Common Mental Health Diagnosis in Children

Attention Deficit Hyperactivity Disorder (ADHD)

 Symptoms
 Daydreaming
 Forgetfulness
 Loses things easily
 Fidgeting
 Talking excessively
 Careless mistakes/Unnecessary risks
 Difficulty resisting temptation
 Difficulty getting along w/ others
 Types
 Predominantly Inattentive: difficulty completing a task or finishing a conversation
without getting distracted. Children who are predominantly inattentive have a
difficult time getting through everyday routines.
 Predominantly Hyperactive-Impulsive: difficulty sitting still, excessive talking,
fidgets, and impulsivity issues.
 Combined: When inattentive and hyperactive-impulse are both present in the
child.
 What helps?
 Healthy diet
 Physical Activity
 Limited screen time
 Healthy sleep schedule
 Teaching skills for organization and memory
Oppositional Defiant Disorder (ODD)

 Must be diagnosed by age 12

 Children w/ ODD are defiant with people they know (Family & Teachers)
 Behaviors can range from:
 Temper
 Refusing to comply
 “Resentful and spiteful”
 Tend to instigate
 Blaming others for their behaviors
 Pushes the limits of boundaries and rules
 Disrespectful to adults
 How to help?
 Utilize the child’s positives!!
 Positive praise & positive reinforcement goes a long way
 Flexibility
 You have to model behavior for the child
 If you are mad/frustrated, walking away is the best thing. Come back & address
it when you are calm.
 Pick your battles
 Find something you can do together (interest, hobby, activity)
 Exercise and relax when possible!
Conduct Disorder

 Aggressive behaviors towards others

 When children seriously break the rules, no matter the consequence (ex. Arrest)
 Behaviors:
 Running away
 Breaking the law
 Skipping school
 Staying out past curfew
 Fighting and bullying
 Cruelty to animals
 Lying
 Stealing
 Property damage
 What helps?
 Strong, healthy relationships with adults
 Healthy eating
 Exercising
 Appropriate amounts of sleep
 Positive parenting interventions
 Bullying prevention
 Teach and model empathy
Tourette Syndrome (TS)

 Children with TS have “tics”.

 “Tics are sudden twitches, movements, or sounds that people do repeatedly. People
who have tics cannot stop their body from doing these things.” (CDC, 2020)
 Types of Tics:
 Motor Tics – body movements (blinking, involuntary jerk of the body)
 Vocal Tics – Sounds (saying a particular word, humming, clearing throat)
 Simple Tics – a few parts of the body
 Complex Tics – multiple body tics (possibly a pattern)
 Usually are seen between the ages of 5-10 years’ old
 When excited or anxious, tics can occur more and for longer
 Tics can change, but are chronic
 Resources to help:
 https://keltymentalhealth.ca/collection/keltys-recommended-resources-tics-
and-tourette-syndrome
 https://www.cdc.gov/ncbddd/tourette/links.html
 https://tourette.org/resources/tourette-resources/
Autism Spectrum Disorder (ASD)

 1 in 54 children have Autism

 Males are 4x as likely to have Autism
 ASD causes social, communication, and behavior challenges
 Children will repeat certain behaviors
 Children with ASD like to stick with the same schedule every day, consistently
 Children with ASD may show the following behaviors, according to the CDC (2020):

 not point at objects to show interest (for example, not point at an airplane flying
over)
 not look at objects when another person points at them
 have trouble relating to others or not have an interest in other people at all
 avoid eye contact and want to be alone
 have trouble understanding other people’s feelings or talking about their own
feelings
 some children with ASD prefer not to be held or cuddled, or might cuddle only
when they want to
 may appear to be unaware when people talk to them, but respond to other
sounds
 be very interested in people, but not know how to talk, play, or relate to them
 repeat or echo words or phrases said to them, or repeat words or phrases in
place of normal language
 have trouble expressing their needs using typical words or motions
 not play “pretend” games (for example, not pretend to “feed” a doll)
 repeat actions over and over again
 have trouble adapting when their routine changes
 have unusual reactions to the way things smell, taste, look, feel, or sound
 lose skills they once had (for example, stop saying words they were using)
 prone to anxiety because of difficulty filtering necessary and unnecessary
information their hear, see, etc. – can easily become overwhelmed
 development can vary, with skills ranging from delayed to advanced
 can occur with or without cognitive disability
*ASD can present with many or just a few of the above symptoms. It can be challenging
to diagnose, as it tends to look quite different from child to child.

