Behavioural problems and behavioural disorder
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The document discusses various behavioral problems and disorders in children, including their causes, characteristics, and treatment approaches. It covers problems seen in infancy like feeding issues and colic, and problems in childhood like temper tantrums, bedwetting, nail biting, and speech/sleep disorders. Behavioral problems are often due to faulty parenting, family environment, or medical issues, and treating the underlying causes is important. Parents require guidance, reassurance, and advice on helping their children overcome behavioral problems.
Behavioural problems and behavioural disorder
- 2. BEHAVIOURAL PROBLEMS WHEN CHILDREN CANNOT ADJUST TO A COMPLEX ENVIRONMENT AROUND THEM, THEY BECOME UNABLE TO BEHAVE IN THE SOCIALLY ACCEPTABLE WAY RESULTING IN EXHIBITION OF PECULIAR BEHAVIORS AND THIS IS CALLED AS BEHAVIOURAL PROBLEMS
- 3. CAUSES • FAULTY PARENTAL ATTITUDE • INADEQUATE FAMILY ENVIRONMENT • MENTALLY AND PHYSICALLY SICK OR HANDICAPPED CONDITIONS • INFLUENCE OF SOCIAL RELATIONSHIPS • INFLUENCE OF MASS MEDIA
- 5. ON THE BASIS OF AGE INFANCY CHILDHOOD ADOLESCENCE
- 6. ON THE BASIS OF NATURE • MOVEMENT • HABIT • TOILETING • SPEECH • SCHOOL • SLEEP • EATING
- 8. INFANCY PROBLEMS • IMPAIRED APPETITE OR RESISTANCE TO FEEDING • ABDOMINAL COLIC • STRANGER ANXIETY
- 9. CHILDHOOD PROBLEMS • TEMPER TANTRUMS • BREATH HOLDING SPELL • THUMB SUCKING • NAIL BITING • ENURESIS OR BED WETTING
- 10. CHILDHOOD PROBLEMS • ENCOPRESIS • TICS OR HABIT SPASM • SCHOOL PHOBIA • ATTENTION DEFICIT HYPER ACTIVITY DISORDER
- 11. CHILDHOOD PROBLEMS TYPES OF PICA OR GEOPHAGIA • AMYLOPHAGIA: • COPROPHAGY: • GEOPHAGY • HYALOPHAGIA • MUCOPHAGIA
- 12. CHILDHOOD PROBLEMS • PAGOPHAGIA • SELF-CANNIBALISM • TRICHOPHAGIA • UROPHAGIA. • XYLOPHAGIA
- 13. CHILDHOOD PROBLEMS SPEECH PROBLEMS • STUTTERING OR STAMMERING • CLUTTERING • DELAYED SPEECH • DYSLALIA
- 14. CHILDHOOD PROBLEMS SLEEP DISORDERS • SLEEP WALKING • SLEEP TALKING • BRUXISM • NIGHT MARES • NIGHT TERRORS
- 15. ADOLESCENCE PROBLEMS • MASTURBATION • JUVENILE DELINQUENCY • SUBSTANCE ABUSE ANOREXIA NERVOSA • BULIMIA NERVOSA
- 17. PROBLEMS OF MOVEMENTS • HEAD BANGING • BREATH HOLDING SPELLS
- 18. PROBLEMS OF HABIT • THUMB SUCKING • NAIL BITING • PICA • TEMPER TANTRUMS • TICS
- 19. PROBLEMS OF TOILET TRAINING • ENURESIS • ENCOPRESIS
- 20. PROBLEMS OF SPEECH • STUTTERING OR STAMMERING • CLUTTERING • DELAYED SPEECH • DYSLALIA
- 21. PROBLEMS AT SCHOOL • SCHOOL PHOBIA
- 22. SLEEP DISORDERS SLEEP DISORDERS • SLEEP WALKING • SLEEP TALKING • BRUXISM • NIGHT MARES • NIGHT TERRORS
- 23. EATING DISORDER • ANOREXIA NERVOSA • BULIMIA NERVOSA
- 25. RESISTANCE TO FEEDING OR IMPAIRED APPETITE • DURING INFANCY FEEDING PROBLEMS OFTEN DEVELOP AT THE TIME OF WEANING. INFANT MAY REFUSE NEW FOOD DUE TO DISLIKE OF TASTE OR DUE TO SEPARATION ANXIETY FROM MOTHERS. IT MAY BE DUE TO DUE TO FORCED FEEDING BY THE MOTHER OR MAY BE DUE TO INDIGESTION OF NEW FOOD AND ABDOMINAL COLIC. THE INFANT MAY HAVE PAINFUL ULCER IN THE MOUTH OR SORE THROAT CAUSING DIFFICULTY IN SWALLOWING. THERE MAY BE NASAL CONGESTION OR ANY OTHER PATHOLOGICAL CAUSE WHICH NEED TO BE EXCLUDED.
- 26. RESISTANCE TO FEEDING OR IMPAIRED APPETITE • MOTHER USUALLY BECOME FRUSTRATED AND ANXIOUS WITH THIS SITUATION, SO THEY NEED REASSURANCE AND GUIDANCE IN RESCHEDULING THE FEEDING TIME AND CHANGE FOOD ITEMS. • PROBLEMS LIKE MOUTH ULCER, NASAL CONGESTION, SORE THROAT OR ANY OTHER CONDITIONS TO BE TREATED ACCORDINGLY. • MOTHER SHOULD BE ENCOURAGED TO PROVIDE TENDER LOVING CARE TO HER INFANT AND TO AVOID SEPARATION.
- 27. ABDOMINAL COLIC ABDOMINAL COLIC IS AN IMPORTANT CAUSE OF CRYING IN THE CHILDREN. SOME INFANT MAY CRY CONTINUOUSLY FOR VARIABLE PERIODS. THIS PROBLEM USUALLY STARTS WITHIN THE FIRST WEEK AFTER BIRTH REACHES THE PEAK BY THE AGE OF 4 TO 6 WEEKS AND IMPROVES AFTER 3 TO 4 MONTHS. THE INFANT MAY CRY LOUDLY WITH CLENCHED FISTS AND FLEXED LEGS.
