Childrens Mental Health

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Childrens Mental Health

• What You Need to Know About the Children in Your
  Classroom

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Normal Development

• Active, Run, Jumps, Climbs
• Like Routines
• Independent
• Indecisive changes mind
• Flashes of temper/Mood Change
• Prolongs nap time
• Whines, Cries, Request Reassurance of love
• Imaginative (May have an imaginary friend)

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Ages 2-3

• Feeds self w/fingers, spoon cup
• Explores genitalia
• Sleeps less/Prolongs good-nights
• Wants to be independent
• Imitates adults
• Plays beside, but not with children
• Not able to share, wait, or take turns
• Uses Single words/short sentences
• Negative/Says No

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Ages 3-4

• Carries things w/o spilling
• May not sleep at nap time, but plays quietly
• Responsive to adults, wants approval
• Cooperates, wants to be the helper
• Me Too Wants to be Included
• Curious about things and people
• Very Talkative/Expressive
• A little better at taking turns, but still does
  not like to share
• Plays well alone/ Group play can be rough
• Jealous
• Shows some guilt

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Ages 4-5

• Continues to gain coordination (should be opening
  milk carrying tray with little spilling)
• Starts things, but may not finish them
• Bossy, boastful
• Plays w/others, but is self-assertive
• Short-lived quarrels
• Speaks clearly, talks a lot
• Tells stories, exaggerates
• Makes up meaningless words w/a lot of syllables
• Laughs, giggles, dawdles
• Asks How Why
• Demonstrates dependence on peers

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Common Diagnoses in Children

• Attention Deficit Hyperactivity Disorder (ADHD)
• Oppositional Defiant Disorder (ODD)
• Conduct Disorder
• Depression
• Anxiety Disorder
• Bipolar Disorder
• Pervasive Developmental Disorders
• Attachment Disorders
• Adjustment Disorders

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ADHD

• There are three categories of ADHD
• Inattention
• Hyperactivity/Impulsivity
• Combined (Inattention Hyperactivity/Impulsivity)

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Symptoms of ADHD

• Inattentiveness
• Does not pay close attention to details
• Cant pay attention for sustained periods (play
  activity, story time)
• Does not seem to listen when spoken to
• Does not follow through on instructions
• Difficulty organizing tasks
• Loses things necessary for tasks
• Easily distracted by things going on around them
• Forgetful
• Avoids tasks or shows dislike for tasks that
  require sustained attention

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Symptoms Contd

• Impulsiveness
• Often blurts out answers before questions
  completed
• Difficulty awaiting turn
• Interrupts or intrudes on others (butts into
  conversations or games)
• Hyperactivity
• Fidgets with hands, feet, squirms in seat
• Leaves seat in classroom or other places
• Runs, climbs inappropriately
• Difficulty playing or engaging quietly
• Acts if driven by a motor (Energizer Bunny)
• Talks Excessively

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Diagnosis

• Six or more symptoms for a period of 6 months
• Must be maladaptive, causing significant
  impairment in 2 or more settings
• Symptoms present before age 7

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Knowing When Its ADHD

• Those Symptoms Sound Like Things All Children
  Do
• Compared to other children in the class, a child
  with ADHD stands out
• Behavioral problems are happening in more than
  one place (i.e. school, home, daycare, church)
• Behavioral interventions are unsuccessful

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Interesting Points about ADHD

• It is diagnosed more in the US than any other
  country
• No real test that can be given to determine
  ADHD (HBP, heart disease, etc)
• Having ADHD is described as listening to a
  static-filled radio station and straining to hear
  the words
• Prevalence rates are 3 to 5 of school age
  children

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Common Characteristics of ADHD

• May blurt out or say inappropriate things
• Cant wait in line
• Cant keep hands and feet to themselves
• Appear careless and messy
• Easily distracted
• Can sound like they are rambling when speaking
• Easily forgets directions
• Appear to be daydreaming
• Squirms a lot, cant sit still

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Oppositional Defiant Disorder

• Oppositional Defiant Disorder (ODD)

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Symptoms of ODD

• Often loses temper
• Often argues with adults
• Refuses to comply with requests
• Deliberately annoys people
• Blames others for his/her mistakes
• Angry and resentful
• Spiteful or vindictive

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Diagnosis

• Pattern of defiant behavior w/ at least four
  symptoms for at least six months
• Impairment is clinically significant

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Knowing when its ODD

• Children say no, have temper tantrums and argue
  all the time
• Compared to other children in the class, a child
  with ODD stands out
• Behavioral problems are a significant problem at
  school, home, daycare, or church
• Regular behavioral interventions are unsuccessful

