MENTAL DISORDERS OF INFANCY, CHILDHOOD, AND ADOLESCENCE, MENTAL RETARDATIONLEARNING DISORDERSMOTOR SKILLS DISORDERCOMMUNICATION DISORDERSPERVASIVE DEVELOPMENTAL DISORDERSAUTISTIC DISORDER, ATTENTION-DEFICIT HYPERACTIVITY DISORDER. CONDUCT DISORDER, TIC DISORDERS  SEPARATION ANXIETY DISORDER

1. SEMINAR ON MENTAL DISORDERS OF
INFANCY, CHILDHOOD AND ADOLESCENCE
Presented by
Selvaraj.p
Ph.D Scholar
Oct-2019 Batch Guide
Dr.Sasi.Vaithilingan
Professor Cum Vice-Principal
VMCON Pondicherry.

2. OBJECTIVES
Identify psychiatric disorders usually first diagnosed in infancy,
childhood, or adolescence
Discuss etiological implications of mental retardation, autistic
disorder, attention deficit-hyperactivity disorder, conduct
disorder, and separation anxiety disorder.
Identify symptomatology and use the information in the
assessment of clients with the aforementioned disorders.
Provide education to clients, families, teachers, caregivers, and
community members for young clients with psychiatric disorders.
Discuss the nurse's role as an advocate for children and
adolescents6/01/2020 VMRF (DU) NSG 19 OCT 07

3. INTRODUCTION
• In any give year 9% to 13 % of children suffer from
clinically significant psychiatric disorders.
• Childhood neuropsychiatric disorders will increase
by more than 50% internationally to become one of
the five most common cause of morbidity,
mortality, and disability among children in the
world ( GBD-2020)
6/01/2020 VMRF (DU) NSG 19 OCT 07

4. • Mental illness that develops before age 6 can
interfere with critical aspects of a child's emotional,
cognitive, and physical development.
• Childhood disorders appears to set in motion chain
of maladaptive behaviour and environmental
responses that foster more persistent psych31-05-
2020opathology.
6/01/2020 VMRF (DU) NSG 19 OCT 07

5. MENTAL RETARDATION
• Mental retardation is defined by deficits in
general intellectual functioning and adaptive
functioning (APA, 2000).
• General intellectual -Intelligence quotient (IQ)
tests.
• Adaptive functioning - The expectations of his
or her age and cultural group.6/01/2020 VMRF (DU) NSG 19 OCT 07

6. CON’T
• Communication
• Self-care
• Home living
• Social skills
• Community use
• Self-direction
• Health and safety
• Functional academics
• Leisure
• Work
6/01/2020 VMRF (DU) NSG 19 OCT 07

7. ETIOLOGY OF MR
• Trauma before birth, such as an infection or exposure to alcohol, drugs, or other
toxins
• Trauma during birth, such as oxygen deprivation or premature delivery
• Inherited disorders, such as phenylketonuria
• Chromosome abnormalities, such as Down syndrome
• lead or mercury poisoning
• Severe malnutrition or other dietary issues
• Severe cases of early childhood illness, such as whooping cough, measles and
meningitis
• Brain injury
6/01/2020 VMRF (DU) NSG 19 OCT 07

8. DEVELOPMENTAL CHARACTERISTICS OF
MENTAL RETARDATION BY DEGREE OF
SEVERITY
• Mild MR – IQ from 50- 70
• Moderate MR – IQ from 35-50
• Severe MR – IQ from 20-35
• Profound MR – IQ below 20
6/01/2020 VMRF (DU) NSG 19 OCT 07

9. MILD MR – IQ FROM 50 TO 70
• Taking longer to learn to talk, but communicating well
once they know how
• Being fully independent in self-care when they get
older
• Having problems with reading and writing
• Social immaturity
• Increased difficulty with the responsibilities of marriage
or parenting
• Benefiting from specialized education plans
6/01/2020 VMRF (DU) NSG 19 OCT 07

