Behavior disorders in children

Introduction
Infancy and childhood are
importance in
determining & patterning the
future behavior &
character. Childhood is a period
of dependency.
Gradually ,children learn to
adjust in the
environment. But when ,there is
any complexity
 COMMON
BEHAVIOURAL
PROBLEMS IN
CHILDREN
1. Feeding problems: food refusal,
Overeating , Vomiting, impaired appetite,
pica, anorexia nervosa
2. Habit disorders: thumb sucking, nail
biting, enuresis, encopresis, tics, breath
holding spell, bruxism (teeth grinding),
rolling and head banging, trichotilomania
3. Speech problems: unclear speech,
delayed speech, dyslalia, stammering or
stuttering.
5.Learning difficulties: school phobia,
truancy [absenteeism], repeated failure,
6. Adjustment disorders: disobedience,
misconduct, temper tantrum
7. Emotional disorders: negativism, jealousy,
shyness, fear , anger, timidity
8. Antisocial problems: delinquency,
destructive attitudes, kleptomania
(compulsive stealing), substance abuse,
Behaviour
problems
in infant
 Resistance to
feeding
or impaired appetite
Develops at the time of
weaning
Due to dislikes &separation
anxiety, Any other minor
problems
Mgt:
Change of food items and
psychological support
 Abdominal colic

Starts with in the first

week after birth,
reaches a peak by the
age 4 to 6 weeks.
The cause of this is not
clearly understood.
It can be due to hunger,
or improper feeding
Mgt:
baby should be placed in upright
position & burping to remove air
Mgt for organic cause
Antispasmodic drugs
 Separation anxiety
Due to insecurity, fear and anxiety,
Mgt:
love and tender care
Emotional support
Gradual approach with strangers
Behavior
problems
in child
hood
 Temper tantrums
Is a sudden out burst or violent
display of anger, frustration.
Bad temper as physical aggression or
resistance such as rigid baby, biting,
kicking, throwing objects, hitting
crying, rolling on the floor, screaming
loudly, banging limbs, etc
 it occurs in maladjusted children
commonly seen in toddlers and
preschoolers, usually found
in boys, single child, pampered
child.
temper tantrum occurs when the
child cannot integrate the internal
impulses & the demand reality.
The child become frustrated and
reacts in the only way he/she knows
 Parents should provide alternative
activity at that time.
Nobody make fun and tease.
Protect from self injury
It can be reduced by calm and loving
approach.
over indulgence should be avoided.
 After temper tantrum the child face
and hands should be washed and
play materials to be provided. For
diversion.
Child tension can be released by
vigorous exercise and physical
activities
 Breath holding spells
Occurs b/w 6 months to 5 yrs of age
It is observed in response to
frustration or anger during
disciplinary conflict.
The child found with violent crying,
This attacks last for 1 or 2 minutes.
Mgt:
Repeated attacks need to be
 Thumb sucking
It is a habit disorders due to feeling
of insecurity & tension reducing
activity.
It may develop due to inadequate
oral satisfaction during infancy as a
result of poor sucking.
If thumb sucking continues beyond 4
yrs of age then complication may
arise as malocclusion &
Mgt:
Psychological support.
Distraction
Engaging the finger for other activity.
Don not scold.
Consultation with dentist & speech
therapist.
 Nail biting
Bad oral habit especially in school
age
It is a sign of tension & self
punishment to cope with hostile
feeling towards parents.
Mgt:
Identify the cause
Psychological support & consult
Clinical psychologist
Enuresis or bed
wetting
Encopresis
 Geophagia or pic
Pica is a habit disorders of eating non
edible substances such as clay,
paints, chalk, pencil, plaster from
wall, hair etc
It may be due to parental neglect,
poor attention of caregivers,
inadequate love and affection etc.
Children may have intestinal
problems vitamin, mineral deficiency,
 Tics or habit
spasm
Tics are sudden abnormal involuntary
movements. It is repetitive,
purposeless, rapid stereotype
movements of muscles. Mainly of the
face and neck.
Tics occurs most often in school
children for discharge of tension in
maladjusted emotionally disturbed
 Tics can be motor Eg: eye blinking,
shrugging shoulders, tongue
protrusion, facial gesture, or vocal
eg. Throat clearing, coughing,
sniffing etc.
Mgt:
Parental reassurance and counseling
 Speech problems
Stutteringor stammering
Cluttering
delayed speech
Dyslalia
Mutism
Sleep disorde
 Common with anxiety , tension &
over activity
These problems present with or
without physical symptoms.
Usually occurs in deep sleep. E.g.:
stage of 3 or 4 of NREM
Night mares and
night terrors
Somnambulism
Somililoquy
Bruxism( teeth
grinding)
School
 Abnormal fear of going to school
Due to afraid to leave parents and
fear about teachers
child may complaints of recurrent
physical complaints
Mgt:
Habit formation of regular school
attendance
Play session & other recreational
activities in school.
Improvement in school environment
Assessment of heath status of the
child and necessary intervention
 Management
Concern words
Waning comments
Time out
Referral
 Behavior
problems of
adolescence
Juvenile delinquency
 Substance abuse
Is a threatening social
problem of school
going & adolescence
age group.
It is periodic or chronic
intoxication by
repeated intake of
habit forming agents.
The abused agents are
 It occurs in frustration, emotional
conflicts, & disturbed family & school
relationship
They are victims of gang activities,
wrong adventure, poor parental
guidance, and lack of recreation, &
education
They may involve in various
 Prevention

provision of adequate
facilities for recreation,,
entrainment,
Proper channelization of
energies, into constructive
activities
provision of metal health
program periodical
Anorexia nervosa
 Nursing
responsibilities
Assessment of specific
problem of the child by
appropriate history &
detection of the cause.
Informing to the parents
make them aware.
Assisting them parents,
teachers and family
members foe necessary
 Promoting healthy
emotional development of
the child by adequate
physical , psychological &
social support.
Creating awareness about
psychological disturbances
Providing counseling