- 28. ABDOMINAL COLIC THE CAUSE IS NOT NEARLY UNDERSTOOD. IT OCCURS COMMONLY IN :- • OVERACTIVE INFANTS WHO ARE OVER STIMULATED BY PARENTS. • DUE TO HUNGER OR IMPROPER FEEDING TECHNIQUE OR PHYSIOLOGICAL IMMATURITY OF THE INTESTINE OR COWS MILK ALLERGY • EXCESSIVE CARBOHYDRATE IN FOOD MAY LEAD TO INTESTINAL FERMENTATION AND ACCUMULATION OF GAS WHICH MAY CAUSE ABDOMINAL DISTENTION AND PAIN.
- 29. ABDOMINAL COLIC ABDOMINAL COLIC OF THE BABY INCREASES ANXIETY AND TENSION OF THE MOTHER. SHE REQUIRE EXPLANATION AND HELP FOR SOLVING THE PROBLEMS. BABY SHOULD BE PLACED IN UPRIGHT POSITION AND BURPING CAN BE DONE TO REMOVE SWALLOWED AIR. • PSYCHOLOGICAL BONDING WITH INFANT NEED TO BE IMPROVED. PRESENCE OF ANY ORGANIC CAUSE TO BE EXCLUDED AND NECESSARY ARRANGEMENTS TO BE MADE. • ANTISPASMODIC DRUG CAN BE ADMINISTERED TO RELIEF COLIC. FREQUENT SMALL AMOUNT FEEDING AND MODIFICATION OF FEEDING TECHNIQUE IS VERY IMP.
- 30. STRANGER ANXIETY THE INFANT DOES NOT BELIEF ANY OTHER PERSON EXCEPT MOTHER, BECAUSE THEY HAVE TRUST RELATIONSHIP WITH MOTHER ONLY. IN ABSENCE OF MOTHER, IF ANY NEW PERSON APPROACHES, THE CHILD WILL CRY DUE TO FEELING OF INSECURITY, FEAR AND ANXIETY. THIS CRYING MAY UPSET THE PARENT, BUT IT IS AN INDICATION THAT PARENT HAVE DONE A GREAT JOB IN THE EMOTIONAL DEVELOPMENT
- 31. STRANGER ANXIETY SEPARATION ANXIETY IS VITAL STEPS OF EMOTIONAL DEVELOPMENT AND MAY CONTINUE UP TO 13 TO 15 MONTHS OF AGE. THIS ANXIETY USUALLY REDUCES WHEN THE STRANGERS GRADUALLY APPROACH FROM DISTANCE IN A FAMILIAR PLACE SPECIALLY IN PRESENCE OF MOTHER AND FATHER. IN THE ABSENCE OF PARENTS LOVING CONCERN OF STRANGER IS VERY IMPORTANT.
- 32. TEMPER TANTRUM
- 33. TEMPER TANTRUM TEMPER TANTRUM IS A SUDDEN OUTBURST OR VIOLENT DISPLAY OF ANGER, FRUSTRATION, AND BAD TEMPER AS PHYSICAL AGGRESSION OR RESISTANCE SUCH AS RIGID BODY, BITING, KICKING, THROWING OBJECTS, HITTING, CRYING, ROLLING ON FLOOR, SCREAMING LOUDLY, BANGING LIMBS ETC.
- 34. TEMPER TANTRUM • TEMPER TANTRUM IN MALADJUSTED CHILDREN. THE ACTIVITY IS DIRECTED TOWARDS THE ENVIRONMENT NOT TO ANY PERSON OR ANYTHING. • IT IS NORMAL IN TODDLER, MAY CONTINUE TO PRE-SCHOOL PERIOD AND BECOME MORE SEVERE INDICATING LOW FRUSTRATION TOLERANCE. IT IS FOUND USUALLY IN BOYS, SINGLE CHILD AND PAMPERED CHILD. IF TEMPER TANTRUM CONTINUES, THE CHILD NEEDS PROFESSIONAL HELP FROM CHILD GUIDANCE CLINIC. PARENT SHOULD BE AWARE ABOUT THE BEGINNING OF TEMPER TANTRUM AND WHEN THE CHILD LOSES CONTROL.
- 35. TEMPER TANTRUM • PARENT SHOULD PROVIDE ALTERNATE ACTIVITY AT THAT FEELING IS NORMAL BUT CONTROLLING ANGER IS AN IMPORTANT ASPECT OF GROWING UP. • THE CHILD SHOULD BE PROTECTED FROM SELF-INJURY OR DOING INJURY TO OTHERS. PHYSICAL RESTRAIN USUALLY INCREASE FRUSTRATION AND BLOCK THE OUTLET OF ANGER. • FRUSTRATION CAN BE REDUCED BY CALM AND LOVING APPROACH. • OVERINDULGENCE SHOULD BE AVOIDED. AFTER TEMPER TANTRUM IS OVER THE CHILD’S FACE AND HAND SHOULD BE WASHED AND PLAY MATERIALS TO BE PROVIDED FOR DIVERSION. THE CHILD TENSION BE RELEASED BY VIGOROUS EXERCISE AND PHYSICAL ACTIVITIES. PARENT MUST BE FIRM AND CONSISTENT IN BEHAVIOUR.
- 37. BREATH HOLDING SPELLS BREATH-HOLDING SPELLS ARE BRIEF PERIODS WHEN YOUNG CHILDREN STOP BREATHING FOR UP TO 1 MINUTE. THESE SPELLS OFTEN CAUSE A CHILD TO PASS OUT (LOSE CONSCIOUSNESS). IT MAY OCCUR IN CHILDREN BETWEEN 6 MONTHS TO 5 YEARS OF AGE
- 38. BREATH HOLDING SPELLS • PARENTS AND FAMILY MEMBERS BECOME VERY ANXIOUS WITH THE ATTACK. ATTEMPT TO PREVENT THE SPELL IS USUALLY NOT SUCCESSFUL. • PARENTS NEED TO ASSURE THE HARMFUL EFFECTS OF THE ATTACK AND SHOULD BE TOLERANT CALM AND QUIET. IDENTIFICATION AND CORRECTION OF PRECIPITATING FACTORS ARE ESSENTIAL APPROACH. REPEATED ATTACK OF THE SPELLS NEED TO BE EVALUATED WITH CAREFUL HISTORY, PHYSICAL EXAMINATION AND NECESSARY INVESTIGATIONS TO EXCLUDE CONVULSIVE DISORDERS OR ANY OTHER PROBLEMS.