10. MODERATE MR – IQ FROM 35-50
• Are slow in understanding and using language
• May have some difficulties with communication
• Can learn basic reading, writing, and counting skills
• Are generally unable to live alone
• Can often get around on their own to familiar
places
• Can take part in various types of social activities
6/01/2020 VMRF (DU) NSG 19 OCT 07

11. SEVERE MR – IQ FROM 20-35
• Noticeable motor impairment
• Severe damage to, or abnormal development of,
their central nervous system
• Minimal verbal skills. Wants and needs often
communicated by acting-out behaviors.
• Poor psychomotor development. Only able to
perform simple tasks under close supervision
6/01/2020 VMRF (DU) NSG 19 OCT 07

12. PROFOUND MR – IQ BELOW 20
• Inability to understand or comply with requests or
instructions
• Possible immobility
• Incontinence
• Very basic nonverbal communication
• Inability to care for their own needs independently
• The need of constant help and supervision
6/01/2020 VMRF (DU) NSG 19 OCT 07

13. PREVENTION
1. PRIMARY PREVENTION
a. Preconception
• Genetic counseling,
• Immunization for maternal rubella.
• Blood tests for marriage licenses
• Adequate maternal nutrition.
• Family planning.
6/01/2020 VMRF (DU) NSG 19 OCT 07

14. b. During Gestation
• Two general approaches to prevention are
associated with this period:
• Prenatal care
• Analysis of fetus for possible genetic disorders
6/01/2020 VMRF (DU) NSG 19 OCT 07

15. c. At delivery
– Delivery conducted by expert doctors and staff,.
– Apgar scoring done at 1 and 5 minutes after the birth of
the child.
– Close monitoring of mother and child
• Injection of gamma globulin, which can prevent Rh-
negative mothers from developing antibodies that
might otherwise affect subsequent children
6/01/2020 VMRF (DU) NSG 19 OCT 07

16. d. Childhood
– Proper nutrition
– Dietary restrictions for specific metabolic disorders until
no longer needed.
• Avoidance of hazards in the child's environment to
avert brain injury from causes such as lead
poisoning, ingestion of chemicals, or accidents. By
amniocentesis, fetoscopy, fetalbiopsy and
ultrasound 6/01/2020 VMRF (DU) NSG 19 OCT 07

17. SECONDARY PREVENTION
–Early detection and treatment of preventable
disorders..
–Early recognition of presence of mental
retardation. A delay in diagnosis may cause
unfortunate delay in rehabilitation.
–Psychiatric treatment for emotional and
behavioral difficulties.
6/01/2020 VMRF (DU) NSG 19 OCT 07

18. TERTIARY PREVENTION
• This includes rehabilitation in vocational,
physical and social areas according to the level
of handicap.
• Rehabilitation is aimed at reducing disability
and providing optimal functioning in a child
with mental retardation
6/01/2020 VMRF (DU) NSG 19 OCT 07

19. CARE AND REHABILITATION OF THE
MENTALLY RETARDED
The prevention and early detection of mental handicaps.
Regular assessment of the mentally retarded person's
attainments and disabilities.
Advice, support, and practical measures for families.
Provision for education, training, occupation, or work appropriate
for each handicapped person.
 Housing and social support to enable self-care.
Medical, nursing, and other services for those who require them
as outpatients, day patients, or inpatients.
 Psychiatric and psychological services
6/01/2020 VMRF (DU) NSG 19 OCT 07

20. LEARNING DISORDERS
• Means a disorder in one or more of the basic
psychological processes involved in
understanding or in using language, spoken or
written
• Which may manifest itself in an imperfect
ability to listen, speak, read, spell or to do
mathematical calculations.
6/01/2020 VMRF (DU) NSG 19 OCT 07

21. CAUSE LEARNING DISORDERS
• Heredity: whose parents have had a learning disability,
• Illness during and after birth
• Stress during infancy: A stressful incident after birth
such as high fever, head injury, or poor nutrition.
• Environment: Increased exposure to toxins
• Comorbidity: Children with learning disabilities are at a
higher-than-average risk for attentional problems or
disruptive behavior disorders.
6/01/2020 VMRF (DU) NSG 19 OCT 07

