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Behavioral Problems in Children & Adolescents
Jaydeep Choudhury
CHAPTER 1:
Behavior Problems in Children: Looking Beyond the Surface
WHY PEDIATRICIANS NEED TO KNOW ABOUT BEHAVIORAL DISORDERS?
BEHAVIORAL DISORDERS: COST TO THE SOCIETY
HOW COMMON ARE BEHAVIOR DISORDERS?
Analyzing Disruptive Behavior: Playing the Role of a Detective
Impact of Behavior Disorders
UNDERSTANDING THE CONTEXT: WHY DO CHILDREN DISPLAY DISRUPTIVE BEHAVIOR?
CONCLUSION
CHAPTER 2:
Intellectual Disability
WHAT IS INTELLECTUAL DISABILITY?
Disorder Characteristics
ETIOLOGY
COMPREHENSIVE ASSESSMENT
WHEN TO SUSPECT
CLINICAL FEATURES
History
Physical Examination
Investigations
Management
Long-term Outcome
CHAPTER 3:
Learning Disorders
ETIOLOGY
Medical Disorders
Epilepsy
Neurological Conditions
Fetal Alcohol Syndrome
Tourette Syndrome
Others
Attention Deficit Hyperactivity Disorder
Psychiatric Disorders
Autism Spectrum Disorder
Learning Disorders
Developmental Dyspraxia
Visual and Auditory Sensory and Perceptual Defects
Specific Learning Disabilities
Definition
Types
Epidemiology
Pathophysiology
Neurobiological Basis
Genetic Basis
Phonologic Basis
Clinical Presentation
Multidisciplinary Team
Evaluation Procedure
Medical History
Birth History
Development History
School History
Family History
Social History
Physical Examination
Neurological Examination
Cognitive Assessment
Educational Assessment
Investigations
Management
Remedial Education
Role of Occupational Therapist
Role of Psychiatrist
Role of School and Classroom Teacher
Resource Room at School
Provisions at School and Educational Board
Classroom Modifications
Give Students with Dyslexia Preferential Seating
Prepare Group for In-class Lessons
Use Multisensory Teaching Methods
Provide Students with Thorough Instructions
Ensure Thorough Understanding of Homework and Classwork
Help Students Develop Organizational Skills
Classroom Behavior and Provisions
Consider Accommodations during School Examination
Role of Government
Provisions
Sarva Shiksha Abhiyaan
Centers for Certification and Diagnosis of Specific Learning Disabilities
Courses in Special Education
COUNSELING THE PARENTS
OUTCOME OF SPECIFIC LEARNING DISABILITIES
CHAPTER 4:
Developmental Coordination Disorder
DEFINITION
EPIDEMIOLOGY
DIAGNOSIS
CLINICAL FEATURES
Comorbidities
Secondary Morbidities or Impact
TREATMENT
Screening
Screening Questionnaires for Parents
Responses
Management
CHAPTER 5:
Stereotypic Movement Disorder
EPIDEMIOLOGY
DIAGNOSTIC CRITERIA
Specify if
Specify Current Severity
Differential Diagnosis
Normal Development
Autism Spectrum Disorder
Tic Disorder
Other Neurological Conditions
COURSE AND OUTCOME
TREATMENT
Behavioral Modification
Drugs
CHAPTER 6:
Communication Disorders
COMPONENTS OF LANGUAGE
Normal Language Development
Prelinguistic Period
Language Development in Toddler and Preschool Years
COMMUNICATION DISORDERS
ASSESSMENT OF THE CHILD WITH SUSPECTED COMMUNICATION DISORDER
History
Examination
Red Flags in a Preschooler
Possible Causes of Communication Impairments
