This document discusses various behavioral problems seen in childhood. It begins by explaining that childhood is a period of dependency, and when children face complex environments, they may develop behavioral issues from inability to adjust. Some common behavioral problems mentioned include enuresis, encopresis, temper tantrums, nail biting, pica, tics and sleep disorders. Potential causes and management strategies are provided for each problem. The document emphasizes the importance of parental support, counseling, behavioral modification, and ensuring children's emotional needs are met to address underlying causes of behavioral issues. It concludes by discussing the roles of healthcare professionals in assessing problems, educating families, making appropriate referrals, and promoting children's well-being.

1. PRESENTED BY JYOTI THAKUR
MSC NURSING 1ST YEAR

3. Childhood is the period of dependency.
Children learn to adjust in the environment but
when there is a complexity around them they
cannot adjust with the circumstances. Then
they become unable to behave in the socially
acceptable way and behavioural problems
develop with them.

4.  When a child demonstrates behaviour that is
noticeably different from that expected in the
school or community.
OR
 A child who is not doing what adults want him
to do at a particular time.

5.  Faulty parental attitude
 Inadequate Family
Environment
 Mentally and physically
sick or handicapped
conditions

6.  Influence of social relationship
 Influence of mass media
 Influence of social change

7.  Harming or threatening themselves, other
people or pets.
 Damaging or destroying property
 Lying or stealing
 Not doing well in school, skipping school

8.  Early smoking, drinking or drug use.
 Early sexual activity
 Frequent tantrums and arguments
 Consistent hostility towards authority figure.

10. RESISTANCE TO
FEEDING
ABDOMINAL
COLIC
STRANGER
ANXIETY

11.  During infancy feeding problems often develop
at the time of weaning. Infant may refuse to
new food.

12.  Dislike of taste.
 Separation anxiety.
 Forced feeding.
 Indigestion of new food.
 Abdominal colic.
 Painful ulcer in the mouth.
 Sore throat.

13.  Reassurance and guidance to mother
regarding feeding.
 Problems like mouth ulcer, sore throat, nasal
congestion, and any other conditions to be
treated accordingly.
 Tender loving care should be provided by the
mother.

15. This problem usually starts within the first week
after birth and reaches a peak by the age of 4
to 6 weeks and improve after 3 to 4 months.

16.  Exact cause is unknown.
 Overactive infants who are over stimulated
by the parents.
 Hunger
 Improper feeding techniques
 Physiological immaturity of the intestine.

17. DO’S
 Upright position and burping
 Frequent small amount of feeding.
 During episode hold child erect or prone in the
lap or on the hot water bottle.
DON’ T’
 Do not use drugs, enemas, carminatives,
suppositories etc.
 Do not feed with each cry.

18. The infant does not belief any other person other than mother. In
absence of mother, if any new person approaches, the child will
start crying due to feeling of insecurity, fear & anxiety.
 Separation anxiety is a vital steps of emotional development &
may continue upto 13-15 months of age.

19.  Relaxation technique.
 slowly exposing them to
stranger.
 This anxiety usually reduced
when the strangers gradually
approach from distance in a
familiar place specially in
presence of the mother or
father.
 In absence of parents, loving
concern of the stranger is very
important.

20. BEHAVIORALPROBLEMS OF CHILDHOOD

21. Enuresis is defined as urinary incontinence
beyond the age of 4 years for daytime &
6 years for night time.

22. PRIMARY – It is the inability to
control urine from infancy
SECONDARY- It is the relapse
after control has been achieved.

23.  Prolonged periods of sleep during infancy
 Genetic causes, Positive family history.
 Slower rate of physical / neurological
development in children up to 3 years of age
 Increased bladder irritability due to UTI
 Organic causes

24. RCT
TRICYCLIC
ANTIDEPRESSANT ANTICHOLINERGICS
ANTIDIURETICS NASAL SPRAY

25.  Help the child in bladder training
 Restriction or elimination of
fluids after the evening meal
 Interruption of sleep to void
 Voiding alarms
 Observe the side effects of
medications
 Positive enforcement should be
given to the child.

