Special kids

Samir Parikh | 10-July-2013

Psychiatric problems in children are on the rise. Correct and timely intervention is the only remedy to cure or control mental health disorders in young kids. We have to approach this menace as a social issue rather than familial problems lest our society will have to bear the brunt. It has been proved that many of these developmental disorders in children can be corrected with sincere and consistent efforts from parents, teachers and therapists, and these children can be able to lead a successful life as they have average or above average intelligence

By Samir Parikh

The number of children suffering from psychiatric problems is steadily on the rise. Ten per cent of all children suffer from a mental health issue and 50 per cent of these go undetected and therefore untreated. Without correct and timely intervention, these disorders adversely affect the child’s functioning at home, school and other settings. Children with untreated psychiatric conditions are at greater risk of school failure, problems with law and order and even suicide.

The nature of these psychiatric and developmental disorders, the manifestation of symptoms and the treatment plan are all very different with children as compared to adults. It is important to be aware of these issues in order to make sure that timely and relevant help is provided to the child. 

If a child is showing some of the symptoms (Given below) for a consistent period, that are age inappropriate and interfere with his day to day functioning, it is possible that he/she requires the intervention of a mental health professional. 

• Frequent mood swings
• Truancy from school    
• Sudden changes in school performance
• Changes in sleep and appetite
• Constant worrying
• Repetitive and odd body movements
• Not doing things that she/he used to enjoy
• Self harm
• Being unnaturally suspicious
• Distorted thinking
• Cruel to others and animals
• Avoiding friends and family

Some common mental health issues seen in children are: 

Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder (ADHD) is the most commonly diagnosed psychiatric condition amongst children with 3-7 per cent of school children suffering from it. Children suffering from this disorder can have problems in attention or hyperactivity and impulsivity. These children have difficulty in paying attention in class and seem to be always ‘on the go’. They seem to never follow instructions or reply when spoken to and their homework never seems to be complete on time. Often, they are labelled as the trouble makers of the school.

These children have average or above average intelligence but are unable to pay sustained attention to any task. As a result, they underperform academically and in other activities. This disorder is treatable with the help of a mental health professional, along with the participation of the teachers and parents. There are many interventions that can be done with these children to help them learn skills to improve attention and reduce hyperactivity. To make these interventions effective, it is important that there is consistency between home and school, i.e. parents and teachers need to work together towards the therapeutic goals of the child. 

Disruptive Behaviour Disorders

These disorders are commonly found to be co-morbid with ADHD or other mental health problems. Oppositional Defiant Disorders are found in younger children wherein they have trouble with authority and are often openly defiant with teachers and parents. They have trouble in getting along with their peers and lose their temper very quickly and easily. They seem to lack empathy and as a result aren’t able to develop meaningful relationships. Conduct Disorder (CD) can be a more serious version of ODD found in older children. They can get very aggressive and are capable of cruelty to other people and animals. They also tend to indulge in activities like stealing and lying. If timely intervention is not provided to these children, they can grow up to be anti-social personalities.

Disruptive behaviour disorders are challenging cases to treat and require a multi-level approach that includes a mental health professional, teachers as well as parents. Cognitive behaviour therapy, an approach used by psychotherapists in order to alter faulty thinking patterns, can be effective with these children. Psychotherapists also help equip parents with effective strategies to handle problem behaviours. 

Autism Spectrum Disorders

Autism is a developmental condition that is usually a lifelong condition present at birth. Children with autism have trouble with communication–both verbal and non-verbal and very restricted patterns of behaviour and activities. While some children can be profoundly affected by autism with no verbal skills, others might be affected only mildly and show certain deficits in communicating with others. The first signs of autism can usually be noticed by 12 to 24 months of age.

For example, they might not respond to their name, have delayed language milestones, may not be able to make and sustain eye contact and have problems in making friends. They might showcase repeated behaviour patterns such as rocking back and forth, flapping their hands etc.  Children with autism need psychological intervention. Applied behavior analysis which is a form of behaviour therapy has been designed to help children learn basic social and communication skills in a facilitative and non-threatening environment. While there is no cure for autism, early intervention can ensure relevant skill-building that can lead to a fulfilling future.

Learning Disability
 
Learning disabilities are problems in the brain’s ability to receive, process, analyse and store information causing problems in learning for a child with LD.  There are many kinds of LD. Some children have problems with numbers and mathematical functions which is a disorder known as dyscalculia. Dyslexia refers to a problem with reading while dysgraphia refers to problems with spelling and writing. These children have average or above average intelligence and early intervention with them can work wonder. Children with LD are given many concessions by the CBSE like provision for a scribe, extra time etc. Special Education is very effective and beneficial with these children.

Anxiety Disorders

Anxiety in children can be considered normal in certain situations. However, in many cases when it is consistent, inappropriate and causing interference in the child’s functioning at home, school and in the community, it is likely that he has an anxiety disorder.
 
Some types of anxiety disorders that can be found in children are:

Separation Anxiety Disorder

When older children or teenagers refuse to go school or sleep without a parent present in the room because they fear that something might happen to their parent in their absence despite repeated reassurances and for no discernible reason, they are going through a Separation Anxiety Disorder. This diagnosis can be made if the behaviour has been present for at least four weeks and causes problems in daily functioning.