COMMON COMMUNICATION DISORDERS
Autism Spectrum Disorder
Dysfluency or Stammering
Disorders of Articulation and Phonology
Developmental Language Delay
LINK BETWEEN COMMUNICATION AND BEHAVIOR PROBLEMS
ROLE OF THE TEAM
CHAPTER 7:
Autism Spectrum Disorder
HISTORY AND EVOLUTION
Incidence and Epidemiology
Clinical Features
Socialization
Emotions
Communication
Repetitive action
Diagnostic Criteria
1. Classical Autism
2. Double Syndrome
3. Transient Autism
Diagnostic Criteria According to DSM-5
Criterion A
Criterion B
Criterion C
Criterion D
ASD DSM-5 Diagnosis: Specifiers and Modifiers
Etiology
Neurobiological Basis
Neurochemical Research
Genetic Factors
Immune System Role in the Biology of Autism
Associated Medical Conditions
Clinical Features
Laboratory Tests and Imaging
Management
Pharmacotherapeutics
Dietary Intervention
Vitamins
Alerting Signs
Early Alerting Signs
Outcome
CHAPTER 8:
Attention-Deficit/Hyperactivity Disorder
HISTORY AND NOMENCLATURE
Etiology
Epidemiology
Diagnosing ADHD
Specify Whether
Specify If
Specify Current Severity
Clinical Features
Assessment
Differential Diagnosis
Comorbid Conditions
Treatment
Education and Family Interventions
Behavioral Management
Behavior Management Strategies for Preschoolers (5 years and below)
Behavior Management Strategies for 6–12 Years Children
Behavior Management Strategies for Teenagers
Pharmacotherapy
Other Drugs
Schooling Issues of ADHD Children
Safety Measures for ADHD Children
Prognosis
Role of Pediatrician
CHAPTER 9:
Disruptive Behavior
OPPOSITIONAL DEFIANT DISORDER
Epidemiology
Etiology
Diagnosis
Angry/Irritable Mood
Argumentative/Defiant Behavior
Vindictiveness
Specify Current Severity
Clinical Features
Early Warning Signs
Differential Diagnosis
Treatment
CONDUCT DISORDER
Epidemiology
Etiology
Diagnosis
Aggression to People and Animals
Destruction of Property
Deceitfulness or Theft
Serious Violations of Rules
Specific Types Based on Age at Onset
Specify Severity
Clinical Features
Course of Disease
Differential Diagnosis
Treatment
INTERMITTENT EXPLOSIVE DISORDER
CHAPTER 10:
Feeding and Eating Disorders in Infancy and Childhood
EPIDEMIOLOGY
ETIOPATHOGENESIS AND DIAGNOSIS
CLASSICAL EATING DISORDERS
Highlights of Changes from DSM-IV-TR to DSM-5
Unclassified Eating Disturbances
Management
CHAPTER 11:
Elimination Disorders
URINARY INCONTINENCE
DAYTIME INCONTINENCE
Etiology
Pathophysiology
Neurological Condition
Anatomical Abnormalities
Clinical Features
Investigations
Management
Behavioral Approaches
Medication
Intensive Evaluation and Treatment
ENURESIS (NOCTURNAL INCONTINENCE)
Classification
Incidence
Genetics
Physiology of Nocturnal Continence
Pathophysiology and Pathogenesis
Clinical Features
Investigations
Management
Monosymptomatic Nocturnal Enuresis
Alarm Therapy
Pharmacotherapy
Alternative and Complementary Therapy
Approach to Nonresponders
CHAPTER 12:
Tic Disorders
EPIDEMIOLOGY
ETIOLOGY
CLINICAL FEATURES
Transient Tic Disorder
Chronic Motor or Vocal Tic Disorder
Tourette's Disorder
DIAGNOSIS
DIFFERENTIAL DIAGNOSIS