26. Don’t
 Avoid to take more fluids at
the evening
 Do not punish the child as it
can give negative emotional
impact on child.
 Avoid diapering

27.  It is the repeated
involuntary passage of
faeces into inappropriate
places.

28.  Constipation precipitated by environment
changes.
 Fear-pain Cycle
 Pressure of schooling
 Fear of using school
bathroom

29.  Painful Stooling.
 Abdominal Pain.
 Distension.
 Moodiness.
 Poor Appetite.
 Low Self Esteem.

30.  DO’S
 Limit drinks with caffeine, such as cola drinks
and tea.
 Provide well-balanced meals and snacks.
 Provide high fiber diet to the child.

31.  DON’T’s
 Do not give fast/junk foods that are high in
fats and sugars.
 Do not give whole milk to 16 ounces a day for
the child over 2 years of age.
 Do not laugh or insult child in front of others.

32.  Temper tantrum is a
sudden outburst or
violent display of anger,
frustrations & bad temper
as physical aggression.
 It begins at age of 18
months to 3 years and
subsides by 3 to 6 years.

33.  Tiredness
 Hunger
 Uncomfortable environment
 Unable to get something
 Maladjusted children.
 It is found in boys & single child & pampered
child.

34.  Appropriate parenting.
 Protection from the physical harms while
attack.
 Time out procedure.
 Guidance and counselling.

35.  It may be due
inadequate oral
satisfaction in early
infancy.
ETIOLOGY
In older children may
be due they are bored,
tired, frustrated or at
bed want to sleep but
feel alone.

36. Do’s
 Appropriate parenting
 Remove the stress.
 Apply some aversive taste substance to thumb
nail.
 Physical barrier like gloves, thumb splint can
be used.

37.  The child should be praised and encouraged to
break the habit of thumb sucking.
 The thumb and finger of child should be
engaged in other work to keep the hand busy.
DONT’S
 The child should not be scolded for this habit.
 Do not leave the child alone.

38.  Malocclusion.
 Misalignment of teeth.
 Difficulty In Mastication &
Swallowing.
 Deformity In Thumb.
 Facial Distortion.
 Speech Difficulties.
 GI Infections.

39.  Nail biting is bad
oral habit especially
in school age.
 children beyond 4
years of age (5 to 7
years).
 It is sign of tension
or self punishment
to cope with hostile
feeling towards
parents.

40. • It is caused by feeling of insecurity conflict &
hostility.
• It may be due pressurised study in school or
home or due to watching frightening violent
scenes.
• It may occur as imitating the parent who is
also nail biter.

41. Do’s
 The cause of nail biting should be identified.
 The child should be praised for well kept hand
by breaking the habit to maintain self
confidence.
 The child hand should be kept busy with
creative activities or play.

42.  Do not give punishment to the child he need
emotional support to overcome the problem.
 Do not leave child alone as it can cause
feeling of insecurity.
 Do not pressurise the child for study.

43.  Pica is a habit disorder
of eating non edible
substance as clay,
paints, chalks, pencil,
eraser, plaster from
wall, earth, scalp, hair
etc.

44.  Deficiency of iron, zinc, or another nutrients.
 Usually remits in childhood but can continue
into adolescence.
 It is common in children before the age group
of 5 years.

45. Do’s
 Behavioural modification should be done and
alleviating the psychosocial stress.
 Give iron supplementation if deficiency
present.
 Give nutritious and iron rich diet to the child.

46.  Do not leave the child alone as they have habit
to put the things in their mouth.
 Do not place chalk, paint, oils, clay etc in easy
reach of child.
 Do not show anger to the child.

47.  Tics are sudden repetitive, purposeless, rapid
stereotype movements of striated muscles
mainly of face & neck.

49. Do’s
 Appropriate parenting
 Guidance & Counselling
 The child should be guide to be calm and happy.
 The parents should provide support to the child.
Don’ts
 Do not punish him try to understand his problem.
 Do not give extra burden or tension to child as it
can cause Tics.

50.  The common sleep problems are difficulty to
sleep, sleep walking, sleep talking, Bruxism.
 Sleep disorder are common in children with
anxiety, tension & over activity

51. Do’s
 Light diet in dinner.
 Parents should allow relax comfortable bed &
emotionally allow the child to relax.
 In advanced if the problem prolongs then
consultation of doctors & psychologists.

52.  No exciting games, pictures & frightening
stories.
 There should be no loud music or noise in the
child room.
 There should be no separation from parents.
 Avoid extreme temperature.

53.  spasmodic repetition of
some syllables with
pauses.
 Difficulty in
pronouncing
consonants.

