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Child Psychiatry

Child Psychiatry

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Published by edawood2
lecture on child psychiatry
lecture on child psychiatry

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Published by: edawood2 on May 24, 2008
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11/16/2012

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Child Psychiatry
Branch of medicine concerned with the study and treatment of mental, emotional,and behavioral disorders of childhood. Child psychiatry has been recognized as a divisionof the field of psychiatry and neurology since the mid 1920s.
Many children and adolescents have mental health problems that interfere with their normal development and daily life activities. Some mental health problems are mild,while others are more severe. Some mental health problems last for only short periods of time, while others, potentially, last a lifetime.Anxiety disorders are the most common mental health problems that occur in childrenand adolescents. Three percent to 5 percent of school-aged children are diagnosed withattention-deficit/hyperactivity disorder (ADHD).Eating disorders, including anorexia nervosa and bulimia nervosa, are common amongadolescent and young women in the US.The National Institute of Mental Health (NIMH) states that research studies have reportedthat up to 3 percent of children and up to 8 percent of adolescents in the US suffer fromdepression.It is important to know that help is available. Most children and adolescents whoexperience mental health problems can return to normal daily activities, if they receiveappropriate treatment
I- Mental RetardationDefinition
: MR is a term for a pattern of persistently slowlearningof basic motor andlanguageskills ("milestones") duringchildhood, and a significantly below-normal globalintellectual capacityas anadult. One common criterion for diagnosis of mental retardation is a testedintelligence quotient(IQ) of 70 or below and deficits in adaptive functioning.People with mental retardation may be described as havingdevelopmental disabilities,globaldevelopmental delay, or learning difficulties.
Signs and Symptoms
There are many signs. For example, children with developmental disabilities maylearn to sit up, to crawl, or to walk later than other children, or they may learn to talk later. Both adults and children with intellectual disabilities may also:
Have troublespeaking.
 
Find it hard toremember things.
Have trouble understandingsocial rules.
Have trouble discerningcause and effect.
Have troublesolving problems. 
Have trouble thinkinglogically. 
Persistence of infantilebehavior.In early childhood mild disability (IQ 60–70) may not be obvious, and may not bediagnosed until children begin school. Even when poor academic performance isrecognized, it may take expert assessment to distinguish mild mental disability fromlearning disabilityor behavior problems. As they become adults, many people can liveindependently and may be considered by others in their community as "slow" rather thanretarded.Moderate disability (IQ 50–60) is nearly always obvious within the first years of life.These people will encounter difficulty in school, at home, and in the community. In manycases they will need to join special, usually separate, classes in school, but they can still progress to become functioning members of society. As adults they may live with their  parents, in a supportive group home, or even semi-independently with significantsupportive services to help them, for example, manage their finances.Among people with intellectual disabilities, only about one in eight will score below50 on IQ tests. A person with a more severe disability will need more intensive supportand supervision his or her entire life.The limitations of cognitive function will cause a child to learn and develop moreslowly than a typical child. Children may take longer to learn to speak, walk, and takecare of their personal needs such as dressing or eating. Learning will take them longer,require more repetition, and there may be some things they cannot learn. The extent of the limits of learning is a function of the severity of the disability. Nevertheless, virtually every child is able to learn, develop, and grow to some extent.
Diagnosis
According to the latest edition of the
(DSM-IV), there are three criteria before a person is considered to have adevelopmental disability: anIQbelow 70, significant limitations in two or more areas of adaptive behavior (i.e., ability to function at age level in an ordinary environment), andevidence that the limitations became apparent inchildhood.
1. IQ below 70
IQtests were created as an attempt to measure a person's abilities in several areas,includinglanguage,numeracyand problem-solving. The average score is 100. People with a score below 75 will often, but not always, have difficulties with daily living skills.
 
Since factors other than mental ability (depression, anxiety, lack of adequate effort,cultural differences, etc.) can yield low IQ scores, it is important for the evaluator to rulethem out prior to concluding that measured IQ is "significantly below average".The following ranges, based on theWechsler Adult Intelligence Scale(WAIS), arein standard use today:
ClassIQ
Profound mental retardationBelow 20Severe mental retardation2034Moderate mental retardation3549Mild mental retardation5069Borderline mental retardation7079
2
. Significant limitations in two or more areas of adaptive behavior
Adaptive behavior, or adaptive functioning, refers to the skills needed to liveindependently (or at the minimally acceptable level for age).To assess adaptive behavior, professionals compare the functional abilities of a childto those of other children of similar age. To measure adaptive behavior, professionals usestructured interviews, with which they systematically elicit information about the person'sfunctioning in the community from someone who knows them well. There are manyadaptive behavior scales, and accurate assessment of the quality of someone's adaptive behavior requires clinical judgment as well. Certain skills are important to adaptive behavior, such as:
Daily living skills, such as getting dressed, using the bathroom, and feedingoneself.
Communicationskills, such as understanding what is said and being able toanswer.
Social skillswith peers,familymembers, spouses, adults, and others.

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