- 39. THUMB SUCKING
- 40. THUMB SUCKING THUMB SUCKING IS A COMMON, GENERALLY HARMLESS CHILD BEHAVIOUR WHOSE PERSISTENT PRACTICE OCCASIONALLY LEADS TO DENTAL, DERMATOLOGICAL, ORTHOPAEDIC, AND PSYCHOLOGICAL PROBLEMS.
- 41. THUMB SUCKING • THUMB SUCKING OR FINGER SUCKING IS A HABIT DISORDER DUE TO FEELING OF INSECURITY AND TENSION REDUCING ACTIVITIES. • IT MAY DEVELOP DUE TO INADEQUATE ORAL SATISFACTION DURING EARLY INFANCY BECAUSE OF POOR BREAST FEEDING. • IN OLDER CHILDREN, THIS HABIT MAY DEVELOP WHEN THEY ARE TIRED, BORED, FRUSTRATED, OR AT BED AND WANT TO SLEEP, BUT FEEL LONELY.
- 42. THUMB SUCKING • IF THIS CONDITION CONTINUES BEYOND 4 YRS. OF AGE THEN COMPLICATION MAY ARISE AS MALOCCLUSION AND MALALIGNMENT OF TEETH, DIFFICULTY IN MASTICATION AND SWALLOWING. • IT MAY CAUSE DEFORMITY OF THUMB, FACIAL DISTORTION OF SPEECH DIFFICULTIES WITH CONSONANTS (D AND T) AND GI TRACT INFECTIONS. IF THIS CONDITION CONTINUES THIS IS THE SIGN OF STRESS.
- 43. THUMB SUCKING • PARENTS AND FAMILY MEMBERS NEED SUPPORT AND TO BE ADVICE NOT TO BECOME IRRITABLE, ANXIOUS, AND TENSE. PRAISING AND ENCOURAGING CHILD FOR BREAKING THE HABIT. • DISTRACTION DURING BORED TIME OR ENGAGING THE THUMB OR FINGER FOR OTHER ACTIVITY TO BE PRACTICED TO KEEP HAND BUSY. CONSULTATION WITH DENTIST AND SPEECH THERAPIST MAY BE REQUIRED TO CORRECT THE COMPLICATION
- 44. NAIL BITING
- 45. NAIL BITING • NAIL BITING IS THE BAD ORAL HABIT ESPECIALLY IN SCHOOL AGE CHILDREN BEYOND 4 YRS. OF AGE (5 TO 7 YRS.). • IT IS THE SIGN OF TENSION AND SELF-PUNISHMENT OF TO COPE WITH THE HOSTILE FEELING TOWARDS PARENTS. IT MAY OCCUR AS IMITATING THE PARENT WHO IS ALSO A NAIL BITTER. IT IS CAUSED BY FEELING OF INSECURITY, CONFLICT AND HOSTILITY. • IT MAY BE DUE TO PRESSURIZED STUDY AT SCHOOL OR HOME DUE TO WATCHING FRIGHTENING VIOLENT SCENES. IT MAY CONTINUE UPTO ADOLESCENCE.
- 46. NAIL BITING • THE CHILD MAY BITE ALL 10 FINGER NAILS OR ANY SPECIFIC ONE. THE BITE MAY INCLUDE FINGER CUTICLE OR SKIN MARGIN OF ALL NAIL BEDS OR SURROUNDING TISSUE.
- 47. NAIL BITING • THE CAUSE OF NAIL BITING TO BE IDENTIFIED BY THE PARENTS WITH THE HELP OF CLINICAL PSYCHOLOGIST AND STEPS TO BE TAKEN TO REMOVE BAD HABIT. • THE CHILD SHOULD BE PRAISED FOR WELL-KEPT HAND BY BREAKING THE HABIT TO MAINTAIN SELF-CONFIDENCE. • THE CHILD’S HAND TO BE KEPT BUSY WITH CREATIVE ACTIVITIES OR PLAY. • PUNISHMENT TO BE AVOIDED. PARENTS NEED REASSURANCE AND ASSISTANCE TO ACCEPT THE SITUATION AND TO HELP THE CHILD TO OVERCOME THE PROBLEM.
- 48. BED WETTING
- 49. BED WETTING • BED WETTING IS THE REPETITIVE INVOLUNTARY PASSAGE OF URINE AT IN APPROPRIATE PLACE ESPECIALLY AT BED, DURING NIGHT TIME, BEYOND THE AGE OF 4 TO 5 YRS. • THE MOST FREQUENT CAUSE IS SMALL BLADDER CAPACITY, IMPROPER TOILET TRAINING AND DEEP SLEEP WITH INABILITY TO RECEIVE THE SIGNALS FROM DISTENDED BLADDER TO EMPTY IT. • THE EMOTIONAL FACTOR RESPONSIBLE FOR THIS IS HOSTILE OR DEPENDENT PARENTS- CHILD RELATIONSHIP, DOMINANT PARENTS, PUNISHMENT, SIBLING RIVALRY, EMOTIONAL DEPRIVATION DUE TO INSECURITY OR PARENTAL DEATH
- 50. BED WETTING • THE OTHER FACTOR INCLUDES THE CHILD WITH EMOTIONAL CONFLICT AND TENSION, DESIRES TO GAIN CARE AND ATTENTION OF PARENTS AS IN INFANCY. • ENVIRONMENTAL FACTOR MAY INCLUDE – DARK PASSAGE TO THE TOILET OR COLD OR FEARS OF TOILET OR TOILET AT DISTANCE FROM BED ROOM MAY CAUSE BED WETTING AT NIGHT.
