Child development disorders

By Doon psychotherapeutic centre

 Introduction
 Child development is about the biological,
psychological and emotional changes that
take place from infancy up until the end of
adolescence .
Difference between growth and
development
 It is important to know the difference
between growth and
development.
 Growth refers to the physical changes in a
child’s size, height, weight, face, shoe size,
length of
arms and legs and body shape.
 Development refers to the continuous
progression whereby a child gains
more complex knowledge.
 Introduction
 Disorders seen in childhood(‘disorders of psychological development’
and ‘behavioural and emotional disorders with onset usually occurring
in childhood and adole scence’) are discussed under the following
headings.
1. Intellectual disability(Mental retardation).
2. Specific developmental disorders
3. Pervasive developmental disorders
4. Hyperkinetic disorders
5. Conduct disorders
6. Tic disorders
7. Enuresis and encopresis
8. Speech disorders
9. Habit disorders
10. Other disorders.
Today we will discuss about Intellectual disability(Mental retardation).
 Normal child development
 For understanding behavioural and psychological
problems of childhood, it is essential to know the
normal patterns of child development.
 The normal development of a child can be divided
into four major areas (these are modified after
the Denver Development Screening Test, DDST).
1. Motor behaviour.
2. Adaptive behaviour.
3. Language, and
4. Personal and social behaviour.
 Important facts about
development
 Developmental milestones are a set of
functional skills or age-specific tasks that
children in general can perform at a specific
age.
 Developmental milestones are age related,
but every child reaches the stages at his/her
own rate.
 The stages of development are closely
integrated.
 with one another. Each stage will greatly
affect the next stage
Different Stages of Development
Developmental Milestones
Gross Motor Skill Development

Fine Motor Skill Development

Cognitive Development

Social and Emotional Development

Speech and Language Development

Fields of development
Gross Motor Skill Development
 Gross motor skills are the use of large
muscles in arms, legs, feet and torso.
 The muscles are used to sit, stand, walk,
run, change positions and balance.
 Fine motor skills
 Fine motor skills are the use of small
muscles in the fingers, wrists, toes, lips
and tongue.
 The muscles are used to pick up or hold
objects , for example, holding a spoon to
eat or a crayon to draw.
 Cognitive Development
 Cognitive Development refers to
skills such as learning, reasoning,
remembering, understanding and
problem solving
 Social and Emotional
Development
 Social and emotional development
involves skills such as self-awareness,
forming relationships with primary
caregivers, interacting with other people,
responding to feelings and learning self-
control.
 Speech and Language
Development
 Speech and Language development
involves gaining skills needed to
understand and use a language. This
includes spoken words as well as body
language and gestures.
Development milestones by median age
 Mental retardation and Intellectual
disability
 Intellectual Disability
 Intellectual disability once called mental
retardation, is characterized by below-
average intelligence or mental ability and a
lack of skills necessary for day-to-day living.
People with intellectual disabilities can and
do learn new skills, but they learn them
more slowly. There are varying degrees of
intellectual disability, from mild to profound.
 What is intellectual disability?
 Someone with intellectual disability has limitations in
two areas. These areas are:
 Intellectual functioning. Also known as IQ, this
refers to a person’s ability to learn, reason, make
decisions, and solve problems.
 Adaptive behaviors. These are skills necessary for
day-to-day life, such as being able to communicate
effectively, interact with others, and take care of
oneself.
 IQ (intelligence quotient) is measured by an IQ test.
The average IQ is 100, with the majority of people
scoring between 85 and 115. A person is considered
intellectually disabled if he or she has an IQ of less
than 70 to 75
 Mild Intellectual disability
(IQ 50-69)
 This is commonest type of intellectual disability
accounting for 85-90% of all cases.
 These individuals have minimum retardation in
sensory-motor areas.
 Individuals in this group can often live on their
own with community support .
 In the preschool period (before 5 years of
age),these children often develop like other
normal children, with very little deficit.
 Later, they often progress up to the 6th class
(grade) in school and can achieve vocational
band social self-sufficiency with a little support.
Moderate Intellectual Disability
(IQ 35-49)
 About 10% of mentally retarded come under
this group.
 They are challenged academically and often
are not able to achieve academically above a
second to third grade level.
 As adults, persons with moderate mental
retardation may be able to perform
semiskilled work under appropriate
supervision.
 In the educational classification, this group
was earlier called as ‘trainable’, although
many of these persons can also be educated.
 In the early years, despite a poor social
awareness , these children can learn to
speak. Often, they dropout of school after
the 2nd class (grade).
 They can be trained to support them
selves by performing semiskilled
or unskilled work under supervision.
 A mild stress may destabilise them from
their adaptation; thus they work best in
supervised occupational settings
 Severe Intellectual disability
(IQ 20-34)
 Severe mental retardation is often
recognized early in life with poor motor
development & absent or markedly delayed
speech & communication skills.
 Individuals in this category can often master
the most basic skills of living, such as
cleaning and dressing themselves.
 Later in life, elementary training in personal
health care can be given and they can be
taught to talk.
 At best, they can perform simple tasks under
close supervision
 Profound Mental Retardation
(IQ BELOW 20)
 This group accounts for 1-2% of all
intellectual disability.
 The achievement of developmental
milestones is markedly delayed.
 They require nursing care & supervision
Causes of Intellectual disability
 ENVIRONMENTAL &
PSYCHOSOCIAL FACTORS
 Child abuse and neglect
 Traumatic brain injury
 Heavy metal poisoning esp. Lead
poisoning
 Cultural deprivation
 Low socio-economic status / Nutritional
problems
 Inadequate caretakers/ Health services
 DOWN SYNDROME
 Langdon Down in 1866, first description
based on physical characteristics associated
with subnormal mental functioning
 caused by an extra copy of the entire
chromosome 21, makes it one of the more
complex disorders. Also called ‘Trisomy 21’
 Features – slanted eyes, epicanthal folds, and a flat
nose, thick tongue, rough skin of hands
 Epidemiology – 15/10,000 births.
 Mostly mild-moderate IQ
 IQ decreases with age
 Continue..
 Difficulty increases with age
 Increased risk of psychotic disorders
 Weakness in language functioning and
 strengths are – sociability, social skills,
interpersonal cooperation
Down syndrome
 FRAGILE X
 Fragile x syndrome is the second most
Common single cause of ID.
 The syndrome results from a mutation on
the x chromosome at what is known as the
Fragile site (xq27.3).
 The typical phenotype includes a large, long
head and ears, short stature, hyper
extensible joints,
 The mental retardation ranges from mild to
severe.
 Cerebral Palsy
 This is a syndrome consisting of a
conglomeration of perinatal disorders of
various aetiologies, presenting with a
common feature of paralysis of limbs.
 The paralysis may be mono plegia, hemi
plegia, paraplegia,triplegia or quadriplegia.
 It is usually of upper motor neuron type,
presenting with spasticity.
 The extrapyramidal
symptoms may be presentand
seizures may occur often