22. SYMPTOMS LEARNING DISORDERS
• Doesn't master skills in reading, spelling, writing or
math at or near expected age and grade levels
• Has difficulty understanding and following instructions
• Has trouble remembering what someone just told him
or her
• Lacks coordination in walking, sports or skills such as
holding a pencil
6/01/2020 VMRF (DU) NSG 19 OCT 07

23. CON’T
• Easily loses or misplaces homework, schoolbooks or
other items
• Has difficulty understanding the concept of time
• Resists doing homework or activities that involve
reading, writing or math, or consistently can't complete
homework assignments without significant help
• Acts out or shows defiance, hostility or excessive
emotional reactions at school or while doing academic
activities, such as homework or reading
6/01/2020 VMRF (DU) NSG 19 OCT 07

24. INTERVENTION
• Extra help: A reading specialist or other trained
professional
• Individualized Education Program (IEP): child's school
or a special educator
• Therapy: Depending on the learning disorder, some
children might benefit from therapy..
• Complimentary/alternative therapy: Research shows
that alternative therapies like music, art, dance can
benefit children with learning disabilities.
6/01/2020 VMRF (DU) NSG 19 OCT 07

25. MOTOR SKILLS DISORDER
• Children with this disorder have associated
problems including difficulty in processing
visuospatial information needed to guide the motor
actions they may not be able to recall or plan
complex motor activities such as: dancing,
• doing gymnastics,
• catching or throwing a ball with accuracy, or
• producing fluent legible handwriting.
6/01/2020 VMRF (DU) NSG 19 OCT 07

26. MOTOR SKILLS DISORDER SYMPTOMS
• Children with this disorder have variable symptoms,
depending on the age of diagnosis (as with most childhood
disorders).
• Young infants may present with non-specific findings, such as
hypotonia (floppy baby) or hypertonia (rigid baby).
• Older infants may be delayed in their ability to sit, stand or
walk.
• Toddlers may have difficulty feeding themselves.
• Older children may have a hard time learning to hold a pencil,
and tend to knock over drinking glasses more often than
expected. 6/01/2020 VMRF (DU) NSG 19 OCT 07

27. MOTOR SKILLS DISORDER TREATMENT
• Practice and repetition are often helpful in
improving handwriting; however, "bypass" methods
are utilized as well.
• These may involve allowing for unlimited testing
times, and using assistive writing devices.
• Other therapies that have been recommended
include cognitive and sensory integration therapy
and kinesthetic training. 6/01/2020 VMRF (DU) NSG 19 OCT 07

28. CON’T
• Many other therapies have been touted as effective, but
have not been researched enough to be recommended
Some therapies, such as "visual training" have been
outright discounted through scientific evaluation.
• It is important to discuss therapeutic options with your
child's physician. There are many modalities which have
been shown to be effective, yet have not been fully tested
in a large enough study to be recommended without
reservations.
6/01/2020 VMRF (DU) NSG 19 OCT 07

29. COMMUNICATION DISORDERS
• A child with a communication disorder has
trouble communicating with others.
• He or she may not understand or make the
sounds of speech.
• The child may also struggle with word
choice, word order, or sentence structure.
6/01/2020 VMRF (DU) NSG 19 OCT 07

30. TYPES OF COMMUNICATION DISORDERS
• Mixed receptive-expressive language disorder. A child has developmental
delays and problems understanding spoken language and speaking.
• Expressive language disorder. A child has developmental delays and
problems speaking.
• Speech-sound disorders. A child has a hard time expressing words clearly
past a certain age.
• Childhood-onset fluency disorder. This is also known as stuttering. It starts
in childhood and can last throughout life.
• Social communication disorder. A child has trouble with verbal and
nonverbal communication that is not caused by thinking problems.
6/01/2020 VMRF (DU) NSG 19 OCT 07

31. CAUSES COMMUNICATION DISORDERS
• Communication disorders may be developmental.
Or they can be caused by:
• Physical problems such as a problem in brain
development
• Exposure to poisons (toxins) during pregnancy, such
as street drugs or lead
• Gene problems
6/01/2020 VMRF (DU) NSG 19 OCT 07

