Common behavioral problems in school children include habit disorders like thumb sucking and nail biting, speech disorders like stammering, eating disorders like pica, sleep disorders, and personality disorders. These problems are often due to developmental delays, stress, genetics, family dynamics, or other psychological factors. Teachers and parents should identify problems early based on how behaviors affect functioning. Management involves addressing underlying causes through counseling, behavioral therapy, ensuring proper sleep/nutrition, and creating a supportive environment. Medication may help in some severe or resistant cases. The document provides examples and treatment approaches for various common behavioral issues in school-aged children.
Role of Child Health Nurse in caring of Hospital ChildAlka Singh
Subject : Child Health Nursing. Topic : Role Of Child Health Nurse In Child care at Hospital, Nursing Diagnosis, Various Measures to make hospital Child Friendly, Nurses Role in Care Of Toddlers, Infants, School Children, Adolescent.
Play in Children or Play Therapy (Importance of Play, Functions of Play, Age-Related Play, Categories of Play, Types of Play, Selection, Safety and Guidelines)..
CHILDHOOD BEHAVIORAL DISORDERS AND ITS MANAGEMENT: AGE AND NATURE: INFANCY , ...Manisha Thakur
CHILDHOOD BEHAVIORAL DISORDERS AND ITS MANAGEMENT: AGE AND NATURE: INFANCY , TODDLERS , ADOLESCENCE: SPEECH DISORDERS: SOMNAMBULISM, SOMNILOQUY. EATING DISORDERS: ANOREXIA NERVOSA AND BULIMIA. MOVEMENT DISORDERS: TICS. SPEECH DISORDERS: STUTTERING, CLUTTERING, STAMMERING. DISORDERS OF TOILET TRAINING: ENURESIS, ECOPRESIS. DISORDERS OF HABIT: TEMPER TANTRUM, BREATH HOLDING SPELLS, THUMB SUCKING, NAIL BITING. ADHD, SCHOOL PHOBIA, STRANGER ANXIETY.
Role of Child Health Nurse in caring of Hospital ChildAlka Singh
Subject : Child Health Nursing. Topic : Role Of Child Health Nurse In Child care at Hospital, Nursing Diagnosis, Various Measures to make hospital Child Friendly, Nurses Role in Care Of Toddlers, Infants, School Children, Adolescent.
Play in Children or Play Therapy (Importance of Play, Functions of Play, Age-Related Play, Categories of Play, Types of Play, Selection, Safety and Guidelines)..
CHILDHOOD BEHAVIORAL DISORDERS AND ITS MANAGEMENT: AGE AND NATURE: INFANCY , ...Manisha Thakur
CHILDHOOD BEHAVIORAL DISORDERS AND ITS MANAGEMENT: AGE AND NATURE: INFANCY , TODDLERS , ADOLESCENCE: SPEECH DISORDERS: SOMNAMBULISM, SOMNILOQUY. EATING DISORDERS: ANOREXIA NERVOSA AND BULIMIA. MOVEMENT DISORDERS: TICS. SPEECH DISORDERS: STUTTERING, CLUTTERING, STAMMERING. DISORDERS OF TOILET TRAINING: ENURESIS, ECOPRESIS. DISORDERS OF HABIT: TEMPER TANTRUM, BREATH HOLDING SPELLS, THUMB SUCKING, NAIL BITING. ADHD, SCHOOL PHOBIA, STRANGER ANXIETY.
COMMON BEHAVIORAL PROBLEMS AND THEIR MANAGEMENT in PEDIATRICSRitu Gahlawat
Childhood is the period of dependency. Gradually, children learn to adjust in the environment.
But when, there is any complexity around them they cannot adjust with that circumstance. Then they become unable to behave in the socially acceptable way and behavioral problems develop with them.
Normal children are healthy, happy and well-adjusted.
Every child should have tender loving care and sense of security about protection from parent and family members.
