COMMON PROBLEM OF ECED CHILDREN
Posted: Monday, November 29, 2010 by melodytavera in Labels: eced 13
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Emotional Problems in Children
Emotional problems in children have become more widely recognized. A child's emotional problem can become a chronic problem if it's not attended to properly and in a timely manner. Many adult emotional problems can also affect children, but these problems may not be as easily recognized in children. Some emotional problems in children can be treated quite easily, but some require long-term care that can be complicated.
Childhood Bipolar Disorder
Childhood bipolar disorder is an emotional problem that can affect children. This childhood emotional problem can be hard to diagnose, because its symptoms are also symptoms of many other childhood emotional problems. Common symptoms include mood swings, irritability, episodes of extreme happiness and episodes of severe depression. Childhood bipolar disorder is a serious condition and should be treated as such. Treatment most often includes a combination of medication (sometimes more than one) and behavior therapy (teaching the child how to handle certain situations better).
Childhood Depression
Childhood depression is an emotional problem that can affect children. This childhood emotional problem is considered serious, but it can be difficult to diagnose because its symptoms are not unique. Common symptoms include irritability, fatigue, hopelessness, social withdrawal and poor performance in school. Childhood depression is most often treated with medication and behavior therapy.
Autism
Autism is an emotional problem that can affect children. This childhood emotional problem is often serious and consists of three distinctive behaviors. These autism behaviors include trouble interacting socially, obsessive and competitive behavior and difficulty with nonverbal and verbal communication. Medications (often more than one) and behavioral and educational therapies and interventions are used to treat autism. Family counseling is also used to help families learn about autistic children and to help them cope.
Childhood Schizophrenia
Childhood schizophrenia is an emotional problem that can affect children. This emotional disorder often affects a child's ability to develop normal social, educational and emotional skills and habits. Children with emotional disorder often have difficulty performing daily tasks, think and act irrationally and have delusions and hallucinations. Childhood schizophrenia is most often treated with a variety of treatments including medications (most often antipsychotics) and psychotherapy (teaches the child to cope with the illness and its challenges).
Tourette syndrome
Tourette syndrome is an emotional problem that can affect children. This emotional problem is also considered a neurological disorder. Tourette syndrome is characterized by stereotyped and repetitive vocalizations and involuntary movements referred to as tics. Tourette syndrome is most often treated with a combination of medication and psychotherapy.
Social Problems
Peer relationships are important to children's development. Friends not only provide companionship and recreation, but meet other needs as well. Through interactions with peers, children learn valuable social skills. They learn how to do things like join groups, make new friends, participate in group problem solving, and manage competition and conflict. Friendships also provide a supportive context in which self-exploration, emotional growth, and moral development can occur. Of course, learning and social support also result from relationships with parents, teachers, and other adults. But it is among other children that children learn how to interact with equals. Also, it is with peers that children spend a very high proportion of their waking hours.
Given the significance of friendships to children, imagine what it would be like to spend over 40 hours a week in school and after-school programs with lots of other people your own age, but to have few of them like you or want to be with you. This is the reality for many children. Indeed, about ten percent of school-age children have no friends in their classes and are disliked by a majority of their classmates.
Peer rejection in childhood often brings with it serious emotional difficulties. Rejected children are frequently discontent with themselves and with their relationships with other children. Many of these children experience strong feelings of loneliness and social dissatisfaction. Rejected children also report lower self-esteem and may be more depressed than other children. Peer rejection is also predictive of later life problems, such as dropping out of school, juvenile delinquency, and mental health problems. Dropping out of school seems to be a particularly frequent outcome. Results from research indicate that, on average, about 25 percent of low-accepted children drop out of school compared to eight percent of other children (Parker & Asher, 1987).
It is easy to think of reasons why having difficulties with peers could lead children to do worse in school and to later drop out. Because students often study with their friends, help each other with homework, and even informally tutor one another, a student who lacks friends is likely to miss out on opportunities to learn school material. Furthermore, a child who is having problems getting along with others may be more upset and distracted and therefore, find it harder to concentrate. Even if a child's academic work is respectable, a child with serious peer relationship problems might drop out because school is not an enjoyable place. Indeed, being at school may be quite stressful.