 What helps?
o Occupational Therapy
o Healthy diet
o Facilitated communication
o Autism Links:
 https://www.cdc.gov/ncbddd/autism/links.html
  https://www.autism-society.org/about-the-autism-
society/publications/resource-materials/
 https://www.autismspeaks.org/sites/default/files/2018-08/Parents
%20Guide%20to%20Autism.pdf
 https://www.helpguide.org/articles/autism-learning-disabilities/helping-
your-child-with-autism-thrive.htm
Depression

 Children may feel worthless, helpless & hopeless

 Child may feel sad or have anxiety regularly
 Child may not want to do things they used to find fun
 Child may get frustrated with tasks or people easily
 Trouble going/staying asleep
 Sleeping too much/not enough
 Eating more/less than usual or not having an appetite at all
 Having body aches
 Concentration issues, decision making problems
 Fatigue
 Guilty feelings
 Suicidal Ideation
Things that could make depression worse:

 Trauma: physical/sexual abuse or loss of a family member

 Major life change: entering foster care
 Some medications
 Alcohol/drug usage
What helps?

 Healthy living
 Coping strategies
 Talking/processing trauma events
 Healthy relationships w/ family & friends
 Sense of purpose
 Medication
 National Suicide Prevention Lifelife (24/7 crisis center): 1-800-273-8255
 Calling your child placement coordinator (during the day) or the crisis line (After hours)
Major Depressive Disorder:

 Chronic feelings of sadness

 Feeling worthless
  Lack of interest in hobbies and activities (new or ones the child once enjoyed)
 Irritability
 Onset is usually adolescence and must be present at least 2 weeks
 Children may expect:
 Difficulty interacting with peers
 Missing school
 Suicidal Ideation
 Fatigue
 Difficulty sleeping
 Changes/Fluctuation in weight
 Comorbidities: Generalized Anxiety Disorder (GAD), Panic Disorder
Persistent Depressive Disorder (PDD):

 Also known as Dysthymic

 A form of chronic depression
 “less severe, but last longer than other forms of depression” –Child Mind Institute
(2020)
 Usually, lasts over one year and symptoms have to be present over 2 months
 Children may experience two or more of the following:
 Irritability
 Depressed mood
 Sadness
 Feeling worthless
 Difficulty finding pleasure in things
 Difficulty sleeping
 Appetite changes
 Fatigue
 Concentration issues
 Low self-esteem
 How Can You Help?
 Be supportive, do not tear the child down
 You are not going to be able to change them, the Child Mind Institute (2020)
states “they have to want that help”
 Work on making your relationship with them stronger
 Use compassion and empathy with children going through this!!
 Validate the emotions they are having, even if you don’t understand why they
are feeling that way. Let them know it is okay to feel that way.
 Use active listening skills, don’t try and solve their problems for them
 Utilize the positives that are displaying, do not harp on the negatives
Disruptive Mood Dysregulation (DMDD):

 “Childhood condition of extreme irritability, anger, and frequent, intense temper

outbursts. - National Institute of Mental Health (2017)
 DMDD is a new diagnosis that was recognized in the DSM-V in 2013
 Symptoms/Signs to look for
 Typically diagnosed between 6-18 years old (usually before age 10)
 Irritability/anger most of the day, everyday
 Verbal or behavior outbursts which occur at least 3x a week
 Difficulty controlling their emotions
 Difficulty functioning day to day in multiple settings (home, school, with other
children)
 Can affect the child’s academic performance
 Disrupt relationships
 Difficulty participating in activities

 Symptoms must occur for at least 1 year

 Increased risk of having depression and anxiety as an adult
 What helps?
 Therapy
 Medication
 Know the child’s triggers
 Try and redirect them before their outburst
 Be predictable and consistent
 Reward the child when they have good behavior
 DO NOT hold past behaviors against them, once you have addressed it with
them!
 Videos to watch:
 https://youtu.be/UPzdAhTxGIc
 https://youtu.be/_yTzJIKmcLQ