They should have opportunity for development of independence, trust, confidence and self-respect.
Parents should be aware about achievements of their children and express acceptance of positive attitude within the social norms.
Behavioral problems always require special attention.
Sometimes children show a wide variety of behaviors which create problems to the parents, family members and society. Most of the problems are minor and do not have any permanent disturbances but produce anxiety to the parents.
During infancy feeding problems often develop at the time of weaning.
Infant may refuse new foods due to dislike of taste or due to separation anxiety from mother.
It may be 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.
Mothers usually become frustrated and anxious with this situation, so they need reassurance and guidance in rescheduling the feeding time and change of food items.
Problems like mouth ulcer, sore throat, nasal congestion or any other conditions to be treated accordingly.
Mother should be encouraged to provide tender loving care to her infant and to avoid separation.
Abdominal colic is an important cause of crying in the children.
Some infants may cry continuously for variable periods.
This problem usually starts within the first week after birth, reaches a peak by the age of 4 to 6 weeks and improves after 3 to 4 months.
The infants may cry loudly with clenched fists and flexed legs.
The cause of this colic is not clearly understood. It occurs commonly in overactive infants who are overstimulated by parents.
It can be due to hunger, or improper feeding technique or physiological immaturity of the intestine or cow's milk allergy or aerophagy.
Excessive carbohydrate in food may lead to intestinal fermentation and accumulation of gas which may cause abdominal distension and pain.
Abdominal colic of the baby increases anxiety and tension of the mother.
Baby should be placed in upright position and burping can be done to remove swallowed air.
Psychological bonding with infant must be improved.
Antispasmodic drugs may be administered to relief the colic.
Frequent small amount feeding and modification of feeding technique are very important.
All children misbehave at some stage of their lives. Very often it is minor, as they push the boundaries of what is acceptable, and they usually drop back into being well-adjusted as quickly as they fell out of it.
But problems can persist and can become entrenched if something isn’t done to tackle them. Dealing with a naughty child requires a fine line of making sure that your chastisement is reasonable and proportionate, while ensuring it has the desired effect.
Behavioral Problems in Children is a new book which is designed to help you deal with a naughty child successfully, before they get out of control. In 6 parts it examines issues such as;
• Behavioral problems in toddlers
• Common problems and how to deal with them
• Reasons for bad behavior
• Solutions
• Dealing with conduct disorder
• Tips and strategies
We all want our children to lead happy and secure lives, but we also want to be able to take them out in public, to a restaurant, or even to the supermarket, without running the risk of an embarrassing tantrum.
Behavioral Problems in Children will help you to achieve that end, by getting to the root of the issues and solving them before they can take hold of your child’s personality. Get a copy today and see the difference it will make to your child’s behavior.
Defines and explains the Physical, Physiological, Gross motor and fine motor, Sensory, Language and Speech Development, Needs of a toddler and accident prevention in toddlers
it is uploaded to nurse educator to teach students about unit -2 healthy child in pediatric nursing. it also help the para medics & general public about normal growth & development of child. it also help to identify deviation from normal growth.
Effect of Hospitalization on Child and Family Jyotika Abraham
Understand the effects of Hospitalization on the child who is admitted along with the siblings, parents and caregivers and the family. Also, understand the Nurses' responsibility towards the admitted child and the family. This Ppt. deals with the Nurses responsibility in detail not only towards the child but also towards the family as they are also tremendously affected by the hospitalization of their child. Understand the stress caused by child hospitalization, the defence mechanisms used by the child, the stressors of hospitalization in children of different age groups, Post hospitalization behaviour, beneficial effects of hospitalization, parental reaction, sibling reaction, informed consent for care, situations in which consent is required. Nursing management and therapeutic care, the safety of the hospitalized child, special hospital situations and discharge.
Mother & Child is a vulnerable group. But many areas concerned with the health of these groups are preventable. This presentation helps you identify preventive aspects in pediatrics.
