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The National Institute of Mental Health Information Resource Center

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The National Institute of Mental Health Information Resource Center

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National Institute of Mental Health (NIMH)

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If you or someone you know has a mental illness, there are ways to get help. Use these resources to find help for yourself, a friend, or a family member.

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The Eating Disorders Program at Texas Children's Hospital was established in 1986. The program provides interdisciplinary inpatient (including 24 hour on-call coverage) and outpatient care for adolescent and young adults with eating disorders. The program also trains the future doctors and psychologists in clinical management of eating disorders.

To support and manage the health of patients, we provide outpatient and inpatient treatment, as determined by medical severity. Our health care professionals are committed to an interdisciplinary team approach with a focus on the healthy development of the patient.

Our team of professionals in the Eating Disorders Program treat the following eating disorders:

Anorexia nervosa

Bulimia nervosa

Binge Eating Disorders or Compulsive Overeating

Unspecified Feeding or Eating Disorders

Other Specified Feeding or Eating disorder

Avoidant Restrictive Food Intake Disorder

Interdisciplinary clinical care involves development and participation in a medical and behavioral evidence-based approach to care. The team consists of 5 board certified Adolescent Medicine physicians, each with three years of fellowship training in the inpatient and outpatient management of eating disorders, clinical psychologists, dieticians, nurses, patient-care extenders, physical therapists, hospital school, child life therapists, hospital chaplain, social work and child adolescent psychiatry consultants.

The Eating Disorder Program at Texas Children's Hospital is a member of the national consortium National Eating Disorder Quality Improvement Collaborative (NEDQIC).

Services

Our health care professionals are committed to an interdisciplinary team approach with a focus on the healthy development of the patient. Interdisciplinary clinical care involves development and participation in a medical and behavioral evidence-based approach to care. Our team meets regularly to coordinate care for our adolescents. Our close collaboration helps each adolescent get the most individualized and comprehensive plan.

Outpatient Treatment

We offer a full team of professionals to help address all aspects of health living. Outpatient Treatment includes:

Medical visits that occur as often as determined necessary by the physician.

Dietitian support is available for individualized intervention of meal planning and nutritional balance.

Individual and family therapists provide psychological and behavioral intervention to address eating concerns, body image and self-esteem concerns, as well as other presenting difficulties with depression or anxiety. In addition, therapists may assist with family communication, helping the family to establish a healthy support system, and education to parents and family members about eating disorders.

Inpatient Treatment

Our inpatient treatment of eating disorder is a medical hospitalization to treat severe malnutrition and medical complications of eating disorders. This program includes:

Daily monitoring from medical professionals and dietitians.

Individual & family provided by team of Psychologists focusing on psychological well-being and transition from hospital to home.

Group therapy is offered three times per week and focuses on coping strategies, distress tolerance, mindfulness, and psychoeducation.

Individual therapy is 2-3 times per week, Family therapy once a week, and Group therapy is 3 times per week.

Hospital school (Monday through Friday)

Monitored physical activity (stretching, strength training and cardiovascular exercise) within our Wellness Center (once medically stable)

Child Life Therapists, including music therapy 2x/week

Hospital Chaplain

Our Team

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The Eating Disorders Program at Texas Children's Hospital was established in 1986. The program provides interdisciplinary inpatient (including 24 hour on-call coverage) and outpatient care for adolescent and young adults with eating disorders. The program also trains the future doctors and psychologists in clinical management of eating disorders.

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If you or someone you know is experiencing a mental health or substance use problem, there are several resources available to find out more information or get connected with help. Check out some mental health resources below:
If you or someone you know is in crisis, contact the Suicide Prevention Lifeline at 1-800-273-TALK (8255), or dial 911 in case of emergency. GENERAL MENTAL HEALTH RESOURCES

Mental Health America

Visit Mental Health America's site for information on mental health, getting help, and taking action.

National Council for Mental Wellbeing

To locate mental health and addictions treatment facilities in your community, use the "Find a Provider" feature on the National Council's website.

National Empowerment Center

The mission of the National Empowerment Center is to carry a message of recovery, empowerment, hope and healing to those diagnosed with a mental illness. The center provides information and advocacy resources.

National Institute of Mental Health (Mental Illness Among U.S. Adults)

The National Institute of Mental Health website provides prevalence statistics pertaining to mental illnesses, including data by age, gender and race.

President's New Freedom Commission on Mental Health

This commission report was released in 2003 as part of an effort to eliminate inequality for Americans with disabilities. It was tasked to "promote successful community integration for adults with a serious mental illness and children with a serious emotional disturbance." The report describes problems and gaps in the U.S. mental health system and makes recommendations for improvements at the federal, state and local levels of government, as well as private and public health care providers.

World Health Organization (Disability from Mental Illness)

The World Health Organization website contains information on the global burden of disease in various parts of the world, including burden due to mental disorders.

National Alliance on Mental Illness

NAMI is a nonprofit, grassroots, self-help, support and advocacy organization of individuals with mental disorders and their families. Their website provides resources on mental disorders that are helpful for people who have experienced mental illness and their families, including support groups, education and training.
DEPRESSION AND SUICIDAL INTENTIONS

American Association of Suicidology

The American Association of Suicidology (AAS) promotes research, public awareness programs, public education and training for professionals and volunteers. AAS also serves as a national clearinghouse for information on suicide.

American Foundation for Suicide Prevention

The American Foundation for Suicide Prevention (AFSP) provides information about suicide, support for survivors, prevention, research and more.

Brain & Behavior Research Foundation

The Brain & Behavior Research Foundation website provides information and downloadable fact sheets on depressive disorders.

Mental Health America

Visit Mental Health America's screening tools page for information on mental health, getting help and taking action.

Depression Screening

The Depression Screening website is sponsored by Mental Health America as part of the Campaign for America's Mental Health. The mission of this website is to educate people about clinical depression, offer a confidential way for people to get screened for symptoms of depression and guide people toward appropriate professional help if necessary.

MoodGYM

MoodGYM has been evaluated in a scientific trial and found to be effective in relieving depression symptoms if people work through it systematically. This website uses cognitive behavioral therapy (CBT) methods to teach people to use ways of thinking that can help prevent depression.

Postpartum Support International

Postpartum Support International's (PSI) website includes resources for support, education and local providers focusing on the emotional changes that women experience during pregnancy and postpartum, including postpartum depression. PSI's toll-free help line is staffed by a team of trained responders who rapidly refer callers to appropriate local resources, including emergency services. 800-944-4PPD (4773)

Progressive Relaxation

Download two progressive relaxation tapes from the Hobart and William Smith Colleges website.

Suicide Prevention Resource Center

The Suicide Prevention Resource Center has fact sheets on suicide by state and by population characteristics, as well as on many other subjects.
NONSUICIDAL SELF-INJURY

Focus Adolescent Services

The Focus Adolescent Services website is designed for parents and covers a wide range of mental health problems, including a section on self-injury.

S.A.F.E. Alternatives (Self-Abuse Finally Ends)

S.A.F.E. Alternatives is a residential treatment program for people who engage in self-injury. The website includes information about self-injury and about starting treatment. S.A.F.E information line: 1-800-DONT CUT (366-8288)
ANXIETY DISORDERS

Anxiety and Depression Association of America (ADAA)

ADAA promotes the early diagnosis, treatment and cure of anxiety disorders.

Benson-Henry Institute for Mind Body Medicine

The Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital has an online store offering CDs, DVDs and books on relaxation techniques.

E-couch

The E-couch website provides information about emotional problems (including depression and anxiety disorders) - what causes them, how to prevent them and how to treat them. It also provides a set of evidence-based online interventions designed to equip the user with strategies to improve mood and emotional state, along with a workbook to track progress and record experiences.

Freedom From Fear

The Freedom From Fear website provides information, screening tools and other resources on many types of anxiety disorders.

International OCD Foundation

The International OCD Foundation includes information about obsessive-compulsive disorder, including information about effective treatments, how to find a health professional who has experience treating the disorder and links to other helpful websites.
PSYCHOSIS AND PSYCHOTIC DISORDERS

Brain & Behavior Research Foundation

The Brain & Behavior Research Foundation website provides downloadable fact sheets on psychotic disorders.

Pendulum

Pendulum is a nonprofit organization providing information on bipolar disorder. The website includes book review, discussion forums, articles and links to other resources.

Schizophrenia.com

Schizophrenia.com provides information, support and education to family members, caregivers and individuals whose lives have been affected by schizophrenia.
SUBSTANCE USE DISORDERS

Centers for Disease Control and Prevention (Smokefree.gov)

Smokefree.gov, created by the Centers for Disease Control and Prevention, provides ideas about how to stop using tobacco. Includes downloadable resources and contacts for online and phone counseling.

National Council on Alcoholism and Drug Dependence, Inc.

The National Council on Alcoholism and Drug Dependence website features information on local resources for getting help for a substance use concern, fact sheets and further information for friends, family members, parents and youth on having a conversation about substance use.

National Institute on Alcohol Abuse and Alcoholism

The National Institute on Alcohol Abuse and Alcoholism is the lead agency for U.S. research on alcohol use disorders and health.

Start Your Recovery

Start Your Recovery works with leading experts in effectively treating substance use issues to offer people a single source of relatable, reliable information at any stage of their recovery journey.

National Institute on Drug Abuse (NIDA)

NIDA provides links to information for parents, teens, health professionals, teachers and others about various drug use problems.

Substance Abuse and Mental Health Services Administration (SAMHSA)

SAMHSA's website has information about substance use disorders of all kinds. It includes information for the public, including families, health professionals, schools and individuals. The website also includes a treatment finder to locate a substance use treatment provider in your area.

DrugScreening.org

DrugScreening.org is a drug use screening site with a questionnaire to help you determine if you or someone you know might have a drug use problem.

AlcoholScreening.org

AlcoholScreening.org is an alcohol use screening site developed by the Boston University School of Public Health. It includes an online test about your own, or someone else's, level of alcohol use, including advice about cutting down or getting professional treatment.
EATING DISORDERS

National Association of Anorexia Nervosa and Associated Disorders (ANAD)

ANAD includes information about eating disorders, how to seek treatment and support groups for people suffering from eating disorders and their families.

National Eating Disorders Association

National Eating Disorders Association has stories of recovery from eating disorders, information about seeking treatment and additional resources for school professionals and caregivers.

National Institute of Mental Health (NIMH)

The NIMH website has links to more information about eating disorders.
HELP LINES

American Psychiatric Association Answer Center

1-888-35-PSYCH (77924)

Live operators available 8:30 a.m. to 6 p.m., Eastern time, refer you to local board-certified psychiatrists.