- 51. BED WETTING • THE ASSOCIATED ORGANIC CAUSE MAY PRESENT E.G. SPINA BIFIDA, NEUROGENIC BLADDER, JUVENILE DIABETES MELLITUS, SEIZURES DISORDER ETC. AND NEED TO BE EXCLUDED. ENURESIS MAY BE PRIMARY AND SECONDARY IN TYPE • PRIMARY: - CHARACTERISED BY DELAYED MATURATION OF NEUROLOGICAL CONTROL OF URINARY BLADDER, WHEN CHILD ACHIEVED NORMAL BLADDER CONTROL USUALLY DUE TO ORGANIC CAUSE. • SECONDARY: - NORMAL BLADDER CONTROL IS DEVELOPED FOR SEVERAL MONTHS AFTER WHICH CHILD AGAIN STARTS BED WETTING AT NIGHT USUALLY DUE TO REGRESSIVE BEHAVIOUR LIKE ILLNESS AND HOSPITALIZATION DUE TO ANY EMOTIONAL DEPRIVATION.
- 52. BED WETING MANAGEMENT DEPENDS UPON THE SPECIFIC CAUSE. • ASSESSMENT OF EXACT CAUSE IS VERY ESSENTIAL BY THROUGH HISTORY, CLINICAL EXAMINATION AND NECESSARY INVESTIGATIONS. • THE ORGANIC CAUSES ARE MANGED WITH SPECIFIC TREATMENT. • NON-ORGANIC CAUSES ARE MANAGED WITH SPECIFIC TREATMENT. THEY ARE MANAGED PRIMARILY WITH EMOTIONAL SUPPORT TO THE CHILD AND PARENTS ALONG WITH ENVIRONMENT MODIFICATION • THE CHILD NEEDS REASSURANCE, RESTRICTION OF FLUID AFTER DINNER, VOIDING BEFORE BED TIME AND ARISING THE CHILD TO VOID, ONCE OR TWICE, THREE TO FOUR
- 53. BED WETTING • THE CHILD SHOULD BE FULLY WAKENING UP BY THE PARENT AND MADE AWARE OF PASSING OF URINE AT NIGHT. THE CHILD CAN ASSUME RESPONSIBILITY FOR CHANGING THE BED CLOTHES. PARENTS SHOULD NOT BE WORRIED ABOUT THE PROBLEM • PARENTS SHOULD ENCOURAGE AND REWARD THE CHILD FOR DRY NIGHTS. • PUNISHMENT AND CRITICISM MAY LEAD TO EMBARRASSMENT AND FRUSTRATION, OF THE CHILD, BLADDER STRETCHING DURING DAY TIME TO BE DONE TO INCREASE HOLDING TIME OF URINE, USING POSITIVE REINFORCEMENT AND DELAYING VOIDING SOMETIME.
- 54. BED WETTING • DRUG THERAPY TRICYCLIC ANTIDEPRESSANT(IMIPRAMINE) ARE USEFUL. • CONDITION THERAPY BY USING ELECTRIC ALARM BELL MATTRESS IS A EFFECTIVE AND SAFEST METHOD WHEN CHILD WAKES UP AS SOON AS BED IS WET. • SUPPORTIVE PSYCHOTHERAPY IS EFFECTIVE. TO CHANGE THE HOME ENVIRONMENT
- 55. ENCOPORESI S
- 56. ENCOPORESIS • ENCOPRESIS IS THE PASSAGE OF FECES INTO INAPPROPRIATE PLACES AFTER THE AGE OF 5 YRS., WHEN THE BOWEL CONTROL IS NORMALLY ACHIEVED. • IT IS MORE SERIOUS FORM OF EMOTIONAL DISTURBANCE DUE TO UNCONSCIOUS ANGER, STRESS AND ANXIETY. • IT CAN BE PRIMARY OR SECONDARY ENCOPRESIS LIKE BED WETTING. ASSOCIATION PROBLEMS ARE CHRONIC CONSTIPATION, PARENTAL OVER CONCERN, OVER AGGRESSIVE TOILET TRAINING, TOILET FEAR, ATTENTION DEFICIT DISORDERS, POOR SCHOOL ATTENDANCE AND LEARNING DIFFICULTIES MAY BE FOUND WITH ENCOPRESIS.
- 57. ENCOPORESIS ASSESSMENT OF THIS CONDITION HISTORY OF BOWEL TRAINING, USE OF TOILETS AND ASSOCIATED PROBLEMS. THE CHILD NEED HELP IN THE ESTABLISHMENT OF REGULAR BOWEL HABIT, BOWEL TRAINING, DIETARY INTAKE OF ROUGHAGE AND INTAKE OF ADEQUATE FLUID. PARENTERAL SUPPORT, REASSURANCE AND HELP FROM PSYCHOLOGIST FOR COUNSELLING OF CHILD AND PARENTS MAY BE ESSENTIAL IN PERSISTENT PROBLEMS.
- 58. PICA
- 59. PICA • AN EATING DISORDER WHICH IS CHARACTERIZED BY CONSUMING NON-EDIBLE SUBSTANCES IS KNOWN AS PICA DISORDER. A PERSON WITH THIS CONDITION CRAVES FOR NON-NUTRITIVE SUBSTANCES LIKE SOIL, CHALK PIECE, CLAY, MUCUS, PAPER, SOAP ETC • IT IS SEEN IN ALMOST ALL THE AGE GROUPS. IT IS VERY COMMON AMONG PREGNANT WOMEN, YOUNG KIDS AND CHILDREN WITH DEVELOPMENTAL DISABILITIES
- 60. PICA • AMYLOPHAGIA: A COMPULSIVE CONSUMPTION OF PURIFIED STARCH IN EXCESSIVE AMOUNTS IS KNOWN AS AMYLOPHAGIA. IT IS MOSTLY SEEN AMONG PREGNANT WOMEN. • COPROPHAGY: AN EATING DISORDER CHARACTERIZED BY EATING FECES IS CALLED COPROPHAGY. IT IS SEEN AMONG ANIMALS AND IS UNCOMMON IN HUMAN BEINGS. • GEOPHAGY: IT IS AN ABNORMAL CRAVING FOR SOIL-LIKE OR EARTHY SUBSTANCES CLAY, CHALK, SOIL ETC. IT IS COMMON AMONG CHILDREN AND PREGNANT WOMEN. • HYALOPHAGIA: PICA DISORDER IN WHICH THE PERSON EATS GLASS OBJECTS IS CALLED HYALOPHAGIA. THIS IS USUALLY USED AS A PERFORMANCE TECHNIQUE BY PERFORMERS. • MUCOPHAGIA: A DISORDER OF FEEDING ON THE MUCUS OF THE INVERTEBRATES AND FISHES IS CALLED MUCOPHAGIA.