TREATMENT
PROGNOSIS
CHAPTER 13:
Sleep Problem
PATTERNS OF NORMAL SLEEP
CONSEQUENCES OF POOR SLEEP
TYPES OF SLEEP PROBLEMS
EVALUATION
COMMON SLEEP PROBLEMS
Sleep Terror
Management
Nightmares
Night Time Fears
Somnambulism
Somniloquy
Confusional Arousals
Bruxism
Delayed Sleep Phase Disorder
GENERAL MANAGEMENT
CHAPTER 14:
Mood Disorder
EPIDEMIOLOGY
ETIOLOGY
Genetic
Familial
Biological
Neuroimaging
Endocrine
Social
Psychological/Cognitive
Behavioral
CLINICAL FEATURES
Major Depression
Dysthymia
Bipolar Disorder
DIAGNOSIS
DIFFERENTIAL DIAGNOSIS
TREATMENT
Depression
Cognitive-behavior Therapy (CBT)
Interpersonal Psychotherapy (IPT)
Supportive Intervention
Behavioral Family Interventions
Pharmacotherapeutic Agents
Bipolar Disorder
PROGNOSIS AND OUTCOME
CHAPTER 15:
Anxiety Disorder
EPIDEMIOLOGY
ETIOPATHOGENESIS
Biochemical Factors
Genetic Factors
TYPES OF ANXIETY DISORDERS
Separation Anxiety Disorder
Generalized Anxiety Disorder
Social Anxiety Disorder
Specific Phobia
Panic Disorder with or without Agoraphobia
Post-traumatic Stress Disorder
Obsessive-compulsive Disorder
MANAGEMENT
Cognitive Behavior Therapy for Anxiety Disorders
CHAPTER 16:
Psychosomatic Disorders
EPIDEMIOLOGY
DIAGNOSIS
CNS Features
ETIOLOGY
School Environment
Financial Background
Lifestyle Changes
Adult Guidance
RISK FACTORS
TREATMENT
Principles of Treatment
Multidisciplinary Approach
Family-focused Cognitive Behavioral Therapy
Comorbid Conditions
CHAPTER 17:
Psychological Effects of Chronic Illness
EPIDEMIOLOGY
FACTORS DECIDING ADAPTATION OF CHILDREN TO CHRONIC ILLNESS
Age of Child at Time of Onset of Illness
Parental Responsibility
Diagnosis
Process of Establishment of Diagnosis
Interference with Function
Impact on Physical Appearance
Persistence of Symptoms
Hope for Recovery
CHILDREN WITH VARIOUS AILMENTS
GENERAL INTERVENTION STRATEGIES
CHAPTER 18:
Study Skills
DEFINITION
IMPORTANCE OF STUDY SKILLS IN INDIAN SCENARIO
ESSENTIALS FOR LEARNING
Multiple Intelligences
Other Factors
EARLY FOUNDATIONS OF LEARNING
Language Development
Writing
Arithmetic
Creative Thinking
Memory and Reasoning
EVIDENCE BASED STUDY STRATEGIES
CLASSIFICATION OF STUDY SKILLS
Preparatory Study Skills
Time Management
Concentration Skills
Acquisition Study Skills
Memory Enhancing Skills
Classroom and Homework Skills
Expression Study Skills
Metacognitive Skills
CHAPTER 19:
School Problems
SCHOOL REFUSAL
Etiology
Clinical Features
Evaluation
Management
BULLYING
Types of Bullying
Physical
Psychological
Relational
Cyber Bullying
CHAPTER 20:
Street Children
CATEGORIES
1. Children on the Street
2. Children of the Street
3. Abandoned Children
THE NUMBER
AGE
LOCATION
GENDER
REASONS WHY A CHILD CHOOSES STREET TO BE HIS HOME
Sociostructural Causes
Economic Causes
Quality of Education
Natural Calamities
Cruelty and Abuse
Broken Homes
Neglect
Peer Group Influence
Influence of Media
PHYSICAL PROBLEMS FACED BY A STREET CHILD
Lack of Adequate Nutrition
Homelessness
Health Problems
PSYCHOLOGICAL PROBLEMS FACED BY A STREET CHILD
A Stressful Past
A Transitory Lifestyle
