MENTAL DISORDERS

Department of Pediatrics

Soochow University Affiliated Children’s Hospital

CLASSIFICATION OF CHILDHOODMENTAL DISORDERS

• The American Psychiatric Association's

Diagnostic and Statistical Manual of Mental

Disorders ( DSM-IV ) provides a standardized

classification system.

Categories of Childhood Mental Disorders

• Mental Retardation

• Leaning Disorders

• Motor Skills Disorders

• Communication Disorder

• Pervasive Developmental Disorder

广泛性发育障碍

• (ADHD) Attention-deficit and

Disruptive Behavior Disorder

• Feeding and Eating Disorder of Infancy

or Early Childhood 婴幼儿期喂养及进食障碍• Tic Disorder 抽动障碍• Elimination Disorder 排泄障碍• Other Disorder

MENTAL RETARDATION

• Mental retardation (MR) is defined as (1) significantly sub-average general intellectual functioning-- an intelligence quotient (IQ) of 70 below, (2) deficits in adaptive functioning-the ability of an individual to meet the standards expected for his or her age by his or her cultural group, and (3) age at time of diagnosis (less than 18 years of age).

• Approximately 1% to 2% of child in the world are mentally retarded.

• The incidence in male is higher than in female.

• Mild Mental Retardation

Mild Mental Retardation About 75% -80% of

mentally retarded children fall into this category. A

child's IQ is between 55 and 70. The category is

equivalent to the educational category "educable".

• Moderate Mental Retardation

Moderate Mental Retardation Children in th

is category have IQ between 40 and 54 and h

ave About 12% of mentally retarded children

The category is equivalent to the educational

category " trainable".

• Severe Mental Retardation

Severe Mental Retardation Children in this

group have an IQ between 25 and 39. About

8% of mentally retarded children fall into this

category.

• Profound Mental Retardation

Profound Mental Retardation About 1%-5%

of mentally retarded children fall into this cate

gory. The IQ of this group of children is below

24.

Assessment

• Child care workers play a major role in identif

ying mentally retarded children through histor

y taking, observation, and developmental scr

eening during early childhood.

• In the newborn and early infancy period, few signs are present, with the exception of various syndromes that have distinctive features.

• Many mentally retarded children are not diagnosed with the condition until they reach school age, particularly if the condition is mild or moderate.

• Delayed developmental milestones are the

major clues to mental retardation. Early

intervention, however, can help to enhance

the child's functioning later.

• A child should receive regular developmental

assessment, such developmental screening tests.

• A functional assessment of the child should include

toileting, dressing, and feeding skills.

• The child's language, sensory, and psychomotor

functioning is also assessed.

• Principle of Treatment

• Diagnosis

• Intervention

Prevent Mental Retardation

• Primary prevention

• Secondary prevention

• Tertiary prevention

AUTISTIC DISORDER

• Autistic disorder is a complex childhood disorder marked by serious distortions in psychologic functioning, the disorder is characterized by severe and pervasive impairment in reciprocal social interaction and communication skills, usually accompanied by stereotypical behavior, interests, and activities.

Assessment

• Initial assessment focuses on language develo

pment, response to others, and hearing acuity,

and it is necessary to assess severe and perva

sive impairment.

• Principle of Treatment

• Diagnosis

• Intervention

(ADHD) ATIENIION-DEFICII HYPERACTIVITY DISORDER

• Children with ADHD show an inappropriate

degree of inattention, impulsiveness, and

hyperactivity.

• ADHD occurs in various cultures and is

difficult to diagnose before 5 years of age.

• Etiology and Pathogenesis

• Assessment

• Principle of Treatment

• Diagnosis

• Intervention

ANXIETY DISORDERS OF CHILDHOOD OR ADOLESCENCE

EATING DISOROERS

• Pica

• Anorexia Nervosa 神经性厌食• Bulimia Nervosa 神经性贪食

TOURETTE'S SYNDROME

多发性抽动症

• A tic is an involuntary, recurrent, random, rapid,

highly stereotyped movement or vocalization.

• Motor tics

• Verbal tics

• Coexisting symptoms

ELIMINATION DISORDERS 排泄障碍

• Functional Encopresis 功能性遗粪

• Functional Enuresis 功能性遗尿