Common behavioral and emotional problems in children include emotional and behavioral disorders, behavioral disorders, and eating disorders. Emotional and behavioral disorders are defined as an inability to build relationships, depression, and developing physical symptoms related to personal problems. Behavioral disorders involve a child not doing what adults want them to do. Eating disorders include pica, which is the repeated ingestion of non-nutritive substances. Causes of problems include biological factors, home and community environment, and characteristics include distorted thinking, anxiety, aggression, and withdrawal. Treatments involve medication, behavioral therapies, and improving parenting and environment.

1. Common behavioral and
emotional Problems In
Children

2. Emotional and Behavioral Problems:
Definition:
 An inability to build or maintain satisfactory interpersonal
relationships with parents and teachers.

3.  A general pervasive mood of unhappiness or depression.
 A tendency to develop physical symptoms or fears
associated with personal or school problems.

4. Behavioral disorder
The behavioral disorder is actually when a child is not
doing what adults want him to do at a particular time.

5. Where as;
A young person is said to have a behaviour
disorder when he or she demonstrates behaviour
that is noticeably different from that expected in
the school or community.

6. Causes of emotional and
behavioral problem in children
There are various causes of emotional and
behavioral problems like;
BIOLOGY:
Biological factors include;
 heredity
 brain disorder
 diet

7. HOME AND COMMUNITY:
It includes;
 Environment
 family functioning
 Poverty
 Abuse
 neglect

8. Characteristics
Children with the most serious ED may exhibit:
 Distorted thinking
 Excessive anxiety
 Bizarre motor acts
 Abnormal mood swings

9. Their behavior signals that they are not coping with their
environment or peers are;
 Hyperactivity
 Aggression
 Self injurious behavior
 Withdrawal
 Immaturity
 Learning difficulties

10. Adverse effects and possible treatments
of the behavioral disorders

11. Categories of Behavioral Disorders:-
Main types of behavioral disorders are;
1 ) Habit Disorders
2 ) Eating Disorders

12. Categories of Behaviour Disorders:-
1 ) Habit Disorders
(Tension releasing disorders)
• Finger (thumb) sucking and Nail biting
• Teeth grinding (Bruxism)
• Head banging and Head jerking
• Tics
a ) grimacing
b ) grunting
c ) scratching nose
d ) copropraxia

13. Finger Sucking and Nail Biting
Its due to;
 Sensory solace for child
(“internal stroking”) to
cope with stressful situation
in infants and toddlers.
 Predisposing factors:
Developmental delay
Neglect

14. Finger (Thumb) sucking & Nail Biting
• Adverse Effects
– Malocclusion – open bite
– Mastication difficulty
– Speech difficulty( D and T )
– Lisping

15. Finger (Thumb) sucking & Nail Biting
• Adverse Effects
– Paronychia and digital
abnormalities

16. Finger (Thumb) sucking & Nail Biting
Treatment:
 Reassure parents that it’s transient.
 Improve parental attention / nurturing.
 Teach parent to ignore and give more attention to
positive aspects of child’s behavior.
 Provide child praise / reward for substitute behaviors.
( positive reinforcement )
 Bitter salves, thumb splints,
 Gloves may be used to reduce thumb sucking.
 Aversive therapy techniques.

17. TEETH GRINDING:
 It is a condition in which child grind,
gnash or clench his teeth.

18. Treatment of teeth grinding:
Recommended treatments for bruxism (teeth
grinding) include
 Behavioral therapies
 Using mouth guards or mouth splints.
 Muscle relaxation exercises.

19. • Head Banging
Rhythmic hitting of the head against a solid
surface often the crib mattress.
• In 5-20% of children during infancy & toddler
years
• Benign & self-limiting
• Can result in callus formation, abrasions,
contusions

20. Head jerking

21. Head banging
Treatment:
◦ Assurance – significant
injury unlikely
◦ Parents should ignore
as concern and punishment
can reinforce it.
◦ Padding

22. TICS:
sudden, repetitive, nonrhythmic motor movement or vocalization
involving discrete muscle groups.
Tics
12 to 20% children,
peak age 5 -7 yr.
Motor Tics
or
Phonetic Tics
More common in boys
than in girls
Increase when stressed,
anxious, fatigued, or bored
Can occur in
any body part
Decrease when focused

23. Tics : Common types
Simple Tics:
 Grimacing
 Yawning
 Grunting
 Sighing
 Blinking
 Wrinkling
 Scratching nose
 Head jerking
 Throat clearing
Complex Tics:
• Jumping
• Spinning
• Touching objects or people
• Echopraxia: Repeating other’s
actions
• Copropraxia: Obscene gestures
• Palilalia: Repeating one’s own
words
• Echolalia: Repeating what someone
else said

24. Few Examples Of Tics Orders

25. Grimacing (Ugly facial expression)

26. Grunting ( Short gruff noise ):

27. Scratching nose

28. Copropraxia ( Obscene gestures):

29. How To Diagnose Tics Disorders
• The tics should occur many times a day
nearly every day or throughout a period
of more than 1 year;
• During this period there should never be
a tic-free period of more than 3
consecutive months;
• The onset should be before age 18 years;
(

30. Tics : Management.
 Medication to help control the symptoms
 Habit reversal training (HRT): a behavioral therapy
 The child and adolescent psychiatrist can also advise the
family about how to provide emotional support and the
appropriate educational environment for the youngster.

