The assessment and management of the following conditions:
ADHD commonly co-occurs with problems like anxiety, learning difficulties, and behavior disorders. It can be safely managed by medication; as well as environmental interventions and family support.
www.adhasa.co.za – Attention Deficit and Hyperactivity Support Group of Southern Africa
Anxiety in childhood has an adverse effect on the child’s self-esteem, social relationships and academic performance. Anxiety may sometimes result in a child refusing to go to school. What is worrying about anxiety in children is, not only that it constricts the child’s socio-emotional development, but the fact that it puts the young person at risk for anxiety disorders in adulthood. It is important to make a distinction between what are normal and developmentally appropriate worries and what has become ‘pathological’ anxiety. It is quite typical for anxiety in young children to present with lots of unexplained physical symptoms as well as puzzling “bad behaviour”.
www.childmag.co.za/there-are-monsters-under-my-bed
www.sadag.org – South African Depression and Anxiety Group
The more worrying and pervasive problem is exposure to chronic trauma. This usually occurs in the guise of child maltreatment or abuse and is more often than not perpetrated by the child’s caregivers. Trauma of this nature has a profound and disturbing influence on the child’s development – emotionally, behaviourally and cognitively. This is called complex trauma and puts the child at risk for multiple and severe psychiatric problems.
Maltreatment in its various guises is responsible for significant emotional, behavioural and cognitive difficulties in the children and adolescents who suffer these indignities. Moreover, these young people are at substantial risk for the development of psychiatric problems that include depression, anxiety and trauma responses, as well as dissociative disorders, substance use disorders and severe behaviour and personality disorders. The prospect of maladaptive responses in affect (mood) regulation, relationships and problem solving skills is high in these children, resulting in huge challenges in a number of areas in their lives.
There are a number of factors that serve as risks for the development of depression: these include being female (after adolescence), family stressors, peer rejection, trouble with romantic relationships, abuse or maltreatment, chronic medical conditions and family history.
Suicidal thoughts and behaviours remain an extremely worrying phenomenon. Unfortunately a number of young people contemplate suicide and several engage in repeated suicide attempts. Aside for mental health problems, there are several factors correlated with suicidal behaviour – those foremost on the list include bullying and substance misuse.
There is a distinction between suicidal behaviour and so-called deliberate self-harm/ non-suicidal self-injury. Self-injury is often associated with the child or adolescents’ attempts to manage unbearable emotional states.
The world is often experienced as bewildering and demanding by children and adolescents on the autistic spectrum, and they are at considerable risk for developing psychiatric problems including anxiety and depression. They have a number of associated problems that include attention-deficit hyperactivity disorder (ADHD), learning and cognitive problems, sleep disorders and seizures – the management of which requires input of a multidisciplinary team.
In many regards disruptive behaviour disorders (oppositional defiant disorder and conduct disorder) do not fit an “illness model” and require structural and environmental interventions as opposed to psychiatric treatment. Nonetheless there are high rates of psychiatric and emotional difficulties, risk for substance misuse and suicidal behaviour associated with behavioural problems – these may be mitigated by psychiatric intervention.
Learning disorders arise “..when the individual’s achievement on individually administered, standardized tests in reading, mathematics, or written expression is substantially below that expected for age, schooling and level of intelligence.” These difficulties often co-occur with well-defined psychiatric conditions such as attention-deficit hyperactivity disorder (ADHD), and may also give rise to psychiatric difficulties like anxiety disorders and depression. Formal psycho-educational assessment is very useful in objectively evaluating and documenting the nature of these disorders.
- The conceptual domain includes skills in language, reading, writing, math, reasoning, knowledge, and memory.
- The social domain refers to empathy, social judgment, interpersonal communication skills, the ability to make and retain friendships, and similar capacities.
- The practical domain centers on self-management in areas such as personal care, job responsibilities, money management, recreation, and organizing school and work tasks.
Children and adolescents with intellectual disability present with a range of cognitive capacities and accompanying developmental delays. The difficulties experienced by the child suffering with milder disabilities may escape detection initially and only become evident in middle childhood or early adolescence with the advent of substantial challenges at school. This is often accompanied by emotional and/or behavioral acting out.
Those on the moderate to severe spectrum may be quite notably impaired in their adaptive functioning, and are not immune from suffering from emotional and psychiatric difficulties. Their capacity to communicate and convey their distress may handicapped, and this requires careful evaluation