32. SYMPTOMS OF COMMUNICATION DISORDERS
• Not speaking at all
• Limited word choice for his or her age
• Trouble grasping simple directions or naming objects
• Most young children with these disorders are able to speak by
the time they enter school. But they still have problems with
communicating.
• School-aged children often have problems understanding and
making words. Teens may have more trouble understanding
or expressing abstract ideas.
6/01/2020 VMRF (DU) NSG 19 OCT 07

33. INTERVENTION
• Treatment will depend on child’s symptoms, age, and general
health. It will also depend on how severe the condition is.
• A speech-language pathologist will work with child to
improve his or her communication skills.
• Treatment is often a team effort. Parents, teachers, and
mental health experts may also be involved. Treatment may
include:
• Individual or group support
• Special classes
6/01/2020 VMRF (DU) NSG 19 OCT 07

34. PERVASIVE DEVELOPMENTAL DISORDERS
• Pervasive developmental disorders are
characterized by pervasive and usually severe
impairment of reciprocal social interaction
skills, communication deviance, and restricted
stereotypical behavioral patterns (Volkmar et
aL, 2005)
6/01/2020 VMRF (DU) NSG 19 OCT 07

35. AUTISTIC DISORDER
• Autism is a neurological developmental disability that
hampers normal brain development, affecting
communication, social interaction, cognition, and
behavior..
• Autism is the third most common developmental
disability.
• According to one of the epidemiological studies by
“Action for Autism”, the prevalence rate is 1.7 million
(estimated rate of 1 in 250 children).
• There is no cure for autism. 6/01/2020 VMRF (DU) NSG 19 OCT 07

36. CAUSES Of AUTISTIC DISORDER
• The exact cause for autism is still not known but
research indicates that it may occur due to a
combination of genetic and environmental factors.
• The environmental factors could be a variety of
conditions affecting brain development, which can
occur before, during or soon after birth.
• It is also observed that any damage to the central
nervous system during infancy can cause autism.
6/01/2020 VMRF (DU) NSG 19 OCT 07

37. SYMPTOMS OF AUTISTIC DISORDER
1.Communication:
• Have significant difficulties in forming meaningful sentences even
when they have extensive vocabularies
• May repeat words or phrases they hear
• May repeat actions again and again
• May use sign language while speaking
• May or may not learn language for communication
• Inability to explain their needs, feelings and emotions
• Inability to interpret conversation, voice, facial expressions, body
language
• Inability to have eye contact when someone is speaking
6/01/2020 VMRF (DU) NSG 19 OCT 07

38. 2. Social interaction:
• As infants, they may not smile or display any anticipatory posture for being
picked up as an adult approaches.
• Difficulty in learning social skills or interacting with people
• May not prefer to make friends and instead plays alone.
• Avoids eye contact
• Inability to understand feelings or emotions of others around them, due to
which they may not reciprocate with appropriate response.
• Trouble adatpting to routine changes
• May respond differently to the way things smell, taste, look, feel, or sound
6/01/2020 VMRF (DU) NSG 19 OCT 07

39. 3.Sensory:
• Difficulty in hearing
• Sensitive to touch, sound, light, color, taste,
smell
• May be sensitive to certain types of food
• May be uncomfortable with touch or physical
contact
6/01/2020 VMRF (DU) NSG 19 OCT 07

40. 4.Behaviour:
• Difficulty in following instructions or directions
• Shows unusual attachment to toys, objects, unusual interest in specific
activities, obsessed about a specific activity
• Activities and play are generally rigid, repetitive, and monotonous
• Not afraid of real danger, but fearful of harmless objects
• Sudden mood changes: bursts of laughing or crying without obvious reason.
Hyperkinesis (excessive abnormal movements due to increase in muscular
activity)
• Aggression and temper tantrum are observed, prompted mostly by change
and demands.
• Short attention span, poor ability to focus on a task
• Feeding and eating problems
6/01/2020
VMRF (DU) NSG 19 OCT 07