COMMON BEHAVIORAL PROBLEMS AND THEIR MANAGEMENT in PEDIATRICSRitu Gahlawat
Childhood is the period of dependency. Gradually, children learn to adjust in the environment.
But when, there is any complexity around them they cannot adjust with that circumstance. Then they become unable to behave in the socially acceptable way and behavioral problems develop with them.
Normal children are healthy, happy and well-adjusted.
Every child should have tender loving care and sense of security about protection from parent and family members.
They should have opportunity for development of independence, trust, confidence and self-respect.
Parents should be aware about achievements of their children and express acceptance of positive attitude within the social norms.
Behavioral problems always require special attention.
Sometimes children show a wide variety of behaviors which create problems to the parents, family members and society. Most of the problems are minor and do not have any permanent disturbances but produce anxiety to the parents.
During infancy feeding problems often develop at the time of weaning.
Infant may refuse new foods due to dislike of taste or due to separation anxiety from mother.
It may be 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.
Mothers usually become frustrated and anxious with this situation, so they need reassurance and guidance in rescheduling the feeding time and change of food items.
Problems like mouth ulcer, sore throat, nasal congestion or any other conditions to be treated accordingly.
Mother should be encouraged to provide tender loving care to her infant and to avoid separation.
Abdominal colic is an important cause of crying in the children.
Some infants may cry continuously for variable periods.
This problem usually starts within the first week after birth, reaches a peak by the age of 4 to 6 weeks and improves after 3 to 4 months.
The infants may cry loudly with clenched fists and flexed legs.
The cause of this colic is not clearly understood. It occurs commonly in overactive infants who are overstimulated by parents.
It can be due to hunger, or improper feeding technique or physiological immaturity of the intestine or cow's milk allergy or aerophagy.
Excessive carbohydrate in food may lead to intestinal fermentation and accumulation of gas which may cause abdominal distension and pain.
Abdominal colic of the baby increases anxiety and tension of the mother.
Baby should be placed in upright position and burping can be done to remove swallowed air.
Psychological bonding with infant must be improved.
Antispasmodic drugs may be administered to relief the colic.
Frequent small amount feeding and modification of feeding technique are very important.
All children misbehave at some stage of their lives. Very often it is minor, as they push the boundaries of what is acceptable, and they usually drop back into being well-adjusted as quickly as they fell out of it.
But problems can persist and can become entrenched if something isn’t done to tackle them. Dealing with a naughty child requires a fine line of making sure that your chastisement is reasonable and proportionate, while ensuring it has the desired effect.
Behavioral Problems in Children is a new book which is designed to help you deal with a naughty child successfully, before they get out of control. In 6 parts it examines issues such as;
• Behavioral problems in toddlers
• Common problems and how to deal with them
• Reasons for bad behavior
• Solutions
• Dealing with conduct disorder
• Tips and strategies
We all want our children to lead happy and secure lives, but we also want to be able to take them out in public, to a restaurant, or even to the supermarket, without running the risk of an embarrassing tantrum.
Behavioral Problems in Children will help you to achieve that end, by getting to the root of the issues and solving them before they can take hold of your child’s personality. Get a copy today and see the difference it will make to your child’s behavior.
Defines and explains the Physical, Physiological, Gross motor and fine motor, Sensory, Language and Speech Development, Needs of a toddler and accident prevention in toddlers
it is uploaded to nurse educator to teach students about unit -2 healthy child in pediatric nursing. it also help the para medics & general public about normal growth & development of child. it also help to identify deviation from normal growth.
Effect of Hospitalization on Child and Family Jyotika Abraham
Understand the effects of Hospitalization on the child who is admitted along with the siblings, parents and caregivers and the family. Also, understand the Nurses' responsibility towards the admitted child and the family. This Ppt. deals with the Nurses responsibility in detail not only towards the child but also towards the family as they are also tremendously affected by the hospitalization of their child. Understand the stress caused by child hospitalization, the defence mechanisms used by the child, the stressors of hospitalization in children of different age groups, Post hospitalization behaviour, beneficial effects of hospitalization, parental reaction, sibling reaction, informed consent for care, situations in which consent is required. Nursing management and therapeutic care, the safety of the hospitalized child, special hospital situations and discharge.
