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Childhood schizophrenia - Symptoms and causes

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This severe mental disorder in children involves hallucinations, delusions, and disordered thinking and behavior that can impair the ability to function.

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What Are Signs of OCD in Children and Teens?

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All kids have worries and doubts. But kids with obsessive-compulsive disorder (OCD) often can't stop worrying, no matter how much they want to. And those worries frequently compel them to behave in certain ways over and over again.

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Obsessive compulsive disorder (OCD) is a disorder of the brain and behavior that often begins in childhood. OCD causes severe anxiety in those affected. OCD involves both obsessions and compulsions that take a lot of time and get in the way of important activities, such as school and extracurricular activities, developing friendships, and self-care.

Obsessions are intrusive and unwanted thoughts, images, or urges that occur over and over again and feel outside of the child's control. These obsessions are unpleasant for the child and typically cause a lot of worry, anxiety, and distress.

Common obsessions may include:

Worrying about germs, getting sick, or dying.

Extreme fears about bad things happening or doing something wrong.

Feeling that things have to be "just right."

Disturbing and unwanted thoughts or images about hurting others.

Disturbing and unwanted thoughts or images of a sexual nature.

Compulsions (also referred to as rituals) are behaviors the child feels he or she "must do" with the intention of getting rid of the upsetting feelings caused by the obsessions. A child may also believe that engaging in these compulsions will somehow prevent bad things from happening.

Common compulsions may involve:

Excessive checking (re-checking that the door is locked, that the oven is off).

Excessive washing and/or cleaning.

Repeating actions until they are "just right" or starting things over again.

Ordering or arranging things.

Mental compulsions (excessive praying, mental reviewing).

Frequent confessing or apologizing.

Saying lucky words or numbers.

Excessive reassurance seeking (e.g., always asking, "Are you sure I'm going to be okay?").

In general, OCD is diagnosed when these obsessions and compulsions become so time-consuming that they negatively interfere with the child's daily life. Typically, the obsessions and compulsions become gradually more severe over time until they get to this point.

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Obsessive compulsive disorder (OCD) is a disorder of the brain and behavior that often begins in childhood. OCD causes severe anxiety in children affected. OCD involves both obsessions and compulsions that take a lot of time and get in the way of important childhood activities, such as school and extracurricular activities, developing friendships, and self-care.

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When parents start googling behavior issues, one phrase tends to jump out: oppositional defiant disorder (ODD). It's easy to see why. "The words 'oppositional' and 'defiant' show up in parents' vocabulary fairly frequently," says David Anderson, PhD, a clinical psychologist at the Child Mind Institute. "It's one of the more aptly named diagnoses that exists."

Whether your child has oppositional defiant disorder (or ODD) or not, learning about the disorder can be helpful. That's because the behavior management strategies used in treatment are evidence-based techniques that all parents will benefit from knowing.

What is Oppositional Defiant Disorder (ODD)?

It is normal for children to be oppositional and defiant at least some of the time. In fact, it's a sign of healthy development. So when does a child have oppositional defiant disorder? The diagnosis should not be given, for example, to a toddler who has just discovered that her new favorite word is "no."

ODD is typically diagnosed around early elementary school ages and stops being diagnosed around adolescence. Kids who have ODD have a well-established pattern of behavior problems. Symptoms include:

Being unusually angry and irritable

Frequently losing their temper

Being easily annoyed

Arguing with authority figures

Refusing to follow rules

Deliberately annoying people

Blaming others for mistakes

Being vindictive

All children can have these symptoms from time to time. What distinguishes ODD from normal oppositional behavior is how severe it is, and how long it has been going on for. A child with ODD will have had extreme behavior issues for at least six months.

Another hallmark of ODD is the toll it takes on family relationships. Regular daily frustrations - ignored commands, arguments, explosive outbursts - build up over time, and these negative interactions damage the parent-child bond and reinforce hostile patterns of behavior.