54.  Caused by spasm of lingual and palatal muscles.
 Precipitated by stress.
 Usually begins between 2 – 5 yrs.
 Child loses self confidence and become more
hesitant.The conflict occur between Child’s
achievement and the parents expectation and the
child loses his confidence.

55. Do’s
 Reassure parents.
 Speech Therapy.
 Children should be given emotional support.
 Older children with secondary stuttering
should be referred to speech therapist.

56. Do not show undue concern and accept his
speech without pressurizing him to repeat or
making him conscious of his handicap.
 Do not remind child the mistake and ridicule
him, that increase the stress and further
aggravate the condition.

57. School failure is very
common presenting
problem.

58.  Fear of mismatched
over critical teachers
 Fear of failing in
examination
 Separation anxiety
 Physical limitations
like hearing
impairment or visual
defects .

59. Do’s
 Habit formation for regular school attendance.
 Play session
 Other recreational activities at school.
 Improvement of school environment
 Family counselling.
Don’ts
 Don’t give extra burden to the child.
 Do not punish the child for studies.

60.  ADHD is the term used to describe a persistent
pattern of inattention or hyperactivity-
impulsivity that is more frequent & severe than
typically observed in individuals at a
comparable level of development.

61.  unknown
 It can be related to injury or trauma or illness
affecting brain
 Multiple causes including psychological factors
are attributed.
 Sex linked operates for this disorder, boys are
more affected than girls.

62.  Reading & Arithmetic Disability
 Impaired Memory
 Poor Language & Speech Development
 Inappropriate Understanding Of Spoken
Words.
 Overactive, Aggressive & Excitable
 Impulsive & Inattentive
 Frustrated & having Impaired Social Functions.

63.  Do’s
 Deliver positive reinforcement to the child
 The child should be encouraged to make more
appropriate choices and to take responsibility
for his and her actions.
 Teach the parents how to make organizational
charts.
Don’ts
 Do not show anger to the child.
 Do not give extra home work or class work to
the child.

64.  Assessment of specific problem of the child.
 Informing the parents and making them aware
about the cause of behavioural problems of
the particular child.
 Assisting the parent’s teachers and family
members for necessary modification of
environment at home, school and community.

65.  Referring the children with behavioural
problems for necessary management.
 Promoting health, emotional development of
the child by adequate, physical, psychological
and social support.
 Providing counselling services for children and
family members to solve the problems.

66.  MATERNAL DEPRIVATION
 FAILURE TO THRIVE

67.  It is a condition characterized by
developmental retardation that occurs as a
result of physical or emotional deprivation. It
is seen primarily in infants.

69.  Parental indifference.
 Age of parents.
 Emotional instability or insecurity of the mother.
 Lack of or delayed development of the mother-child
attachment process.
 Unwanted pregnancies.
 Adaptability of the child.
 Unfavourable socio-economic conditions within the
family.

70.  Lack of physical growth.
 weight below the third percentile for age and size.
 Malnutrition.
 pronounced withdrawal.
 Silence
 Apathy
 Irritability
 A characteristic posture and body language
 Featuring unnatural stiffness and rigidity with a
slow response reaction to others.
 Lack of age appropriate response to social
interactions.

71. •Child was removed by the
mother’s care but by looked
after by someone familiar
whom he trust.
PARTIAL
DEPRIVATION
•Mother or mother’s substitute
is unable to give the loving
care to the child.
COMPLETE
DEPRIVATION

72.  Treatment often requires hospitalization,
especially in cases of severe malnutrition.
 Counselling of parents.

73.  The child should be very close to mother.
 When the mother comes to know that the child
is showing the signs of deprivation she should
give more attention to him.
 The child should not left unattended.
 Provide child emotional support.
 Mother should always be there for the child.
 She should be encourage to proper
breastfeeding and weaning to the child.

74.  Dorothy R Marlow “Textbook of Pediatric Nursing”
Published by Elsevier, Edition-6th.
 Wong’s “Essentials Of Pediatric Nursing” Published by
Marilyn J. Hockenberry & David Wilson, Edition-8th.
 DuttaParul” Textbook of Pediatric Nursing” Jaypee
brothers medical publisher pvt limited, Second edition
2009.
 Gupta Piyush” Essential Pediatric Nursing” A.P Jain and
Co. Publishers, Second edition.



75. THANKYOU