Anxiety Disorders
Generalized Anxiety Disorder

 A child shows distress about an event/fear that interferes with their daily activities,
school, or at home
 A child’s focus and persistence that something bad will happen & fear of the future
 Can cause irritability, tiredness, inability to fall or stay asleep, anger, etc.
 How to Help?
o Identify the child’s triggers
o Find coping strategies
o Help the child manage their anxiety
o Provide expectations that are realistic
o If you are going to ask the child questions, make sure they are open ended
o Medication can help
o Exercise/Yoga
o Mindfulness

Obsessive Compulsive Disorder (OCD)

 Having “obsessions and/or compulsions”

 Examples
 Having unwanted thoughts, images, or impulses that repeatedly occur,
causing anxiety or depression
 Thinking or saying words repeatedly
 Performing a task repeatedly
 Having to do something repeatedly, because of “a certain rule” that has
to be done exactly right for the obsession to end
 Child who display these behaviors do them because it makes them feel better
 The obsessions and compulsions can be changed over time. (hand washing,
cleaning, counting numbers, repeating words, etc.)
Panic Disorder

 Panic Disorder: Sudden, intense fear which can cause the child to have symptoms, like
increased heart rate, difficulty breathing, shaking, nervousness, dizziness, etc.
 Panic attacks are common, and people often report feeling as if they are dying or having
a heart attack.
 Symptoms can last from a few minutes to a few hours
 Panic disorder can affect a child when it comes to family, school, peers
 ***Can be difficult to diagnose*** so your child may show symptoms, but not have a
diagnosis yet
 Utilizing the child’s coping mechanism is key to helping them
 Teach children mindfulness and grounding techniques
Phobia Disorder

 A child may have an extreme fear of something, such as, needles, bugs, going
somewhere, natural disasters, etc.
 Consult with your child’s therapist regarding the best way to manage phobias, as
treatments depend upon the type of phobia, interference in the child’s life, etc.
 Assist the child with identifying what makes them feel safe
Post-Traumatic Stress Disorder (PTSD)

 The psychological effects of trauma on a child’s brain and PTSD are factored from:
 Age of the child when first traumatized
 Frequency of trauma
 The biological parent/legal guardian’s response to the trauma
 Types of trauma:
 Sexual Abuse/Human Trafficking
 Sexual Abuse/Incest
 Physical Abuse
 Emotional Abuse
 Neglect
 Maltreatment
 Traumatic Grief
 Traumatic separation (FOSTER CARE)
 Symptoms develop as a means of keeping themselves safe, and include:
o Avoidance of trauma reminders
o Intense emotional/behavioral reactions when exposed to trauma reminders
o Flashbacks or recurrent thoughts of traumatic event
o Being easily triggered/mood swings/tantrums
o Arguing, fighting with others
o Distrust of caregivers and the world
o Young children may reenact trauma in their play
o Difficulty remembering details about the event
o Negative beliefs about self (“I am bad.”)
o Blaming themselves
o Persistent negative emotions (fear, same, anger, etc.)
o Difficulty experiencing positive emotions (love, happiness, etc.)
o Feeling detached from others
o Irritable behavior and angry outburst
o Reckless or self-destructive behaviors
 o Hyper vigilant – constantly on the lookout for danger (causes difficulty focusing)
o Exaggerated startle response
o Sleep disturbance

*PTSD can look like many other mental health disorders, including ODD, Major
Depressive Disorder, ADHD, Disruptive Mood Dysregulation Disorder, etc.