Parenting Under Fire

"Kids who have behavioral issues push parents towards the extremes," says Dr. Anderson. "They push parents to become permissive and they push parents to become hyper-coercive in the hope that a larger amount of control will get the kid to listen."

Neither of these extremes make for ideal parenting. It is never a parent's intention to reinforce bad behavior, and we often don't realize when we're doing it. Here are two common scenarios:

You tell your child to stop playing a game and get ready for bed. He ignores your first two requests. By the third time you ask, you're so mad that you yell.

You tell your child to stop playing a game and get ready for bed. He throws a tantrum because he wants to keep playing. You don't want him to be so worked up before bedtime, so you back down and say he can play for another ten minutes - but then he has to go to bed.

In the first scenario, your child learns that yelling is an acceptable way to get a message across. More subtly, he might also be learning that he can continue ignoring those first few requests - when you escalate the situation is when he knows you're serious.

In the second scenario, your child has learned that throwing a tantrum might give him something that he wants, so he'll be more likely to do it again in the future.

Both of these scenarios can set families up for future conflicts, and the more they are repeated the more they become familiar patterns of behavior that are harder to break out of. Your child doesn't have to have ODD for these scenarios to happen, but repeated negative interactions like these make diagnosing a behavior disorder much more likely.

And just like parents aren't necessarily to blame, neither are the kids, says Dr. Anderson. "Through no conscious effort of the child, he learns through hundreds of trials that this is a way to continue getting what he wants."

This also explains why kids who have ODD might act out more at home. Dr. Anderson notes, "Kids who have ODD are likely to be more oppositional with people they know well, partly because the pathways are so well worn. Whereas in a place like school, where a kid has less control in general over their environment, the types of behaviors that are common to ODD may not pay off as much."

ADHD and Other Risk Factors

There is a very high overlap in kids who have ADHD who are also diagnosed with ODD. Depending on the study, the overlap could be 30 to 50 percent of kids with ADHD also have ODD.

Dr. Anderson explains the connection like this: "Kids with ADHD are biologically loaded to be distractible, to be impulsive, to have difficulty staying in one place for a little while. So kids with ADHD start off doing things that parents perceive as off limits. And then when those kids get negative feedback they start to become even more negatively oriented towards adults." These repeated patterns of negative interactions can lead to developing ODD.

But another pathway into developing ODD has more to do with a child's temperament and might be apparent early on. Children who had a lot of difficulty soothing themselves as toddlers and continue to struggle with an age-appropriate ability to control their emotions in the face of disappointment or frustration can sometimes develop ODD. The adults in their environment might be more inclined to accommodate their demands in order to keep the family functioning as harmoniously as possible.

Kids who have experienced a lot of life stress and trauma are also more likely to develop ODD.

Why Treatment is Important

It's important to get treatment to improve the parent-child relationship, which is crucial to the health and happiness of the entire household. It is also important for your child's future. Some children will grow out of oppositional defiant disorder, but others will continue to have behavior issues, which could lead to peer rejection and difficulty forming healthy relationships, not to mention continued family discord.

They'll also be less likely to achieve their potential. If something doesn't go their way, they might think it's anyone's fault but theirs. Dr. Anderson says they might also "retreat to the places where they know they can get what they want. That might mean that they try even less, push even more on the people who are closest to them, who they actually care about the most, causing even more frayed relationships."

A small percentage of kids with ODD go on to develop something called conduct disorder, which is a more severe behavior disorder that includes criminal acts like stealing, setting fires and hurting people. Getting treatment sooner rather than later improves a child's trajectory.

What Treatment for ODD Looks Like

Parents play a key role in treatment for oppositional defiant disorder. This might be surprising, since children are the ones given the diagnosis, but in ODD the parent-child relationship needs to be repaired, which means both parties need to make changes to get back on track.

All programs have certain goals in common, like helping parents find the middle ground between being too authoritative and too permissive. A behavioral therapist helps parents learn how to train their child's behavior through setting clear expectations, praising kids when they follow through and using effective consequences when they don't. Parents also learn to use these strategies consistently - one reason why behavior management strategies sometimes don't work is because parents try different, conflicting techniques, or don't stick to one program long enough to see gains. Parents and children will also learn problem solving skills they can rely on when they run into issues.