Mother & Child is a vulnerable group. But many areas concerned with the health of these groups are preventable. This presentation helps you identify preventive aspects in pediatrics.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Common behavioural problem and management for school child
1. COMMON BEHAVIORAL
PROBLEM AND ITS
MANAGEMENT FOR
SCHOOL CHILD
PRESENTED BY:
R.SIVABARATHY
M.SC (N) 1STYEAR
CON
JIPMER
2. •These problems are related to:
Inappropriate behavior and feelings
Unsatisfactory inter personal relationship
School learning problem
Unhappiness
Physical symptoms
Fears related to school
4. Ways to identify a problem in
the child:
•If that behavior inhibits his ability to work in classroom or
interest with peers
•If he is constantly talking and disrupting other classmates
and is not focusing on the work.
5. Definition:
•Behavior problems are viewed as discrepancy between
the child’s behavior and demands placed on him by his
parents, teachers and colleagues.
10. Thumb sucking:
•Thumb sucking is defined as non nutritive sucking of
fingers or thumb.
•Age of occurence: thumb sucking is common in oral
stage as the babies have a natural urge to suck.
11. • Causes:
Parental causes:
Over protection by parents
Neglect by parents
Strictness of parents
Disharmony between parents
Due to teachers:
Excessive strictness
Excessive punitive attitude of teachers
Due to siblings and friends:
Excessive competition
Separation from close friend or sibling
13. Problems caused by thumb sucking:
• Thumb sucking in children younger than 4 is not a
problem, but if it continues up to 5 years or above it
indicates presence of an emotional problem.
• Prolonged thumb sucking may lead to dental problem
like misaligned teeth or sometimes malformation of the
upper palate of mouth.
• May also develop speech problem like misprouncingT
and alphabet D, lipsing and thrusting out the tongue child
talking.
14.
15. Management:
•Usually thumb sucking can be managed at home and
includes parents setting rules and providing distractions.
•Many experts recommend ignoring thumb sucking in
children as most children stop it on their own.
16. Do’s
• Divert and distract the child
attention
• The hand and fingers of the
child should be busy
• Offer prize and reward to the
child for not thumb sucking
• Put gloves on child’s hands or
wrap the thumb with a cloth or
bandage
• A non toxin bitter tasting
substance can be applied on
child’s thumb so that he may
not suck it
• Take help of elder children for
explanation to younger siblings
Don’t
• Do not scold the child or punish
him or forcefully remove thumb
from the mouth
• Do not tie the child’s thumb and
fingers
• Do not nag, scold or beat the child
• Do not leave the child repeatedly
cold, wet or hungry
17. Nail biting:
•Onychophagia or nail biting is a common oral
compulsive habit in children and adults. It is just a
way of coping with stress or comforting self.
18. Causes:
• Out of curiosity or boredom
• To relieve stress or anxiety
• Because of habit
• Because of nervousness
• Lack of confidence
• Feeling shy
• Fear or jitteriness due to horror scene or family environment
• Feeling of insecurity
• Tiredness
• Constant nagging
19. Management:
• Application of a clear, bitter tasting nail polishes to the nail, the
bitter flavor discourages nail biting.
• keep the fingernails of child neatly trimmed to cut down on the
temptation to bite.
• Keep the child hands clean to cut down on ingestion of germs.
• Reassure the child with love and affection.
• Don’t pressurize the child to stop biting nails, as their adds to
their stress.
• Don’t lag or punish the child.
20. Tic disorders:
• Characterized by persistent pressure of tics, which are abrupt,
repetitive, involuntary movements and sounds that are
purposeless.Tics are sudden non – rhythmic behaviors that are
either motor or vocal.