31. Eating Disorders
• Pica

32. Eating disorder - Pica
Repeated or chronic ingestion of non
nutritive substances.
Examples:
mud, paint, clay, plaster, charcoal, soil.

33. Pica
Geophagia Eating of mud, soil, clay, chalk, etc.
Pagophagia Consumption of ice
Hyalophagia Consumption of glass
Amylophagia Consumption of starch
Xylophagia Consumption of wood
Trichophagia Consumption of hair
Urophagia Consumption of urine
Coprophagia Consumption of feces

34. Pica
Predisposing factors :
Parental neglect
Poor supervision
Lack of affection Psychological neglect,
(orphans)
 Family disorganization
 Lower socioeconomic class
 Autism
Mental retardation

35. Pica
Screening indicated for:
 Iron deficiency anemia
 Worm infestations
 Lead poisoning
 Family dysfunction

36. Pica - Management

37. Pica - Management
 Parental care
 Developing safe eating habits
 Multivitamins and calcium intake
 Avoid punishment

38. Disruptive Behavioral Disorder

40. Oppositional defiant disorder (ODD)
• Easily angered, annoyed or irritated
• Frequent temper tantrums
• Argues frequently with adults, particularly the most
familiar adults in their lives, such as parents
• Refuses to obey rules

41. Oppositional defiant disorder (ODD)
 Seems to deliberately try to annoy or
aggravate others
 Low self-esteem
 Low frustration threshold
 Seeks to blame others for any misfortunes or
misdeeds.

42. Conduct Disorders
• Frequent refusal to obey parents or other authority figures
• Repeated truancy
• Tendency to use drugs, including cigarettes and alcohol, at a
very early age
• Lack of empathy for others

43. Conduct Disorders
• Aggressive to animals and other people or
showing sadistic behaviors including bullying
and physical or sexual abuse
• Keenness to start physical fights & Using
weapons
• Frequent lying

44. Conduct Disorders
• Criminal behaviour such as stealing,
deliberately lighting fires, breaking into
houses and vandalism
• A tendency to run away from home
• Suicidal tendencies – rarely.

45. Strategies to minimize anger
 Exercise that can Help decrease
anger, depression, and disruptive
behaviors.
 More exposure to out door activities
than indoor.

46. Adverse effects and possible treatments
of the emotional disorders

47. Categories of emotional disorders
 School phobia
 Temper tantrums
 Evening colic
 Breath holding spasms
 Speech disorder
 Stuttering/stammering

48. School phobia
 Approximately 1 to 5% of school-aged children have
school refusal
 Most common in 5- and 6-year olds and in 10- and 11-
year olds
 School refusal differs from truancy

49. School Phobia
What can parents do?
1. Have a physician examine the child to determine if he
or she has a legitimate illness.
2. Listen to the child talk about school to detect any clues
as to why he or she does not want to go.

50. What can parents do?
1. Talk to the child's teacher, school
psychologist, and/or school counselor to
share concerns.
2. Together determine a possible cause or
causes
3. Develop an appropriate plan of action

51. School Phobia
 The goal is to have the child return to school and
attend class daily
 However, if the school phobia is extreme, a therapist or
psychiatrist's assistance may be necessary.

52. Temper tantrums
• It is an emotional outburst, usually associated with children
or those in emotional distress, that is typically characterized
by
• Stubbornness
• Crying
• Screaming
• Anger ranting
• A resistance to attempts at pacification
• In some cases, hitting.

53. Temper Tantrum - Causes
 In 18 months to 3 yrs olds due to
development of sense of autonomy.
 Child displays defiance, negativism /
oppositionalism by having temper tantrums.
 Normal part of child development.
 Gets reinforced when parents respond to it
by punitive anger.
 Child wrongly learns that temper tantrums
are a reasonable response to frustration.

54. Temper Tantrums
Precipitating factors
Hunger
Fatigue
Lack of sleep
Innate personality of child
Ineffective parental skills
Over pampering
Dysfunctional family / Family violence
School aversion

55. Temper Tantrums –Management
In general, parents advised to:
 Set a good example to child
 Pay attention to child
 Spend quality time
 Have open communication with child
 Have consistency in behavior

56. Temper Tantrums –Management
During temper tantrum:
Parents to ignore child and once child is calm, tell
child that such behavior is not acceptable
Verbal reprimand should not be abusive
Never beat or threaten child
Impose “Time Out” - if temper tantrum is disruptive,
out of control and occurring in public place.