- 61. PICA • PAGOPHAGIA: A FORM OF PICA IN WHICH THE PERSON CONSUMES EXCESSIVE AMOUNTS OF ICE CUBES OR ICED DRINKS IS KNOWN AS PAGOPHAGIA. THIS CONDITION IS ASSOCIATED WITH THE IRON DEFICIENCY. • SELF-CANNIBALISM: IT IS THE SELF-EATING PRACTICE. SELF- CANNIBALIAM IS ALSO CALLED AUTOCANNIBALISM OR AUTOSARCOPHAGY. • TRICHOPHAGIA: THIS CONDITION IS CHARACTERIZED BY EATING HAIR, MOSTLY ONE’S OWN. THE LONG HAIR IS FIRST CHEWED WITHOUT PULLING THEM FROM THE SCALP AND THEM SWALLOWED. SOMETIMES THE PATIENT MIGHT ALSO EAT OTHER PEOPLE’S HAIR. • UROPHAGIA: THE PRACTICE OF CONSUMING URINE IS CALLED UROPHAGIA. THE REASON FOR THIS MIGHT BE HEALTH CONCERNS AS URINE IS REGARDED, BY SOME, EARTHY AND WITH HEALING PROPERTIES. • XYLOPHAGIA: THIS KIND OF PICA DISORDERS INVOLVES THE CONSUMPTION OF WOOD. PEOPLE USUALLY EAT THINGS MADE OF WOOD LIKE PENCIL, PAPER, WOOD BARK ETC. THIS IS SEEN MOSTLY AMONG CHILDREN.
- 62. PICA • IT IS COMMON IN POOR SOCIOECONOMIC FAMILY AND IN MALNOURISHED AND MENTALLY SUBNORMAL CHILDREN. CHILDREN WITH PICA MAY HAVE INTESTINAL PARASITIZES, LEAD POISONING, VITAMINS AND MINERAL DEFICIENCY. • MANAGEMENT IS DONE BY PSYCHOTHERAPY OF THE CHILD AND THE PARENTS.
- 63. TICS
- 64. TICS • A TIC IS A SUDDEN, REPETITIVE, NONRHYTHMIC MOTOR MOVEMENT OR VOCALIZATION INVOLVING DISCRETE MUSCLE GROUPS. • TICS CAN BE INVISIBLE TO THE OBSERVER, SUCH AS ABDOMINAL TENSING OR TOE CRUNCHING. • COMMON MOTOR AND PHONIC TICS ARE, RESPECTIVELY, EYE BLINKING AND THROAT CLEARING. • IT OCCURS MOSTLY IN SCHOOL CHILDREN FOR DISCHARGE OF CHILDREN IN MALADJUSTED EMOTIONALLY CHILD. IT IS OUTLET OF SUPPRESSED ANGER AND WORRY ABOUT CONTROL OF AGGRESSION.
- 65. TICS • TICS CAN BE MOTOR OR VOCAL. MOTOR TICS CAN BE FOUND AS EYE BLINKING; GRIMACING SHRUGGING SHOULDER, TONGUE PROTRUSION, FACIAL GESTURE. ETC. VOCAL TICS ARE FOUND AS THROAT CLEARING, COUGHING, BARKING, SNIFFING. • A SPECIAL TYPE OF CHRONIC TIC IS FOUND AS ‘GILLES DE LA TOURETTE’S SYNDROME’ CHARACTERIZED BY MULTIPLE MOTOR TICS AND VOCAL TICS. IT SEEMS TO BE A GENETIC DISORDER WITH ONSET AT 11 YEARS OF AGE • PARENTERAL REASSURANCE AND COUNSELLING OF THE CHILD AND PARENTS USUALLY USEFUL TO MANAGE SIMPLE MOTOR AND VOCAL TICS.
- 66. SPEECH PROBLEM
- 67. SPEECH PROBLEM • SPEECH DISORDER IS COMMON IN CHILDHOOD. THESE CAN BE FOUND AS DISTURBANCES OF VOICE, ARTICULATION, AND FLUENCY. • STUTTERING OR STAMMERING • STUTTERING, ALSO KNOWN AS STAMMERING, IS A SPEECH DISORDER IN WHICH THE FLOW OF SPEECH IS DISRUPTED BY INVOLUNTARY REPETITIONS AND PROLONGATIONS OF SOUNDS, SYLLABLES, WORDS OR PHRASES AS WELL AS INVOLUNTARY SILENT PAUSES OR BLOCKS IN WHICH THE PERSON WHO STUTTERS IS UNABLE TO PRODUCE SOUNDS. • MANAGEMENT OF STAMMERING INCLUDES BEHAVIOUR MODIFICATION AND RELAXATION THERAPY TO RESOLVE THE CONFLICT AND EMOTIONAL STRESS. • PARENTS NEED TO BE COUNSELLED TO RATIONALIZE THEIR EXPECTATION. THE CHILD SHOULD BE REASSURED AND HELP IN BREATH CONTROL EXERCISE AND SPEECH THERAPY. CRITICISM MAKE CHILD MORE HANDICAPPED
- 68. SPEECH PROBLEM CLUTTERING IT IS CHARACTERIZED BY UNCLEAR AND HURRIED SPEECH IN WHICH WORD TUMBLE OVER EACH OTHER. THERE ARE AWKWARD MOVEMENTS OF HAND; FEET AND BODY. THESE CHILDREN HAVE ERRATIC AND POORLY ORGANIZED PERSONALITY AND BEHAVIOR PATTERN. THEY NEED PSYCHOTHERAPY.