Substance Abuse
Unlearning of Learned Behavior
Depression
Aggressiveness
SOCIAL PROBLEMS
Deprivation of Needs and Lack of Resources and Opportunities
Exploitation
Security
Abuse
STIGMATIZATION
IMMEDIATE MEASURES
LONG-TERM MEASURES
CHAPTER 21:
Substitute Care
COMMON BEHAVIORAL PROBLEMS
Reactive Attachment Disorder
Defying Authority
Aggression
Anger Outbursts
Running Away
Clinging and Crying
Stealing
Lying
Others
CHAPTER 22:
Behavioral Problems in Adolescents
ANOREXIA NERVOSA
DSM-5 Diagnostic Criteria for Eating Disorders: Anorexia Nervosa
Specific Current Type: Restricting Type
Binge-eating/Purging Type
Clinical Features
Physical Symptoms
Physical Signs
Laboratory Findings
Biochemical
Endocrine
Hematological
BULIMIA NERVOSA
DSM-5 Proposed Diagnostic Criteria for Bulimia Nervosa
Clinical Features
Physical Symptoms
Physical Signs
Laboratory Findings
Bulimia Alone
Bulimia with Vomiting
Bulimia with Vomiting and Laxative-diuretic Abuse
BINGE EATING DISORDER
DSM-5 Proposed Diagnostic Criteria for Binge Eating Disorder
EATING DISORDER NOT OTHERWISE SPECIFIED
DSM-5 Proposed Diagnostic Criteria
Atypical Anorexia Nervosa
Sub-threshold Bulimia Nervosa
Purging Disorder
Night Eating Syndrome
Other Feeding or Eating Condition not Elsewhere Classified
MANAGEMENT
Anorexia Nervosa
Inpatient Medical Hospitalization
Psychiatric Residential Treatment
Day Treatment
Intensive Outpatient Psychiatric Treatment
Nutritional Counseling
Psychotherapeutic Intervention
Medications
Bulimia Nervosa
Hospitalization
Psychodynamic Therapy
Interpersonal Therapy (IPT)
Nutritional Counseling
Pharmacologic Therapy
PREVENTION
PROGNOSIS
Anorexia Nervosa
Bulimia Nervosa
SEXUALIZED BEHAVIOR
Issues Bothering Girls
Issues Bothering Boys
GENDER IDENTITY DISORDER
Etiology of Deviant Sexual Behavior
Characteristics of Paraphilic Disorders
Additional Changes to Paraphilic Disorders
Clinical Features of Major Paraphilias
Fetishistic Disorder
Transvestic Disorder
Sexual Masochism Disorder
Sexual Sadism Disorder
Voyeuristic Disorder
Exhibitionistic Disorder
Pedophilic Disorder
Frotteuristic Disorder
MANAGEMENT OF SEXUAL DYSFUNCTION
Treatment of Sexual Dysfunction
Treatment of Paraphilias
Biological Treatment
Behavioral Therapy
Distinguishing Sexual Exploitation
Adolescent Sexual Offenders
ASSESSMENT FOR SUICIDE RISK
NEW RISK SYNDROMES CATEGORY
Psychosis Risk Syndrome
Minor Neurocognitive Disorder
Parents should be Aware of the Following Signs in Adolescents
RISK FACTORS FOR SUICIDE
MANAGEMENT
Three Steps Parents can take
Three Steps Friends can take
PREVENTION OF SUICIDE
SUICIDE CRISIS AND INTERVENTION
POSTVENTION
CHAPTER 23:
Adolescent Parenting
ACTIONS THAT SHOULD MAKE PARENTS CAUTIOUS
ROLE OF PARENTS
DEALING WITH THE SITUATION
TYPES OF PARENTING
Authoritarian Style of Parenting
Permissive Parenting
Neglectful Parenting
Authoritative Parenting
CHAPTER 24:
Addiction and Related Disorders
EPIDEMIOLOGY
ETIOPATHOGENESIS
SCREENING AND ASSESSMENT
URINE DRUG SCREENING
OFFICE INTERVENTION
INDEX
TOC
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