American Psychological Association of Public Education Line

1-800-964-2000

Follow the automated instructions and press the number 1. Then, an operator will refer you to local board-certified psychologists.

National Suicide Prevention Lifeline

1-800-273-TALK (8255)

This hotline is available 24 hours a day, seven days a week. Calls are transferred to trained counselors in more than 130 sites nationwide. This service also has a new feature for veterans. When veterans, their families or friends call this number and press 1, they can talk to a trained, caring professional in a specialized veterans call center. Calls are free and confidential.

The Trevor Project

1-866-488-7386

This is a free and confidential suicide prevention help line for LGBTQ youth that offers hope and someone to talk to, 24 hours a day.

National Cancer Institute Smoking Quitline

1-877-44U-QUIT (1-877-448-7848)

(English and Spanish)

Smoking Cessation Centers

1-800-QUIT-NOW (1-800-784-8669)

(Available in 17 states; English and Spanish)
SUPPORT GROUPS

Al-Anon and Alateen

Al-Anon and Alateen provide information and support for the family members and friends of people with alcohol problems. The sites include lists of meetings in the United States and Canada.

American Self-Help Group Clearinghouse

American Self-Help Group Clearinghouse is a keyword-searchable database of 1,100 national, international, model and online self-help support groups. Also listed are self-help clearinghouses worldwide, research studies, information on starting face-to-face and online groups and a registry for persons interested in starting national or international self-help groups.

Depression and Bipolar Support Alliance

Use the "Find a Support Group Near You" tool on the Depression and Bipolar Support Alliance website to find out if a support group is meeting in your area. These are peer-led support groups.

Eating Disorders Anonymous

Following the 12-step approach used by Alcoholics Anonymous, Eating Disorders Anonymous can help people struggling with eating disorders. The website lists meetings nationwide.

Narcotics Anonymous and Alcoholics Anonymous

Narcotics Anonymous and Alcoholics Anonymous include information on support groups for drug and alcohol addiction in your area.

Overeaters Anonymous

Following the 12-step approach used by Alcoholics Anonymous, Overeaters Anonymous can help people struggling with compulsive eating and binge eating. The website lists Overeaters Anonymous meetings nationwide.

Recovery International

Recovery International, a self-help mental health organization, sponsors weekly group peer-led meetings in many communities, as well as telephone and Internet-based meetings. Click "Find a Meeting" to find the next Recovery International meeting in your area.

Schizophrenia and Related Disorders Alliance of America (Schizophrenics Anonymous)

Schizophrenics Anonymous is comprised of self-help groups established to support the recovery of people who experience schizophrenia. The website lists locations of self-help groups.

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Mental Health Resources - Mental Health First Aid

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If you or someone you know is experiencing a mental health or substance use problem, there are several mental health resources that can help.

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Eating Recovery Center is accredited through the Joint Commission. This organization seeks to enhance the lives of the persons served in healthcare settings through a consultative accreditation process emphasizing quality, value and optimal outcomes of services.

Organizations that earn the Gold Seal of Approval™ have met or exceeded The Joint Commission's rigorous performance standards to obtain this distinctive and internationally recognized accreditation. Learn more about this accreditation here.

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Eating Disorder Treatment Centers | Anorexia, Bulimia & Binge Eating

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Eating Recovery Center is accredited through the Joint Commission. This organization seeks to enhance the lives of the persons served in healthcare settings through a consultative accreditation process emphasizing quality, value and optimal outcomes of services. Organizations that earn the Gold Seal of Approval™ have met or exceeded The Joint Commission's rigorous performance standards to obtain this distinctive and internationally recognized accreditation.

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Obsessive-compulsive disorder as known as OCD, is a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions)and/or behaviors (compulsions) that he or she feels the urge to repeat over and over (National Institute of Mental Health, 2019). Many people who suffer from OCD typically show signs and symptoms in obsession or compulsions or both, which can interfere with all aspects of life, such as work, school, and personal relationships (National Institute of Mental Health, 2019). 

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Obsessive-compulsive disorder as known as OCD, is a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions)and/or behaviors (compulsions) that he or she feels the urge to repeat over and over (National Institute of Mental Health, 2019). Many people who suffer from OCD typically show signs and symptoms in obsession or compulsions or both, which can interfere with all aspects of life, such as work, school, and personal relationships (National Institute of Mental Health, 2019). 

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National Institute of Mental Health (NIMH)

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Overview

Obsessive-compulsive disorder (OCD) is a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts ("obsessions") and/or behaviors ("compulsions") that he or she feels the urge to repeat over and over.

Signs and Symptoms

Risk Factors

Treatments and Therapies

Join a Study

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Obsessive-compulsive disorder (OCD) is a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts ("obsessions") and/or behaviors ("compulsions") that he or she feels the urge to repeat over and over. Signs and Symptoms Risk Factors Treatments and Therapies Join a Study

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Lo sentimos, la página que usted busca no se ha podido encontrar. Puede intentar su búsqueda de nuevo o visitar la lista de temas populares.

Children who have obsessive-compulsive disorder (OCD) are plagued with unwanted thoughts, images or impulses that are difficult to suppress, causing them great stress and worry. These are called obsessions. To alleviate the anxiety caused by their obsessive thoughts, they perform repetitive, ritualized actions called compulsions. A child with OCD might need to line things up, touch things in a certain order when leaving the room or wash his hands repeatedly.

Obsessions Common in Kids With OCD

Contamination: Kids with this obsession are sometimes called "germaphobes." In schools, this plays out with kids worrying about other kids sneezing and coughing, touching things that might be dirty or getting sick in many different ways. This is the most common obsession seen in children.

Magical thinking: This is a kind of superstition, like "step on a crack, break your mother's back," taken to extremes. For example, kids might worry that their thoughts can cause someone to get hurt, or get sick. A child might think, "Unless my things are lined up in a certain way, mom will get in a car accident."

Catastrophizing: Some kids easily jump to the conclusion that something terrible has happened. For example, if her parents are five minutes late picking her up, a girl who is catastrophizing might tell herself that they've decided to abandon her.

Scrupulosity: This is when kids have obsessive worries about offending God or being blasphemous in some way.

What ifs: Kids may be plagued by a lot of different kinds of thoughts about bad things they could do. "What if I hurt someone? What if I stab someone? What if I kill someone?"

The "just right feeling": When OCD first develops, from about 6 to 9 years of age, kids may not know why they are doing something, but just that they need to do it until they get what we call the "just right feeling." So: "I'll line these things up until it just kind of feels right, and then I'll stop." And then over time - in the 9- to 12-year-old range - it evolves into magical thinking and becomes more superstitious in nature.

Behaviors You Might See in Students With OCD

Frequent requests to go to the bathroom: This could be to wash hands, if someone near the child was coughing or sneezing, or if she touched something that she perceives as contaminated. She could be washing items-pens, pencils, backpacks, books. It could also be an excuse to get out the classroom and just be away from everyone, and have some respite.

Constant reassurance-seeking: This takes the form of repetitive questions. "Are you sure that's the answer? Could you tell me again? Did you hear what I said?" Checking doors, windows, lockers, desks. Over and over and over again.

Getting stuck on tasks: Sometimes kids with OCD will need to finish something to completion, or understand it to completion, before they're able to move on. So if a child is working out what he did wrong on a math test, and the teacher says, "Now let's open the textbook and start a new chapter," he's not going to be able to shift gears.

Retracing: If a child leaves the classroom and worries that she left a pencil behind, she'll go back into the classroom and go to her desk and check. If she had a bad thought as she went through the doorway, she might have to "fix it" by going back through the doorway again saying a good word. If she had a bad thought when she went down a flight of stairs on the way to class, she might need to go back up that same stairway at the end of the period, even if it means being late to her next class.

Obsessive erasing: A child could be erasing a lot because the letters have to look perfect. Or he could have used a word that disturbs him. For example, if he has a fear of vomiting and he's written the word vomit, he might not be able to stand seeing that word, so he erases it. Kids start having erasers worn down to the metal. Teachers start to see holes in the paper. Words will be drawn over on the back of the page. A lot of different areas of writing become problematic.

Behaviors Often Confused With Another Disorder

Some behaviors associated with OCD are easy to confuse with ADHD, learning problems or being oppositional.

Distraction: If a child is busy thinking that if she doesn't turn the pen cap and count to four the right way then her mom is going to get sick, she's not going to be paying attention in class. And if her teacher calls on her to answer a question, her distraction might look like ADHD, but it isn't.

Slowness on exams, papers and tasks: Sometimes when kids take a long time, they're struggling with the perfectionism of needing to do things the right way. This could look like learning problems, or inattention, but it isn't.

Avoidance: Teachers might see a child who doesn't want to sit on the floor, or pick things up that touched the floor, or get his hands dirty in art class. He may avoid a lot of playground activities - kids with germ fears will view the playground the way some adults view the subway: it's gross. Why touch anything there?

Tapping and touching symmetrically: If a child sits down at her desk and she accidentally kicks the chair of the kid next to her with her right foot, she's going to have to then kick it with her left foot. That might look like somebody who's being oppositional, or somebody who's got too much energy, but actually it's OCD.

Complaints of anxiety and fatigue: There's one interesting theory that kids with OCD are smarter than other kids. And if you consider how much thinking they're doing, they're really using their brain more frequently than a lot of other kids are. But when that's coupled with a lot of anxiety, you can have a lot of fatigue. So it's common for kids with OCD to want to come home and take a nap after school.

How to Help Students With OCD

For children struggling with OCD, functioning in school can be complicated and very difficult. Here are some things you can do to help them, and the class as a whole, focus on learning:

Seating arrangement: If the school has noisy hallways, you might not want to have a child with OCD sit by the door. You might have her sit in the front, where she's less able to hear the noise and can stay more focused on her work. On the other hand, a child who has very observable symptoms, and doesn't want other kids to see her fidgeting with her hands, rocking or getting up a lot, might be better off closer to the door, toward the back of the room.

Extended time for tests and papers: If writing is a problem for a child who needs to find the perfect way to say something, he's going to need more time to finish those essay questions or papers.

Laptops for writing: If writing and rewriting/erasing is really problematic for a child, consider letting her use a laptop for taking notes, and having all assignments be typed instead of handwritten.

Private testing rooms: Research is quite clear that kids with OCD do better, are less overwhelmed and are more in control of their thoughts and their reactions if they're in a quiet place away from the other kids.

Skip reading out loud: Kids who feel they need to read perfectly may have to go back and reread sentences or whole paragraphs over and over to make sure they've got them right. So reading becomes a very laborious task, and reading in front of the class can become a nightmare. So if we know doing this is a problem for children, we can spare them.