41. INTERVENTION
• Occupational therapy: Teaches skills to enable the child live as independently as
possible
• Sensory integration therapy: Helps the child deal with sensory information like
sights, sounds, and smells.
• Speech therapy: Speech therapists work with the child and help improve
communication. They use alternate methods like gestures, picture boards, etc.,
• Music therapy: Singing, composition, and live music making are used in this form
of therapy.
• Picture Exchange Communication System (PECS):Picture symbols or cards are used
to teach communication.
• Early intervention
• Parental training
6/01/2020 VMRF (DU) NSG 19 OCT 07

42. ATTENTION-DEFICIT HYPERACTIVITY DISORDER
• ATTENTION-DEFICIT HYPERACTIVITY
DISORDER(ADHD) is a complex
neurodevelopmental disorder that can affect a
child’s success at school, as well as their
relationships.
• ADHD is a disorder marked by an ongoing pattern of
inattention and/or hyperactivity-impulsivity that
interferes with functioning or development
6/01/2020 VMRF (DU) NSG 19 OCT 07

43. CLINICAL SYMPTOMS
• Self-focused behavior
• Interrupting
• Trouble waiting their turn
• Emotional turmoil
• Fidgeting
• Problems playing quietly
• Unfinished tasks
6/01/2020 VMRF (DU) NSG 19 OCT 07

44. CON’T
• Lack of focus
• Avoidance of tasks needing extended mental effort
• Mistakes
• Daydreaming
• Trouble getting organized
• Forgetfulness
• Symptoms in multiple settings
6/01/2020 VMRF (DU) NSG 19 OCT 07

45. TREATMENT
• Pharmacotherapy
– CNS stimulants: Dextroamphetamine, methylphenidate, pemoline
– Tricyclic antidepressants
– Antipsychotics-Serotonin specificre-uptake inhibitors
• Psychological therapies
– Behavior modification techniques
– Cognitive behavior therapy
– Social skills training
6/01/2020 VMRF (DU) NSG 19 OCT 07

46. CONDUCT DISORDER
• Conduct disorder (CD) is a mental disorder diagnosed
in childhood or adolescence that presents itself
through a repetitive and persistent pattern of behavior
in which the basic rights of others or major age-
appropriate norms are violated.
• It occurs three times more often in boys than in girls. As
many as 30% to 50% of these children are diagnosed
with antisocial personality disorder as adults
6/01/2020 VMRF (DU) NSG 19 OCT 07

47. SYMPTOMS OF CONDUCT DISORDER
• Aggressive conduct
• Deceitful behavior
• Destructive behavior
• Violation of rules
6/01/2020 VMRF (DU) NSG 19 OCT 07

48. • AGGRESSIVE CONDUCT
• Intimidating or bullying others
• Physically harming people or animals on purpose
• Committing rape
• Using a weapon
• DECEITFUL BEHAVIOR
• Lying
• Breaking And Entering
• Stealing
• Forgery 6/01/2020 VMRF (DU) NSG 19 OCT 07

49. • DESTRUCTIVE BEHAVIOR
• Destructive conduct may include arson and other
intentional destruction of property.
• VIOLATION OF RULES
• Skipping school
• Running away from home
• Drug and alcohol use
• Sexual behavior at a very young age
6/01/2020 VMRF (DU) NSG 19 OCT 07

50. CLASSIFICATION
1. Mild: Include lying, truancy, and staying out
late without permission.
2. Moderate: Include vandalism and theft.
3. Severe: Include forced sex, cruelty to animals,
use of a weapon, burglary, and robbery.
6/01/2020 VMRF (DU) NSG 19 OCT 07

51. ETIOLOGY
• Genetic vulnerability-Damage to the frontal lobe of the brain
has been linked to conduct disorder.
• A lack of impulse control
• A reduced ability to plan future actions
• A decreased ability to learn from past negative experiences
• Environmental adversity
• Child abuse
• A dysfunctional family
• Parents who abuse drugs or alcohol
• Poverty
6/01/2020 VMRF (DU) NSG 19 OCT 07

