Mental Develomental DisorderElmeida EffendyDepartment of Psychiatry*

*Diagnostic classification according to ICD-10I.Disorders of psychological development1. Specific developmental disorders of speech & language1. Specific speech articulation disorder2. Expressive language disorder2. Specific developmental disorders of scholastic skills1. Specific reading disorder2. Specific spelling disorder3. Specific disorder of arithmetical skills4. Specific scholastic skills disorder

*3. Specific developmental disorder of motor function4. Mixed specific developmental disorder5. Pervasive developmental disorder1. Childhood autism2. Retts syndrome3. Aspergers syndrome6. Other disorders of psychological development7. Unspecified disorder of psychological development

*II. Behavioral & emotional disorders with onset usually occurring in childhood & adolescence1. Hyperkinetic disorders1. Disturbance of activity & attention2. Hyperkinetic conduct disorder2. Conduct disorder3. Mixed disorders of conduct & emotions4. Emotional disorders with onset specific to childhood 1.Separation anxiety disorder of childhood

*5. Disorders of social functioning with onset specific to childhood & adolescence1. Elective mutism2. Reactive attachment disorder of childhood6. Tic disorders1. Transient tic disorder2. de la Tourettes syndrome

*7. Other behavioral & emotional disorders with onset usually occurring in childhood & adolescence1. non organic enuresis2. non organic encopresis3. feeding disorder of infancy & childhood4.stuttering

*Attention Deficit Hyperactivity DisorderDiminished sustained attention, higher level of impulsivity in a child or adolescent than expected for someone of that age & developmental level3-7 % of pre pubertal elementary schoolBoys : girls : 2-9 : 1Symptoms must be present before age 7 ( usually by age 3)

*Autistic Disorder= early infantile autism= childhood autism= Kanners autism

Characterized by deviant reciprocal social interaction, delayed & aberrant communication skills & a restricted repertoire of activities & interests

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Qualitative impairment in social interactionQualitative impairment in communicationRestricted repetitive & stereotyped patterns of behavior, interests & activities

*Marked impairment in the use of multiple non verbal behaviors such as eye to eye gaze, facial expression, body posturesFailure to develop peer relationships appropriate to developmental levelA lack of spontaneous seeking to share enjoyment interests or achievements with other peopleQualitative impairment in social interaction

*Qualitative impairment in communicationDelay in the development of spoken languageIn individual with adequate speech, marked impairment in the ability to initiate or sustain a conversation with othersStereotyped & repetitive use of language or idiosyncratic languageLack of varied, spontaneous make-believe play appropriate to developmental level

*Restricted repetitive & stereotyped patterns of behavior, interests & activities stereotyped & repetitive motor mannerism : hand or finger flapping or twisting or complex whole body movementsPersistent preoccupation with parts of objects

Separation Anxiety DisorderA. Developmentally inappropriate & excessive fear of anxiety concerning separation from those to whom the individual is attached, as evidenced by at least 3 of the following :*

1. Recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures2. Persistent & excessive worry about losing major attachment figures or about possible harm to them, such as illness,injury,disasters or death3.Persistent & excessive worry about experiencing an untoward event (getting lost, being kidnapped, having accident, becoming ill)that causes separation from a major attachment figures*

4. Persistent reluctance or refusal to go out, away from home, to school,to work or elsewhere because of fear of separation5. Persistent & excessive fear of or reluctance about being alone or without major attachment figures at home or in other settings6. Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figures*

7. Repeated nightmares involving the theme of separation8. Repeated complaints of physical symptoms (e.g. Headaches,stomaches, nausea, vomiting) when separation from major attachment figures occurs or it is anticipated*

B. The fear, anxiety or avoidance is persistent, lasting at least 4 weeks in children & adolescents & typically 6 months or more in adultsC. The disturbance causes clinically significant distress or impairment in social, academic, occupational or other important areas of functioning*

D. The disturbance is not better explained by another mental disorder, such as refusing to leave home because of excessive resistance to change in autism spectrum disorder, delusions or hallucinations concerning separation in psychotic disoreders, refusal to go outside without a trusted companion in agoraphobia, worries about ill health or other harm befalling significant others in generalized anxiety disorder,or concern about having an illness in illness anxiety disorder*

*TreatmentDepends on the type of the disordersIf the obtained symptom came from environment or family, hence the effectiveness of treatment determined by family or environment that concerned in the treatment strategy

*Treatment for child could be in form of :1. Family therapy2. Environmental manipulation3. Play therapy4. Behaviour therapy5.Pharmacological therapy6. Psychotherapy

*For child with education problems should be overcome with special school

*For several cases may be :

1. Cannot overcome the environment2. Environment as the root cause of the problems experienced by child3. Dangerous child hurting others or own selfFor these kind of child treated in special place.

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