Books on tape: If kids get so hung up reading that it takes forever, listening to the books can be a solution.

Break homework into chunks: If looking at a whole page of math makes kids feel overwhelmed and anxious - think of the potential for mistakes! - the problems can be broken up over four pages. It helps kids stay focused on doing the problems instead of worrying.

How to Minimize Behavioral Problems

Plan an escape route: Try working out a communication system so that if the student feels symptoms coming on, she can signal to you and leave the classroom, or go to a protected place in the classroom, without interrupting the class. It can prevent an embarrassing and disruptive blowup of symptoms in the classroom, and the other kids picking on or bullying her about it.

Be aware of triggering events: It's very important for teachers to know what kind of things might trigger the symptoms. Fatigue is a huge piece of OCD, and it can be exacerbated by medication. So it's important to know that if a child is drowsy in class, and maybe he's putting his head down, it's not because he's being oppositional or disrespectful, but because he's overwhelmed with fatigue.

Advance notice: Irritability and frustration are two of the longer-lasting things that kids with OCD are feeling on a daily basis. Changes in schedule can be very disruptive for a child with OCD, so it can be helpful for teachers to give advance notice of things. Kids who know what to expect are less likely to be thrown by the change.

Children with OCD are often teased and bullied because of their symptoms. Kids feel very uncomfortable about their rituals, knowing that they're being watched. It can be helpful to educate the whole class about what's going on, especially if a child is going to be in the same school for a number of years, and it can inspire a surprising amount of support from other children.

Peer understanding program: A peer understanding program includes a presentation in the classroom that explains (with the child participating) what OCD is. The child might say, "Listen, I have OCD. It's an anxiety disorder. It makes me think that my hands are dirty and I have to wash my hands a lot, so if you see me getting up and going to the sink to wash my hands, that's why." Psychologists can role-play with the teacher and child ahead of time, to anticipate questions his classmates might ask, and how to answer them.

A buddy system: A buddy is like a peer coach who sits next to the child and prompts him to keep up with note taking and staying on task. It can be great for the buddy, to foster a sense of confidence and pride and to be able to help someone in need, and great for fostering friendship.

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Lo sentimos, la página que usted busca no se ha podido encontrar. Puede intentar su búsqueda de nuevo o visitar la lista de temas populares. Children who have obsessive-compulsive disorder (OCD) are plagued with unwanted thoughts, images or impulses that are difficult to suppress, causing them great stress and worry.

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American School Counselor Association (2021). ASCA Student Standards: Mindsets and Behaviors for Student Success. Alexandria, VA.

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American School Counselor Association (2021). ASCA Student Standards: Mindsets and Behaviors for Student Success. Alexandria, VA.

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Mental illness is the most common disease adolescents suffer from in society today, and it can affect an individual mentally, physically, emotionally, and socially. According to the Centers for Disease Control and Prevention (2021), among the more common mental disorders that can be diagnosed in childhood are attention-deficit/hyperactivity disorder (ADHD), anxiety, and behavior disorders.

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Mental illness is the most common disease adolescents suffer from in society today, and it can affect an individual mentally, physically, emotionally, and socially. According to the Centers for Disease Control and Prevention (2021), among the more common mental disorders that can be diagnosed in childhood are attention-deficit/hyperactivity disorder (ADHD), anxiety, and behavior disorders.

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Centers for Disease Control and Prevention

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ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood.

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Bipolar Disorder in Teens and Young Adults: Know the Signs

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Bipolar Disorder in Teens and Young Adults: Know the Signs

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A Closer Examination of Bipolar Disorder in School-Age Children

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A Closer Examination of Bipolar Disorder in School-Age Children

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A Closer Examination of Bipolar Disorder in School-Age Children

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IEP vs. 504 Plan: What Is the Difference Between IEP and 504 Plan?

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IEP vs. 504 Plan: What Is the Difference Between IEP and 504 Plan?

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IEP vs. 504 Plan: What Is the Difference Between IEP and 504 Plan?

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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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Individuals with Disabilities Education Act (IDEA)

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Individuals with Disabilities Education Act (IDEA)

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Individuals with Disabilities Education Act

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Individuals with Disabilities Education Act (IDEA)

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The U.S. Department of Education’s Individuals with Disabilities Education Act website brings together department and grantee IDEA information and resources. The IDEA makes available a free appropriate public education to and ensures special education and related services to eligible children with disabilities.

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Accommodations for students with bipolar disorder and related disabilities 

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Accommodations for students with bipolar disorder and related disabilities 

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Not all students who have disabilities require specialized instruction. For students with disabilities who do require specialized instruction in the United States, the IDEA controls the procedural requirements and an IEP is developed. "Special education" under IDEA means the child has been identified as having unique educational needs related to his/her disability and is entitled to an Individualized Education Program (IEP) to meet these needs.

The IDEA process is more involved than that of Section 504 of the Rehabilitation Act. The IDEA requires that measurable growth and progress towards written goals and objectives be documented.

For students with disabilities who do not require specialized instruction but need the assurance that they will receive equal access to public education and services, a document is created to outline their specific accessibility requirements. Section 504 is a federal civil rights law. The purpose of Section 504 is to protect persons with disabilities against discrimination for reasons related to their disabilities.

While students with a 504 plan do not require specialized instruction, and specific goals and objectives are not necessarily outlines nor is data tracked, the plan should be reviewed annually to ensure that the student is receiving the most effective accommodations for his/her specific circumstances.

Unlike IDEA, Section 504 does not guarantee that a child with a disability will receive an individualized educational program that is designed to meet the child's individual educational needs. Rather, it guarantees that accommodations will be made relative to their specific medical needs.

Eligibility for protections under Section 504 depends on the child in question having a physical or mental impairment which must substantially limit at least one major life activity. Major life activities include walking, seeing, hearing, speaking, breathing, learning, reading, writing, performing math calculations, working, caring for oneself, and performing manual tasks. Section 504 requires an evaluation that draws information from a variety of sources.

A child who receives Section 504 protections has fewer rights than the child who receives special education services under the IDEA. The child who receives special education services under the IDEA is automatically protected under Section 504.

Section 504 is designed to guarantee that children with disabilities will not be discriminated against. It is also important to understand that if your child does not qualify for special education services under IDEA, your child does not have the procedural protections that are available under the IDEA.

Under Section 504, the child with a disability may receive accommodations and modifications that are not available to children who are not disabled. These accommodations and modifications are also available under IDEA. For example; accommodations could include, but not be limited to, such things as:

Tests taken in a separate location with time limits waived or extended.

The use of a word processor due to fine motor, visual motor deficits.

Shortened assignments.

Standardized tests answers written directly in the test booklet and transferred onto answer sheet by teacher or assistant.

Class notes provided rather than having the student copy from the chalkboard or overhead.

Allowing the child to leave the classroom 2 to 3 minutes early to avoid crowded hallways.

Preferential seating in the classroom.

Provision of a daily assignment sheet to be filled out by the student and verified by the teacher for accuracy. The parent could then check to make sure that all the work is accomplished. This would assist with homework prioritizing and management.

Please note: These are simply examples. All or none of these may be suitable for your child.

Students with bipolar disorder may or may not have a need for specialized instruction provided within an IEP. For some students, simply being granted accommodations that make allowance for the side effects of medications, related anxiety issues, or results of mood changes is sufficient.

Students with bipolar disorder who are well-controlled on medication may or may not be plagued by racing thoughts, distracting thoughts, an inability to concentrate, decreased energy; all of which will require modifications in the teaching environment or instructional strategies.

For other students, the side effects of medications may be significant enough to require changes in instruction provided or curriculum modifications. Some of the common side effects of medications include: tremors (trembling of hands), blurred vision, loss of coordination, slurred speech, sedation, ataxia (unsteady movement), dizziness, seizures. Some students with bipolar disorder may also have one of a number of other disabilities that impacts their access to the general education curriculum; such as vision or hearing impairment, learning disability, processing problems, or other disability. The co-morbidity rates of ADHD, anxiety disorder, conduct disorder, oppositional-defiant disorder and learning disabilities in students with bipolar disorder tell us that we should explore all avenues available to meet the educational needs of our children.

The following accommodations are meant to serve as a resource for parents unsure of what possibilities exist:

Students on some medications may need:

increased access to water, unlimited access to restrooms (particularly students taking Lithium)

decreased reading assignments or having books on tape or computer screen-reading due to blurred vision

modified school arrival, shortened day, scheduling of core content during the student's most alert time, reducing homework and extending deadlines, providing notes, allowing longer or more frequent breaks, allowing exercise or other movement due to sleep impairment or to sedation of medications

provision of notes and listening guides, work monitoring, extended time on assignments, extra set of books for home use, breaking assignments into more manageable pieces, use of checklists, providing written instructions and/or other visual cues, use of word banks on fill-in types of tests and other modifications that aid retrieval/memory, testing in a separate room, or extended test time, use of multiple choice formats, use of oral exams rather than written demands, use of noise-canceling headsets, - all for impaired concentration, memory

reducing or discontinuing homework may be necessary for some students due to difficulties with concentration, sleep patterns, mood irritability. For these students it may be necessary to schedule a resource room period at the beginning of the day to get assignments ready for the day, or at the end of the day to complete assignments before leaving school

preferential seating can be used to help with vision, focus, reduce visual or auditory distraction, allow for discrete monitoring

and while a 504 plan will simply list the type of accommodation needed and the reasons for it/them, an IEP must contain objectives that are written with specific criteria; such as -Given a grade level reading assignment of 1 chapter with 4 comprehension questions, (name) will answer the questions with 60/70/80% accuracy. Or given an assignment containing 5 long division problems, (name) will complete 3/4/5 problems at 80% accuracy.

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Accommodations for Students with Bipolar Disorder and Related Disabilities - International Bipolar Foundation

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Error! You must specify a value for the Video ID, Width, Height and Anchor parameters to use this shortcode! Not all students who have disabilities require specialized instruction. For students with disabilities who do require specialized instruction in the United States, the IDEA controls the procedural requirements and an IEP is developed.

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 What Do Mental Health Professionals Do in Schools?

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 What Do Mental Health Professionals Do in Schools?

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What do mental health professionals do in schools (1)

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Appropriate and Inappropriate Activities for School Counselors 

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Appropriate and Inappropriate Activities for School Counselors 

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ASCA Ethical Standards for School Counselors

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ASCA Ethical Standards for School Counselors

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American Counseling Association Code of Ethics

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American Counseling Association Code of Ethics

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Eating Disorders are serious but treatable disorders that are characterized as mental health illnesses. Eating disorders are often associated with preoccupations with food, weight, shape, anxiety about eating, or the consequences of eating certain foods. According to American Psychiatric Association (2021), eating disorders affect several million people at any given time, most often women between the ages of 12 and 35, and often co-occur with other psychiatric disorders most common mood and anxiety disorders, obsessive-compulsive disorder, and alcohol and drug abuse problems.