52. RISK FOR CONDUCT DISORDER
• Being male
• Living in an urban environment
• Living in poverty
• Having a family history of conduct disorder
• Having a family history of mental illness
• Having other psychiatric disorders
• Having parents who abuse drugs or alcohol
• Having a dysfunctional home environment
• Having a history of experiencing traumatic events
6/01/2020 VMRF (DU) NSG 19 OCT 07

53. INTERVENTION
• Behavioral, educational and
psychotherapeutic
• Drug treatment may be indicated in the
presence of epilepsy, hyperactivity, impulse
control disorder and episodic aggressive
behavior and psychotic symptoms.
6/01/2020 VMRF (DU) NSG 19 OCT 07

54. TIC DISORDERS
• Tics are irregular, uncontrollable, unwanted, and
repetitive movements of muscles that can occur in
any part of the body.
• Tic disorders usually start in childhood, first
presenting at approximately 5 years of age. In
general, they are more common among
males compared with females.
6/01/2020 VMRF (DU) NSG 19 OCT 07

55. TYPES OF TICS DISORDERS
• Motor tics: These include tics, such as head and
shoulder movements, blinking, jerking, banging,
clicking fingers, or touching things or other people.
Motor tics tend to appear before vocal tics,
although this is not always the case.
• Vocal tics: These are sounds, such as coughing,
throat clearing or grunting, or repeating words or
phrases. 6/01/2020 VMRF (DU) NSG 19 OCT 07

56. CATEGORIES
• Simple tics: These are sudden and fleeting tics using
few muscle groups. Examples include nose
twitching, eye darting, or throat clearing.
• Complex tics: These involve coordinated
movements using several muscle groups. Examples
include hopping or stepping in a certain way,
gesturing, or repeating words or phrases.
6/01/2020 VMRF (DU) NSG 19 OCT 07

57. SYMPTOMS
• Worsen with emotions, such as anxiety, excitement,
anger, and fatigue
• Worsen during periods of illness
• Worsen with extreme temperatures
• Occur during sleep
• Vary over time
• Vary in type and severity
• Improve over time 6/01/2020 VMRF (DU) NSG 19 OCT 07

58. INTERVENTION
• Treatment depends on the type of tic disorder and
its severity. In many cases, tics resolve on their own
without treatment.
• THERAPIES
• Exposure and response prevention (ERP):
• Habit reversal therapy
6/01/2020 VMRF (DU) NSG 19 OCT 07

59. CON’T
• MEDICATION
• Anti-seizure medications
• Muscle relaxants
• Medications that interact with dopamine
• COPING AND SELF-HELP TIPS
• Avoiding stress and anxiety
• Getting enough sleep
6/01/2020 VMRF (DU) NSG 19 OCT 07

60. SEPARATION ANXIETY DISORDER
• Separation anxiety is a normal stage of
development for infants and toddlers. Young
children often experience a period of separation
anxiety, but most children outgrow separation
anxiety by about 3 years of age.
• In some children, separation anxiety is a sign of a
more serious condition known as separation anxiety
disorder, starting as early as preschool age.
6/01/2020 VMRF (DU) NSG 19 OCT 07

61. SYMPTOMS OF SEPARATION ANXIETY DISORDER
• Clinging to parents
• Extreme and severe crying
• Refusal to do things that require separation
• Physical illness, such as headaches or vomiting
• Violent, emotional temper tantrums
• Refusal to go to school
• Poor school performance
• Failure to interact in a healthy manner with other children
• Refusing to sleep alone
• Nightmares
6/01/2020 VMRF (DU) NSG 19 OCT 07

62. RISK FACTORS FOR SEPARATION ANXIETY DISORDER
• A family history of anxiety or depression
• Shy, timid personalities
• Low socioeconomic status
• Overprotective parents
• A lack of appropriate parental interaction
• Problems dealing with kids their own age
• Moving to a new home
• Switching schools
• Divorce
• The death of a close family member
6/01/2020 VMRF (DU) NSG 19 OCT 07