 What helps:
o Listening when a child wants to talk about their trauma but not forcing them to
o Identify ways to help the child feel safe, lovable, and capable
o Understanding their behavior is not about you
o Providing consistent expectations
o Let them know their feelings matter
o Reassure children ways they can keep themselves safe and ways the parents can
help the child feel safe
o Set healthy boundaries to assist child with understanding parent/child,
adult/child relationships
Separation Anxiety Disorder

 Separation Anxiety: the child may show anxiety/distress when they are separated from
someone, such as, their parents
 Separation Anxiety can also occur with foster parents!
 Difficulty sleeping
 May have issues going to school or other places without primary caregiver
 Worry about losing important caregivers or if the caregiver will be harmed or even die
 These children may seem clingy and worry about getting lost from a caregiver
 Often struggle with sleep
 Nightmares of separation
 Frequent physical symptoms when separated or knows will have to separate from a
caregiver (stomach aches, headaches, nausea, diarrhea)
Adjustment Disorder:
- Long lasting unusual response to a stressful situation
- Events that can cause distress in children:
 Parents’ divorce
 A breakup
 Death of a loved one
 Moving
 A major disappointment – remember this is based on how the child perceives a
situation, you may not perceive what happened as a major event but they might
- Symptoms/signs to look for
  Fighting
 Don’t want to go to school
 Depression/Anxiety
 Difficulty expressing emotions appropriately
 Difficulty using coping skills
 Difficulty going/staying asleep
 Consistent, frequent episodes of crying
 Isolating themselves from others
 Property damage
- Boston Children’s Hospital (2020) provides the information below:
Adjustment disorder with depressed mood

 low mood
 tearfulness
 feelings of hopelessness

Adjustment disorder with anxiety

 nervousness
 worry
 jitteriness
 fear of separation from a caregiver

Adjustment disorder with anxiety and depressed mood

 nervousness
 worry
 jitteriness
 fear of separation from a caregiver
 low mood
 tearfulness
 feelings of hopelessness

Adjustment disorder with disturbance of conduct

 violating the rights of others

 Truancy, destruction of property, reckless driving, fighting

Adjustment disorder with mixed disturbance of emotions and conduct

 fear of separation from a caregiver

 violation of the rights of others
  truancy, destruction of property, reckless driving, fighting
 low mood
 tearfulness
 feelings of hopelessness
 nervousness
 worry
 jitteriness

- Comorbidities w/ Adjustment disorder: Depression, Anxiety, Substance Use

Acute Stress Disorder

 A child develops Acute Stress Disorder when they have a major reaction to an event,
such as:
 Death of a loved one
 Serious sickness of a loved one
 Serious injury or accident
 Natural Disaster
 Violence
 Sexual Assault
 Stressful experience (that they perceive as a major event)
 Symptoms usually become present after 3 days to a month after the event
 Children may experience difficulty with:
 Using coping mechanisms
 Day to day activities at home, school, or anywhere else
 Feeling foggy or dazed
 Distressed when exposed to similar events/stimuli
 Trying to stay away from the place or people who remind them of what
happened
 Nightmares
 Difficulty sleeping
 Guilt or hopelessness
 Hypervigilance
 Acute Stress Disorder is not as chronic as PTSD, however if it lasts more than a month it
could be PTSD

Disinhibited Social Engagement Disorder

  When children try to form an attachment with someone, after only meeting them a
couple of times.
 Child doesn’t understand “Stranger Danger”
 Children with Disinhibited Social Engagement Disorder will/can become attached to a
stranger they just met
 Children may look to a stranger when they need support or comfort (Ex. If they trip and
fall or another child hurts their feelings)
 Child have to show at least two of the following:
 Engage with people they do not know
 Exhibit behaviors (verbal or physical) that aren’t culturally appropriate
 Won’t check in or tell a guardian where/when they go somewhere
 Go with an adult they do not know
 Information for Foster Parents
 Be cautious of where your Child is and who is around
 The child may walk off with a stranger
 SAFETY ISSUES!
 This is not impulse control; these children do not understand/feel like they need
to tell a guardian
 History of neglect has to be present!
 Basic emotional needs have not been met
 Constant change in caregivers (especially kids in foster care!!), which does not
allow them to form a healthy, permanent attachment with an adult
 Growing up in a setting that doesn’t allow the child to form healthy relationships
(when children are in residential settings)
Reactive Attachment Disorder (RAD)