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Eating Disorders are serious but treatable disorders that are characterized as mental health illnesses. Eating disorders are often associated with preoccupations with food, weight, shape, anxiety about eating, or the consequences of eating certain foods. According to American Psychiatric Association (2021), eating disorders affect several million people at any given time, most often women between the ages of 12 and 35, and often co-occur with other psychiatric disorders most common mood and anxiety disorders, obsessive-compulsive disorder, and alcohol and drug abuse problems.

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What Is Anorexia?

Also known as anorexia nervosa, this eating disorder is a serious mental health issue with potentially life-threatening consequences. Since anorexia symptoms tend to develop slowly over time, they can be difficult to recognize. Fortunately, the dedicated clinicians at Eating Disorder Solutions can diagnose this eating disorder and provide treatment.

Most often, anorexia develops in teenage girls. However, it is problem that can develop at any age, and affects many adults as well. Sadly, anorexia is the most commonly diagnosed eating disorder in the country.

In general, anorexia nervosa is characterized by an obsession with body shape, food intake and weight to the point of starvation. Individuals with anorexia restrict how much they eat because they worry about being fat even when they aren't. They may even lose more weight than is healthy for their age and height. Some of them achieve weight loss by purging, excessive exercising, taking diuretics or laxatives, or a combination of these unhealthy behaviors.

Usually, individuals with anorexia have trouble coping with their emotions, have low self-esteem and feel like they don't meet everyone else's standards. They may also struggle with negative situations or traumatic events in their lives. Eating Disorder Solutions takes a multifaceted approach to anorexia nervosa recovery in Dallas, Texas. We believe that recovery is possible when individuals learn to manage their anorexia symptoms, emotions, resolve underlying problems and eat a balanced diet. Our mission is to teach each client how to achieve these goals.

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Symptoms of Anorexia

Although the most prevalent symptoms of anorexia nervosa are starvation and an obsession with body shape, food intake and weight, there are many others to be aware of. Some of the most obvious physical anorexia symptoms include a thin appearance, extreme weight loss, cold intolerance, dizziness, frequent fatigue and seizures. Other symptoms may be concealed or only discovered by a doctor:

Abdominal pain and constipation

Abnormal blood count

Bluish fingers and brittle nails

Decreased libido in adults

Dehydration

Dry skin and hair loss

Elevated liver enzymes

Irregular heart rate

Loss of bone calcium (Osteoporosis)

Low blood pressure

Skipped period in girls or women

Swollen arms and legs

Teeth erosion from purging

Typically, individuals with anorexia constantly worry about calories and following a strict diet. They often pretend that they aren't hungry when they are, are terrified of weight gain, lie about how much they eat and have trouble sleeping. In addition, their self-esteem revolves around an unrealistic perception of their appearance and expectations of how they should look.

We discuss all of these possible behavioral issues and distorted beliefs when we assess individuals for anorexia symptoms. In doing so, we can provide an accurate diagnosis and begin to develop a personalized treatment plan.

Warning Signs of Anorexia

Even before individuals develop anorexia symptoms, their loved ones might notice red flags that something is wrong. Sometimes, self-aware individuals notice these signs of anorexia in themselves. Generally, the early signs revolve around an obsession over dieting and restricting food intake, such as:

Adopting eating rituals, such as weighing food and spitting it out after chewing

Avoiding eating in public

Making excuses for not eating

Not eating elaborate meals that they cook for others

Only eating what they believe are "safe" foods

Refusing to eat anything or specific food groups, such as carbohydrates and fats

Skipping meals

The warning signs of anorexia might be difficult to differentiate from normal dieting behaviors at first. Other times, it's hard to determine what is considered underweight because it's different for each individual.

Over time, these early anorexia symptoms get worse, and the habits become time-consuming. Eventually, those closest to the individual begin to notice, which can potentially disrupt their career, education and relationships. Other habits that loved ones might notice include:

Avoiding friends and losing interest in regular activities

Frequently measuring or weighing themselves

Complaining about being overweight

Repeatedly looking for "flaws" in the mirror

Difficulty concentrating

Developing a lack of emotion

Wearing layers or baggy clothes to hide their weight

Individuals don't always experience all of these behavioral, mental and physical signs. However, they typically have several. It's critical for anyone suffering to seek treatment when they notice any anorexia symptoms in themselves or loved ones. By getting help as soon as possible, they can prevent the potentially life-threatening side effects.

Anorexia Treatment Programs

A diagnosis and thorough treatment are necessary when individuals recognize anorexia symptoms. However, it's important that they don't try to diagnose or treat this eating disorder on their own. Instead, they'll require access to the right level of professional care in order to address all of their needs.

The team of doctors, nurses, dietitians and therapists at Eating Disorder Solutions have a vast amount of experience treating anorexia nervosa. We can provide comprehensive treatment options that addresses the emotional, mental and physical problems from which clients suffer. With a combination of individual counseling, group therapy, nutritional education and family therapy, we can tackle the obstacles that contribute to anorexia symptoms and habits. In fact, our facility offers four levels of treatment in order to meet varying needs throughout the recovery process.

Our residential program is the highest level of care at our facility. In fact, we're one of very few facilities that offer such a high level of care for eating disorders. This program requires individuals who suffer from anorexia symptoms live at our treatment center until they are stable and ready to return home. While the duration of treatment might only be a few weeks for some individuals, others may need a few months.

During residential treatment clients will receive 8 to 10 hours of therapy every day. On the weekends, we plan special outings for those who participate in the recovery program. We like to get families involved in counseling as well so that they can learn about what their loved ones are going through and how to support them at home after residential treatment.

As part of our full continuum of care, our team continues to provide guidance as individuals adjust to living at home after residential treatment. Anorexia symptoms can creep back up when individuals have to deal with life stressors on their own making ongoing support critical.

Through our partial hospitalization eating disorder program, we aim to avoid that. It involves visiting our facility five or six days a week for five hours of therapy each day. The actual amount of time that individuals spend in treatment will depend on their specific recovery needs. Although it doesn't include 24-hour support, it continues to provide structure our clients' lives to help them stay on track.

Similar to our partial hospitalization program, our intensive outpatient eating disorder program prevents the recurrence of anorexia symptoms by providing ongoing support during recovery. It consists of visiting our facility three days a week for three hours each day. How long each individual spends in the program depends on how much guidance that they need.

Although it includes the lowest level of care for eating disorders, our standard outpatient eating disorder program provides ongoing therapy for clients who request it. They visit our treatment center once or twice a week for one hour of counseling each time. By choosing this program, they ensure that they get continuous guidance to maintain their recovery.

If you or someone you love suffers from anorexia symptoms, don't hesitate to seek treatment. Get the right level of care to prevent the dangerous effects of anorexia and begin the path to a healthy future. Reach out to the specialists at Eating Disorder Solutions for extensive, customized treatment today.

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Anorexia Signs & Symptoms | Eating Disorder Solutions

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Also known as anorexia nervosa, this eating disorder is a serious mental health issue with potentially life-threatening consequences. Since anorexia symptoms tend to develop slowly over time, they can be difficult to recognize. Fortunately, the dedicated clinicians at Eating Disorder Solutions can diagnose this eating disorder and provide treatment.

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Any person, at any stage of their life, can experience an eating disorder. More than one million Australians are currently living with an eating disorder (1).

Of people with eating disorders, 12% have bulimia nervosa compared to 3% with anorexia nervosa, 47% with binge eating disorder and 38% with other eating disorders (1). Of people with bulimia nervosa, 70% are female (2).

Eating disorders are not a choice but are serious mental illnesses. Eating disorders can have significant impacts on all aspects of a
person's life - physical, emotional and social. The earlier an eating disorder is identified, and a person can access treatment, the greater the opportunity for recovery or improved quality of life.
Figure 1. Prevalence of eating disorders by diagnosis
What is bulimia nervosa?
Bulimia nervosa frequently begins during or after a period of dieting. A person with bulimia nervosa will experience a sense of lack of control and will eat a large amount of food within a relatively short period of time. The person will often feel guilt and shame during or after the episode and will engage in compensatory behaviours with the intention to prevent weight gain.
Bulimia nervosa is a serious, potentially life-threatening mental illness. Bulimia nervosa is characterised by recurrent episodes of binge eating, followed by compensatory behaviours, such as vomiting or excessive exercise to prevent weight gain.

A person with bulimia nervosa can become stuck in a cycle of eating in an out-of-control manner, followed by attempts to compensate for this, which can lead to feelings of shame, guilt and disgust. These behaviours can become more compulsive and uncontrollable over time, and lead to an obsession with food, thoughts about eating (or not eating), weight loss, dieting and body image.

These behaviours are often concealed and people with bulimia nervosa may attempt to keep their eating and exercise habits secret. As a result, bulimia nervosa may go undetected for a long period of time.

Characteristics of bulimia nervosa
Binge eating
Binge eating involves two key features:

* Eating a very large amount of food within a relatively short period of time (e.g., within two hours)
* Feeling a sense of lack of control over eating (e.g., feeling unable to stop yourself from eating)
Compensatory behaviours
Compensatory behaviours are used as a way of trying to prevent weight gain after binge eating
episodes. They include:

* Vomiting
* Misusing laxatives or diuretics
* Fasting
* Excessive exercise
* Use of any drugs, illicit, prescription and/or 'over the counter', inappropriately for weight control

Self-evaluation
A person with bulimia nervosa places an excessive emphasis on body shape or weight in their self-evaluation. This can lead to the person's sense of self-esteem and self-worth being largely defined by the way they look.

Risk factors

The elements that contribute to the development of bulimia nervosa are complex, and involve a range of biological, psychological, and sociocultural factors. Any person, at any stage of their life, is at risk of developing an eating disorder. An eating disorder is a mental illness, not a choice that someone has made.

Warning signs

The warning signs of bulimia nervosa can be physical, psychological, and behavioural. It is possible for a person with bulimia nervosa to display a combination of these symptoms, or no obvious symptoms.