63. INTERVENTION
• Child-directed interaction (CDI), which focuses on
improving the quality of the parent-child
relationship.
• Bravery-directed interaction (BDI), which educates
parents about why their child feels anxiety.
• Parent-directed interaction (PDI), which teaches
parents to communicate clearly with their child.
• Medication-Antidepressants 6/01/2020 VMRF (DU) NSG 19 OCT 07

64. NON-ORGANIC ENURESES
• Enuresis is more commonly known as bed-wetting.
Nocturnal enuresis, or bed-wetting at night, is the
most common type of elimination disorder. Daytime
wetting is called diurnal enuresis. Some children
experience either or a combination of both.
• The condition is not diagnosed unless the child is 5
years or older.
6/01/2020 VMRF (DU) NSG 19 OCT 07

65. SYMPTOMS
• The main symptoms of enuresis include:
• Repeated bed-wetting
• Wetting in the clothes
• Wetting at least twice a week for
approximately three months
6/01/2020 VMRF (DU) NSG 19 OCT 07

66. FACTORS ASSOCIATED WITH ENURESIS
• Faulty training:
• Emotional disturbances
• Physical diseases and anatomic defects
6/01/2020 VMRF (DU) NSG 19 OCT 07

67. TREATMENT
• Behavior therapy is effective in more than 75% of
patients
• Alarms and Bladder training
• Rewards
• Medication are available to treat enuresis, but they
generally are only used if the disorder interferes
with the child's functioning and usually are not
recommended for children under 6 years of age.
6/01/2020 VMRF (DU) NSG 19 OCT 07

68. FEEDING AND EATING DISORDERS
• Pica,
• Rumination disorder,
• Feeding disorder
6/01/2020 VMRF (DU) NSG 19 OCT 07

69. PICA
• Pica is persistent ingestion of non nutritive
substances such as paint, hair, cloth, leaves,
sand, clay, or soil. Pica is commonly seen in
children with mental retardation; it
occasionally occurs in pregnant women.
6/01/2020 VMRF (DU) NSG 19 OCT 07

70. RUMINATION DISORDER
• Rumination disorder is the repeated
regurgitation and rechewing of food. The child
brings partially digested food up into the
mouth and usually rechews and reswallows
the food. The regurgitation does not involve
nausea, vomiting, or any medical condition
6/01/2020 VMRF (DU) NSG 19 OCT 07

71. FEEDING DISORDER
• Feeding disorder of infancy or early childhood is
characterized by persistent failure to eat adequately,
which results in significant weight loss or failure to gain
weight. Feeding disorder is equally common in boys
and in girls and occurs most often during the First year
of life. Estimates are that 5% of all pediatric hospital
admissions are for failure to gain weight, and up to 50%
of those admissions reflect a feeding disorder with no
predisposing medical condition
6/01/2020 VMRF (DU) NSG 19 OCT 07

72. SUMMARY
Psychiatric disorders are more difficult to diagnose in children
than in adults because their basic development is incomplete
and children may lack the ability to recognize or to describe
what they are experiencing. The disorders of childhood and
adolescence most often encountered in mental health
settings include pervasive developmental disorders, ADHD,
and disruptive behavior disorders. Communication with
children takes skill, thoughtfulness, and practice. Privacy is
the single most important criterion by which adolescents
judge their interactions with health care providers
6/01/2020 VMRF (DU) NSG 19 OCT 07

73. REFERENCE
• Mary C. Townsend, Essentials of Psychiatric Mental Health Nursing, FA Davis
company publication, Philadelphia, 4th edition.
• Louise Rebraca Shives, Basic Concepts of Psychiatric Mental Health Nursing,
Lippincott Williams & Williams’s publication, Flordia.8th edition.
• https://www.healthline.com/health/mental-retardation#levels-of-
intellectual-disability
• https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-
disorder-adhd/index.shtml
• https://www.healthline.com/health/conduct-disorder#diagnosis
• https://www.healthline.com/health/anxiety/separation-anxiety#treatment
6/01/2020 VMRF (DU) NSG 19 OCT 07