Review for Behavioral and Emotional Problems -Child

Summary of Recommendation and Evidence

Population	Recommendation	Grade (What's This?)
Screening of both Genders	This screening is recommended for children.	B

Overview

During a child's developmental years, they are constantly growing and changing. It is imperative to note that one must keep this in mind when diagnosing and treating emotional and behavioral disorders in children. If a problem, is not temporary or short-lived, then should parents seek out a trained and qualified professional to help their children.

According to the National Institute of Mental Health (NIMH), emotional and behavioral disorders affect 10-15 percent of children globally. One of particular childhood-onset mental disorder that is widely studied, treated, and diagnosed is ADHD, attention deficit/hyperactivity disorder, and the NIMH cites that 3-5 percent of children globally suffer from this disorder.

Behavioral and Emotional Problems in Children

Attention-Deficit Hyperactivity Disorder (ADHD)

This disorder is one of the most common mental disorders among children, and two to three more boys than girls are affected. Many children are unable to sit still, finish tasks, plan ahead, or even be aware what is going on around them. ADHD can continue on into adolescence and even adulthood.

Autism

Children with autism appear to be remote, indifferent, isolated in their own world, and are unable to form emotional connections with other poeple. Autism is a found in every region of the country, it is more common in boys than girls, and affects about 1 or 2 people in every thousand. This brain disorder can manifest itself in mental retardation, language delays, and other children are very high-functioning with intelligence and speech in tact.

Bi-polar Disorder

Bi-polar disorder generally begins during early childhood and continues into adulthood. It is characterized by intense mood swings. For example, a child may have excessive "high" or euphoic feelings, then suddenly, sadness depression. This is thought to be a genetic illness and diagnosis for children under 12 is generally not common and is often misdiagnoses as ADHD.

Anxiety

Anxiety disorders often cause children to feel distressed, uneasy, even frightened for no apparent reason. Some common anxiety disorders are panic disorders characterized by episodes of intense fear that occur without warning or provocation. Obsessive-Compulsive Disorder, which are compulsive, repeated behaviors or thoughts that seem like they are impossible to stop.

Risk factors in children

The causes of ODD, CD and ADHD are unknown but some of the risk factors include:

Gender – Boys are much more likely than girls to suffer from emotional or behavioural disorders. It is unclear if the cause is genetic or linked to socialisation experiences.
Gestation and birth – Difficult pregnancies, premature birth and low birth weight may contribute in some cases to the child’s problem behaviour later in life.
Temperament – Children who are difficult to manage, temperamental or aggressive from an early age are more likely to develop emotional and behavioural disorders later in life.
Family life – Emotional or behavioural disorders are more likely in dysfunctional families. For example, a child is at increased risk in families where domestic violence, poverty, poor parenting skills or substance abuse are a problem.
Learning difficulties –Problems with reading and writing are often associated with behaviour problems.
Intellectual disabilities – Children with intellectual disabilities are twice as likely to have behavioural disorders.
Brain development – studies have shown that areas of the brain that control attention appear to be less active in children with ADHD.

Diagnosis of children

Diagnosis methods may include:

Diagnosis by a specialist service, which may include a paediatrician, psychologist or child psychiatrist
In-depth interviews with the parents, child and teachers
Behaviour check lists or standardised questionnaires.

A diagnosis is made if the child’s behaviour meets the criteria for disruptive behaviour disorders in the Diagnostic and Statistical Manual of Mental Disorders from the American Psychiatric Association.

Treatment

Treatment is usually multifaceted and depends on the particular disorder and factors contributing to it, but may include:

Parental education – for example, teaching parents how to communicate with and manage their children.
Family therapy – the entire family is helped to improve communication and problem-solving skills.
Cognitive behavioural therapy – to help the child to control their thoughts and behaviour.
Social training – the child is taught important social skills, such as how to have a conversation or play cooperatively with others.
Anger management – the child is taught how to recognise the signs of their growing frustration and given a range of coping skills designed to defuse their anger and aggressive behaviour. Relaxation techniques and stress management skills are also taught.
Support for associated problems – for example, a child with a learning difficulty will benefit from professional support.
Encouragement – many children with behavioural disorders experience repeated failures at school and in their interactions with others. Encouraging the child to excel in their particular talents (such as sport) can help to build self-esteem.
Medication – to help control impulsive behaviours.