21. Types:
Simple : using only a few muscles or simple words.
Simple motor tics: these are simple brief meaningless
movements like eye blinking, facial grimacing, head jerk
or shoulder shrugs, they usually last than one second.
Simple phonic tics: these are meaningless sounds or
noise like throat clearing, coughing, sniffing barking or
hissing.
22.
23. •Complex: using many muscles groups or full words and
sentences.
•Complex motor tics: these tics involve slower, longer
and more purposeful movements like sustained looks,
facial gestures, biting, banging ,whirling or twisting
around or obscene gestures.
•Complex phonic tics: these tics include syllabus, words,
phrases and statements like “shut up” or “yes, you’ve
done it” .The child’s speech may be abnormal with
unusual rhythms, tones and accent.
24.
25. Onset:
• The age of onset of tic disorder is 2 -15 years. In 75% cases of
Tourette’s disorder, the symptom appear by the age of 11 years.
• Transient tic disorder occurs in approximately 4-24% of school
children.Tourette’s disorder is 3-4 times more common in males
than females.
26. Causes:
• There appear to be both functional and structural abnormalities
in brains of people with tic disorders.
• It is believed that abnormal neurotransmitters contribute to this
disorders.(basal ganglia and anterior cingulate cortex)
27. Management:
• A holistic approach is recommended for the treatment of tic disorder.
• Collaborative work
• Educating the patient and family about the course of disorder in a
reassuring manner.
• Completion of necessary diagnostic test
• Comprehension assessment including the child’s cognitive abilities,
perception, motor skills, behaviour and adaptive functioning.
• Cognitive behavior therapy
• Medications: typical neuroleptics, alpha adrenergic receptor agonist ,
atypical antipsychotics .
28. Prevention:
•There are few preventive strategies for tic disorders.There
is some evidence that maternal emotional stress during
pregnancy and severe nausea and vomiting during first
trimester of pregnancy may affect tic severity.
•Attempting to minimize prenatal stress may possibly serve
a limited preventive function.
•We have to give stress free environment to child.
29.
30. Enuresis:
•Enuresis or bed wetting is a disorder of involuntary
micturition in children who are beyond the age,
when normal bladder control is acquired. Bladder
control is normally acquired by the age of 2 – 31/2
years.
•If it is not acquired beyond 4-5 years of age, it is
abnormal.When bed wetting occurs repeatdly, it
is called as enuresis.
31. Types:
• Primary : It refers to the condition in which children have never been
successfully trained to control urination.There may be delay in
maturation of sphincter control.
• Secondary: It refers to the condition in which children have been
successfully trained, but revert to bed wetting in response to some
stress.it may be due to parent child maladjustment.
32. •Another classification :
Nocturnal enuresis: it means bed wetting during
night
Diurnal enuresis: it means bed wetting during
day time
Mixed enuresis: it includes a combination of both
nocturnal and diurnal type.
34. Management:
• Reassure the child and parents
• Try to build the child’s self confidence
• Should not give any liquids like tea or milk after 5 pm in the evening.
• Should be habitually made to pass urine before going to bed
• Should arouse the child after 2-3 hours of sleep and persuade him to walk unaided
to the toilet.to empty bladder.
• Bed wetting alarms
• Medications: in very resistant cases tricyclic antidepressants like amitriptyline,
imipramine and nortriptyline are given orally at night for 2 months.
35.
36.
37. Encopresis:
• Encopresis also known as paradoxical diarrhea is involuntary
fecal soiling in children who are past the age of toilet training.
• Incidence: as each child achieves bowel control at his or her own
rate. Physicians do not consider stool soiling to be a medical
condition unless the child is at least 4 years old.
38. Causes:
• Constipation
• In most children the problem begins with painful passage
of hard constipated stool
• Over the time, child become reluctant to pass stool or
holds stools to avoid pain.This holding in of stool become
a habit.