Parent training programs might include sessions with parents and children working together, or just parents alone. Some different programs include:

Parent-Child Interaction Therapy (PCIT)

Parent Management Training (PMT)

Defiant Teens

Positive Parenting Program (Triple P)

The Incredible Years

Clinicians might also recommend social skills training to help improve your child's peer relationships or cognitive behavioral therapy if she is struggling with anxiety or depression.

There is no FDA-approved medication for ODD, but medications are sometimes used as an adjunct to behavioral therapy. Anti-psychotic medications like Abilify (aripiprazole) and Risperdal (risperidone), which have been shown to reduce aggression and irritability, are frequently used in cases where a child is at risk of being removed from the school or home. Stimulant medication may be used if a child has excessive impulsivity, including those who have an ADHD diagnosis. Antidepressants (SSRIs) may be helpful if a child has underlying depression or anxiety.

Regardless of the treatment plan your therapist recommends, parents will need to provide a lot of encouragement. "Make no mistake, kids do not often just suddenly wake up with the insight that they wish their behavior was better and then ask all the adults in their life how they can change," warns Dr. Anderson. "They'll stick with whatever behavior is working for them, even if it's not working that well."

But once the family dynamic begins to change, and kids (and parents) begin to feel more confident in their ability to get along, everyone will be a lot happier.

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What Is Oppositional Defiant Disorder (ODD)? - Child Mind Institute

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Learn about the symptoms of ODD and how treatment can improve the parent-child relationship and improve a child's behavior.

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Background
On November 19, 1975 Congress passed the first federal special education law. That law, called the Education of All Handicapped Children Act (EHA) or Public Law 94-142, established the right of school-aged students with disabilities to receive what Congress called a "free appropriate public education" or, as it's known, FAPE. In 1996, the EHA was amended and the right to a free appropriate public education was extended to preschool-aged children with disabilities ages three through five.

In 1990 the EHA was amended again and renamed the Individuals with Disabilities Education Act or IDEA. IDEA was amended and changed again in 1992, 1997 and 2004. Though still commonly known as IDEA, the name of the 2004 legislation is actually The Individuals with Disabilities Education Improvement Act of 2004 or IDEIA. NOTE: IDEA and IDEIA are used interchangeably and refer to the same law.

IDEA is important because it provides the minimum requirements each state must meet in order to receive federal special education funds. State laws and regulations may exceed the federal requirements. However, no state law or regulation can take away a right given to children and families under the federal law.

The IDEA is divided into 4 parts:

Part A - General Provisions, Definitions and Other Issues

Part B - Assistance for Education of All Children with Disabilities

Part C - Infants and Toddlers with Disabilities

Part D - National Activities to Improve Education of Children with Disabilities

If you are a parent of a school-aged child, you will find most of the information of interest to you in Part B. If your child is under three, you will want to become familiar with the requirements of Part C. In Texas, the Early Childhood Intervention program, or ECI, is responsible for the provision of Part C services.

You can find the regulations for IDEA 2004 here. Please note that this is a large PDF document and may take some time to download.

The first 9 pages summarize the major Changes in the regulation. The next 196 pages provide Analysis of the Comments received regarding the proposed changes to the regulations and can provide parents with some good explanations on the intent of the law. An analysis of the Costs and Benefits of the major changes begins on page 205. The actual regulations start on Page 215 of the document (Pg. 46753 of the Federal Register).

Resources for Learning More About IDEA:

The Legal Framework for the Child-Centered Special Education Process - This online document was developed by Education Service Center Region 18. It is predominately for use by school districts as a resource for ARD committees in developing student IEPs. However, since it contains a summary of the federal and state requirements for special education by topic, it is also a useful resource for parents.