Generalised Anxiety Disorder

A child with Generalised Anxiety Disorder (GAD) is a constant worrier. He worries about many small or big things and cannot be reassured despite repeated attempts to do so. This child will have many worries and fears and may show certain physical symptoms such as tense muscles, concentration issues, difficulty in sleeping and a need for perfectionism.

Panic Disorder

This is an anxiety disorder wherein the person experiences short ‘panic attacks’. While going through a panic attack, they might feel breathlessness, dizzy, heart pounding and have a feeling of impending doom. They might feel like they are about to die. When a child goes through frequent panic attacks, he is said to be having a Panic Disorder. This child may be afraid of going out of the house for fear of having a panic attack outside.

Social Phobia

Social phobia refers to a fear of performing in social situations like speaking in front of an audience or going to school. It is more commonly seen in older children and teenagers. These children are very self-conscious and sensitive to criticism. They avoid social situations and have trouble in being assertive and standing up for themselves. They may show symptoms like sweating, dry mouth, and breathlessness, blushing or blanking out.

Obsessive-Compulsive Disorder
 
OCD generally finds its roots in childhood. Children with OCD have intrusive thoughts over which they are unable to exert control despite knowing that these thoughts are unreasonable. These thoughts are anxiety provoking and the only way to find relief from these obsessions is to indulge in a ritual or a compulsion that helps in avoiding some imaginary outcome and therefore dispelling the anxiety for a short period. These compulsions are time consuming and stop the person from leading a normal life. Such a child requires medication and psychotherapy to overcome this condition.

Selective Mutism

As the name suggests, children with this disorder speak in certain situations and settings and do not speak at all in other settings. Some children may be perfectly talkative at home but completely withdrawn and quiet in school. Without intervention, many children go on to have social phobia.

Tourette’s Syndrome

This refers to a condition wherein the children have certain tics. They have the need to perform a peculiar behaviour/action in order to relieve anxiety. These tics can be anything from blinking, frowning to vocal tics like yelling, clearing the throat or tongue clicking.  About 90 per cent of children with Tourette’s Syndrome also have another disorder like ADHD or OCD or anxiety. They may also have depression due to the ridicule and misunderstanding from peers that this disorder begets. Children with this disorder would need attention from a mental health professional.

Mood Disorders

Depression is a kind of mood disorder that is very common in adults, but can be found in children as well. When a child is depressed, he may have very different ways of showing it. Some might complain of several aches and pains and become very moody.  They may have crying spells and prefer to be alone and stop enjoying things that they used to.

Teenage depression is on the rise and these teens are at a very high risk of suicide. It is therefore important to provide timely help to treat depression.

Schizophrenia

This is a serious psychiatric disorder that is not very commonly found in children. The symptoms in children may be different from that of adults. These children may have behaviour that changes slowly with time. They become more reclusive and shy and seem to be in their own world. They have severe anxiety and fear that don’t make sense to others, they may seem to be seeing or hearing things that is not real. These children need a combination of medical and psychotherapeutic interventions that also encompasses activities in school and at home.

Dealing with examphobia 
    
There are endless pressures and challenges faced by a child today on his path to adulthood. The alarming rise in mental health issues in children is an indication of the stress that children are under – whether it is to perform in examinations, pressure to look attractive or to experiment with risky behaviours like sex and drugs. Childhood and adolescence has become a minefield for psychological and behavioural risk factors. Providing life skills to children to enable them to deal with these challenges is the need of the hour.

Exam stress has been rising to almost epidemic proportion. In this context, it is essential that we teach our children the skills that are required to handle exam stress effectively. Exam stress shows itself not just as a psychological feeling of nervousness but can also manifest as bodily symptoms. Students with extreme anxiety over exams experience indigestion, headaches, acidity, blackouts etc. Poor concentration, “blanking out”, confusions and poor organisation are also warning signs of exam stress. Students suffering from anxiety think negatively, have a fear of failure and experience feelings of inadequacy. The first reaction of someone with exam stress is to imagine the worst.

Taking exams is a life skill. Like most other life-skills it improves with practice. It is important for students to remember that while the effort is in their hands, the result is not under their control. Good preparation is the most important step in combating anxiety. Using study skills like note-making, highlighting and mnemonics is a good idea. The normal attention span of a person is 45 minutes, so it is advisable to study for 45 minutes with short breaks of 10 minutes. It is also important to maintain a healthy and balanced lifestyle. While studying is important so are other needs like social and physical activities. Feeling anxious is perfectly natural before giving an exam and with the right perspective i.e. no exam is the end of the world, it is possible to overcome this monster of exam anxiety.

Sexual behaviour of teenagers 

With a rising number of teenagers experimenting with sexual behaviour at an early age and the heavily sexualised world of mass media, sex education has become a need in schools. The strategy of ignoring sex and all things related to sex only leads to ignorance and wrong information through unreliable sources like the internet and peers. Wrong information is more dangerous than no information. The only way to ensure that teens make decisions with relation to their sexual lives is to equip them with the right information.

Most students are clueless about where they can get accurate information since matters pertaining to sex are usually not discussed at home or in the public, at the same time sexually themed media is all around them. This gives very confusing signals to the teens encouraging them to ‘experiment’ with sex.

We are familiar with the time-tested slogan ‘prevention is better than cure’. Providing our children with life-skills and tools to deal with stress is the only effective prevention of mental health disorders.

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