Children & Adolescents

Mental health affects the way we think, feel and act. It is crucial to address the needs of emotional wellbeing among children to help them move forward in their unique journeys of development. At Mind Plus, we care for and understand the emotional and behavioural demands that kids and young people may experience in current times. We have extensive assessment tools and intervention strategies administered by a team of proficient psychiatrists, psychologists and therapists. 

Common Mental Health Disorders prevalent among Children

Autism Spectrum Disorder (ASD)

Autism Spectrum Disorder, is a complex neurodevelopmental disorder characterized by abnormalities/challenges in social skills, verbal & non verbal communication and unusual /repetitive behaviors and interests. It typically has an onset in the preschool years, but some symptoms can even be present in a child of 2 years or so. ASD is defined as a spectrum disorder because its symptoms, abilities, and characteristics are expressed in many different combinations and in any degree of severity.

Common signs & symptoms:

  • Failure to initiate or sustain social conversations
  • Inability to make eye contact
  • Failure to follow the gestures when you point things out
  • Have narrow interests and activities
  • React atypically to sights, textures, smell and sounds.
  • An urge to follow patterns and routines.
  • Unusual repetitive actions and movements of a part or whole body eg, rocking back-forth, flapping hands etc.
  • Delayed speech and atypical speech patterns eg. repeating a word/sound
  • Unusual attachments to toys or strange objects such as keys, light switches etc.

Do you recognise some of these symptoms in your child? Diagnosis is possible as early as 2 years. Childhood Autism Rating Scale (CARS) is a popular tool of standardised assessment. Early interventions with a good mix of behaviour therapy, social skills training and if required special education can help individuals with ASD achieve near normal functioning depending on the severity of the symptoms.

Attention Deficit Hyperactivity Disorder (ADHD)

Children with ADHD display persistent age inappropriate symptoms of inattention, hyperactivity, and impulsivity that are sufficient to cause impairment in most activities of daily living.

It is more commonly prevalent in boys than girls, and in younger children as compared to adolescents. On the face of it, we generally think that such children are just ‘naughty’ or ‘too young to concentrate on things’, ADHD leads to children having more trouble than their peers with thinking, learning, expressing feelings or controlling behaviour. Their impulsivity and overreactivity may also cause severe disruptions in their social interactions.

  • Get distracted easily
  • Show prominent restlessness and impulsivity
  • Unable to sit in one place for a substantial duration
  • Rarely completed an activity before moving on to the next task
  • Failure to follow instructions
  • Constantly fidgets eg taps the hand or squirms on the chair
  • Have trouble waiting for turns or seem to answer questions without thinking through
  • Have troubled social relations due to their impulsivity and inattention eg. lack of friends in class
  • Shows signs of hyperactivity in inappropriate environments eg classroom
  • Performs relatively poorly in studies or activities which require persistent focus 

Can you identify some of these signs in your child? Early identification and a comprehensive plan of intervention can be beneficial. Common pathways of treatment include behaviour therapy, parent management training, educational support and medication if necessary.

Specific Learning Disorder (SLD)

Having a strong academic skill set has been regarded as a marker of success at school and coping with life in general. Unlike popular belief, this group of disorders is not related to the child’s level of intelligence or motivation. A learning disability is an umbrella term for a wide range of learning disorders. Essentially the gap between the individual’s level of achievement (IQ) and actual performance is what signifies a learning disability. A child with SLD has difficulties in receiving and  processing the information.

To be classified as a disorder, the performance problems must significantly interfere with academic achievement or daily living.

The most common types of SLD involve difficulties learning keystone academic skills of reading, writing, spelling, or mathematics. The individual may show a combination of symptoms, which makes analysis difficult but not impossible.

Dyslexia – Impairment in Reading

Reading difficulties include letter and word recognition, speed/fluency of reading, 

Usually, dyslexia involves difficulty in written letters and their sounds. Because of this, it is often presented as reversal errors in written work eg p/b, n/u etc. Persistent difficulty may eventually lead to limited vocabulary, problems in reading comprehension.

Dysgraphia- Impairment in Writing

At times, the child may read properly, however, may face trouble in written expression. Dysgraphia includes more than just ‘poor handwriting’.The physical act of forming letters and words may eventually lead to hindrance in the child’s ability to express ideas.

Dyscalculia- Impairment in Mathematics

A child with a mathematics-based learning disorder may struggle with remembering and organizing numbers, operation signs, and number “facts” or fluent calculation (like 3+2=5 or 3×2=6). Children with math learning disorders might present troubles with counting (such as counting by twos or counting by fives) or have difficulty telling time.