57. Evening Colic
 Intermittent episodes of abdominal pain and severe
crying in normal infants
 Begins at 1-2 weeks age and persists till 3-4 mo.
 Crying usually in late afternoon or evening
 Infant cries for 3 hrs. per day
 for 3 days per week
 for 3 weeks ”

58. Evening Colic
Attack
• Begins suddenly with a loud cry
• Crying continuous – lasts for several hours –
mostly in the late afternoon or evenings
• Face becomes red and legs drawn up on the
abdomen
• Abdomen becomes tense
• Attack terminates after exhaustion or after
passage of flatus or feces

59. Evening Colic
Causes
• More likely if the child is
over active and parents are
over anxious.
 Over stimulation from parents
• Not known

60. Evening Colic Management
 During Episode
– Hold the child erect or prone
– Avoid drugs
– Colic drops for infants

61. Evening Colic Management
 Counseling - Coping with the parents
– Reassure the parents that infant is not sick
– They need to soothe more with repetitive
sound and stimulate less with decrease in
picking up and feeding with every cry

62. Breath Holding Spasms

63. Breath Holding Spasms
Precipitating Factors:
• Frustration
• Injury
• Anger
• Anemia

64. Breath Holding Spasms Management:
 No treatment is usually needed
 Iron supplements to children with iron
deficiency
 During a spell :
 Make sure your child is in a safe place
where he or she will not fall or be hurt.
 Place a cold cloth on your child's forehead
during a spell to help shorten the episode.

65. Breath Holding Spasm Management:
 After the spell, try to be calm.
 Avoid giving too much attention to the
child, as this can reinforce the behaviors
that led to the event.
 Avoid situations that cause a child's
temper tantrums.

66. Speech disorder:
Children with speech disorder have problems
saying sounds, syllables, and words.
CAUSE:
Actually the brain has problems planning to move
the body parts (e.g., lips, jaw, tongue) needed for
speech.

67. Stuttering/stammering :
In this the child repeats or prolongs words, syllables or
phrases. The child with a stutter (or stammer) may
also stop during speech and make no sound for certain
syllables.

68. Tips for parents Who Have children
with Emotional Disturbance
 Get to know your child
 Develop rules
 Watch out for triggers
 Be positive
 Be firm with your child in instructions.
 Pay proper attention.

69. Keep your eyes open
 Open your eyes and observe if a child seems sad,
withdrawn, distant, more moody than usual, or angry.
 Recognize if there seems to be greater confrontation
between this child and siblings, if friends stop calling or
coming over, or if the child can’t seem to find his place
in school.

70. 2. Develop a Working Relationship With
Teachers
 Reach out to your child’s teachers before your child
reaches ‘zero hour.’
 If you think that there may be an issue, it is a good idea
to set up a meeting with the teacher and ask how you can
work in harmony.

71. 3. Work on social skills
Help your child be successful academically and socially.
A child who is happy in school is a child who can focus on
studying and doing well.
One who believes that school is all about academics and no
social life unfortunately makes a big mistake.

72. Cont…
 Set rules.
 Set routines for meals and bedtimes.
 Develop your child’s ability to empathize others.
 Help your child learn how to express frustration,
disappointment and anger without hurting others.
 Establish basic rules of conduct: no hitting,
kicking, biting, spitting, (no hands allowed), and
no hurting others through our words.

73. 4. Help children become independent
When children feel as if they are gaining skills and
becoming self-sufficient, they grow more confident in their
abilities. You will watch their self-esteem take off. Each
year, every child should be able to point with pride to a
newfound skill or added responsibility that comes with age.

74. Cont…
Teaching our children to;
 pick out their clothing
 dress themselves as they grow older
 tie their own shoes
 pack school snacks and make lunches
 set their own alarm clocks instead of waking them up

75. Cont…
 Allow a young child to complete puzzles and
feed himself on his own and as he grows, to do
his homework and projects by himself.

76. Cont….
Have your child help around the house and gain
responsibilities instead of waiting to be served
like;
 putting away laundry
 helping to serve guests
 Cooking
 keeping their room in order.

77. 5. Communicate with Each Child
 Our children should never be afraid to speak with us. No
matter how tough the topic.
 They should hesitate to communicate with parents.
 After all, we are their parents and if they cannot believe
in our love for them, whose love can they believe in?

78. Cont…
 Work on communicating with your child
 Put the time and energy in so that he knows that he matters in your
life.
 Talk to your child every day-even if it’s just for a few minutes.
 Put down your iPhone
 Turn off your laptop when your child (or you) return home, at
mealtimes and story times, and when you pick your child up from
school.
 Look at him and make eye contact while having a conversation.
 Speak to your child in the tone and with the words that you wish he
would use with others.

79. Most Important
 Express your love every day, no matter
how tough the day.
 Always encourage your child.
 Give positive reinforcement.