- 69. SPEECH PROBLEM • DELAYED SPEECH DELAYED SPEECH BEYOND 3 TO 3.5 YEARS CAN BE CONSIDERED AS ORGANIC CAUSES LIKE AUTISM, MENTAL RETARDATION, HEARING DEFECTS OR SEVERAL EMOTIONAL PROBLEMS. THE EXACT CAUSE MUST BE EXCLUDED FOR NECESSARY INTERVENTIONS.
- 70. SPEECH PROBLEM DYSLALIA MOST COMMON DISORDER OF DIFFICULTY IN ARTICULATION. IT CAN BE CAUSED BY ABNORMALITIES OF TEETH, JAW, PALATE OR DUE TO EMOTIONAL DEPRIVATION. TREATMENT OF STRUCTURAL ABNORMALITIES AND SPEECH THERAPY SHOULD BE DONE ADEQUATELY.
- 71. SLEEP DISORDER
- 72. SLEEP DISORDER SLEEP DISORDER ARE COMMON IN CHILDREN WITH ANXIETY, TENSION, AND OVERACTIVITY. THESE PROBLEMS ARE PRESENT WITH OR WITHOUT PHYSICAL SYMPTOMS OF BEHAVIOURAL DISORDERS. DISTURBANCE OF SLEEP USUALLY OCCUR IN DEEP SLEEP, I.E. STAGE 3 OR 4 OF NREM (NON- RAPID EYE MOVEMENT) SLEEP. THE COMMON SLEEP PROBLEMS ARE DIFFICULTY TO FALL ASLEEP, NIGHT MARES, NIGHT TERRORS, SLEEP WALKING (SOMNAMBULISM), SLEEP TALKING (SOMILILOQUY), BRUXISM (TEETH GRINDING), ETC.
- 73. SLEEP DISORDER • IN NIGHT MARES, THE CHILD AWAKENS FROM A FRIGHTENING BAD DREAM AND IS CONSCIOUS OF SURROUNDINGS. • IN NIGHT TERRORS, THE CHILD AWAKENS DURING SLEEP, SITS UP WITH SCREAMING AND TERRIFIED TO RECOGNIZE THE SURROUNDING AND AFTER SOMETIMES SLEEPS AGAIN. • SLEEPWALKING USUALLY OCCURS ONE TO TWO HOURS AFTER FALLING ASLEEP AT NIGHT. RARELY, IT MAY INVOLVE UNUSUAL BEHAVIOURS, SUCH AS CLIMBING OUT OF A WINDOW OR URINATING IN A WARDROBE.
- 74. SLEEP DISORDER • SOMNILOQUY OR SLEEP-TALKING IS A PARASOMNIA THAT REFERS TO TALKING ALOUD WHILE ASLEEP. IT CAN BE QUITE LOUD, RANGING FROM SIMPLE MUMBLING SOUNDS TOO LOUD SHOUTS AND LONG, FREQUENTLY INARTICULATE SPEECHES, AND CAN OCCUR MANY TIMES DURING A SLEEP CYCLE. • SLEEP BRUXISM IS CONSIDERED A SLEEP-RELATED MOVEMENT DISORDER. PEOPLE WHO CLENCH OR GRIND THEIR TEETH (BRUX) DURING SLEEP ARE MORE LIKELY TO HAVE OTHER SLEEP DISORDERS, SUCH AS SNORING AND PAUSES IN BREATHING (SLEEP APNEA).
- 75. SLEEP DISORDER • IN ALL THESE PROBLEMS, THE CHILD SHOULD HAVE LIGHT DIET IN DINNER AND PLEASANT STORIES OR SCENE AT BED TIME. • NO EXCITING GAMES AND PICTURES AND FRIGHTENING STORIES. • PARENTS SHOULD ALLOW RELAX COMFORTABLE BED AND EMOTIONALLY HEALTHY ENVIRONMENT. • IN CASE OF SLEEP WALKING DOORS AND WINDOWS TO BE KEPT CLOSED AND DANGEROUS OBJECTS TO BE REMOVED • IN ADVANCED AND PROLONGED PROBLEMS CONSULTATION WITH DOCTORS AND PSYCHOLOGIST IS ESSENTIAL FOR SPECIFIC DRUG THERAPY AND PSYCHOTHERAPY.
- 76. SCHOOL PHOBIA
- 77. SCHOOL PHOBIA • SCHOOL PHOBIA IS PERSISTENT AND ABNORMAL FEAR OF GOING TO SCHOOL. IT IS COMMON IN ALL SOCIAL GROUP. IT IS EMOTIONAL DISORDER OF THE CHILDREN WHO ARE AFRAID TO LEAVE THE PARENTS. • IT IS SYMPTOM OF CRISIS SITUATION OF DEVELOPMENT STAGES AND CRY FOR HELP WHICH NEEDS SPECIAL ATTENTION. • CONTRIBUTING FACTORS ARE ANXIETY, UNCONGENIAL SCHOOL ENVIRONMENT LIKE TEASING BY OTHER STUDENTS, POOR STUDENT TEACHER RELATIONSHIP, UNHYGIENIC ENVIRONMENT FEAR OF EXAMINATION.
- 78. SCHOOL PHOBIA • THE CHILD MAY COMPLAIN OF RECURRENT PHYSICAL COMPLAINTS LIKE ABDOMINAL PAIN, HEADACHES WHICH SUBSIDES IF THE CHILD IS ALLOWED TO REMAIN AT HOME. • THE PROBLEM CAN BE MANAGED BY HABIT FORMATION FOR REGULAR SCHOOL ATTENDANCE; PLAY SESSION AND OTHER RECREATIONAL ACTIVITIES AT SCHOOL, IMPROVEMENT OF SCHOOL ENVIRONMENT AND ASSESSMENT OF HEALTH STATUS .OF THE CHILD TO DETECT ANY HEALTH PROBLEMS FOR NECESSARY INTERVENTION.
