MENTAL DISORDERS Department of Pediatrics Soochow University Affiliated Children’s Hospital

CLASSIFICATION OF CHILDHOOD MENTAL 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 this category have IQ between 40 and 54 and have 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 category. The IQ of this group of children is below 24.

Assessment Child care workers play a major role in identifying mentally retarded children through history taking, observation, and developmental screening 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 development, response to others, and hearing acuity, and it is necessary to assess severe and pervasive 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