identifying children with emotional disorders

8/6/2019 Identifying Children With Emotional Disorders

http://slidepdf.com/reader/full/identifying-children-with-emotional-disorders 1/32

Identifying children withemotional disorders

Ola Ibigbami

Sr. Registrar

Dept Of Mental Health

Wesley Guild Hospital

Ilesha, Nigeria



OBJECTIVES

� Who are we concerned about (and why)

� To look at the current classifications

� Describe normal development

� Have an overview of the various disorders

� Current situation in Nigeria



Introduction

� A five-year national OVC Plan of Action, which

was approved by the Federal Executive Council

in March 2007 and officially launched in May

2007 by President Obasanjo, provides key

actions for accelerating support to OVC in six

technical components:



� Service Delivery Environment,

� Education,

� Health,� Household Level Care and Economic

strengthening,

� Psychosocial Needs and Social Protection and

� Monitoring andEvaluation.



Psychosocial Needs and Social

protection

� Virtually all Health problems of children have a

psychosocial implication.

� Caregivers or Support group personnel are

important in meeting the needs of children who

are OVCs.

� The social welfare system has been incapacitated

and underdeveloped over the years.� A large population of children with ED are not

identified for the care they need



What is wrong with this child?



Is anything wrong with this child?



Or these Child



Emotional disorders (ED)

According to Individuals with Disabilities Education Act (IDEA), Public Law 101-476, asfollows:

Emotional disturbance is defined as follows:

The term means a condition exhibiting one or more of the following characteristics over along period of time and to a marked degree that adversely affects a child's educational

performance:y (A) An inability to learn that cannot be explained by intellectual, sensory, or health

factors.

y (B) An inability to build or maintain satisfactory interpersonal relationships with peersand teachers.

y (C) Inappropriate types of behavior or feelings under normal circumstances.

y (D) A general pervasive mood of unhappiness or depression.

y (E) A tendency to develop physical symptoms or fears associated with personal or schoolproblems.(ii) The term includes schizophrenia. The term does not apply to children who aresocially maladjusted, unless it is determined that they have an emotional disturbance.



Classification According To ICD-10

F90-99 Behavioural & emotional disorders with onset usuallyoccurring in childhood/adolescence

� F90 Hyperkinetic disorder:.0 Disorder of activity andattention, .1 Hyperkinetic conduct disorder

� F91 Conduct disorders: .0 Conduct disorder confined to thefamily context, .1Unsocialised conduct disorder; .2 Socialised

conduct disorder; .3 Oppositional defiant disorder� F92 Mixed disorders of conduct and emotions: .0 Depressive

conduct disorder

� F93 Emotional disorders with onset specific to childhood: .0Separation anxiety disorder; .1 Phobic disorder of childhood;.2 Social sensitivity disorder; .3 Sibling rivalry disorder



F90-99 Behavioural & emotional disorders

� F94 Disorders of social functioning with onset specific tochildhood or adolescence:.

� 0 Elective mutism; .1 Reactive attachment disorder of childhood; .2 Dis inhibition attachment disorder of childhood

� F95 Tic disorders: .0 Transient tic disorder; .1 Chronic motor orvocal tic disorder; .2 Combined vocal and multiple motor tic

(Tourette syndrome)� F98 Other emotional and behavioural disorders with onset

usually occurring during childhood: .0 Enuresis; .1 Encopresis;.2 Feeding disorder of infancy or childhood; .3 Pica; .4Stereotyped movement disorder; .5 Stuttering (Stammering); .6

Cluttering



Childhood Development

� Every normal human being must pass through

some stages of development. These could be:

� Physical/Motor Development

� Language / Communication

� Intellectual development,



NORMAL DEVELOPMENT

�

First year of life:� Rapid development of motor & social functioning.

� Baby smiles at faces three weeks after birth

� Selective smiling appears at six months

� Fear of strangers at eight months

� End of first year the child should have close & secure

relationship with mother or other close carer & enjoy

making sounds� Say mama, dada, & a few other words.