The academic benefits of having friends show up very early in a child's school career. Consider, for example, research by Ladd (1990) on children who are making the transition from preschool programs to kindergarten. This research suggests that those who start kindergarten with a friend in their class make a better adjustment to school than those who do not start with a friend. Furthermore, children who maintain their friendships as the school year progresses like school better, and children who make new friends make greater gains in school performance.
The quality of a child's peer relationships should be taken seriously. In the next issues of this newsletter, we will discuss the kinds of behavior problems and social skill deficits that lead to peer rejection. We will describe some ways that adults can help children who are having problems to get along better with their peers. The child care setting is an important place to help foster positive peer relations and the development of social skills.
Social Problem Solving, Social Behavior and Children's Peer Popularity
CHILDREN'S FRIENDSHIPS clearly play a major role in promoting social development and adjustment (Parker & Asher, 1987). To function successfully in peer relationships, children require a variety of behavioral skills, including the ability to gain entry to groups and to resolve interpersonal conflicts. Underlying these behavioral skills are social problem-solving skills, including the ability to recognize social problems, generate alternative strategies for resolving social problems, and appreciate the consequences of actions (Erwin, 1993). The social utility of various cognitive and behavioral abilities may be ascertained by comparing popular and unpopular children. This understanding is important for designing effective social skills training interventions with isolated children.
Social isolation may result because children are actively rejected by their peers or because they are socially withdrawn and neglected by their peers (Rubin, 1985). These different forms of social isolation are typified by distinctive patterns
Five common behavior problems that parents often deal with include whining, bedtime battles, tantrums, spoiled behavior, and disrespect.
There are five very common behavior problems that almost every parent will experience when dealing with their children. Of course, every child is different, and some children will struggle more with some problems than other children. If you are a parent, however, chances are you will have to deal with at least one or two of these problems as your child grows and matures.
One of the most common problems that parents have to deal with is their child’s whining. How does a child begin whining? More than likely, your child began whining when she discovered that you paid more attention to her when she was in distress. While that distress may have begun with a legitimate situation, it probably developed into your child’s way of getting your attention, even if that attention was negative. How can you deal with the whining? You need to take the attention away from your child. You simply should not respond to your child’s whining. When she begins to whine, you can very calmly tell her that you will not answer her or address her problem until she speaks to you in an ordinary voice, then walk away from her and continue to ignore her whining behavior. When she realizes that the whining isn’t getting the result she desires, she should stop.
Another common problem that parents encounter is bedtime battles. Does your child go calmly to bed, only to repeatedly get up for that last sip of water or visit to the bathroom? Does it take you one to two hours to get your child to finally settle in for the night? There are several ways you can handle this depending upon the age of your child. If your son or daughter is a toddler or pre-schooler, you may want to keep a chart. Each time your child goes to bed and stays in bed, reward her with a sticker. After a designated time period in which she stayed in the bed for several consecutive nights, let her choose a particular treat, such as a small toy or a visit to a new playground. Be sure you praise her for being a good girl. If your child is older, you may need to dock any extra time that he takes staying in the bed. Explain to your child that the longer he stalls going to bed, the less time he will be allowed to watch television or play on the computer.
If your child has the irritable habit of throwing a tantrum every time you go to the supermarket, you are not alone. Often, these habits intensify simply because it is easier to give in to your child than to address the problem. How can you handle these tantrums? Probably the most important thing you should remember is that you should never give in to them. This may mean that you have to leave the store. Once you leave the store, however, don’t let your child’s behavior go without consequences. Once you get home, you will need to instill some sort of time-out or loss of privilege, depending on the age of your child.