* Signs of damage due to vomiting including swelling around the cheeks or jaw, calluses on knuckles, damage to teeth and bad breath
* Feeling bloated, constipated or developing intolerances to food
* Loss of or disturbance to menstruation
* Fainting or dizziness
* Fatigue or lethargy
* Sleep disturbances
* Compromised immune system (e.g., getting sick more often)
* Sudden weight loss, gain or fluctuation

* Preoccupation with eating, food, body shape and weight
* Intense fear of gaining weight
* Preoccupation with food or activities relating to food
* Heightened anxiety or irritability around mealtimes
* Heightened sensitivity to comments or criticism (real or perceived) about body shape or weight, eating or exercise habits
* Low self-esteem and feelings of shame, self-loathing or guilt
* Body dissatisfaction and negative body image
* Depression, anxiety, self-harm or suicidality
* Obsession with food and need for control

* Repetitive dieting behaviour such as counting calories, skipping meals, fasting or avoidance of certain foods or food groups
* Evidence of binge eating such as disappearance or hoarding of food
* Evidence of vomiting or misuse of laxatives, appetite suppressants, enemas and/or diuretics
* Frequent trips to the bathroom during or shortly after meals
* Patterns or obsessive rituals around food, food preparation and eating
* Avoidance of, or change in behaviour in social situations involving food
* Social withdrawal or isolation from friends and family
* Secretive behaviour around eating
* Compulsive or excessive exercising
* Substance misuse
* Inappropriate hydration behaviours

It is never advised to 'watch and wait'. If you or someone you know may be experiencing an eating disorder, accessing support and treatment is important. Early intervention is key to improved health and quality of life outcomes.

Impacts and complications

A person with bulimia nervosa may experience serious medical and psychological consequences (3, 4).

Some of the medical impacts and complications associated with bulimia nervosa include:
* Chronic sore throat, indigestion, heartburn and reflux
* Inflammation and rupture of the oesophagus and stomach from frequent vomiting
* Stomach and intestinal ulcers
* Chronic irregular bowel movements, constipation and/or diarrhoea due to deliberate misuse of laxatives
* Heart problems including slow heart rate, irregular heartbeat and low blood pressure
* Electrolyte disturbance, including potassium and sodium
* Osteoporosis or osteopenia: a reduction in bone density caused by a specific nutritional deficiency
* Fatigue and lethargy
* Loss of or disturbance to menstruation
* Increased risk of infertility
* Death

Some of the psychological impacts and complications associated with bulimia nervosa include:
* Extreme body dissatisfaction/distorted body image
* Obsessive thoughts and preoccupation with eating, food, body shape and weight
* Social withdrawal
* Feelings of shame, guilt, and self-loathing
* Depressive or anxious symptoms and behaviours
* Self-harm or suicidality
* Substance misuse

It is possible to recover from bulimia nervosa, even if a person has been living with the illness for many years. The path to recovery can be long and challenging, however, with the right team and support, recovery is possible. Some people may find that recovery brings new understanding, insights and skills.

Treatment options

Access to evidence-based treatment has been shown to reduce the severity, duration and impact of bulimia nervosa.

Evidence-based psychological therapies to consider for the treatment of bulimia nervosa in children and adolescents include:
* Eating disorder-focused CBT (CBT-ED) with family involvement
* Bulimia nervosa-focused family therapy (5)

Evidence-based psychological therapies to consider for the treatment of bulimia nervosa in adults include:
* Guided self-help CBT-ED
* CBT-ED
* Interpersonal psychotherapy (IPT) (5)

Most people can recover from an eating disorder with community-based treatment. In the community, the minimum treatment team includes a medical practitioner such as a GP and a mental health professional.

Inpatient treatment may be required when a person needs medical and/or psychiatric stabilisation, nutritional rehabilitation and/or more intensive treatment and support.

Getting help

If you suspect that you or someone you know may have bulimia nervosa, it is important to seek help immediately. The earlier you seek help the closer you are to recovery. Your GP is a good 'first base' to seek support and access eating disorder treatment.

To find help in your local area go to NEDC Support and Services.

1. Deloitte Access Economics. Paying the price: the economic and social impact of eating disorders in Australia. Australia: Deloitte Access Economics; 2012.
2. Hay P, Girosi F, Mond J. Prevalence and sociodemographic correlates of DSM-5 eating disorders in the Australian population. J Eat Disord. 2015;3(1):1-7.
3. Gibson D, Workman C, Mehler PS. Medical complications of anorexia nervosa and bulimia nervosa. Psychiatr Clin North Am. 2019;42(2):263-74.
4. Allen KL, Byrne SM, Oddy WH, Crosby RD. DSM-IV-TR and DSM-5 eating disorders in adolescents: prevalence, stability, and psychosocial correlates in a population-based sample of male and female adolescents. J Abnorm Psychol. 2013;122:720-32.
5. Heruc G, Hurst K, Casey A, Fleming K, Freeman J, Fursland A, et al. ANZAED eating disorder treatment principles and general clinical practice and training standards. J Eat Disord. 2020;8(1):63.
Download the bulimia nervosa fact sheet here.

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Any person, at any stage of their life, can experience an eating disorder. More than one million Australians are currently living with an eating disorder (1). Of people with eating disorders, 12% have bulimia nervosa compared to 3% with anorexia nervosa, 47% with binge eating disorder and 38% with other eating disorders (1).

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Centers for Disease Control and Prevention

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Many children have fears and worries, and may feel sad and hopeless from time to time. Strong fears may appear at different times during development. For example, toddlers are often very distressed about being away from their parents, even if they are safe and cared for. Although fears and worries are typical in children, persistent or extreme forms of fear and sadness could be due to anxiety or depression. Because the symptoms primarily involve thoughts and feelings, they are sometimes called internalizing disorders.

Anxiety

When a child does not outgrow the fears and worries that are typical in young children, or when there are so many fears and worries that they interfere with school, home, or play activities, the child may be diagnosed with an anxiety disorder. Examples of different types of anxiety disorders include

Being very afraid when away from parents (separation anxiety)

Having extreme fear about a specific thing or situation, such as dogs, insects, or going to the doctor (phobias)

Being very afraid of school and other places where there are people (social anxiety)

Being very worried about the future and about bad things happening (general anxiety)

Having repeated episodes of sudden, unexpected, intense fear that come with symptoms like heart pounding, having trouble breathing, or feeling dizzy, shaky, or sweaty (panic disorder)

Anxiety may present as fear or worry, but can also make children irritable and angry. Anxiety symptoms can also include trouble sleeping, as well as physical symptoms like fatigue, headaches, or stomachaches. Some anxious children keep their worries to themselves and, thus, the symptoms can be missed.

Related conditions include Obsessive-Compulsive Disorder and Post Traumatic Stress Disorder.
Learn more about anxiety in children
Depression

Occasionally being sad or feeling hopeless is a part of every child's life. However, some children feel sad or uninterested in things that they used to enjoy, or feel helpless or hopeless in situations they are able to change. When children feel persistent sadness and hopelessness, they may be diagnosed with depression.

Examples of behaviors often seen in children with depression include

Feeling sad, hopeless, or irritable a lot of the time

Not wanting to do or enjoy doing fun things

Showing changes in eating patterns - eating a lot more or a lot less than usual

Showing changes in sleep patterns - sleeping a lot more or a lot less than normal

Showing changes in energy - being tired and sluggish or tense and restless a lot of the time

Having a hard time paying attention

Feeling worthless, useless, or guilty

Showing self-injury and self-destructive behavior

Extreme depression can lead a child to think about suicide or plan for suicide. For youth ages 10-24 years, suicide is among the leading causes of death. Read about youth suicide prevention.

Some children may not talk about their helpless and hopeless thoughts, and may not appear sad. Depression might also cause a child to make trouble or act unmotivated, causing others not to notice that the child is depressed or to incorrectly label the child as a trouble-maker or lazy.
Learn more about depression in children
Treatment for anxiety and depression

The first step to treatment is to talk with a healthcare provider such as your child's primary care provider, or a mental health specialist, about getting an evaluation. The United States Preventive Services Taskforce recommends screening for anxiety in children aged 8 to 18 years and for depression in adolescents aged 12 to 18 years. Some of the signs and symptoms of anxiety or depression in children could be caused by other conditions, such as trauma. Specific symptoms like having a hard time focusing could be a sign of attention-deficit/hyperactivity disorder (ADHD). It is important to get a careful evaluation to get the best diagnosis and treatment. Consultation with a health provider can help determine if medication should be part of the treatment. A mental health professional can develop a therapy plan that works best for the child and family. Behavior therapy includes child therapy, family therapy, or a combination of both. The school can also be included in the treatment plan. For very young children, involving parents in treatment is key. Cognitive-behavioral therapy is one form of therapy that is used to treat anxiety or depression, particularly in older children. It helps the child change negative thoughts into more positive, effective ways of thinking, leading to more effective behavior. Behavior therapy for anxiety may involve helping children cope with and manage anxiety symptoms while gradually exposing them to their fears so as to help them learn that bad things do not occur.

Treatments can also include a variety of ways to help the child feel less stressed and be healthier like nutritious food, physical activity, sufficient sleep, predictable routines, and social support.

Get help finding treatment

Here are tools to find a healthcare provider familiar with treatment options:

Managing Symptoms: Staying Healthy

Being healthy is important for all children and can be especially important for children with depression or anxiety. In addition to getting the right treatment, leading a healthy lifestyle can play a role in managing symptoms of depression or anxiety. Here are some healthy behaviors that may help:

Prevention of anxiety and depression

It is not known exactly why some children develop anxiety or depression. Many factors may play a role, including biology and temperament. But it is also known that some children are more likely to develop anxiety or depression when they experience trauma or stress, when they are maltreated, when they are bullied or rejected by other children, or when their own parents have anxiety or depression.

Although these factors appear to increase the risk for anxiety or depression, there are ways to decrease the chance that children experience them. Learn about public health approaches to prevent these risks:

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Anxiety and Depression in Children | CDC

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Although fears and worries are typical in children, persistent or extreme forms of fear and sadness could be due to anxiety or depression. Learn about anxiety and depression in children.

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Anxiety: Helping Handout for School and Home

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Anxiety: Helping Handout for School and Home

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Pica is the persistent eating of substances such as dirt or paint that have no nutritional value.

The Handbook of Clinical Child Psychologycurrently estimates that prevalence rates of pica range from 4%-26% among institutionalized populations. Research among non-institutionalized populations takes the form of individual case studies, making prevalence rates difficult to estimate.

How Is Pica Diagnosed?

If pica is suspected, a medical evaluation is important to assess for possible anemia, intestinal blockages, or potential toxicity from ingested substances. If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical exam. The doctor may use certain tests -- such as X-rays and blood tests -- to check for anemia and look for toxins and other substances in the blood, and to check for blockages in the intestinal tract. The doctor also may test for possible infections caused by eating items contaminated with bacteria or other organisms. A review of the person's eating habits may be conducted.