- 80. ADHD ADHD OFTEN BEGINS IN CHILDHOOD AND CAN PERSIST INTO ADULTHOOD. IT MAY CONTRIBUTE TO LOW SELF-ESTEEM, TROUBLED RELATIONSHIPS AND DIFFICULTY AT SCHOOL OR WORK. SYMPTOMS INCLUDE LIMITED ATTENTION AND HYPERACTIVITY. IT IS CHARACTERIZED BY PROBLEMS PAYING ATTENTION, EXCESSIVE ACTIVITY, OR DIFFICULTY CONTROLLING BEHAVIOUR WHICH IS NOT APPROPRIATE FOR A PERSON'S AGE. THE SYMPTOMS APPEAR BEFORE A PERSON IS TWELVE YEARS OLD, ARE PRESENT FOR MORE THAN SIX MONTHS, AND CAUSE PROBLEMS IN AT LEAST TWO SETTINGS (SUCH AS SCHOOL, HOME, OR RECREATIONAL ACTIVITIES).
- 81. ADHD • MOST ADHD CASES ARE OF UNKNOWN CAUSES. IT IS BELIEVED TO INVOLVE INTERACTIONS BETWEEN GENETICS, THE ENVIRONMENT, AND SOCIAL FACTORS. CERTAIN CASES ARE RELATED TO PREVIOUS INFECTION OF OR TRAUMA TO THE BRAIN. PREDISPOSING FACTOR CAN BE PREMATURITY OR LBW. • THE MANIFESTATION MAY BE COMBINATION OF READING AND ARITHMETIC DISABILITY, IMPAIRED MEMORY, POOR LANGUAGE AND SPEECH DEVELOPMENT, INAPPROPRIATE UNDERSTANDING OF SPOKEN WORDS ETC. THE CHILD IS USUALLY OVERACTIVE, AGGRESSIVE, EXITABLE, IMPULSIVE AND INATTENTIVE.
- 82. ADHD • MANAGEMENT IS DONE BY TEAM APPROACH INCLUDING PEDIATRICIAN, PSYCHOLOGIST, PSYCHIATRIST, PEDIATRIC NURSE SPECIALIST, SCHOOL HEALTH NURSE, TEACHERS, SOCIAL WORKERS AND PARENTS. • APPROACHES INCLUDE BEHAVIOR MODIFICATION, COUNSELLING, AND GUIDANCE OF PARENTS AND APPROPRIATE TRAINING AND EDUCATION OF CHILD. DRUG THERAPY CAN HELP TO IMPROVE THE CNS DYSFUNCTION OR OTHER ASSOCIATED PROBLEMS.
- 84. MASTURBATION • MASTURBATION OR GENITAL STIMULATION BY HANDLING THE GENITALS GIVES PLEASURE TO THE CHILDREN. THE INFANT AND TODDLER DO THIS OUT OF CURIOSITY. THE OLDER CHILDREN MASTURBATE OUT OF ANXIETY OR SEXUAL FEELING. BOYS DURING TEEN YEARS MOSTLY ENGAGE WITH THESE PRACTICES. • ADOLESCENT EXPERIENCE SEXUAL EXCITEMENT AND ERECTION OF PENIS OR CLITORIS. • PARENTS SHOULD BE INFORMED THAT MASTURBATION IS NORMAL RESPONSE DURING PRE-PUBESCENT AND PUBESCENT STAGE AND HAS A ROLE IN PHYSICAL AND EMOTIONAL DEVELOPMENT. IT PROVIDES A VARIETY OF SEXUAL EXPERIENCES.
- 85. MASTURBATION • IN CASE OF EXCESSIVE MASTURBATION THE CHILD NEEDS SPECIAL ATTENTION, FACILITIES FOR RECREATION AND DIVERSION, SEX EDUCATION AND COUNSELLING. PARENTS SHOULD BE EXPLAINED TO PROVIDE LOVE AND AFFECTION AND ATTENTION TO THE OLDER CHILDREN WITH SPECIFIC CONCERN ABOUT THEIR FEELING.
- 87. JUVENILE DELIQUENCY • JUVENILE DELINQUENCY MEANS INDULGENCE IN AN OFFENCE BY A CHILD IN THE FORM OF PREMEDIATED, PURPOSEFUL, UNLAWFUL ACTIVITIES DONE HABITUALLY AND REPEATEDLY. USUALLY THESE CHILDREN BELONGS TO BROKEN FAMILY OR EMOTIONALLY DISTURBED FAMILY WITH OVERCROWDED UNHEALTHY ENVIRONMENT AND HAVING FINANCIAL OR LEGAL PROBLEMS. • FACTORS :- URBANIZATION, CHANGING LIFE STYLE, MASS MEDIA, CHANGE IN MORAL STANDARDS, LACK OF EDUCATIONAL OPPORTUNITIES, POOR ECONOMY, UNHEALTHY STUDENT-TEACHER RELATIONSHIP AND LACK OF DISCIPLINE.
- 88. JUVENILE DELIQUENCY • THIS BEHAVIOUR INCLUDE LYING, THEFT, BURGLARY, TRUANCY FROM SCHOOL, RUN AWAY FROM HOME, HABITUAL DISOBEDIENCE, FIGHTS, ANTISOCIAL GANG, CRUELTY TO ANIMALS. • PREVENTION IS BY ELIMINATION OF CONTRIBUTING FACTOR. THE PROBLEM DELINQUENT BEHAVIOURS IS NOW INCREASING IN INDIA AND OTHER COUNTRIES. • PREVENTIVE MEASURES TO BE EMPHASIZED BY HEALTHY FAMILY AND SCHOOL ENVIRONMENT. • HEALTHY PARENT CHILD RELATIONSHIP • THE CHILD MUST BE REFERED TO CHILD GUIDANCE CLINIC. A TEAM APPROACH IS NECESSARY IN MANAGEMENT OF THIS CONDITION INCLUDING SOCIAL WORKERS, PSYCHOLOGISTS, PSYCHIATRISTS, PAEDIATRICIAN, COMMUNITY HEALTH NURSE, SCHOOL TEACHERS, FAMILY MEMBERS AND PARENTS.
