Speech difficulty (D and T)  Lisping  Paronychia and digital abnormalities
  • 10. MANAGEMENT  Reassure parents that it’s transient.  Improve parental attention / nurturing.  Teach parent to ignore; and give more attention to positive aspects of child’s behavior.  Provide child praise / reward for substitute behaviors.  Bitter salves, thumb splints, gloves may be used to reduce thumb sucking.
  • 12.  In 18 months to 3 year olds due to development of sense of autonomy.  Child displays defiance, negativism / oppositionalism by having temper tantrums.  Normal part of child development.  Gets reinforced when parents respond to it by punitive anger.  Child wrongly learns that temper tantrums are a reasonable response to frustration
  • 13. MANAGEMENT  In general, parents advised to:  Set a good example to child  Pay attention to child  Spend quality time  Have open communication with child  Have consistency in behavior
  • 14.  During temper tantrum:  Parents to ignore child and once child is calm, tell child that such behavior is not acceptable  Verbal reprimand should not be abusive  Never beat or threaten child  Impose “Time Out” - if temper tantrum is disruptive, out of control and occurring in public place.
  • 16. Intermittent episodes of abdominal pain and severe crying in normal infants Begins at 1-2 weeks age and persists till 3-4 months. Crying usually in late afternoon or evening
  • 17. CAUSE  Not known  More likely if the child is over active and parents are over anxious  Could be a manifestation of -hunger, -aerophagia, -immaturity of intestine, -overfeeding,
  • 18. MANAGEMENT  During Episode  Hold the child erect or prone  Avoid drugs  Counseling - Coping with the parents  Reassure the parents that infant is not sick  They need to soothe more with repetitive sound and stimulate less with decrease in picking up and feeding with every cry.
  • 20.  By 6-7 months age infant can differentiate from primary care givers and others  At this age they develop fear of others.  This may last for a few months to peak around 13-15 months  It might be an indication for later development of behavioral problem as separation anxiety.
  • 21. MANAGEMENT  Teach relaxation technique such as slowly exposing them to stranger,  Initially from a distance  Asking them to greet and slowly advance  Reassure the parents that the behavior gradually declines  But if persists, refer to child psychiatrist
  • 22. PICA
  • 23. Repeated or chronic ingestion of non-nutritive substances. It’s an eating disorder. Normal in infants and toddlers. Examples: mud, paint, clay, plaster, charcoal, soil.
  • 24. PREDISPOSING FACTORS  Parental neglect  Poor supervision  Mental retardation  Lack of affection Psychological neglect, orphans)  Family disorganization  Lower socioeconomic class  Autism
  • 25. MANAGEMENT  Screening for:  Iron deficiency anemia  Worm infestations  Lead poisoning  Family dysfunction  Treat accordingly to cause.
  • 26. BREATH HOLDING SPASMS
  • 27.  Behavioral problem in infants and toddlers.  Child cries and then holds breath until limp.  Cyanosis may occur.  Sometimes, loss of consciousness or even seizure can occur.  It is child’s attempt to control environment: parents/caregivers.  Benign condition: no risk of epilepsy developing in later life.
  • 28. MANAGEMENT  Referral to Child Guidance Clinic.  Referral to Child Psychologist – If BHS accompanied with head banging or highly aggressive behavior.
  • 30.  Defect speech  Stumbling and spasmodic repetition of some syllables with pauses  Difficulty in pronouncing consonants  Caused by spasm of lingual and palatal muscles  Usually begins between 2 – 5 years  Reminding and ridiculing aggravate  Child loses self-confidence and become more hesitant  They can often sing or recite poems without stuttering
  • 31. MANAGEMENT  Parents should be reassured  They should not show undue concern and accept his speech without pressurizing him to repeat  Children should be given emotional support  Older children with secondary stuttering should be referred to speech therapist