Common traits of Learning Disorders

  • Signs of mirror writing or altering the order of letters and numbers eg. 6/9 2/7
  • -Difficulty copying from the board
  • Inaccurate, hesitant effortful and slow reading
  • Frequent mistakes in reading, writing, recalling numbers
  • Difficulty in grasping age appropriate arithmetic concepts eg addition, subtraction etc.
  • Difficulty in keeping score or telling time
  • Inconsistent form of writing eg cursive/uppercase/lowercase/capital letters
  • Difficulty in organising thoughts on paper
  • While writing, words and letters are often left incomplete
  • Discrepancy between achievement in nonverbal and verbal problem situations eg child may be efficient in solving jigsaw puzzles, but not in sentence completion
  • Difficulty controlling pencils, lines, forming shapes

Does your child show some of these symptoms? And, are they interfering in his/her daily living and performance? Early diagnosis and proper timely intervention can assist in coping with learning disabilities. Popular treatment pathways include educational guidance and support at school and home, play therapy, expressive arts based strategies, behavioral strategies and parent management training.

Conduct Problems

Conduct Problems are identified with age inappropriate actions and attitudes that conflict with the societal norms, family expectations and ideas of mutual respect and rights. These may also include anti-social behaviours ranging from swearing to even assault or vandalism. An individual is beyond ‘mischievous’ and indulges in unhealthy ‘rule breaking’ behaviour consistently, and is also unwilling to accept that their behaviour may hurt or harm others. This is mostly observed in boys than girls. Individuals may show inappropriate behvaiors by age 5 and before age 10 in some cases.

The two kinds of Conduct Problems are-

Oppositional Defiant Disorder – The common feature is defying control of authority figures by not following rules and indulging in behaviors like extreme stubbornness, feeling anger, arguments, and even blaming others for their own behaviours.

Conduct Disorder – A severe form of ODD, it also includes behaviours which are aggressive and antisocial in nature. Most behaviors are intended to hurt others or cause harm to their property disregarding any rights of the other person. In this, the individual not only defies control but also seeks to control others with unruly behaviours eg bullying/threatening others, intentionally destroying property of others etc. 

Common signs of Conduct Problems are-

  • Persistently angry/irritable mood
  • Often argues with authority figures
  • Actively defying rules and instruction at home or school
  • Presence of frequent aggresive behaviors towards animals, people
  • Deliberate destruction of property
  • Lacks empathy or guilt after having done something inappropriate
  • Known to start fights/arguments

Can you identify some of the above mentioned signs of conduct problems in your child? It is important that these are diagnosed early. There are plenty of standardised assessment tools available to clinically identify such problems eg Child and adolescent Symptom Rating Scale, Conduct Disorder Rating Scale (CDRS), Oppositional Defiant Disorder Rating Scale (ODDRS). Prominent treatment pathways include Parent Management Training (PMT), CBT, Play therapy etc. 

Eating Disorders

The patterns of feeding and eating behaviours among children are a normal and crucial part of their development. But at times due to biological factors or allied societal norms or media attention, troublesome eating behaviors can progress to psychological disorders. It affects children and adolescents differently and the causes for either also differ. Among infants and children, Pica is common. And among adolescents, Anorexia Nervosa and Bulimia Nervosa are common.

Pica

An eating disorder among kids which often goes ignored, where the child eats inedible substances for example, clay, hair, chalk, paper etc. It starts off in infancy when the child put things in their mouth as a part of their behaviour to explore the environment. Although, children with Pica also eat normal foods, persistent feeding behaviours of inedible or non nutritional substances are observed. A lot of research suggests that Pica is largely found in kids with intellectual disability.

Anorexia

Eating related problems are commonly noted during adolescence especially when teenagers are coping with negative body image. In anorexia, an individual is often preoccupied with diet and being slim that he/she may indulge in starving oneself to achieve that weight loss. Under the fear of gaining weight and misperception of their body image, they undertake extreme measures that significantly disrupt their daily functioning.

Bulimia Nervosa

Unlike in Anorexia Nervosa, Bulimia Nervosa is recognised by behaviours of over-eating. Individuals usually consume large amounts of food followed by extreme attempts to avoid gaining weight under the feeling of guilt. For the latter, they may choose to indulge in purging (vomiting), intense exercise and crash dieting. This cycle can be very unhealthy if not treated early.

Common traits of Eating Disorders

  • Excessively fearful about gaining weight
  •  Deny feeling hungry
  •  Intense changes in weight
  •  Feeling guilty/ashamed after eating
  •  Have strange eating rituals eg. weigh yourself before eating
  •  Extreme concern with body image eg. frequently check in the  mirror for flawed appearance
  •  Frequent instances of vomiting

Can you identify some of these symptoms in your child? Are they interfering with the child’s physical health and daily living? Early diagnosis with the help of standardized assessment tools like Eating Disorder Examination Questionnaire (EDE-Q) can help to manage them in time and prevent any grave consequences. Popular treatment options include a mix of medicine (if necessary) and psycho-social intervention eg CBT, family therapy etc.