40. Management:
• Administer the enema or series of enemas, as it creates pressure within the rectum
and gives the child an urge to pass stool
• Suppositories and laxatives can also be used to promote bowel evacuation.
• Establish a regular toilet routine.
• Behavioral technique
• Training: children may respond to teaching about appropriate use of muscles and
other physical response during defecation.
• This may help them to learn how to recognize the urge to defecate.
• Children are taught how to use their abdominal, pelvic and anal sphincter muscles
which they have so often used to retain stool.
42. Stammering/stuttering:
•Is a speech disorder in which the flow of speech is
disrupted by involuntary repetitions and prolongation of
sounds, words or syllables.Also there are involuntary
silent pauses or blocks.
45. Clinical features:
•Problem in starting a word or phrase
•Hesitation before certain sound has to be uttered
•Repetition of a sound, word or syllabus
•Speech may come out in spurts
•Trembling lips and jaws/ when trying to talk
•Interjections like “uhm” used more frequently before
attempting to utter certain sounds.
46. Management:
• Aim at teaching the child skills, strategies and behavior that help in oral
communication.This include fluency shaping therapy and stuttering
modification therapy.
• Parents should not put undue pressure on the child, regarding fluency of
speech during preschool age.
• Give the child sufficient time to express himself
• Never criticize the child for his/her speech
• Encourage the child to speak clearly by teaching him/her songs and
nursery rhymes.
• Make the child feel that parents are interested in his talks.
48. PICA
• Is characterized by an appetite for substances largely non
nutritive and the habit must persist for more than one month, at
an age when earing such objects is considered developmentally
inappropriate.
• Pica is eating of non edible substances such as chalk, clay, coal,
mud etc.,
50. Causes:
•Due to acquired taste or neurological mechanism like iron
deficiency or chemical imbalance
•May linked to mental disability
•Stressors such as maternal deprivation, family issues,
parental neglect, pregnancy, poverty and a disorganized
family structure are strongly linked to pica.
51. Management:
• Presentation of attention, food or toys not contingent on pica being attempted.
• Discrimination training between edible and non edible items
• Detect nutritional deficiencies and treat them. Eg) anemia, hypocalcemia, etc
• Make meal time pleasant
• Meet the emotional needs of child
• Don’t leave the child alone
• Keep the child busy, as boredom may give him time for eating non edible
substances.
52.
53. Anorexia nervosa:
•Is characterized by voluntary refusal to eat, significant
weight loss, an intense fear of becoming over weight
and a pronounced disturbance of body image.
•Incidence: is seen in about 5% of adolescent females and
5 – 10% of all males.The disorder starts by the age of 10 -
19 years.
55. C/F :
• Extreme weight loss
• Intense or irrational fear of weight gain
• Distorted body image, weight or shape
• Other physical manifestation like,
• Amenorrhea for up to 3 months
• Hypothermia
• Muscle wasting
• Cardiac dysrhythmias
• Hypotension
• Dry skin
• Brittle nails
• Cold intolerance
56. Management:
•Nutritional counselling
•Individual therapy to correct distortions and deficits in
psychological thinking
•Family therapy to correct disturbed patterns of interactions
in family
•In certain cases, antidepressants and selective serotonin
reuptake inhibitor prove to be effective
•Enhance self esteem and self worth of the individual so that
he/she learns to like self, learns to trust and develop an
identity beyond their thin body.
57. Bulimia nervosa:
• Is a disorder of binge eating, where the individual consumes
large amount of food with lack of control followed by various
compensatory behaviors (like self induced vomiting) to control
weight.
• Incidence: is higher than anorexia nervosa, about 1-1.5%
females with lower rates in males.
• This disorder is seen in age group of 15 – 30 years.