Indulging your child too much and too often may turn your child into a selfish, spoiled brat. While you may have thought that you were lavishing your child with love by giving into her every whim and desire, you may soon learn that your child’s desires are unending. If you have somehow helped to create a demanding child, you can reverse this behavior pattern, even though it may take a while. Don’t give in to your child’s every wish. Instead, help your child discover ways to earn certain privileges or objects. Show your child that there are many people who are in need. Be sure you volunteer at activities that your child can help with. Teach your child to give to others, instead of only wanting to obtain things for herself.
Finally, many parents wake up one morning to suddenly find that their son or daughter thinks he or she can talk back in a disrespectful manner. Of course, when a child talks back to a parent, that parent may lose his or her temper rather quickly, but you should keep in mind that this is often what a child wants. If your child senses that he has the power to make you lose control, he may exert that power more and more often. Your child needs to show you respect, and in order to teach him this, you will need to talk to him respectfully, but firmly. If he speaks to you disrespectfully, you should tell him that you will not discuss anything with him until he can talk respectfully to you. Let him know that he will not get any kind of response out of you until he changes his tone. Behavior problems can be overwhelming, but with firmness and consistency, parents can do a lot to manage their child’s behavior.
Common Behavioral Problems in Children
- These can be usefully classified into psychosocial disorders, habit disorders, anxiety disorders, disruptive behavior and sleeping problems.
Psychosocial Disorders
These may manifest as disturbance in:
Emotions e.g. anxiety or depression
Behaviors e.g. aggression
Physical function e.g. psychogenic disorders
Mental performance e.g. problems at school
This range of disorders may be caused by a number of factors such as parenting style which is inconsistent or contradictory, family or marital problems, child abuse or neglect, overindulgence, injury or chronic illness, separation or bereavement.1
The child's problems are often multi-factorial and the way in which they are expressed may be influenced by a range of factors including developmental stage, temperament, coping and adaptive abilities of family, the nature and the duration of stress. In general, chronic stressors are more difficult to deal with than isolated stressful events.
Children do not always display their reactions to events immediately although they may emerge later. Anticipatory guidance can be helpful to parents and children in those parents can attempt to prepare children, in advance, of any potentially traumatic events e.g. elective surgery or separation. Children should be allowed to express their true fears and anxieties about impending events.
Young children will tend to react to stressful situations with impaired physiological functions such as feeding and sleeping disturbances. Older children may exhibit relationship disturbances with friends and family, poor school performance, behavioral regression to an earlier developmental stage, development of specific psychological disorders such as phobia or psychosomatic illness.
It can be difficult to assess whether the behavior of such children is normal or sufficiently problematical to require intervention. Judgment will need to take into account the frequency, range and intensity of symptoms and the extent to which they cause impairment.
Habit Disorders
These include a range of phenomena that may be described as:
Tension reducing habit disorders
Thumb sucking
Repetitive vocalizations
Tics
Nail biting
Hair pulling
Breath holding
Air swallowing Head banging
Manipulating parts of the body
Body rocking
Hitting or biting themselves
All children will at some developmental stage display repetitive behaviors but whether they may be considered as disorders depends on their frequency and persistence and the effect they have on physical, emotional and social functioning. These habit behaviors may arise originally from intentional movements which become repeated and then become incorporated into the child's customary behavior. Some habits arise in imitation of adult behavior. Other habits such as hair pulling or head banging develop as a means of providing a form of sensory input and comfort when the child is alone.
Thumb sucking - this is quite normal in early infancy. If it continues it may interfere with the alignment of developing teeth. It is comfort behavior and parents should try to ignore it while providing encouragement and reassurance about other aspects of the child's activities.
Tics - these are repetitive movements of muscle groups that reduce tension arising from physical and emotional states, involving the head, the neck and hands most frequently. It is difficult for the child with a tic to inhibit it for more than a short period. Parental pressure may exacerbate it while ignoring the tic can reduce it. Tics can be differentiated from dystopias and dyskinetic movements by their absence during sleep.
Stuttering - this is not a tension reducing habit. It arises in 5% of children as they learn to speak. About 20% of these retain the stuttering into adulthood. It is more prevalent in boys than girls. Initially it is better to ignore the problem since most cases will resolve spontaneously. If the diffluent speech persists and is causing concern refer to a speech therapist.