Before making a diagnosis of pica, the doctor will evaluate the presence of other disorders -- such as intellectual disabilities, developmental disabilities, or obsessive-compulsive disorder -- as the cause of the odd eating behavior. This pattern of behavior must last at least one month for a diagnosis of pica to be made.

How Is Pica Treated?

Given the risk of medical complications (such as lead poisoning) associated with pica, close medical monitoring is necessary throughout treatment of the eating behavior. Additionally, close collaboration with a mental health team skilled in treating pica is ideal for optimal treatment of these complex cases.

The Handbook for Clinical Child Psychology currently supports general behavioral strategies as the most effective treatment approach for pica, with training in which foods are edible and which foods cannot be eaten through the use of positive reinforcement.

What Complications Are Associated With Pica?

There are many potential complications of pica, such as:

Certain items, such as paint chips, may contain lead or other toxic substances and eating them can lead to poisoning, increasing the child's risk of complications including learning disabilities and brain damage. This is the most concerning and potentially lethal side effect of pica

Eating non-food objects can interfere with eating healthy food, which can lead to nutritional deficiencies.

Eating objects that cannot be digested, such as stones, can cause constipation or blockages in the digestive tract, including the intestines and bowels. Also, hard or sharp objects (such as paperclips or metal scraps) can cause tears in the lining of the esophagus or intestines.

Bacteria or parasites from dirt or other objects can cause serious infections. Some infections can damage the kidneys or liver.

Co-existing developmental disabilities can make treatment difficult.

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Pica is the persistent eating of substances such as dirt or paint that have no nutritional value. The Handbook of Clinical Child Psychology currently estimates that prevalence rates of pica range from 4%-26% among institutionalized populations. Research among non-institutionalized populations takes the form of individual case studies, making prevalence rates difficult to estimate.

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The Recovery Village Drug and Alcohol Rehab

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Editor Camille Renzoni

Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in... read more

Medically Reviewed By Kim Langdon, MD

Kimberly Langdon, MD is a retired University-trained obstetrician/gynecologist with 19 years of clinical... read more

Rumination disorder is a type of eating disorder that is somewhat rare in the United States. Sometimes called rumination syndrome, this condition involves regurgitating food and is common among infants. Fortunately, treatment options exist for rumination eating disorder, and the condition can be managed successfully.

What Is Rumination Disorder?

Rumination disorder, or rumination eating disorder, is characterized by the regurgitation of food, possibly re-chewing it, and then re-swallowing the food. For the person who has this condition, rumination disorder is relatively effortless, unlike vomiting which requires forceful abdominal muscle contractions. In an infant who has this condition, they may roll their tongue and arch their back during the episode.

Also known as rumination syndrome, this condition is thought to represent a motility disorder with involuntary relaxation of the muscles that control the opening and closing of the esophagus.

Who Is Affected by Rumination Disorder?

Infants are most commonly affected by rumination disorder, and the age of onset is usually between three and 12 months. Infants tend to outgrow the syndrome, but some people carry these behaviors into adulthood. It is quite uncommon, but the exact incidence is unknown because adolescents and adults may hide the behavior out of embarrassment.

Signs and Symptoms of Rumination Disorder

Rumination disorder signs and symptoms may include:

Effects of Rumination Disorder

Many effects of rumination disorder result from food and acid returning to the mouth . These effects and other rumination disorder health risks may include:

Causes of Rumination Disorder

The causes of rumination disorder cannot always be determined. There may be multiple underlying reasons, such as a weakened esophageal sphincter that readily permits food contents from the stomach to return to the mouth.

Cultural, socioeconomic and psychological factors are the most commonly cited causes of rumination disorder. Specifically, the bond between mother and infant may be impaired from maternal neglect or from an overstimulated, chaotic environment.

Other theories surrounding the cause for rumination disorder are based on negative or positive reinforcement. Increased attention from other people as a response to the regurgitation, or to cure boredom may be other causes. Psychiatric disorders such as depression and might be other causes of rumination disorder.

Physical conditions may predispose a person to rumination disorder. Some of these conditions include:

Diagnosing Rumination Disorder

Rumination disorder diagnosis is based on blood tests to check for anemia or electrolyte abnormalities. Anemia may occur due to damage to the stomach or esophageal walls. Imaging studies are done to diagnose rumination disorder or other predisposing conditions. A barium swallow can show a hiatal hernia, narrowing of the esophagus and abnormal motility of the esophagus or stomach.

An upper gastrointestinal (GI) series and small bowel follow-through test can diagnose an ulcer or other mechanical or physical problems of the intestines. Other lab tests that may be helpful are cultures for Heliobacter pylori (which is a bacteria that causes ulcers), studies to measure the rate of stomach emptying, motility, pH testing and X-rays.

Rumination diagnosis is based upon ruling out other gastrointestinal conditions , and the condition must be present for one month.

Risk Factors for Rumination Disorder

The main risk factor for rumination disorder is being institutionalized due to profound intellectual disability . People of average intelligence can develop rumination disorder, but due to the secretive nature of the disorder in adults, the true incidence and risk factors are presently unknown. More research is needed to determine a comprehensive list of risk factors and rumination disorder health risks.

Rumination Disorder Statistics

Statistics on rumination disorder are difficult to find due to the lack of existing studies. Current rumination disorder statistics include:

Amongst institutionalized people, the incidence of rumination disorder is 8-10 percent

There is a slightly higher incidence of rumination disorder among female gender than among males

Up to of people who have bulimia also struggle with rumination

Rumination Disorder and Co-Occurring Conditions

Pica and rumination disorder are two separate conditions that may be associated with each other. is the eating of non-food or non-nutritive substances. While it may be possible that rumination occurs after pica, pica does not cause rumination.

In one German study , the p revalence rates of recurring pica behavior were significantly elevated if recurring rumination disorder was present.

Related Topic: Treatment for pica

Additionally, bulimia and rumination disorder are two different conditions that people may think co-occur. is a behavioral disorder that is the result of deliberate eating and purging with self-induced vomiting, use of laxatives or enemas. The purpose of these behaviors is to prevent weight gain in a person who has unrealistic body expectations. In contrast, rumination disorder is a medical condition that is involuntary regurgitation of food that is re-swallowed.

Rumination disorder and substance abuse may be related if the rumination is due to an underlying depressive or anxiety disorder where the person self-medicates with alcohol or drugs. Substance abuse could also be associated with rumination directly because of the shame or embarrassment that the ruminator experiences.

Treatment for Rumination Disorder

Rumination disorder treatment consists of non-aversive and mild aversive techniques that are supportive and psychodynamic. If the rumination is to self-stimulate, the treatment results tend to be temporary. If it is socially motivated, then treatment can eliminate the symptoms. Some non-aversive techniques include:
If you or a loved one struggle with a drug or alcohol addiction and co-occurring rumination disorder, The Recovery Village can help. The Recovery Village facilities offer addiction treatment options as well as counseling for co-occurring mental health disorders. Reach out to a representative to learn more.

Papadopoulos V, Mimidis K. " The rumination syndrome in adults: A review of the pathophysiology, diagnosis and treatment ." ResearchGate, 2007. Accessed March 2019.

Chial HJ, Camilleri M, Williams DE, et al. " Rumination syndrome in children and adolescents: diagnosis, treatment, andprognosis ." American Academy of Pediatrics, 2003. Accessed March 2019.

Tack J, Talley NJ, Camilleri M, Holtmann G, Hu P. " Functional gastroduodenal disorders. " PubMed.gov, 2006. Accessed March 2019.

Idaira Y, et al. " Factors affecting the oral condition of patients with severe motor and intellectual disabilities ." PubMed.gov, 2008. Accessed March 2019.

Green AD, Alioto A, Mousa H, Di Lorenzo C. " Severe pediatric rumination syndrome: successful interdisciplinary inpatient management. " Northwestern University, 2011. Accessed March 2019.

Hartmann A, et al. " Prevalence of pica and rumination behaviors in German children aged 7-14 and their associations with feeding, eating, and general psychopathology: a population-based study ." European Child & Adolescent Psychiatry , August 2018. Accessed March 2019.

Black, Rosemary. " Rumination disorder: The Eating Disorder You Never Heard of ." Psycom, 2018. Accessed March 2019.

Lumen. " Rumination Syndrome (307.53) ." (n.d.) Accessed March 2019.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

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Rumination Eating Disorder Overview | The Recovery Village

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Editor Camille Renzoni Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in... read more Medically Reviewed By Kim Langdon, MD Kimberly Langdon, MD is a retired University-trained obstetrician/gynecologist with 19 years of clinical...

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Avoidant Restrictive Food Intake Disorder

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Avoidant Restrictive Food Intake Disorder

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Avoidant restrictive food intake disorder (ARFID), previously known as selective eating disorder (SED), is an eating disorder characterized by an individual severely limiting the amount and/or types of food consumed.

The avoidance of food is based on sensory characteristics, and/or concern about unpleasant consequences of eating, resulting in failure to meet individual nutritional needs.

It usually occurs in childhood, but can develop at any age. It is more severe than typical childhood "picky eating" and tends to affect the child's overall appetite, food intake, growth, and development.

ARFID is similar to the eating disorder anorexia in that it restricts food intake. However, ARFID differs in that it does not involve anxiety or obsession over bodyweight, appearance, or the fear of fatness.

Nonetheless, ARFID and anorexia have similar physical symptoms (and thus, medical consequences) due to both disorders involving a failure to meet nutritional needs.

Being a relatively new recognized eating disorder, there is still much unknown about ARFID, particularly as it relates to older adolescents and adults. Research is ongoing in this area and will hopefully shed more light on this important topic in order to help people who suffer from it.﻿﻿﻿

Below are both behavioral and physical symptoms people with ARFID often exhibit.﻿﻿﻿﻿

Behavioral

Individuals with ARFID may exhibit the following behavioral, psychological, or physical symptoms:

Significant weight loss

Dressing in layers to hide weight loss or stay warm

Complains of constipation, abdominal pain, cold intolerance, fatigue, and/or excess energy

Complains of consistent, vague gastrointestinal issues around mealtimes that have no known cause, such as an upset stomach, feels full, etc.

Sudden or severe restriction in types or amount of food eaten

Will only eat certain textures of food

Gags on food, or has fears of choking or vomiting

Decreased appetite or interest in food

Small range of liked foods that decreases over time (i.e., picky eating that gradually worsens)

No body image anxiety or fear of weight gain

Physical symptoms may include:

Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)

Menstrual irregularities, missing periods, or periods stopping completely for a person who is post-puberty.