NORMAL DEVELOPMENT

� Second year of life:

� Attachment behaviour well established.

� Temper tantrums if exploration is frustrated

� End of second year, able to put two or three

words together as a simple sentence.



NORMAL DEVELOPMENT

±Two to five years:

± Temper tantrums continue, but diminish & disappear

before age of five.

± Asks lots of questions due to curiosity about

environment.

± Learns about sexual identity, differences between

males & females in appearance, clothes, behaviour &anatomy.

± Sexual play & exploration common at this stage.



NORMAL DEVELOPMENT

�Common problems in early childhood :

� Difficulties in feeding and sleeping

� Clinging to parents (separation anxiety)� Temper tantrums, oppositional behaviour

� Minor degrees of aggression



NORMAL DEVELOPMENT

� Middle childhood :

� Understand position in family

� Identity as boy or girl

� Learns to cope with school, read, write

� Common problems:

� Fears, nightmares, minor difficulties in

relationship with peers, disobedience andfighting.



NORMAL DEVELOPMENT

� Adolescence:

� Growing period between childhood & maturity.

� Physical changes of puberty occur between 11-13 in girls & 13 -17 in boys

� It is popularly but wrongly believed that emotional turmoil &alienation from the family are characteristic of adolescence.

� Peer group relationships are important & membership of agroup is common.

� Marked increase in heterosexual interest

� How far & in what way sexual feelings are expressed dependsgreatly in the standards of society & on rules in the family.



NORMAL DEVELOPMENT

� Importance of Developmental Psychopathology

� The childs stage determines whether behaviouris abnormal or pathological

� The effects of life events differ as the child grows

up� Psychopathology may change as the child grows

older

�

Several factors influence the continuity ordiscontinuity of these problems such as adversefamily environment



How do we identify this children?

� Most of the time , it is someone without aclinical experience that knows something iswrong.

� A recent study in south Africa looked atchildren living in a deprived environment andcompared orphans with non-orphans.

�

They found that both groups hadpsychological problems but more in theorphan group.



Findings

� Children orphaned by AIDS may have unmetpsychological needs. Further research is neededto identify risk and protective factors for orphans,and into the effects of differing carearrangements, as rising orphan numbers maylead to an increase in child-headed householdsand street-children.

� Currently, very few organisations provide

psychosocial support for children who areparentally bereaved by AIDS, and only a smallminority of children receive support.



Simple steps to identifying them.

� Criteria (A) Inability to learn.

� Poor school performance.

�School refusal

� Truancy



yB) Poor satisfactory interpersonal relationships

with peers and teachers.

y

Labeled as been difficult to be with.yGet into fights

yWithdrawn: like staying alone



� C) Inappropriate types of behavior or feelings

under normal circumstances.

�

Crying spells� Odd laughter

� Age inappropriate playing regressive

behaviour� Poor response or inappropriate response to

the feeling of others



� D) A general pervasive mood of unhappiness or

depression.

� Poor feeding- poor growth- frequently falling sick

� Crying spells

� Bed-wetting/ Soiling themselves during the day

� Staying alone

� Reduced interest in play and peer interaction



� E) A tendency to develop physical symptoms

or fears associated with personal or school

problems.

� Unusual fear with going too or staying in

school

� Frequent night terrors



� Distorted thinking

� Excessive anxiety

�

Hyperactivity



Current situation in Nigeria

� Our culture has negative implication on child

psychological development:

�

Children Must be seen not heard!� Children should not eat meat!

� Children must not talk where there are adults!

�

Not enough information about the health of children

� Different cultures



Positive side

� Stronger Family network! ( this is now getting

eroded)

�

We are now seeing more of some disordersinitially thought to be foreign



Conclusion

� People who work in the field with children andadolescents need to be observant, caring andattentive to their wards.

� They must always have a high index of suspicion when they notice any of this things.

� They should make it a point of duty to seek

appropriate help� It is better to find out that all is well than not

to find out anything at all



Thank you for Listening

identifying children with emotional disorders

Documents