 Children are diagnosed between 9 months – 5 years’ old

 When a child’s emotional needs (safety, interaction, and affection) are not being met,
they are at risk of developing RAD.
 “Repeated changes of primary caregiver that prevent formation of stable attachments”
can cause RAD
 These children do not have a “preferred caregiver”; difficulty creating a bond with
caregivers
 these children have trouble expressing their emotions appropriately, express affection,
or look for an adult when stressed/worried
 Trauma can affect the brain by altering the connectivity of the brain and the chemicals
found in the brain
 Neglect is more harmful to the brain than abuse and other trauma
 Genetics, behavior, and environment are all connected
 Children with RAD do not process or respond to distress the same way as other children
  These children will soothe themselves and calm down when no one is giving them
attention
 Children may experience:
 Irritability
 Sadness
 Fear
 Issues interacting with others
 Withdrawn
 What helps a child with RAD?
 Living in an environment that is consistent, stable, and nurturing.
 The child needs have to be met based on their developmental ability not their
age.
 Family therapy
 Parent training
 Video explaining RAD: https://youtu.be/c4zxlCZKlLI
 **For children in foster care, permanency planning is key!**
 Comorbidities: physical growth delays, developmental delays
 When older: eating disorders, anger management, depression, anxiety, school
problems, drug and alcohol abuse

Bipolar Disorder

 Previously called Manic-Depressive disorder

 Children may have:

 Changes in sexual behavior
 Make sudden changes to their appearance
 Hallucinations and/or delusions can present themselves
 Hostility and physical aggression can occur
 Depression
 Suicidal Ideation (15x greater than someone without Bipolar Disorder)
 Need to be IVC’ed
 Depressive Episodes
 Loss of interest in things they once enjoyed
 Sadness
 Increased sleeping
 Manic Episodes
 Inflated ego, feeling invincible
 Grandiose thinking; feeling like they can do anything
 Self-confidence
  Reckless
 Energetic
 Psychotic episodes can have kids exhibit delusions
 Onset is usually mid to late teens, however children can be diagnosed younger
 Lifelong condition!!
 Watch for suicidal ideation
 Eating disorders
 Sleeping changes
 Personality changes
 Appearance changes
 Happiness after being very depressed
 Giving away their things
 More about Psychosis
 Thinking and emotion will not be realistic
 Hallucinations (visual or auditory)
 Delusions
 What can help?
 Stress reductions
 Sleep hygiene
 Managing comorbidities
Intermediate Explosive Disorder (IED)

 Children with IED experience “short episodes of intense, uncontrollable anger or

aggression with little or no apparent cause”. (Child Mind Institute, 2020)
 Onset is late childhood or adolescence
 Children with IED cannot control emotions, they usually explode without any reason and
can last 30 minutes
 Episodes can become more intense and can eventually result in property damage
and/or harm to others
 IED effects the relationships children have with other people
 IED also effects school performance
 Children may experience
 Road rage
 Instigating fights
 Breaking furniture
 Punching holes in the wall
 Out of Control feeling
 Higher risk of suicide
 What helps?
 Effective, open communication
  Staying calm
 Don’t give in
 Positively praise their good behavior
 Avoid their triggers
 Comorbidities: anxiety, depression, and substance use

Gender Dysphoria

 A child experiences Gender Dysphoria when they do not self-identify as the gender they
have been assigned.
 Assigned gender: biological sex/gender
 Experienced/expressed gender: how a child/person views themselves – not limited to
male or female
 Typically appears more during adolescence/puberty but can appear in young children as
well
 Children experiencing this may be extremely uncomfortable with roles and expectations
given to them based on their assigned gender
 Some children may cross-dress or prefer styles more commonly worn by their
experienced/expressed gender
 A child may want to have a gender reassignment surgery, cross-sex hormone treatment
and/or be referred to with different pronouns
 Brain scans have shown individuals with Gender Dysphoria have brains more similar to
that of their expressed gender than their assigned gender
 “Gender dysphoria is also not the same being gay/lesbian.”
 Definitions and Pronouns can be found at: https://www.psychiatry.org/patients-
families/gender-dysphoria/what-is-gender-dysphoria

References
Acute Stress Disorder Basics. (2020). Child Mind Institute. Retrieved from:
https://childmind.org/guide/guide-acute-stress-disorder/

Adjustment Disorder Basics. (2020). Child Mind Institute. Retrieved from:

https://childmind.org/guide/guide-adjustment-disorder/

Adjustment Disorders. (2020). Boston Children’s Hospital. Retrieved from:

http://www.childrenshospital.org/conditions-and-treatments/conditions/a/adjustment-
disorders/symptoms-and-causes

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(5th ed.). Washington, DC.