Difficulties concentrating

Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low blood cell counts)

Slowed heart rate

Dizziness

Fainting

Feeling cold all the time

Problems sleeping

Dry skin

Brittle nails

Fine hair on body

Thinning of hair on head, dry and brittle hair

Muscle weakness

Cold, mottled hands and feet, or swelling of feet

Poor wound healing

Impaired immune functioning

Individuals with avoidant restrictive food intake disorder avoid eating and restrict their food intake to such an extent that they are not meeting their nutritional needs. Because of this, they may have one or more of the following symptoms for diagnosis:﻿﻿﻿﻿

Significant weight loss, failure to gain weight as expected, or faltering growth patterns

Significant nutritional deficiency

Dependence on oral nutrition supplements or tube (enteral) feedings

Considerably impaired psychosocial functioning

No evidence of a disturbed perception of body weight or shape﻿﻿

Healthcare providers must exclude other diagnoses, such as physical illness, as well as other mental disorders that decrease appetite and/or intake, such as other eating disorders or depression.

If left untreated, nutritional deficiencies can be life-threatening. In addition, social functioning can be noticeably decreased, such as not participating in family meals or spending time with friends when food is involved.

Risk Factors

While there are still some unknowns about ARFID, researchers have been able to identify some risk factors. Individuals may be more likely to develop ARFID if they have autism spectrum disorder, attention deficit hyperactivity disorder (ADHD) or other intellectual disabilities.

Children whose picky eating doesn't go away after prolonged periods of time, or who have extreme picky eating have a higher risk of developing ARFID. Many children with ARFID also have a co-occurring anxiety disorder, and they are also at high risk for other psychiatric disorders.

Therapy, such as cognitive-behavioral therapy, is commonly used to help patients normalize their eating and help decrease anxiety around food. Family-based treatment and parent training may also be beneficial.

Working with a multidisciplinary team of healthcare professionals, which includes physical, nutritional, psychological, and psychiatric interventions, can offer a whole-person approach to recovery.

How one person copes may be different from another person. One of the main goals in coping with an eating disorder is that you turn to healthy coping strategies, rather than dysfunctional or destructive ones. The following strategies may be helpful in coping with ARFID or other eating disorders:

Be aware of personal triggers and come up with an action plan if you encounter one (or more) of your tiggers.

Surround yourself with a support system. Whether it be family, friends, neighbors, or coworkers, find some people in your life you can count on for support in your journey to recovery and beyond.

Be mindful and participate in self-care activities. Identify what you need to do in order to maintain good physical and mental health, while also meeting your social and psychological needs. Find ways to incorporate these activities of self-care into your lifestyle on a regular basis.

Parents and carers of people with ARFID play an important role in recovery. It's important that those who care for individuals with ARFID have healthy coping skills as well. Parents and carers also need to be physically, emotionally, and spiritually healthy, as a loved one's recovery can be just as difficult to cope with.

Engaging in self-care, joining a support group (in person or online), or participating in therapy are just a few ways to manage the responsibility of caring for someone with an eating disorder.

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What Is Avoidant Restrictive Food Intake Disorder?

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Avoidant restrictive food intake disorder (ARFID), previously known as selective eating disorder (SED), is an eating disorder characterized by an individual severely limiting the amount and/or types of food consumed. The avoidance of food is based on sensory characteristics, and/or concern about unpleasant consequences of eating, resulting in failure to meet individual nutritional needs.

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Risk indicators of anxiety throughout adolescence- The TRAILS study

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Centers for Disease Control and Prevention. (2021, March 22). Children’s Mental Health. Data and Statistics on Children’s Mental Health.

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Centers for Disease Control and Prevention. (2021, March 22). Children’s Mental Health. Data and Statistics on Children’s Mental Health.

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Centers for Disease Control and Prevention: Children’s Mental Health. 

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Centers for Disease Control and Prevention: Children’s Mental Health. 

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Centers for Disease Control and Prevention

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Mental health is an important part of children's overall health and well-being. Mental health includes children's mental, emotional, and behavioral well-being. It affects how children think, feel, and act. It also plays a role in how children handle stress, relate to others, and make healthy choices.

Mental disorders among children are described as serious changes in the way children typically learn, behave, or handle their emotions, causing distress and problems getting through the day. Among the more common mental disorders that can be diagnosed in childhood are attention-deficit/hyperactivity disorder (ADHD), anxiety, and behavior disorders.

There are different ways to assess mental health and mental disorders in children. CDC uses surveys, like the National Survey of Children's Health, to describe the presence of positive indicators of children's mental health and to understand the number of children with diagnosed mental disorders and whether they received treatment. In this type of survey, parents report on indicators of positive mental health for their child and report any diagnoses their child has received from a healthcare provider. The information on this page provides data about indicators of positive mental health in children and mental health disorders that are most common in children.

Facts about mental health in U.S. children

National data on positive mental health indicators that describe mental, emotional, and behavioral well-being for children are limited. Based on the data we do have:

Facts about mental disorders in U.S. children

ADHD, anxiety problems, behavior problems, and depression are the most commonly diagnosed mental disorders in children. Estimates for ever having a diagnosis among children aged 3-17 years, in 2016-19, are given below.

ADHD 9.8% (approximately 6.0 million)

Anxiety 9.4% (approximately 5.8 million)

Behavior problems 8.9% (approximately 5.5 million)

Depression 4.4% (approximately 2.7 million)

Some of these conditions commonly occur together. For example, among children aged 3-17 years in 2016:

Having another mental disorder was most common in children with depression: about 3 in 4 children with depression also had anxiety (73.8%) and almost 1 in 2 had behavior problems (47.2%).

For children with anxiety, more than 1 in 3 also had behavior problems (37.9%) and about 1 in 3 also had depression (32.3%).

For children with behavior problems, more than 1 in 3 also had anxiety (36.6%) and about 1 in 5 also had depression (20.3%).

For adolescents, depression, substance use and suicide are important concerns. Among adolescents aged 12-17 years in 2018-2019 reporting on the past year:

Learn more about high-risk substance use among youth. Learn more about suicide.

Mental, behavioral, and developmental disorders begin in early childhood
1 in 6 U.S. children aged 2-8 years (17.4%) had a diagnosed mental, behavioral, or developmental disorder.

Prevalence of mental disorders change with age

Diagnoses of ADHD, anxiety, and depression become are more common with increased age.

Behavior problems are more common among children aged 6-11 years than younger or older children.

Adverse childhood events (ACEs) are associated with children's physical and mental health. In 2016-2019, among children aged 6-17 years:

Children who were discriminated against based on race or ethnicity had higher percentages of one or more physical health conditions (37.8% versus 27.1%), and one or more mental health conditions (28.9% versus 17.8%).

Racial/ethnic discrimination was almost seven times as common among children with three other ACEs compared to those with no other ACEs.

Note: The estimates reported on this page are based on parent report, using nationally representative surveys. This method has several limitations. It is not known to what extent children receive these diagnoses accurately. Estimates based on parent-reported diagnoses may match those based on medical records, but some children may also have mental disorders that have not been diagnosed, or receive diagnoses that may not be the best fit for their symptoms. Limited information on measuring children's mental health nationally is available.

Read more about children's mental health from a community study.

Access to mental health treatment

Early diagnosis and appropriate services for children and their families can make a difference in the lives of children with mental disorders. Access to providers who can offer services, including screening, referrals, and treatment, varies by location. CDC is working to learn more about access to behavioral health services and supports for children and their families.
View information by state describing the rates of different types of providers who can offer behavioral health services providers by county. Read a recent report describing shortages of services, barriers to treatment, and how integration of behavioral health care with pediatric primary care could address the issues. Read a policy brief on potential ways to increase access to mental health services for children in rural areas
Data sources for mental health and related conditions

There are many different datasets which include information on children's mental health and related conditions for children living in the United States.

Healthy People 2030
Healthy People 2030 sets data-driven national objectives to improve health and well-being over the next decade, including children's mental health and well-being.

National Survey of Family Growth (NSFG)
NSFG gathers information on family life, marriage and divorce, pregnancy, infertility, use of contraception, and general and reproductive health.

National Health and Nutrition Examination Survey (NHANES)
NHANES assesses health and nutritional status through interviews and physical examinations, and includes conditions, symptoms, and concerns associated with mental health and substance abuse, as well as the use and need for mental health services.

National Health Interview Survey (NHIS)
NHIS collects data on children's mental health, mental disorders, such as ADHD, autism spectrum disorder, depression and anxiety problems, and use and need for mental health services.

National Survey of Children's Health (NSCH)
NSCH examines the health of children, with emphasis on well-being, including medical homes, family interactions, the health of parents, school and after-school experiences, and safe neighborhoods. This survey was redesigned in 2016.

For previous versions of this survey, see also:
National Survey of Children's Health (NSCH 2003, 2007, 2011-12)
National Survey of Children with Special Healthcare Needs (NS-CSHCN 2001, 2005-6, 2009-10)

National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome (NS-DATA)
NS-DATA collects information about children, 2-15 years old in 2011-2012, who had ever been diagnosed with ADHD and/or Tourette syndrome (TS), with the goal of better understanding diagnostic practices, level of impairment, and treatments for this group of children.

National Survey on Drug Use and Health (NSDUH)
NSDUH, administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), provides national- and state-level data on the use of tobacco, alcohol, and illicit drugs (including non-medical use of prescription drugs), as well as data on mental health in the United States.

National Vital Statistics System (NVSS)
NVSS contains vital statistics from the official records of live births, deaths, causes of death, marriages, divorces, and annulment recorded by states and independent registration areas

National Youth Tobacco Survey (NYTS)
NYTS is a nationally representative school-based survey on tobacco use by public school students enrolled in grades 6-12.

School Associated Violent Death Study (SAVD)
SAVD plays an important role in monitoring trends related to school-associated violent deaths (including suicide), identifying the factors that increase the risk, and assessing the effects of prevention efforts.

School Health Policies and Programs Study (SHPPS)
SHPPS is a national survey assessing school health policies and practices at the state, district, school, and classroom levels. Collected data includes mental health and social service policies.

Web-based Injury Statistics Query and Reporting System (WISQARS)
WISQARS is an interactive database system that provides customized reports of injury-related data.

Youth Risk Behavior Surveillance System (YRBSS)
The YRBSS monitors health-risk behaviors, including tobacco use, substance abuse, unintentional injuries and violence, sexual behaviors that contribute to unintended pregnancy, and sexually transmitted diseases.