Special Education Rules Side-by-Side - This document, produced by TEA, contains current federal regulations, state laws, and state rules for special education in an easy to use side-by-side format. This is a very useful document for parents. You can keep up with rule changes by being added to the Texas Administrative Code Updates Rules Mailing List.

IDEA Manual ( http://www.disabilityrightstx.org or https://www.thearcoftexas.org/idea-manual/) - Disability Rights Texas and the Arc of Texas produce a manual for parents that explains in simple language the major requirements of the IDEA. The manual also contains sample letters and guides to help parents through the special education process.

Office of Special Education Programs (OSEP) - This federal agency is a division of the U.S. Department of Education. OSEP has a variety of functions designed to provide leadership and support for improving educational results of students with disabilities. Their website also includes many useful Links to other resources useful to parents.

Center for Parent Information & Resources - IDEA Resources

.S. Department of Education's IDEA Website - Information about IDEA, as well as other disability-related issues. Their documents are easy to read and can be easily downloaded from their website.

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en Español * Share * Background On November 19, 1975 Congress passed the first federal special education law. That law, called the Education of All Handicapped Children Act (EHA) or Public Law 94-142, established the right of school-aged students with disabilities to receive what Congress called a "free appropriate public education" or, as it's known, FAPE.

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Section 504 Accommodations & Modifications | Forming a Section 504 Plan | Navigate Life Texas

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If your child needs special accommodations at school with the way content is taught, supported, or tested, you might be able get assistance through a Section 504 plan.

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Depression is a psychiatric disorder that afflicts young people with chronic feelings of sadness or worthlessness-the defining characteristic of the disorder is that it robs a person of the capacity for pleasure. Unhappiness triggered by events is not uncommon in children, but it normally goes away when circumstances change.

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Obsessive and compulsive disorder (OCD) symptoms intensely impact individuals and the entire system...

There is a lot of misinformation out there about intrusive thoughts. Here is your opportunity to...

When I was 9-months pregnant with my second baby, I tried to find a children's picture book to read...

Find Help. Learn More. Support ADAA.

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Generalized Anxiety Disorder (GAD) | Anxiety and Depression Association of America, ADAA

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People with GAD don't know how to stop the worry cycle and feel it is beyond their control.

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Overview

Occasional anxiety is an expected part of life. You might feel anxious when faced with a problem at work, before taking a test, or before making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, school work, and relationships.

There are several types of anxiety disorders, including generalized anxiety disorder, panic disorder, and various phobia-related disorders.

Signs and Symptoms

Risk Factors

Treatments and Therapies

Join a Study

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Occasional anxiety is an expected part of life. You might feel anxious when faced with a problem at work, before taking a test, or before making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time.

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National Institute of Mental Health (NIMH)

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Overview

Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental disorder that causes unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks.

There are three types of bipolar disorder. All three types involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely "up," elated, irritable, or energized behavior (known as manic episodes) to very "down," sad, indifferent, or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.

Bipolar I Disorder- defined by manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depressive symptoms and manic symptoms at the same time) are also possible.

Bipolar II Disorder- defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes that are typical of Bipolar I Disorder.

Cyclothymic Disorder (also called Cyclothymia)- defined by periods of hypomanic symptoms as well as periods of depressive symptoms lasting for at least 2 years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.

Sometimes a person might experience symptoms of bipolar disorder that do not match the three categories listed above, which is referred to as "other specified and unspecified bipolar and related disorders."

Bipolar disorder is typically diagnosed during late adolescence (teen years) or early adulthood. Occasionally, bipolar symptoms can appear in children. Bipolar disorder can also first appear during a woman's pregnancy or following childbirth. Although the symptoms may vary over time, bipolar disorder usually requires lifelong treatment. Following a prescribed treatment plan can help people manage their symptoms and improve their quality of life.

Signs and Symptoms

Risk Factors

Treatments and Therapies

Join a Study

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Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental disorder that causes unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks. There are three types of bipolar disorder. All three types involve clear changes in mood, energy, and activity levels.