- 89. SUBSTANCE ABUSE
- 90. SUBSTANCE ABUSE SUBSTANCE ABUSE OR DRUG ABUSE IS AN THREATENING SOCIAL PROBLEM OF SCHOOL GOING ADOLESCENT AGE GROUP. IT IS PERIODIC OR CHRONIC INTOXICATION BY REPEATED INTAKE OF HABIT FORMING AGENTS. IT IS PERSISTENT OR SPORADIC USE OF DRUGS OR SUBSTANCE INCONSISTENT WITH UNRELATED TO MEDIAL AND SOCIAL WITHIN A GIVEN CULTURE.
- 91. SUBSTANCE ABUSE • THE ABUSED AGENTS ARE MAINLY TOBACOO, ALCOHOL SLEEPING PILL, TRANQUILLIZERS, MOOD ELEVATORS STIMULANTS, OPIATES, LSD, COCAINE HERION AND CANNABIS. • THE CHILDREN WITH THIS BEHAVIOURAL DISORDERS ARE HAVING FRUSTRATION, EMOTIONAL CONFLICTS AND DISTRIBUTED FAMILY AND SCHOOL RELATIONSHIP. THEY ARE VICTIM OF GANG ACTIVITIES, WRONG ADVENTURE, POOR PARENTAL GUIDANCE AND LACK OF RECREATION AND EDUCATION.
- 92. SUBSTANCE ABUSE PREVENTION:- • PROVISION OF ADEQUATE FACILITIES FOR RECREATION AND ENTERTAINMENT, ESPECIALLY IN THE HOSTELS • INCULCATION OF THE DANGERS OF DRUG ABUSE AMONG STUDENTS , THEIR TEACHERS AND FAMILY MEMBERS. • STRICT IMPLEMENTATION OF DRUG CONTROL MEASURES. • THE ADDICTED CHILDREN NEED PSYCHOTHERAPY, DEADDICTION, WHEREVER NECESSARY
- 93. ANOREXIA NERVOSA
- 94. ANOREXIA NERVOSA • ANOREXIA NERVOSA IS A EATING DISORDER OCCUR MOST OFTEN IN ADOLESCENT GIRLS. THE PROBLEM IS FOUND AS REFUSAL OF FOOD TO MAINTAIN NORMAL BODY WEIGHT BY REDUCING FOOD INTAKE ESPECIALLY FATS AND CARBOHYDRATES. THE AFFECTED ADOLESCENT GIRL PRACTICES VIGOROUS EXERCISE FOR WEIGHT REDUCTION OR INDUCE VOMITING BY STIMULATING GAG REFLEX TO REMAIN SLIM • THERE IS NO SPECIFIC ORGANIC CAUSE OF ANOREXIA NERVOSA. THE AFFECTED ADOLESCENT MAY HAVE ASSOCIATED CONDITIONS LIKE DISEASE OF LIVER, KIDNEY, HEART OR DIABETES.
- 95. ANOREXIA NERVOSA • PARENT OF AFFECTED ADOLESCENT MAY BE ANORECTIC AND HAVING CONFLICT IN RELATIONSHIP WITH THE CHILD OR OVERPROTECTIVE WHICH LEAD TO DEVELOPMENT OF IMMATURITY, ISOLATION AND EXCESSIVE DEPENDENCE. • THE AFFECTED ADOLESCENT IS CHARACTERIZED BY UNDER NUTRITION, MARKED WEIGHT LOSS, BIZZARE FOOD INTAKE PATTERNS, DRYNESS OF SKIN, HYPOTHERMIA, HYPOTENSION, BRADYCARDIA AMENORRHEA CONSTIPATION ETC
- 96. BULIMIA NERVOS A
- 97. BULIMIA NERVOSA • BULIMIA NERVOSA IS A SERIOUS, POTENTIALLY LIFE- THREATENING EATING DISORDER CHARACTERIZED BY A CYCLE OF BINGEING AND COMPENSATORY BEHAVIORS SUCH AS SELF-INDUCED VOMITING DESIGNED TO UNDO OR COMPENSATE FOR THE EFFECTS OF BINGE EATING. SYMPTOMS • FREQUENT EPISODES OF CONSUMING VERY LARGE AMOUNT OF FOOD FOLLOWED BY BEHAVIORS TO PREVENT WEIGHT GAIN, SUCH AS SELF-INDUCED VOMITING. • A FEELING OF BEING OUT OF CONTROL DURING THE BINGE-EATING EPISODES. • SELF-ESTEEM OVERLY RELATED TO BODY IMAGE.
- 98. BULIMIA NERVOSA • TREATMENT FOR BULIMIA INVOLVES PSYCHOLOGICAL COUNSELING AND SOMETIMES MEDICINES SUCH AS ANTIDEPRESSANTS. TREATMENT DOES NOT USUALLY REQUIRE STAYING IN THE HOSPITAL, ALTHOUGH THIS IS SOMETIMES NEEDED. BOTH PROFESSIONAL COUNSELING AND ANTIDEPRESSANT MEDICINE CAN HELP REDUCE EPISODES OF BINGING AND PURGING
- 99. NURSING RESPONSIBILITI ES Assessment of specific problem of the child by appropriate history and detection of the responsible factors. Informing the parents and making them aware above about the causes of behavioural problems of the particular child Assisting the parents, teachers and family members for necessary modification of environment at home, school and community. Encouraging the child for behaviour modification, as needed.
- 100. NURSIN G RESPON SIBILITIE S Promoting healthy emotional development of the child by adequate physical, psychological and social support. Promoting Creating awareness about psychosocial disturbances which may lead to behavioural problems during developmental stages. Creating Providing counselling services for children and their parents to solve problems Providing Referring the children with behavioural problems for necessary management. Referring