58. C/F:
• Intense fear of getting fat and are very sensitive to weight gain
because they lack impulse control
• Binge eating stops when abdominal discomfort occurs
• After binge eating the adolescents feel out of control, depressed,
guilty and anxious
• Self induced vomiting and misuse of laxatives and diuretics is also
seen, due to which the person loses the ability to experience
hunger and satiety
• Fasting or excessive exercise as compensatory behaviors to prevent
weight gain.
59. Management:
• Behavior modification
• Cognitive therapy may required
• Dietary counselling
• Selective serotonin reuptake inhibitor drugs have been effective
in reducing the urge to binge and in treating depression.
61. • Sleep disorders are common during the preschool years.
These problems resolve and diminish as the child gets older.
• Most of the sleep problems are related to irregular sleep
habits or anxiety about going to bed and sleeping
• In school age children, sleep walking (somnambulism) and
sleep talking (somniloquy) occur in about 15% children, mainly
boys.
• The sleep walking event is usually not recommended in the
morning.
• Somniloquy can occur at any age and its prevalence rate is 7-
8%. It does not indicate a health concern or need for
intervention.
62. Management:
• Establish a bedtime routine
• Establish a wake up time
• Avoid giving stimulants such as sugar or caffeine to the child near
bedtime
• Make the bedroom cozy and inviting
• Avoid disturbances in sleep like television
• Maintain silence in and near bedroom
• Be with the child while he falls asleep
• Provide pleasant activity like story telling prior to sleep
65. Temper tantrums:
•Temper tantrum is a behavior problem, where children
assert their independence by violently objecting to
discipline through the display of anger at uncontrollable
level.
67. Management:
•Educate the parents that temper tantrums are child’s way of
releasing frustration so they should ignore them
•Parents should talk to the child to find out the cause of
frustration
•Provide adequate rest and sleep to the child
•Parents should show the child that he is loved even though his
behavior is disapproved
•Parents should be good role model for the child
•Parents should not be over protective for the child though
they should provide security and support to the child.
68.
69. Shyness:
• Shyness leading to complete withdrawal is consider as a behavior
problem.
• Causes:
• Genetic inheritance
• Environmental causes like lack of exposure, cultural norms,
society etc.,
70. Management:
• Assess the causes of shyness
• Talk to the child
• Provide exposure to the child by arranging small get to gather with
peer group
• Do not pay attention on the child’s mistakes
• Do not criticize the child
• Reward the child whenever he performs well or takes on initiative
• Encourage the child
71. JUVENILE DELINQUENCY:
• Antisocial behavior is the most taxing and troublesome,
affecting not only the family but also various levels of
society.
• Parents refer to these children as bad boys who need to
go to the house of correction
• Teachers call them incorrigble and beyond correction.
• The psychiatrist and psychologist call them emotionally
disturbed while judiciary has one term for them –
denlinquents.
72. Definition:
• In which a child or adolescents purposefully and
repeatedly does illegal activities.
• The children act, 1960 in India defines a delinquent as a
child who has committed on offence such as theft, sexual
assault, murder, burglary or inflicting injuries, running
away from home, etc.,
73. Presentation of antisocial problems in children:
• Constant disobedience
• Lying
• Stealing
• Fire setting
• Destructiveness
• Cruelty
• Truancy from school
• Running away from home
• Sexual problem
• Drug and alcohol intake with dependence
• gambling
75. Measure and diagnosis of delinquency:
•For confirming the diagnosis
•For understanding the dynamics of problems
•For planning the management and treatment of
delinquents
•For judicial reasons and helping the court
•For reasons of prognosis
76. •The diagnostic findings procedure:
•Interview
•Mental status examination
•Neurological examination
•EEG
•Psychological test
79. Drug:
•Tranquilizers in adequate dose need to be given
•Chlorpromazine given orally in dose of 25 – 50 mg
three times a day is the best.
•Haloperidol can be given orally in dose of 1.5 – 10
mg three times a day
•Injectable route for uncontrolled aggression