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Interesting points of ODD

• Children with ODD often have comorbid ADHD
• If not treated, it may lead to Conduct Disorder
• A child with ODD may have strong peer
  relationships and social skills (may be strong
  leaders)
• Quality of adult-child relationships will improve
  with treatment
• Prevalence rates are 2 to 16 of school age
  children

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Conduct Disorder
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Symptoms of Conduct Disorder

• Aggression to people and animals
• Bullies, threatens or intimidates others
• Often initiates physical fights
• Cruel to people or animals
• Deliberate destruction of property
• Deliberately sets fires
• Deceitfulness or theft
• Lies to obtain goods
• steals
• Serious violation of rules

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Diagnosis

• Repetitive pattern of behavior where rights of
  others or societal rules are violated
• Three or more symptoms in the past 12 months with
  at least one in the last six months
• Impairment is clinically significant

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Knowing when its Conduct Disorder

• Children get into fights and take things that
  dont belong to them
• Compared to other children in the class, a child
  with Conduct Disorder stands out
• Behavioral problems are a significant problem at
  school, home, daycare, and church
• Regular behavioral interventions are unsuccessful
• Children often show no remorse

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Interesting points of Conduct Disorder

• Most children and adolescents grow out of Conduct
  Disorder
• The earlier treatment begins the better
• Medications are generally unsuccessful
• Behavior modification and genuine relationships
  are more effective
• It is very rare in young children
• Prevalence rates are 2 to 9 in females and 6 to
  16 in males

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Mood Disorders

• Depression
• Anxiety
• Bipolar Disorder

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Depression
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Symptoms of Depression

• Feelings of sadness or crying that does not go
  away
• Feelings of guilt for no reason feeling no good
  or worthless
• Loss of confidence
• Life seems meaningless or like nothing good is
  ever going to happen again
• You dont feel like doing a lot of things that
  you used to like to do
• Difficulty concentrating, forgetfulness,
  difficulty making decisions

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Depression Symptoms Contd

• Easily irritated by things that did not irritate
  you before. Reaction to the irritation is
  excessive for the situation
• Sleeping pattern changes to sleeping more than
  usual or less than usual.
• Eating pattern changes to eating more than usual
  or loss of appetite
• Feelings of restlessness and tiredness most of
  the time
• Thoughts of death, feeling like you are dying or
  plan to commit suicide

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Childhood Anxiety Disorders

• Separation Anxiety Disorder
• Panic Disorder
• Post-Traumatic Stress Disorder
• Social Anxiety
• Obsessive-Compulsive Disorder
• Specific Phobias

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Symptoms of Separation Anxiety

• An unrealistic and lasting worry that something
  bad will happen to the parent or caregiver if the
  child leaves.
• An unrealistic and lasting worry that something
  bad will happen to the child if he or she leaves
  the caregiver.
• Refusal to go to school in order to stay with the
  caregiver.

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Symptoms of Separation Anxiety Contd

• Refusal to go to sleep without the caregiver
  being nearby or to sleep away from home.
• Fear of being alone.
• Nightmares about being separated.
• Complaints of physical symptoms, such as
  headaches and stomachaches, on school days.
• Repeated temper tantrums or pleading.

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Bipolar Disorder
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Symptoms of Bipolar Disorder

• Same Depressive Symptoms seen earlier by occur in
  Bipolar Disorder
• Additional Symptoms may include
• Severe changes in mood from unusually happy or
  silly to irritable, angry, or aggressive
• Unrealistic highs in self-esteem. May feel
  indestructible or that they have super-human
  powers/abilities.
• Significant increase in energy level. Can go
  without sleep for days without being tired.

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Bipolar Symptoms Contd

• Excessive involvement in multiple projects and
  activities. May move from one thing to the next
  and become easily distracted.
• Increased talking. Can be talking too much, too
  fast, rapid changes in topic, and/or cant be
  interrupted.
• Increase risk-taking behavior such as abusing
  drugs, alcohol, and/or unprotected

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Pervasive Developmental Disorders

• Autistic Disorder
• Retts Disorder
• Childhood Disintegrative Disorder
• Aspergers Disorder

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Vignettes

• Divide into groups
• Review case studies given and decide on
  spokesperson for group
• Decide on behavioral interventions and/or
  referrals that will be appropriate for each case
• Give details about prevention of behavior as well
  as intervention for handling occurrences

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Review of Head Start Discipline Policy

• Discipline is to be individualized and consistent
• Discipline will never be humiliating or
  physically harmful

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Policy Steps

• Prevention
• Five steps for Helping the Noncompliant Child
• Redirection
• Conference with the child/time out
• Contact the site manager/FES to schedule meeting
  with the parent
• Refer the child to the HS intervention team