Autism Spectrum Disorder Basics. (2020). Child Mind Institute. Retrieved from:
https://childmind.org/guide/guide-to-autism-spectrum-disorder/

Behavioral Treatment for Kids with Anxiety. (2020). Child Mind Institute. Retrieved from:
https://childmind.org/article/behavioral-treatment-kids-anxiety/

Bipolar Disorder. (2020). National Institute of Mental Health. Retrieved from:

https://www.nimh.nih.gov/health/statistics/bipolar-disorder.shtml

Bipolar Disorder. (2020). Child Mind Institute. Retrieved from: https://childmind.org/guide/guide-

to-bipolar-disorder/

Children’s Mental Disorders. (2020). Centers for Disease Control and Prevention. Retrieved
from: https://www.cdc.gov/childrensmentalhealth/symptoms.html

Common Mental Health Diagnosis in Children and Youth. (2020). Association for Children’s
Mental Health. Retrieved from: http://www.acmh-mi.org/get-information/childrens-
mental-health-101/common-diagnosis/

Corbin, J. R. (2007). Reactive attachment disorder: A biopsychosocial disturbance of

attachment. Child and Adolescent Social Work Journal, 24, 539-552.

Depression. (2018). National Institute of Mental Health. Retrieved from:

https://www.nimh.nih.gov/health/topics/depression/index.shtml
Disinhibited Social Engagement Disorder. (2020). Retrieved from:

https://www.verywellmind.com/what-is-disinhibited-social-engagement-disorder-4138254

Disruptive Mood Dysregulation Disorder. (2017). National Institute of Mental Health.

Retrieved from: https://www.nimh.nih.gov/health/topics/disruptive-mood-dysregulation-

disorder-dmdd/disruptive-mood-dysregulation-disorder.shtml

Eating Disorders Symptoms and Causes. (2020). Boston Children’s Hospital. Retrieved from:

http://www.childrenshospital.org/conditions-and-treatments/conditions/e/eating-

disorder/symptoms-and-causes

Intermittent Explosive Disorder. (2020). Child Mind Institute. Retrieved from:

https://childmind.org/guide/intermittent-explosive-disorder/

Major Depression Disorder Basics. (2020). Child Mind Institute. Retrieved from:

https://childmind.org/guide/major-depressive-disorder/

Oppositional Defiant Disorder. (2020). American Academy of Child & Adolescent Psychiatry.

Retrieved from:

https://www.aacap.org/aacap/families_and_youth/facts_for_families/fff-

guide/Children-With-Oppositional-Defiant-Disorder-072.aspx

Panic Disorder in Children and Adolescents. (2013). American Academy of Child & Adolescent

Psychiatry. Retrieved from:

https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-

Guide/Panic-Disorder-In-Children-And-Adolescents-050.aspx

Parenting A Depressed Teenager (2020). Child Mind Institute. Retrieved from:

https://childmind.org/article/how-to-help-your-depressed-teenager/
Persistent Depressive Disorder Basics. (2020). Child Mind Institute. Retrieved from:

https://childmind.org/guide/persistent-depressive-disorder-dysthymia/

Reactive Attachment Disorder Basics. (2020). Child Mind Institute. Retrieved from:

https://childmind.org/guide/reactive-attachment-disorder/

Watching for Signs of Psychosis in Teens. (2020). Child Mind Institute. Retrieved from:

https://childmind.org/article/watching-for-signs-of-psychosis-in-teens/

What is Gender Dysphoria? (2016). American Psychiatric Association. Retrieved from:

https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-gender-dysphoria

What to Do (and Not Do) When Children Are Anxious. (2020). Child Mind Institute. Retrieved

from: https://childmind.org/article/what-to-do-and-not-do-when-children-are-anxious/