References

1. Perou R, Bitsko RH, Blumberg SJ, Pastor P, Ghandour RM, Gfroerer JC, Hedden SL, Crosby AE, Visser SN, Schieve LA, Parks SE, Hall JE, Brody D, Simile CM, Thompson WW, Baio J, Avenevoli S, Kogan MD, Huang LN. Mental health surveillance among children - United States, 2005-2011. MMWR 2013;62(Suppl; May 16, 2013):1-35. [Read summary]

2. Bitsko RH, Claussen AH, Lichtstein J, Black LJ, Everett Jones S, Danielson MD, Hoenig JM, Davis Jack SP, Brody DJ, Gyawali S, Maenner MM, Warner M, Holland KM, Perou R, Crosby AE, Blumberg SJ, Avenevoli S, Kaminski JW, Ghandour RM. Surveillance of Children's Mental Health - United States, 2013 - 2019 MMWR, , 2022 / 71(Suppl-2);1-42. [Read article]

3. Ghandour RM, Sherman LJ, Vladutiu CJ, Ali MM, Lynch SE, Bitsko RH, Blumberg SJ. Prevalence and treatment of depression, anxiety, and conduct problems in U.S. children. The Journal of Pediatrics, 2018. Published online before print October 12, 2018 [Read summary]

4. Bitsko RH, Holbrook JR, Ghandour RM, Blumberg SJ, Visser SN, Perou R, Walkup J. Epidemiology and impact of healthcare provider diagnosed anxiety and depression among US children. Journal of Developmental and Behavioral Pediatrics. Published online before print April 24, 2018 [Read summary]

5. Cree RA, Bitsko RH, Robinson LR, Holbrook JR, Danielson ML, Smith DS, Kaminski JW, Kenney MK, Peacock G. Health care, family, and community factors associated with mental, behavioral, and developmental disorders and poverty among children aged 2-8 years - United States, 2016. MMWR, 2018;67(5):1377-1383. [Read article]

6. Hutchins HJ, Barry CM, Valentine V, Bacon S, Njai R, Claussen AH, Ghandour RM, Lebrun-Harris LA, Perkins K, Robinson LR (submitted). Perceived racial/ethnic discrimination, physical and mental health conditions in childhood, and the relative role of other adverse experiences. Adversity and Resilience Science published online May 23, 2022. [Read summary]

7. US Department of Health and Human Services Health Resources and Services Administration & Maternal and Child Health Bureau. Mental health: A report of the Surgeon General. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, and National Institutes of Health, National Institute of Mental Health; 1999. [Read report]

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Data and Statistics on Children's Mental Health | CDC

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Read data highlights about children's mental health.

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ADHD in the Classroom: Effective Intervention Strategies

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ADHD in the Classroom: Effective Intervention Strategies

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ADHD in the Classroom Effective Intervention Strategies

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Recent research on Conduct Disorder has been very promising. For example, research has shown that most children and adolescents with conduct disorder do not grow up to have behavioral problems or problems with the law as adults; most of these youth do well as adults, both socially and occupationally. Researchers are also gaining a better understanding of the causes of conduct disorder, as well as aggressive behavior more generally. Conduct disorder has both genetic and environmental components. That is, although the disorder is more common among the children of adults who themselves exhibited conduct problems when they were young, there are many other factors which researchers believe contribute to the development of the disorder. For example, youth with conduct disorder appear to have deficits in processing social information or social cues, and some may have been rejected by peers as young children.

Despite early reports that treatment for this disorder is ineffective, several recent reviews of the literature have identified promising approaches treating children and adolescents with conduct disorder. The most successful approaches intervene as early as possible, are structured and intensive, and address the multiple contexts in which children exhibit problem behavior, including the family, school, and community. Examples of effective treatment approaches include functional family therapy, multi-systemic therapy, and cognitive behavioral approaches which focus on building skills such as anger management. Pharmacological intervention alone is not sufficient for the treatment of conduct disorder.

Conduct disorder tends to co-occur with a number of other emotional and behavioral disorders of childhood, particularly Attention Deficit Hyperactivity Disorder (ADHD) and Mood Disorders (such as depression). Co-occurring conduct disorder and substance abuse problems must be treated in an integrated, holistic fashion.

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Recent research on Conduct Disorder has been very promising. For example, research has shown that most children and adolescents with conduct disorder do not grow up to have behavioral problems or problems with the law as adults; most of these youth do well as adults, both socially and occupationally.

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Clinical Practice Guidelines for the management of conduct disorder

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Clinical Practice Guidelines for the management of conduct disorder

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Clinical Practice Guidelines for the management of conduct

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Oppositional Defiant Disorder (ODD) in Children

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Oppositional Defiant Disorder (ODD) in Children

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What is oppositional defiant disorder (ODD) in children?

Oppositional defiant disorder (ODD) is a type of behavior disorder. It is mostly diagnosed in childhood. Children with ODD are uncooperative, defiant, and hostile toward peers, parents, teachers, and other authority figures. They are more troubling to others than they are to themselves.

What causes ODD in a child?

Researchers don’t know what causes ODD. But there are 2 main theories for why it occurs:

Developmental theory. This theory suggests that the problems start when children are toddlers. Children and teens with ODD may have had trouble learning to become independent from a parent or other main person to whom they were emotionally attached. Their behavior may be normal developmental issues that are lasting beyond the toddler years.

Learning theory. This theory suggests that the negative symptoms of ODD are learned attitudes. They mirror the effects of negative reinforcement methods used by parents and others in power. The use of negative reinforcement increases the child’s ODD behaviors. That’s because these behaviors allow the child to get what he or she wants: attention and reaction from parents or others.

Which children are at risk for ODD?

ODD is more common in boys than in girls. Children with the following mental health problems are also more likely to have ODD:

Mood or anxiety disorders

Conduct disorder

Attention-deficit/hyperactivity disorder (ADHD)

What are the symptoms of ODD in a child?

Most symptoms seen in children and teens with ODD also happen at times in other children without it. This is especially true for children around ages 2 or 3, or during the teen years. Many children tend to disobey, argue with parents, or defy authority. They may often behave this way when they are tired, hungry, or upset. But in children and teens with ODD, these symptoms happen more often. They also interfere with learning and school adjustment. And in some cases, they disrupt the child’s relationships with others.

Symptoms of ODD may include:

Having frequent temper tantrums

Arguing a lot with adults

Refusing to do what an adult asks

Always questioning rules and refusing to follow rules

Doing things to annoy or upset others, including adults

Blaming others for the child’s own misbehaviors or mistakes

Being easily annoyed by others

Often having an angry attitude

Speaking harshly or unkindly

Seeking revenge or being vindictive

These symptoms may look like other mental health problems. Make sure your child sees his or her healthcare provider for a diagnosis.

How is ODD diagnosed in a child?

If you notice symptoms of ODD in your child or teen, you can help by seeking a diagnosis right away. Early treatment can often prevent future problems.

A child psychiatrist or qualified mental health expert can diagnose ODD. He or she will talk with the parents and teachers about the child’s behavior and may observe the child. In some cases, your child may need mental health testing.

How is ODD treated in a child?

Early treatment can often prevent future problems. Treatment will depend on your child’s symptoms, age, and health. It will also depend on how bad the ODD is.

Children with ODD may need to try different therapists and types of therapies before they find what works for them. Treatment may include:

Cognitive-behavioral therapy. A child learns to better solve problems and communicate. He or she also learns how to control impulses and anger.

Family therapy. This therapy helps make changes in the family. It improves communication skills and family interactions. Having a child with ODD can be very hard for parents. It can also cause problems for siblings. Parents and siblings need support and understanding.

Peer group therapy. A child develops better social and interpersonal skills.

Medicines. These are not often used to treat ODD. But a child may need them for other symptoms or disorders, such as ADHD.

How can I help prevent ODD in my child?

Researchers don’t know what causes ODD. But certain approaches can help prevent the disorder. Young children be helped by early intervention programs that teach them social skills and how to deal with anger. For teens, talk therapy (psychotherapy), learning social skills, and getting help with schoolwork can all help reduce problem behaviors. School-based programs can also help to stop bullying and improve relationships among teens.

Parent-management training programs are also important. These programs teach parents how to manage their child’s behavior. Parents learn positive reinforcement methods, and also how to discipline their child.

How can I help my child live with ODD?

Early treatment for your child can often prevent future problems. Here are things you can do to help:

Keep all appointments with your child’s healthcare provider.

Take part in family therapy as needed.

Talk with your child’s healthcare provider about other providers who will be involved in your child’s care. Your child may get care from a team that may include counselors, therapists, social workers, psychologists, and psychiatrists. Your child’s care team will depend on his or her needs and how serious the disorder is.

Tell others about your child’s conduct disorder. Work with your child’s healthcare provider and school to develop a treatment plan.

Reach out for support. Being in touch with other parents who have a child with ODD may be helpful. If you feel overwhelmed or stressed out, talk with your child’s healthcare provider. He or she may direct you to a support group for caregivers of children with ODD.

When should I call my child’s healthcare provider?

Call your child’s healthcare provider right away if your child:

Feels extreme depression, fear, anxiety, or anger toward him or herself or others

Feels out of control

Hears voices that others don’t hear

Sees things that others don’t see

Can’t sleep or eat for 3 days in a row

Shows behavior that concerns friends, family, or teachers, and others express concern about this behavior and ask you to seek help

Call 911 if your child has suicidal thoughts, a suicide plan, and the means to carry out the plan.

Key points about ODD in children

Oppositional defiant disorder (ODD) is a type of behavior disorder. Children with ODD are uncooperative, defiant, and hostile toward peers, parents, teachers, and other authority figures.

Developmental problems may cause ODD. Or the behaviors may be learned.

A child with ODD may argue a lot with adults or refuse to do what they ask. He or she may also be unkind to others.

A mental health expert often diagnoses ODD.

Therapy that helps the child interact better with others is the main treatment. Medicines may be needed for other problems, such as ADHD.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

Know the reason for the visit and what you want to happen.

Before your visit, write down questions you want answered.

At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

Ask if your child’s condition can be treated in other ways.

Know why a test or procedure is recommended and what the results could mean.

Know what to expect if your child does not take the medicine or have the test or procedure.

If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

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Oppositional Defiant Disorder (ODD) in Children

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Oppositional defiant disorder (ODD) is a type of behavior disorder. It is mostly diagnosed in childhood. Children with ODD are uncooperative, defiant, and hostile toward peers, parents, teachers, and other authority figures.

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Suffering in Silence: Examining Obsessive Compulsive Behaviors in the School Setting

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Suffering in Silence: Examining Obsessive Compulsive Behaviors in the School Setting

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Suffering in Silence- Examining OCD in School Setting

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Social Interest in Children With and Without Oppositional Defiant Disorder

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Social Interest in Children With and Without Oppositional Defiant Disorder

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Social Interest in Children With and Without