Anxiety Disorders
Anxiety and fearfulness are part of normal development; however, when they persist and become generalized they can develop into socially disabling conditions and require intervention. Approximately 6-7% of children may develop anxiety disorders and of this 1/3 may be over-anxious while 1/3 may have some phobia. Generalized anxiety disorder, childhood onset social phobia, separation anxiety disorder, obsessive compulsive disorder and phobia are demonstrated by a diffuse or specific anxiety predictably caused by certain situations.
School phobia occurs in 1-2% of children of which an estimated 75% may be suffering some degree of depression and anxiety. Management is by treating underlying psychiatric condition, family therapy, parental training and liaison with school to investigate possible reasons for refusal and negotiate re-entry.
Disruptive Behaviors
Much behavior, which is probably undesirable but a normal occurrence at an early stage of development, can be considered pathological when they present at a later age. In the young child many behaviors such as breath-holding or temper tantrums are probably the result of anger and frustration at their inability to control their own environment. For some of these situations it is wise for parents to avoid a punitive response and if possible to remove themselves from the room. It is quite likely that the child will be frightened by the intensity of there own behavior and will need comfort and reassurance. While some isolated incidents of stealing or lying are normal occurrences of early development they may warrant intervention if they persist. Truancy, arson, antisocial behavior and aggression should not be considered as normal developmental features.
Attention deficit hyperactivity disorder this is characterized by poor ability to attend to tasks, (e.g. makes careless mistakes, avoids sustained mental effort) motor over activity (e.g. fidgets, has difficulty playing quietly) and impulsiveness (e.g. blurts out answer, interrupts others). For the diagnosis to be made, the condition must be evident before age 7 years, present for >6 months, seen both at home and school and impeding the child's functioning. The condition is diagnosed in 3-7% of school-age children.
Methylphenidate (initiated by specialists only) is a stimulant medication that provides reduction of symptoms, at least in the short term.2 Management usually includes family therapy (a programmed of behavioral modification for the child and the parents), although further research confirming its benefits is needed. 3, 4, 5 Essential fatty acids may alleviate some symptoms.6
Sleeping Problems
Sleep disorders can be defined as too much or too little sleep than is appropriate for the age of the child. By the age of 1-3 months the longest daily sleep should be between midnight and morning. Sleeping through the night is a developmental milestone but at the age of 1 year 30% of children may still be waking in the night. Stable sleep patterns may not be present until age 5 years but parental or environmental factors can encourage the development of circadian rhythm.
Sleep disturbance can have a deleterious affect on the cognitive development of children, as well as the functioning of the parents. One study of 2-3 year olds found a significant link between sleep disturbance and emotional and behavioral disorders.7 other links include memory loss and obesity.8
Regular bedtimes, quieter activities and the creation of marked differences between the sounds, activities and light levels associated with night time sleeping and daytime activities may help to encourage better sleep patterns. A solid evidence base now supports the use of behavioral treatments in infants and pre-school children (under 5).9 All of these are based on the objective of the parents gaining control of the bedtime routine. They include unmodified extinction (ignoring the child's cries but monitoring for illness or injury), modified extinction (ignoring the child for a specified period of time) and positive routines (doing some quiet pre-sleep activity and ensuring that falling asleep is associated with a positive parental-child interaction).10 One study found that parental interventions that encourage independence and self-soothing were associated with extended and more consolidated sleep compared to more active interactions that were associated with shorter and more fragmented sleep.11
Hypnotherapy has been found to be of benefit in school-age children.12
The BNF for Children states that the use of hypnotics, except for occasional short-term treatment of night terrors and sleep-walking, is never justified.13 However, it is recognized that the treatment of pediatric insomnia is an area that needs further research.14
Melatonin is sometimes of benefit in sleep disorder associated with visual impairment, cerebral palsy, attention deficit hyperactivity disorder and autism. It is unlicensed for this indication and specialist supervision is recommended for initiation and monitoring.13